Gross Anatomy

by Mara Altman

  PMT didn’t catch on very widely; mostly, it seems, because it suffered from a case of bad timing. As Karen Houppert reported in her book The Curse: Confronting the Last Unmentionable Taboo: Menstruation, in the 1940s the military began recruiting women to aid in the World War II effort. She wrote that because of this, the whole idea around menstruation shifted. Women suddenly looked up to Rosie the Riveter with her biceps flexed. They were told that they were strong, agile, and dexterous—their periods and premenstrual pains couldn’t stop them from doing anything. Even informational videos were made to teach women that premenstrual suffering was nothing more than folkloric balderdash.

  In one video, called Strictly Personal, the doctor who narrated tried to set them straight. “Some twentieth-century girls still believe that lavender-and-old-lace hokum about no activity and no bathing during menstruation,” he informed female recruits. “That’s Victorian stuff. And so is that trash about nerves and sensibility during this period.”

  As soon as the war ended, though, and men streamed home from the front, Houppert explained, women were pressured to give up their jobs and take up their place back at home with the kids. This was aided, she wrote, by a new slew of studies claiming that “the workplace was potentially hazardous to women’s unborn children, and that women’s cycles made them less-competent workers than men.” This occurred around the same time that Dalton came on the scene with her theories about PMS.

  At this point in my research, I had to take a short break. I should no longer be surprised that history had so many unsavory things hidden within it, but I was. I didn’t like the idea that we were allocated menstrual issues depending on the convenience of society and the job market at the time. PMS was all starting to sound rather manipulative and fucked-up.

  The more I read, the more this Dalton lady seemed like a real piece of work. She conducted studies and published papers stating that premenstrual women could temporarily become shoplifters, accident-prone, suicidal, a danger to their children, and violent, as well as be the cause of divorce.

  In her book Once a Month, she wrote that women’s abilities degraded staggeringly during “that time of the month.” Women, therefore, “can be assigned to less-skilled jobs such as packing and stacking during their vulnerable days,” she advised, “rather than remaining on tasks that are much more complex.” She also wrote poppycock like this about the premenstrual woman: “She may buy totally inappropriate dresses that don’t fit and are the wrong color, and which she will never wear.”

  Nonsense, I say! Any woman who has ever set foot in a clothing store knows that no matter the day, buying dresses that are deemed ugly once they are brought home is an inescapable part of the shopping experience.

  In the 1980s, Dalton made headlines again when she stood as an expert witness on two different murder cases. She asserted that because the two women were premenstrual when they slaughtered their victims—a coworker and a lover—they should be given less time, which they were indeed granted. While she tried to explain that only the most extreme instances of PMS caused violent psychosis, the criminal cases and the resulting media blitz nevertheless managed to popularize the term “PMS” around the world.

  My panties, if I hadn’t been commando when I was reading about Dalton, would have been in a gigantic uncomfortable wad. Basically, she came up with some real cray-cray stuff. If she presented her theories today, I would imagine she’d be met with rotten eggs and hundreds of angry op-eds, but as it is, whether we are aware of it or not, she formed the foundation for what we now think of PMS.

  I wish life were straightforward, but unfortunately, it’s not. See, Dalton, just as easily and depending on perspective, could be viewed as a hero. Women who had complained of premenstrual symptoms—bad moods and episodes of anger—felt like they had been dismissed by doctors and told that what they were feeling was “all in their heads.” Dalton was one of the first who validated women’s feelings by telling them that what they were feeling was real.

  The thing is, though, she then went a step further: She determined that PMS was a medical condition that could be fixed. After Dalton, premenstrual symptoms were no longer something that were considered normal and expected before a period; they had become pathologized—something to be treated.

  * * *

  When I was born, my mom had a hysterectomy, so by the time I heard her PMS stories, they had already turned into lore. Now that I was taking a closer look at PMS and had learned some of its questionable origins, I wanted to talk to my parents again to better understand their take on the cycle. Surely, their outlook in some way had rubbed off on me.

