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Apr 26
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Do these surveys provide definitions?

- cramps yes, mood swings no?

- energy is natural ... but also supernatural?

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I admit I was startled to see that typo, on a doctor’s blog.

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Us doctors are people too! You'd be surprised the amount of nonsense I spout on topics I'm an ostensible expert in. Exploratory thoughts, babble vs prune mode, varying levels of concentration, beginner mindset, etc. Academics are good at eventually producing really high quality answers on topics they focus on. Basically the opposite personality type of a day trader.

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I do think the whole PMS business is much overstated. Hormones influence mood just as surely as they produce that one pimple each month until you finally outgrow that - but lots of things induce moods in both sexes.

Becoming an acronym suggests something else was going on, a primness meets we-talk-about-everything meets (ironically) feminism and its special pleading.

I never understood it entirely as I had endometriosis which meant menstrual pain trumped PMS insofar as I experienced the latter.

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The acronym just tells us that the people who want to sell NSAIDs ran some commercials and they know people prefer to medicalize and euphamism bodily waste related terms so I wouldn't read too much into the acronym.

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Maybe. There were no commercials for pharma when I was a girl, and yet "I'm PMS-ing" had begun to enter the common parlance, though I am certain none of us teenagers had the self-awareness to know whether we were being unusually bitchy on a given day. They liked the sound of it.

(For myself, I was still a child at heart, playing in the street and wishing others still wanted to play; though I got my period at the then-usual age, 13, I would tend to forget it completely between times, so essentially I got my period for the first time, like twenty times.)

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Unless you're a vampire, I find that hard to believe. Bayer aspirin had a TV ad as early as 1962 with print ads going back into the 19th century

But I'm just being picky because you were right on the substantive point. PMS entered common language as a result of it's use as a defense in criminal cases not as a result of pharma ads.

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Endometriosis is actually when the inner lining of the uterus grows outside of the uterus and can be seen on MRI or through surgery. Hope this helps!

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Aack, sorry, brain collision from writing about posting a poll.

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Did you try controlling for age? Because of the menopause, I expect you'd see a lot more older women in the non-PMS cohort. If older women are (for whatever reason) inherently less likely to believe in the supernatural, it might look like a correlation between PMS and supernatural beliefs. Ditto for neuroticism.

(I'd probably have expected older generations to have *more* belief in the supernatural, but who knows. It does seem plausible that younger women are more neurotic.)

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Upvoting this.

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I was gonna say look into age for another reason - there seems a trend in young women online currently to "reclaim" believing in supernatural stuff as a great feminine thing (...not great) and also, I think in the same women, to be way more open about what a shitshow periods and PMS can be - they're less willing to just act normal while in agony and feeling like crap (valid!). As a woman in her 30s, I feel like I've been taught to distance myself from acknowledging anything PMS related because it'll get used against me/women? Younger women don't seem to feel this and I notice them maybe leaning into it.

So the women marking their PMS as more severe or reporting presence of PMS may not actually experience it more severely but have more openness to describing it in that way. And also be more open to describing belief in the supernatural? Some general link of leaning into claiming feminine coded things that often get mocked/dismissed?

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To be woman is to be red! Lol.

Aleve is the great friend of women. No need for agony!

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Oh, to live in a world where Aleve is enough for everyone!

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It was enough for me for the longest time, and only in the last year before the endo had strangled the organs in my abdomen, intestines and ovaries, did it stop working. That was actually a sign! Presently one of my ovaries ruptured, and it was removed. I do believe that was a painful experience though I had little to compare it to; perhaps it is like appendicitis. After that, though, I never had any more menstrual pain and never took it again. However, I think Aleve is the best for "disguise muscle cramps, make them fade away" and I urge people, men too, to try it.

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I'm glad it worked so well for you! I take it and it makes things manageable but still pretty torturous - and I say that as someone who's had ovarian torsion go ignored for weeks because I was so calm at A&E and not throwing up like most people with torsion do. I just think experience of pain in general is so wildly variable, response to painkillers is wildly variable, and "normal, nothing is medically wrong" menstrual pain for each person is also wildly variable.

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Oh yes, I threw up on the floor of the ER! I guess that was why. I felt so bad I had not made it to a trash can. I sensed a slight judgment on the part of the graveyard shift that I had not so made it, but I was not able to crawl as fast as a baby lol.

