"I used to think I was going a little crazy" : women's resistance to the pathologization of premenstrual change

For centuries, expert explanations for women's reproductive distress have centered on the corporeal body, with the wandering womb, and more recently raging hormones or neurotransmitter imbalances, positioned as to blame. In Western medicine, premenstrual change is positioned as Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD), a fixed and unitary pathology within the woman, deemed to be caused by biomedical or psychological factors (Ussher, 2006). However, the absence of reports of premenstrual psychological distress in many non-Western cultures, such as China, Hong Kong and India (Chang et al., 1995; Hoerster et al., 2003; Yu et al., 1996), and reports of an association between diagnosis of PMDD and acculturation in Asian, Latina and Black women living in North America (Pilver et al., 2011 ), raise questions about the validity of individualizing biomedical and psychological theorizing of premenstrual change (Cosgrove & Caplan, 2004). This has led to the suggestion that PMS and PMDD are socially constructed labels or culture-bound syndromes (Chrisler, 2004). From a feminist social constructionist perspective, premenstrual change is deemed to be a normal part of women's experience, which is positioned as PMS or PMDD because of Western cultural constructions of the menstruating woman as labile or dysfunctional, and the premenstrual phase of the cycle as a time of pathology (Chrisler & Caplan, 2002; Ussher, 2006). In this view, women monitor premenstrual moods and behavior in relation to often unrealistic feminine ideals of calmness, consistency, and capability (Brooks et al., 1977; Ussher 2004) and blame themselves, or their bodies, for perceived transgressions, taking up the subject position 'PMS sufferer' (Chrisler & Johnston-Robledo, 2002).