  I was sitting on my sofa in New York City, looking down over a crowded street—taxis honking and a glut of meandering pedestrians. Meanwhile, my parents were at their home in North County San Diego, where they’ve managed, for the past forty years, to foster and revel in one of the best relationships I’ve ever witnessed. They are so inseparable that I call them Keena—shorthand for Ken and Deena.

  After warming them up on the phone with some easygoing chatter, I asked them how they’d dealt with PMS back when my mom had ovaries. Their honesty was surprising if not a tiny bit disconcerting.

  “As I recall, we interacted very poorly because I would be a total shit all of a sudden,” said my dad. “I’d be doing everything wrong. I’d be coarse, callous, and offensive.”

  “Sounds about right,” said my mom.

  “After a certain amount of time, it was clear that it would happen monthly,” he said. “She would hate to have it be the thing, you know, because this is her—this is how she feels.”

  “He has it pretty good, doesn’t he?” my mom said.

  “She’d say, ‘How could it be a chemical thing? It isn’t and you’re a shit to say so,’” he explained. “I think it took us a few years to get onto this Midol thing.”

  Even though Midol has no psychotropic properties, my parents swore that the medication was the cure to a bitchy woman. Literally, it is just Tylenol and caffeine. Maybe the medication relieved cramping pain that made my mom feel irritable, or it’s possible she experienced the placebo effect. All I know is, when I was a teenager, they’d both tried to push it on me as well.

  “So you would tell Mom to take Midol when she started acting cunty?”

  “Yes, and then she’d take my head off,” he said, “but then after a while she started to allow that it did help her and helped us get along better.” After a pause, he added with a slight laugh, “It seemed to improve my behavior considerably.”

  I could just imagine my mom on the other side of the country, feigning annoyance by knocking him on the shoulder and playfully rolling her eyes.

  “So, Mom, how did you take that when Dad was like, ‘Go take a Midol’?” I asked.

  “I really felt demeaned when he would say that,” she said, “but I felt like I was not in control of myself. I was acting unlike my normal self and maybe I was flaring out at people and I should take something to help that out. Sometimes I didn’t want to take the Midol. I wanted to voice my—”

  “She wanted to express her womanly power,” said the male half of Keena.

  “Why do you call it that?” I asked.

  “She was expressing herself,” he said. “‘Guys are shits and they try to take the power.’ She was getting her power.”

  I had to imagine that my dad’s interpretation—womanly power—had something to do with the era in which this took place, the 1960s and 1970s, when there was a big feminist push for equality. A few decades earlier, when a woman’s foremost role was to be a mother, the renowned psychoanalyst Karen Horney theorized that a woman had PMS because of the denial of her desire to have children. This was yet another example of what Stolberg, the historian, had mentioned earlier: It might not be PMS, but how we choose to interpret it, that is more important.

  “In those early years, I had a lot of difficulty expressing myself, believe it or not,” my mom said. “When I got my period, I would get angry at all
those things that normally I wouldn’t. I would get angry.”

  I didn’t say anything, but I would be too if my husband tried to drug me in an attempt to “improve” my behavior.

  “I refused to take the Midol sometimes,” my mom said, “but when I took it, I realized it was better.”

  “Why?”

  “We got along better,” she said. “I calmed down.”

  I lobbed the next, somewhat facetious, question at my dad. “So when Mom got her hysterectomy, was that a good time?”

  “It was awesome,” he said.

  My mom laughed. They both did. It was a sensitive subject, but I guess they could look back on all of it with humor. Maybe that’s how couples make it through the long haul—the struggles, the bumps, all turn into fodder. But then the conversation quickly degraded.

  My dad turned the tables. He asked me if I thought I experienced those same mood changes.

  My chest constricted. I felt defensive. “Sometimes maybe,” I said, “but not regularly.” I was telling the truth; it didn’t seem to happen each and every month. I noticed it and named it only when my feelings didn’t make sense to me, such as the day I went bonkers on Dave that I described at the beginning of this chapter.