Maybe you have what Florence King called "spinning ovaries".

Take it early, take it often!

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It would be a shame if we were all left dumber by an implication below that endometriosis was imaginary or anything to do with “PMS”. I don’t know that it is very common - and I rather suspect it might be mitigated by frequent pregnancies - but it is definitely a thing if varying in severity.

The gynecologist who took my ovary mentioned in case I saw the bill and wondered, that he’d had to call in a general surgeon when he found he needed someone else’s skills to remove the uterine tissue all adhered to and bound up with the bowel.

They say that rogue uterine tissue can get up as far as the armpit.

I do assign some responsibility to myself for not having more children.

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I'll second this, and not even in "being open about something" but interpreting XYZ as normal / part of life (even if it sucks) vs pathology, there's been a big shift historically because modern lives are generally so healthy and comfortable, even WHO changed its definition of health from absence of disease to full wellbeing.

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I do think that's a great part of it, also the publicising of "those aches and pains are not just ordinary aches and pains, there's now a fancy term for it (such as Pre-Menstrual Syndrome)".

If you have a pain in your abdomen, well, pains in the abdomen happen sometimes, it could be anything, just take an over the counter pain killer and it'll go away.

But now there's a specific medical term for pains in the abdomen around a particular time, and now if you get a pain in the abdomen at that time, maybe/surely it is Specific New Condition and not just a pain!

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I thought that PMS referred to more of a supposed mood alteration prior to menstruating, but I wouldn't be surprised if the lady public had conflated the two.

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From what I gathered it refers to a whole package, thus "syndrome", of discomfort, of which pain doesn't seem to be anywhere near the core problem, and most certainly not abdominal pain. A child of mine with bad pms can apparently tell to a day where she is in her cycle by largely mood/energy levels related symptoms.

But the main point (if we have a label for a set of phenomena it becomes a Thing, more than when they are "merely" co-ocurring phenomena, and then we tend to notice it more and thus report it more) stands. And if the Thing gets classified as a pathology, this might boost the noticing too.

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Symptoms of PMS are wide ranging and include physical and mental symptoms https://my.clevelandclinic.org/health/diseases/24288-pms-premenstrual-syndrome. hope this helps!

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I think it's one of those chicken-and-egg questions. Did older generations just put up with it because that's how life goes, this is going to be painful, suck it up and deal with it? Yes. Are modern generations (kids these days!) more likely to react the other way, and any pain at all is blown up into "it's PMS, it's endometriosis, I'm suffering Genuine Medical Condition"? Also, yes.

Undoubtedly, periods will be painful at least sometimes - you're shedding the lining of the uterus, there are going to be muscle contractions, some blood loss, some loss of iron and minerals, and so on.

Were women's claims around pain and mood swings dismissed in the past because of the attitude that (a) you must expect this and (b) women exaggerate every little twinge? I think that happened.

Do younger people (not just women!) tend to expect, for various reasons, that it should be totally painless and if there is *any* pain, then this needs medication and is A Condition? I think also that happens.

But whether younger women are not as tough, or whether periods are more painful today, is not something I can say one way or the other because I don't know.

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Hmm I don't quite follow the logic that because something is predictably painful/"natural" that it means it should just be accepted as part of life? (I'm not sure if you're saying this but it feels kinda implied). Surgery is predictably painful and so we treat it with appropriate pain medication. I dunno, I'm also conflicted on what should be pathologised - but as someone who's suffered through a lot of unnecessary pain because I "didn't want to be difficult/weak", I kinda admire people who fight to not put up with that!

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I think there was an inclination in the past to ignore/downplay, for whatever reasons, reports of pain around natural processes and then we swung to the opposite side with the expectation of 'a pill for every ill' and any discomfort at all requires immediate and total relief.

For some things yes it will be mildly painful/uncomfortable, this is normal and does not indicate anything bad happening, you can get moderate pain relief but we're not going to prescribe heavy-duty painkillers because it'll pass in a little while. 'Just put up with it' is intensely frustrating when you're experiencing it, but sometimes intervention does more harm than good.

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> Undoubtedly, periods will be painful at least sometimes - you're shedding the lining of the uterus, there are going to be muscle contractions, some blood loss, some loss of iron and minerals, and so on.

The claim doesn't appear to follow from the support.

Shedding material is generally painless. Mucus, peeling skin, milk teeth, scabs, fingernails, hair, whatever. There are all kinds of processes where what was incorporated within your body detaches and/or sheds.

Muscle contractions are also generally painless. There is a known failure mode where they aren't, but that's unusual. There are muscle contractions when you blink, when your heart beats, when you breathe, and, really, when you do anything at all. How much pain do you expect from those?

Blood loss is painless and this would appear to have no exceptions. Your nerves don't extend into your blood; that would prevent it from circulating. Having a blood sample taken may vary from painless (if the person taking the sample is skilled) to painful (if not), but that's all about sticking the needle in. Getting the blood out never hurts.

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This makes me wonder why uterine cramps are painful at all. I gather it has something to do with prostaglandins, but spending so much time in purposeless pain seems a little fitness-reducey, so maybe there's a more teleological explanation out there?

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It made me wonder what was going on too, though I have nothing relevant to say about it.

Though, I wouldn't ask why uterine *cramps* are painful. Most muscles can cramp and cramping is painful. The question, to me, seems to be more why cramps occur at all.

Interestingly, wikipedia defines cramps as being specific to skeletal muscle, suggesting that the uterus cannot cramp. This mostly makes me want to see a detailed treatment of what exactly is going on. But my first guess would be that we refer to menstrual "cramps" based on the perception that they feel like the cramps that occur in other muscles.

Something that bothers me now is that I have a sense that "cramps" can refer to a sort of dull ache in various muscles, whereas the wikipedia article unambiguously identifies cramps as sharp shooting pains. I have experienced the phenomenon that wikipedia identifies as a cramp, and I might have chosen to describe it as a cramp - or I might not - but it certainly isn't what I consider to be the paradigm of a "cramp".

(There may also be an element of euphemism involved in the use of the word; I knew a girl who, if you asked what was wrong when she complained that she was feeling worse than usual, preferred to respond with an unelaborated "cramps".)

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The discomfort is in the muscles of the lower back and even the thighs, but certainly also the abdomen as well. The usual answer is that chemicals are washing through them.

ETA: as for fitness, well, I guess nature has no interest in rewarding you for not getting pregnant!

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What can I say to this except "Tell me you're a (cis) man without telling me you're a (cis) man" 😀

"Getting the blood out never hurts" - I've actually seen someone (a man) with that cannula in arm for taking blood samples/if needing IV put in, and he was a bit impatient about not pressing down when it was taken out, and the consequence was blood all over him and the hospital floor. He was certainly vocal about it!

Let me, without going into the (literally) gory details, gently inform you that vaginal/menstrual bleeding is not the same thing as getting blood drawn. Generally, no, it doesn't hurt. But sometimes - well, it can be messy, it can be painful, and you haven't lived until you've bled through a light-coloured skirt and onto the office chair and not learned about this until you went to the bathroom 😣

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How is blood loss not being painful support for the idea that menstruation will necessarily be painful because it involves blood loss?

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It's more the entire package rather than the blood loss on its own, you're correct there. If you tend to bleed a lot, you may feel sick/weak which doesn't help if also dealing with muscle cramps.

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I think they may not be getting that the whole schmear was very swollen and ready for implantation. It’s not like the lining of a raincoat …

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I think the older generation just didn't talk about this in any open forums because these simply didn't exist.

Maybe mums and daughters shared things but dad wasn't included because "women's stuff".

And let's not even mention the whole hysteria epidemic that male doctors consistently ascribed to women's health. I imagine a lot of the legacy thinking around the whole issue is still influenced by that stale paradigm.

We have visibility now because of the tech that has opened up the debate for full sharing and comparing experiences.

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Virginia Woolf had a line in one of her books (around WWI) about a woman sitting down at work because it was "that day of the month when being on one's feet was agony."

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I've never had period pains and I've conceived kids the old fashioned way so everything must be working. My husband says I am more easily irritable the day before my period.

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Why would menopausal or post menopausal women answer a question about PMS?

I realize this survey hinges on women being hysterical and irrational but give them a *little* credit.