  Then all of a sudden, my parents started to gang up on me.

  “Mara,” said my mom. “I’ve noticed when you get your period.”

  “You’re more sensitive,” said my dad.

  “Yeah, you are,” said my mom.

  “How do you know, though?” I asked. “You don’t know when I have my period.”

  “I don’t know if Ken knows, but I know,” she said.

  “How do you know?” I asked.

  “Because your manner changes and you have less patience,” she said.

  This exchange reminded me of being back in high school. They used to sit me down at the kitchen table and recount my mom’s PMS story suggestively—the way she’d become incensed and intensely critical. They’d wanted me to reflexively see that I was acting out, just like my mom had done.

  See, it’s normal. Women get crazy. If you take a Midol, you can calm down just like I did when I had ovaries.

  The defensiveness I felt at the moment was the same that I’d felt as a teenager. “So when you told me to take Midol when I was in my teens, was it because you couldn’t bear to be around me in that state, or did you want to save me from myself?” I asked.

  “I think it was difficult to be around you,” said my dad. “I know that’s the wrong answer, but you’d be incredibly sensitive. And I actually wanted you to be happier, but it was arguments that were not going to end right—no chance of being resolved—and I’d experienced that and knew all about that.”

  “And you know what the absolute worst thing you could ever say is?” I asked rhetorically. “‘You need some Midol.’”

  “It makes women really mad,” he said, laughing, and then joked, “That’s why Deena wouldn’t take her Midol sometimes.” He asked me if I ever tried to take the medication.

  “No, I never took it,” I said. “I thought it was idiotic. It didn’t make sense to me. I felt fine.”

  “But you do get moody, Mara,” my mom chimed in. It was funny coming from her—ironic maybe—the same person who minutes before had described how awful it felt to be accused of hormonally incited mood swings.

  After more back-and-forth, we slowly shifted subjects—we talked about their dog, Marble, and ended the evening by discussing how perfect this year’s crop of avocados was going to be. It wasn’t until later, when the neon lights of shops blinked on for the night and I spotted the flickering televisions in apartment windows across the way, that I realized the importance of our conversation.

  As a teenager, I’d fiercely opposed PMS—I’d get livid at the mere mention that any of my emotions could be due to some blip in brain chemistry—only to now find myself grown up and embracing PMS as if it were my rightful inheritance. I didn’t need anyone to accuse me of PMS now, because I mostly put it upon myself. I used it as an apology and as an excuse. That shift occurred unperceptively and I wasn’t sure how or why.

  * * *

  After talking to my parents, I saw just how deeply rooted the idea of PMS is in our psyches. Before I’d even felt a mood shift for myself as a teenager, my parents had already told me that my body would betray my mind. It just seemed like a given that once a month women would lose their shit.

  Because PMS seemed so real by this point, I wanted to understand the other side of the argument. Who were the people who don’t believe PMS is actually a thing?

  I began by reaching out to Carol Tavris. She’s a psychologist and feminist, who is well known for her war against psychobabble. She even wrote a book called Psychobabble and Biobunk and another one called The Mismeasure of Woman. She didn’t seem to want to talk, but she sent me an intriguing email.

  She listed some studies that proved PMS didn’t exist and then wrote, “The ‘crying study’ is especially cute—women think they cry more when they have ‘PMS,’ but they don’t.” Then, as a sign-off, she added, “How much easier to say, ‘It’s my hormones,’ rather than, ‘It’s George.’”

  After that, without even telling me who George was, she went radio silent.

  Tavris, apparently, was not into elucidation, so I thought I’d learn more from Joan Chrisler, a professor of psychology at Connecticut College. When I read her many PMS papers (but like, many), I came to the conclusion that she believed PMS was a big wad of horseshit.