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Wasn't the Q referring to "when you were menstruating", or at least readable as such? I'm post menopausal and I answered in hindsight. Same would apply to young women who are pregnant, breast feeding, or using contraception that either stops or greatly reduces periods and associated hormonal swings (eg Morena coil).

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I still don’t get how this would bear on a recollection of 30-odd years of menstruation.

If anything, in menopause - spoiler - bleeding becomes very sporadic and you feel sad more often than not, and in some women, irritable; and superannuated … just a general loss of perkiness.

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I was only commenting here on why a post menopausal or rather nonmenstruating woman would answer the question at all, or really why I answered myself.

Tho I can kinda understand various thinking paths that would lead to the idea that older women might report less PMS, and mayyyybe be less neurotic -- especially women in Scott's sample which isn't exactly representative of any general population.

I'm dubious that they'd be less likely to believe in fairies (tho this could be mediated by neuroticism as per my other comment).

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> If anything, in menopause - spoiler - bleeding becomes very sporadic and you feel sad more often than not

> and superannuated

It's always sad when raw physical facts are delivering a message you'd prefer not to receive. 🙁

There's a song in the Peter Pan musical, I Won't Grow Up, that includes the lyric "'Cause growing up is awfuler / than all the awful things that ever were". I was once trying to find the lyrics to that song, and I searched for that couplet, since that was what I could remember from it.

I turned up somebody's blog post that had been given that headline. The body of the post was "Today I found out my dad has cancer."

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It's definitely something that can't be sugarcoated.

I'm reminded of a line from that poet who recently died, that the internet seemingly selected as her epitaph: "We look at the world once, in childhood. The rest is memory."

The chief consolation is that there is more to think about, as time passes, even if there is less to look at, and less to look forward to.

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I can't remember if I answered it or not, but if I did, it certainly was "in my experience when I was menstruating".

I think that data is as valuable as "currently menstruating" even simply as a comparison between 'historical and current experience'. It would certainly give some indication of "has the rate gone up?" and let you explore "is this because of more occurrences, or simply more recognition that this is a thing?"

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I don't think it would be wrong to answer the survey if you no longer had periods! Without context it's impossible to know whether Aella/Scott are after "For women with periods, does having PMS make XYZ more likely" or "For women, does having both periods and PMS make XYZ more likely". I'd probably still have answered if I were a woman that didn't currently have periods: better to do what the survey asks for than to second guess it and risk skewing responses.

Regarding giving credit: I'm sorry if I inadvertently gave offense. For what it's worth, I'd be very surprised if PMS were purely psychosomatic, but even if it were I don't think that would reflect poorly on those suffering from it.

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It's not only menopause. I got PMS symptoms as a teenager, for the first few years after I got my period, and it gradually stopped. So even among those who still menstruate, you might be less likely to experience it as you get older.

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I know a woman who said she could see that her daughter was starting to be hormonal when she was in the single digits. Never had any daughters so can't speak to it myself, but she was an engineer and very analytical so I trust her.

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I'm pretty sure Scott's question about PMS took into account menopause. I think it said something like "if you're a woman who has menstrual periods, do you suffer from PMS?"

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How do these compare to for men?

(I ask because women generally believe in the supernatural at a higher rate than men, right? So I have to wonder if there could be a common cause between that and PMS...)

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Data point: I'm a man, I believe in the supernatural, and once every 28 days I feel a dull pain in my abdomen and transform into a wolf.

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The lunar month is 29.5 days, not 28.

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Yeah, that's why it's such an interesting data point. Dude is overclocking the moon. ;)

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Hm, the synodic month is 29.5 days, but the sidereal month is 27.3. But the moon's been getting further and further from the earth, so possibly, if we go back far enough into pre-history, we could find a time when the synodic month was only ~28.4 days?

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I'm not sure about that, because while tidal drag makes the month longer, it also makes the day longer (it transfers angular momentum from Terra's rotation to Luna's orbit). My quick calculations seem to indicate that the solar-days-per-synodic-month ratio has actually been decreasing (as one would expect, since the end-state is tidal lock with tidal lunar day = infinity, sidereal month = sidereal day, and synodic month = solar day). But there are complications that I didn't take into account (e.g. glaciations affecting Terra's rotation, and perturbations from other planets affecting Luna's orbit), so I'm not sure what the actual ratios have been over time.

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Maybe it would be (or have been) useful to ask the same women if they had the same strange beliefs before they had their period. One could imagine that PMS leads to neuroticism (as you suggested) and that neuroticism then leads to strange beliefs.

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Never had pms, never didn't believe in God (if that is what is considered supernatural beliefs here). 80% trait neuroticism. 84% openness.

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This seems like confounders galore here, of people who report PMS symptoms; of people who believe in supernatural; and of people who self-report as neurotic.

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"This maybe slightly contradicts a suggestibility hypothesis (lots of people say Donald Trump is bad; wouldn’t that convince more suggestible people that Donald Trump is bad?)"

'Suggestibility' here is a tricky concept that is probably *not* best understood as "being suggestible" like "believing things other people tell you". Think something like: how much can you *believe* in something? Can you make tulpas, be hypnotized, have intense reactions to psychoaffective drugs, spot Patterns, daydream for hours, dive deep into fiction? The correlation between these things and "believing what other people tell you" is quite possibly negative. I...have no idea how this should interact with PMS, though, which seems to be suggestible in the other sense in Aella's framework. (In all likelihood, there are multiple axises of "how, phenomenologically, someone is a member of the believing-in-things cluster" that are covered up by studying this in largeish quantitative studies and are, amongst other things, gender-skewed".)

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Probably two factors. People who have more easily perterbed emotions in general may see stronger shifts from PMS hormones and have a stronger reaction to their own strange experiences, leading to belief in the occult.

People who don't experience strong mood swings as a general rule may simply be more level-headed and come up with more rational explations for odd experiences.

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This. The confounder is the finding.

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I'm confused, are people entertaining the possibility that PMS is not real? As in, that there is a significant fraction of (menstruating, cis) women who are miserable for several days before their period? Is it some "growth mindset"-like wishful thinking?

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It's an interesting line of enquiry. What would be wrong would be drawing a general conclusion from data with this heavy a selection bias (rationalists who take Aella/ACX surveys).

Also, the question they are attempting to answer is not "is PMS real?", it's '"is PMS associated with the level of belief in the supernatural?". And just statistically speaking, some of these analyses will be spuriously statistically significant because Scott collected so many variables.

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Some results will be spurious, but this particular one was intended to be a replication of Aella's survey. And according to her, that survey itself not exploratory, but attempted to test her hypothesis (generated based on inspiration from the book). Thus, we essentially have 2-3 non-exploratory checks (hypothesis based on book + 2 surveys) of the general idea. Thus, I'm very doubtful about this being a spurious correlation.

Confounders are always a possibility, of course.

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I read the book review and I have replied here: https://www.astralcodexten.com/p/survey-results-pms-symptoms/comment/54880274?r=1fn40

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I think there is a notable amount of women who don't get mood symptoms particularly strongly but get more physical symptoms - pain, energy etc. Or who get both but would attribute feeling miserable just to the sensible response to being in pain, rather than "mood symptoms". And that's just in naturally cycling women - there's also gonna be a bunch of women on hormonal contraception methods that disrupt the cycle significantly. When I was on the implant for years I never really had a distinct cycle/would go months without a period, so even if hormones affected my mood I couldn't track them as clearly.

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Yes. I grew up learning as a kid that PMS is an urban legend. No idea whether this is actually true, but it's consistent with my experience. Note that PMS isn't the same as menstrual pain and cramps, which are obviously real. I do also wonder how PMS is supposed to "work" if a woman is on a hormonal contraceptive, which an awful lot of women are.

I think there might be a generational component to this -- Google ngram viewer searches for "PMS" and "pre-menstrual syndrome" show a first appearance in the 60s, a sharp increase peaking in 2000, and then a sharp decline. I haven't heard anyone talk about PMS for a looong time.

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Having been on a range of hormonal contraceptives, they all modified my PMS somewhat - mostly making it less bad but one particular combination made me angry and gave me violent urges, which didn't come back when we swapped off that one.

I am pretty sure it's not psychosomatic as my usual experience of it is that I'll get the emotional impact and then check the calendar and discover it's that time of the month rather than anticipating it happening.

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How exactly do you distinguish? Many women do have emotional shifts (eg get horny...among many other things) during their periods and if that stuff happens before any noticeable flow isn't it pre-menstural.