  Premenstrually, she believes that we have been conditioned to pay attention only to our negative emotions. Even researchers, in her opinion, are biased. Something called the “Menstrual Distress Questionnaire” has been used to assess a woman’s mental state. Chrisler wonders how women would perceive themselves differently if it had been called the “Premenstrual Joy Questionnaire.”

  I got Chrisler on the phone. “So does PMS exist or not?” I asked.

  “To ask is it real or not is too simplistic a question,” Chrisler said. Maybe it’s the submissive in me, but I liked how she gave me the smackdown. “The question is,” she corrected, “is it normal or is it a disorder?” She explained that when we say, “I have PMS,” we are actually saying that we have a medical condition—an illness.

  PMDD (a.k.a. PMS on steroids) is in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was inducted under much scrutiny and debate. Detractors, like Chrisler, think it was added in an attempt for pharmaceutical companies and psychologists to reap billions from the pathologization of women’s bodies. For extreme cases, antidepressants have become a common treatment.

  “If it’s really strong and you can’t cope with it and you need some kind of help, then you have a condition, but most of us don’t have a condition,” she explained. “We can just move on.” She would prefer if women, instead of blaming their bodies when they felt moody, could just say something benign like “I got up on the wrong side of the bed this morning.”

  “But me and my friends use PMS all the time,” I said. I felt compelled to give her some examples. “We say, ‘Today sucked, I must be PMS’ing,’ or ‘I want to kill everyone—it’s probably PMS.’” It wasn’t something we shared over megaphones or anything—just within our closest circle of friends.

  Chrisler didn’t respond, so naturally I had to fill the silence.

  “It feels so good,” I added, “so how can it be bad?”

  “I worry about this a lot,” she finally said.

  “Why?”

  “When we say things like that,” she said, “we are saying that our moods are illegitimate.”

  Chrisler believes that women use PMS as a scapegoat because of pressures to conform to the feminine gender role. “If you want to be seen as nurturing, sweet, affectionate, and a good wife, mother, and friend,” she said, “it’s convenient to have something to blame your stress and sadness and anger on.”

  I had to take a moment to let that soak in; it was a trippy and somewha
t concerning revelation: By using PMS to rationalize my more extreme emotions, was I actually playing into what society wanted me to be—a demure girl who doesn’t cause a kerfuffle?

  All unsavory emotions could be sealed up in the PMS Box and then tossed out—edited out of the story line—like unwanted garbage.

  She told me to implant what she was about to say deeply into my consciousness because it was important. “Hormones do not create emotions,” she said, “but they can exacerbate them.”

  This was terrible news; I think she was saying that when I think I’m experiencing PMS, I might actually feel the way it feels like I feel.

  I wasn’t ready to buckle from her pressure. “But—” I began.

  And that’s all I got out before she let out a little sigh. I obviously wasn’t “getting it” fast enough.

  Chrisler said that using PMS wasn’t negative only on an individual level, but also for women in general. She made it seem like anytime a woman uses PMS as an excuse for her behavior, a misogynist gets his wings. “A lot of hostile sexists have this notion that women can’t be in any positions of power, because they can’t control themselves and they are just going to ruin everything,” she said. “So they still pull it out! They still use PMS against us! And when we buy into it, we encourage them to do it even though we don’t want them to.”

  She had an interesting point, and I felt like a shitty feminist.

  “You can’t have it both ways,” she said.

  We talked for another bit about the power of labels. I mulled the idea in my head and tried to turn the tables. I wondered what would happen if we started telling men that after they ejaculated, they would suffer from post-ejaculation depression (PED)—emptiness, dissatisfaction, and the desire to flee. Maybe, like PMS, their experiences would suddenly be considered an affliction.

  “I love that!” Chrisler said.

  She continued to say many interesting things. She’s a real majestic, knowledgeable lass, though she’d probably object to the words “majestic” and “lass” because she’s so no-nonsense about everything. She’s also postmenopausal. She told me it ain’t half bad from the other side, so that was nice.