Tho this discussion illustrates that there may not be agreement on what exactly this means.

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Certain types of birth control are FDA approved for treatment of PPMD ( a more extreme form of PMS) so presumably it reduces risk.

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I truly don't understand the difference people keep talking about between PMS and menstrual cramps. They all just feel like cramps and general crappiness that peaks about 1-2 days after you get your period (for those people who experience cramps, as around a quarter of women don't report experiencing any PMS symptoms at all).

My weirdest PMS symptom for many years was insomnia. I usually need 8-9 hours of sleep to function, but in high school the day before my period, I simply would never get tired. I'd come home from school, do my homework for the week all night, and then go back to school the next day and have a normal day. That superpower went away as I got older, unfortunately.

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Scott, you just gave me PMS. When I took the survey, I said I don't have PMS symptoms because as far as I know, PMS is a **mood**. PMS-ing is an expression of the mood swings and irritability. But according to this review, it is described so broadly in the West that it does cover my pre-menstrual experience. So, I guess I suffer from PMS now?? Thanks, Obama.

All kidding aside though, I still would not describe myself as having 'PMS' because the unpleasant symptoms don't disrupt my life much. But there's people with my exact same experience who would say that they do have PMS symptoms. So, that's another confounder. Maybe people who believe in the supernatural are more likely to say that they "have PMS".

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Tomorrow you'll start seeing ghosts.

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If it disrupts your life, it's more likely to reach the threshold for diagnosis of PMDD. PMS is below that threshold. So you can safely claim to have PMS if you have any symptoms at all.

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PMS (or at least PMS reporting, so take with salt) is highly culturally specific located, hence the penis thieves analogy (or, anorexia).

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Culturally specific also comes along with environmentally specific, meaning that people who live in a certain place and time may share genetics and lifestyle factors. The modern American diet/lifestyle is not a terribly healthy one, so it's not a stretch to consider that maybe it's the externals of the culture itself that causes a bodily process to be more common.

To put it another way, Americans have a lot of heart attacks too, compared to other cultures, but no one looks at that and says "this has gotta be psychosomatic".

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There is certainly a question to be asked about "if you are having general malaise that may or may not be associated with your period before you start your period, do you attribute that to PMS specifically or not?" and then "what would make you think it's PMS?" and "is it people more susceptible to contagion of belief (e.g. believe in fairies, energy healing, witchcraft, ghosts) who are then also more likely to think that PMS happens to all women?"

There's a whole tillage farm's worth of confounders here, not just one field's worth, but there may indeed be something like "wishful thinking" going on - not all wishes are benign, after all. If you're the kind of person who creates "That must have been a ghost" out of random sounds and movements, you may also be the kind of person who creates "This must be PMS" out of random mood shifts or momentary twinges.

That does not mean "PMS is not real" but it may indicate "PMS is not as common as believed".

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Psychosomatic does not mean "not real." (if that is where you were going with that)

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A middle ground would be that the underlying biology based condition is real but rare, and that a significant percentage of those experiencing the symptoms are experiencing a psychosomatic version of it. An analogue would be Long COVID which probably started as a primarily biological phenomenon, but which then triggered widepsread psychosomatic symptoms mirroring the biological ones.

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Yeah this seems like the right take. Anecdotally it seems like there are a small subset of people that have really bad mood swings in the run up to their period, and a much larger group who have as a prior that periods frequently cause mood swings before or during (and therefore are inclined to say 'huh, maybe it's PMS' when they feel down).

When I get low energy and minor twinges I'm often unsure whether I'm developing a cold or am just tired/overworked; if you told me that a new study found that most 'mild flu' symptoms were actually just caused by sleep deprivation or stress I'd be skeptical but not utterly disbelieving.

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I think it's probably a little real, particularly the physical symptoms, but I'm curious about the possibility the mental symptoms might be psychosomatic.

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I suspect it is a mix. Scott's post linked above has a personal anecdote about it, and I certainly know women who do not track their cycle and have to be told they are "PMSing" every month. I also know someone who gets severely suicidal a couple of days prior and then gets reminded that it's that time of the month.

Given how severe postpartum depression can get, I find it utterly unsurprising that periodic hormonal changes can also trigger severe mood swings that are not "psychosomatic". Of course, there are plenty of women who only experience physical symptoms, or none at all. Some not even during their period. Lucky b****es.

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I think some of the commenters are entertaining the idea that PMS isn't real, or at least that most of it is social influence.

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Right. At least Scott isn't. But yeah, it is like they don't know many women.

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I think we can reject that hypothesis. This is a rationalist blog!

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The only solution is to work up a theory that heterosexual men aren't really attracted to women, it's all social pressure.

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Easy to demonstrate. A simple poll showing a high correlation between desiring female companionship and yarning for societal approval

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I think you meant yearning, but yarning-- telling stories-- also applies.

Science fiction isn't evidence of anything, but "The [Widget, the [Wadget]. and Boff" by Theordore Sturgeon includes a man who's suicidal because he isn't interested in performative heterosexuality (he likes sex with women, but he doesn't want to make a big show of it for other men).

Also, this is sort of the flip side, but I've read enough by fat women about men who want sex with them, but not to be seen with them in public-- there are reputational aspects for men which trump the desire for sex, since the woman might be offended enough to turn him down.

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My theory would be that if you have more problems (especially like PMS which makes it clear you are not in total control of your mind) you tend more towards supernatural explanations because they are useful to keep you functioning through the problems, and you also have more neuroticism because bad things do in fact regularly happen to you...

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Could elaborate on this: "[having] PMS (...) makes it clear you are not in total control of your mind"? What do you mean by that and what makes you think it's true?

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It seems obvious to me, at least for the mood side of PMS-- you're going along, thinking in your usual way, and then your emotions go cattywumpus. Why did they do that? It just happens. Who's in charge? Certainly not your conscious mind.

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I realise there are a lot of different sets of symptoms under the PMS umbrella, but mine makes me more inclined to catastrophise and generally overreact to stuff; I can keep a lid on it now with lots of practice and carefully not making any big decisions when it's in effect, but it does remind me how vulnerable my reasoning and emotional state is to physical factors.

(One of the kinds of hormonal birth control I tried also gave me violent urges and made me very angry; before I was medicated for it at all I got considerably suicidal on the week before my period; so I've experienced quite a range of it...)

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Psychogenic seems like a good replacement for psychosomatic. It is marginally less often confabulated with "it's all in your head".

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I'm not sure how it can be psychogenic when I don't notice the cause until I notice the symptoms? Theoretically it could be subconscious but that's a weird thing to subconsciously track.

How it manifests when the physical condition occurs, how people experience and talk about it and cope with it, those all make sense to be culture bound, but not that there is a physical thing that causes a psychological effect in the first place.

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The claim about hormones seems more plausible to me. Most people I've heard about who believe in the supernatural will cite having weird sensations as one cause of believe, and unusual sensations also feature prominently in most supernatural stories. Hormones can fuck with your perceptions and mood quite a lot, so that connection would be rather straightforward, and that PMS is connected to hormones is already the mainstream position anyway.

Though also voting for "likely to be spurious correlation" as well.

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Isn't it generally agreed that conditions like PCOS affect mental health, particularly stress responses and anxiety. And hormonal contraception is sometimes prescribed to help with that. So would give precedent for the hormonal explanation. If people feel unexplained anxiety they will subconsciously look for causes and that may influence belief in supernatural

Might be interesting to include question on those kind of conditions in the next survey?

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More to the point, certain brands of BC are FDA approved to treat PMDD, a clinically significant form of PMS.

But yes, in addition to PCOS, perimenopause and menopause are both known to cause mood disorders, and there are RCTs showing HRT improves symptoms. One plausible mechanism is oestrogen drop, since that occurs both prior to menstruation and in perimenopause and menopause. And both BC and HRT contain it. It's hard to rule out whether that's independent of physical symptoms or not, but at least there are plausible mechanisms at play.

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I don't think PCOS can really give us any useful info given the key symptoms are: struggling to conceive, being overweight, excess hair growth etc. I'd be surprised if this group didn't have higher rates of depression/anxiety ??

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Your number one hypothesis should always be: DEMOGRAPHICS. Is the correlation robust to controlling for age? For country/state? Education level?

9 times out of 10 such things end up being some boring demographic thing like "young women get PMS and believe more in the supernatural".

If it's not some simple demographic thing, perhaps skeptical women are vaguely offended by the existence of PMS and try not to attribute their moods to it. But before jumping to such explanations I want to see demographic checks.

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Yes for age. Haven't checked education level.

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Great that you've checked! I suggest adding checks for confounders explicity to the post - lots of people in the comments are dismissing the results as probably simply confounded by age. Just writing "XYZ even when controlling for age" would be enough without showing your working, I think.

Thanks for the interesting post!

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After age, I would think the biggest potential confounder might be birth control usage?

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I strongly endorse this - in my experience (this is adjacent to my professional field) many exciting tentative correlations boil down to much more mundane demographic factors. Some of them can be quite hard to catch, but once you do it's often a 'd'oh!' moment and all becomes clear.

The self-selection element of both surveys alone makes this pretty likely in my estimation; neither population is what I'd call typical.

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Seems like a proxy for proclivity to see causal patterns. If you only need one or two cases to accept that PMS is (above the threshold you impute the question to present) causing an effect maybe you only need one or 2 cases to conclude prayer of grandma's locket caused something.

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Yeah, this seems like the obvious explanation and I'm confused why people don't just attribute it to this and move on.

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Well, it would be good for someone to do the follow-up and verify it -- but yah that or sampling issues. After all, there is substantial overlap between the crystal gripping hippies and women who see their periods as sacred/important/etc things where women who aren't in this group may be more likely to just find it unappealing to give that kind of answer or think about it too much.

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this doesnt smell right to me, maybe i need to run a poll too but seems like all the women i talk to share my experience of like

forgetting about our period

"oh man i feel so run down and moody, is something wrong with me?? 😭 *3 days later* oh it's my period," happens to a lot of us. every. month.

seems much more likely that being exhausted/in pain/moody compromises your reasoning, or makes you grasp for meaning, or something along these lines

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I don't claim to know anything about anything but recently I've been thinking about the idea that a lot of stuff people refer to as "body-mind connection" (and a lot of experiential emotion stuff more generally) has to do with like, patterns of muscle tension that people do when having various feelings/experiences. like, I have noticed that when feeling stressed/anxious/afraid I will tend to semi-volitionally tense a lot of muscles, especially abdominal muscles; I think I also do a version of this (maybe differently?) when assigning myself a task I want to not forget? this then has further effects on my felt experience, and if it's a chronic thing then it likely also has effects on very physical body things (e.g. if you are chronically stressed and chronically tense your ab muscles this probably affects how you move and may end up affecting other muscles and stuff in the area). also I think the connection goes both ways somewhat - you can mimic a emotional state by messing with bodily signals.

anyway periods certainly do stuff to muscle tension patterns and it makes some sense to me that this might end up interacting with emotions sometimes and maybe interacting with how people tend to experience emotions in general (though I'm struggling to formulate the exact mechanism of the latter - maybe something like, if someone tends to feel a lot of anxiety with accompanying muscle tension they're likelier to interpret other muscle tension as anxiety or have that sensation trigger anxiety since it's a very familiar state for them? I guess like, sometimes when I've been sufficiently anxious I've given myself actual abdominal pain as a result, and if someone has that experience a lot and then they have period-related abdominal pain that might feel like anxiety or trigger anxiety?)

...but also, if someone does get PMS for say, hormonal reasons, I think one of the emotions it may cause *is anxiety*, in which case it is obviously true that people who get PMS have more anxiety than people who don't

(and also, people who get anxiety more in general will also have more total instances of "anxiety AND near period" and thus more material to infer spurious causality from and are not necessarily *that* careful about checking base rates)

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I am a young-ish woman who doesn't take hormonal contraception and I get very strong PMS in the sense that if I know I feeling psychologically particularly unwell I know I will get my period the next few days. I have OCD so there is a very concrete ability to feel my mental stability in realising how strong my obsessions are. I also get my period very unregularly so it's not like I would be able to deduce my period coming from the passed days, so I never doubted PMS's reality. I know many mentally ill women who feel the same. So something I could see from anecdotal evidence is that maybe PMS amplifies preexisting mental conditions and that maybe neurotic people are more likely to believe in ghosts.

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Next year ask if people experience bloating before their periods, because that is believed to be a result of hormones as well. Of course bloating could be making people feel 'fat', and that might be effecting their mood independently of any hormonal effects.

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