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.
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.
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.
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.)
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.
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.)
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?
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.
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.
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".
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.
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.
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!
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.
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.
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.
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!
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.
> 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.
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?
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".)
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!
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 😣
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.
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.
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."
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.
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).
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.
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).
> 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."
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.
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?"
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.
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.
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.
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?"
(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...)
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?
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.
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.
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.
"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".)
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.
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?
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.
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.
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.
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.
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.
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.
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.
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".
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.
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".
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".
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.
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.
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.
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.
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.
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...
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?
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.
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...)
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.
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.
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?
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.
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 ??
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.
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.
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.
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.
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.
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)
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.
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.
Exactly. People have been trained to see PMS as "an imbalance" - and several comments to that effect have been made here - without taking into consideration that childbearing-age women's hormones are supposed to be shifting back and forth every menstrual cycle. High in estrogen during the first part of the month, high in progesterone the second part of the month, with a brief rise in estrogen and drop again 7 days after ovulation, and prior to the period arriving, both hormones plummet. It would be indeed strange if these hormonal shifts didn't have at least some psychological effects; they certainly have physical effects.
When it happens to men no one doubts it. No one says that "Roid Rage" is psychosomatic - that men have "read online that steroids make them cranky and so are acting that out" I mean the entire notion is ludicrous on the face of it. It's clearly caused by hormone levels, and men have noticed that low testosterone also causes some psychological symptoms for them alleviated by taking testosterone supplements.
Sometimes things that are natural and even beneficial are still unpleasant. When I work out, my muscles hurt afterwards, but that doesn't mean something is wrong when that happens.
Yes, precisely. Thanks for elaborating so clearly.
I've even seen people talk as if the entire cyclical phenomenon is caused by estrogen. Like just the presence of estrogen in someone's system (e.g. via taking estrogen orally at a consistent level) leads to these symptoms, somehow in a cyclical way. People also tend to assume it's high estrogen that causes pms, and don't realise that estrogen is lower during their period.
A mixture. For some people it won't cause symptoms, for some it will be mild and they won't notice it, for some the pattern might not be obvious. And some may be on the pill and so not experiencing the same shift.
But a verifiable shift in hormones is happening; that's just what the menstrual cycle is. We know those hormones can affect mood. I don't know why we would default to the assumption that any perceived changes are psychosomatic when there's a measurable physical change happening.
This makes 100% sense to me if we look at pms less as a fully psychosomatic condition and more as something that will be mediated by sensitivity (physical, cognitive, some neuropsychological in-between) to pain, discomfort and even just change. The best measure for that I can think of is Big5 N -- called neuroticism but in fact related more to how intensely people experience "negative" emotions, not necessarily "being neurotic" in the psychopathology sense.
It seems to me though that self reported "being neurotic" and "proper actual N" will be correlated (maybe highly) because humans as such are oversensitive to threats.
So -- still hypothesising -- regardless of "actual" intensity of PMS (assuming it's even a thing), women with higher N will be more likely to notice it, and report it.
The idea that higher N will also influence beliefs in the supernatural feels (irrationally and intuitively) plausible, if we accept the premise that delusional beliefs (beliefs in things that don't exist NOT SHARED BY OTHERS IN THE COMMUNITY/SOCIETY - that's the take used for example in WHO psychosis protocol), paranoia, anxiety, other fear-related conditions are all part of the same bundle related to higher sensitivity to threat signals, then it also sticks.
Obligatory introspective anecdata: when asked if I experienced PMS when menstruating "naturally", I had trouble even remembering if I had it. I suspect it would have needed to be very very bad for me to notice and register. Then my brain broke post-menopause as a result of one traumatic experience that sensitised me to body-malfunction and now I notice every twinge and ache and any change. Was I still menstruating, I'd probably notice subtle changes I'd not have even registered 10-15 years ago.
This is a terrible question for self-reporting, as it’s going to pick up noise from different women’s theory of the self.
Anecdotally, I’ve encountered women who clearly experience mood/behavioural changes when they’re pre-menstrual but insist they don’t (in one instant, only realising after it was pointed out to them). If they’d answered the survey, they’d have been no||no.
I think the root of this is lots of people (especially men, but plenty of women) have a worldview in which the mind isn’t influenced by the condition of the body. This very easily leads to people thinking they don’t get PMS because it would never occur to them that this was a thing. This could very easily apply to whole cultures, explaining away the culture-bound theory if the idea isn’t floating around in that culture.
The real comparison questions should be “Do you react differently to non-food related situations when you’re hungry?” or “How much are your thoughts affected by chemical processes in your body?”
The second of these correlations isn’t surprising, as if you accept you’re “neurotic” you accept your cognition isn’t purely rational. Belief in ghosts is more of a stretch, but does suggest a massive gulf in worldview which should come up all over the place.
Yes, this. Noticing PMS requires a moderate degree of self-awareness ("I am in a bad mood today" rather than "everyone is being a jerk to me today") and executive function / observational skills / pattern recognition (noticing the correlation with it happening shortly before a period, which is more difficult and requires more attention and observation than if it happened during).
I would expect some kind of U-shaped curve, with the least neurotic women not getting PMS, the most neurotic not realising if they get it, and only those in the middle self-reporting it.
(I don't experience it AFAIK, so I guess I don't know which of those two extremes I'm in...)
This matches my experiences, too. There are people who, even if they have an intellectual understanding of the mechanism, for whatever reason don't want to admit that their mind is affected by their body. I'll omit a discussion of the ways in which predictable hormone cycles are used as a fully general excuse to devalue a person's thoughts and opinions. But there's a difference between people who can notice what's happening and compensate in the moment, people who notice what's happening, let it have its way, but then deal with it afterwards, and people who either don't notice or don't want to notice, and who insist even afterwards that their emotions are entirely an appropriate response to the outside world, and have nothing whatsoever to do with the state of their body.
That last category of people seems especially likely to believe in things like "there must be a reason I feel like this" rather than "I'm probably just imagining things". And who knows, maybe it has some benefits, in keeping them from talking themselves out of noticing very real patterns.
"This is bad practice and for exploratory purposes only"
One thing I've been thinking a lot about is *why* it's bad practice. Obviously there's the p-hacking/multiple comparisons issue, but the alternative to testing lots of correlations is to use solid theory to decide which correlations to test, and that requires a place for the theory to come from. If that place doesn't ultimately ground out in correlations, then where does it ground out?
Over time, I've come up with some answers to this:
* The unit of analysis is a big issue. If you correlate over people, then you shatter any connections that might have been observed at a smaller unit of analysis, e.g. if the periods coincide with some other thing.
* Root causes of phenomena often have high skewness (because skewness tends to diffuse away as you go down through the causal chains, so non-root-causes tend to have lower skewness). If you have a fixed set of quantitative or semi-quantitative questions in a survey, then it's hard to observe information with high skewness, because the highly skewed variables that are relevant vary a lot from person to person. On the other hand, if you looked qualitatively at a single individual, it would be more obvious.
* Correlation adjusts for the variance in both the predictor and the outcome, but it is easier for causality to flow from variables with high variance to variables with low variance than vice versa. Thus one should focus the analysis on variables with especially high variance.
I'm currently working on an alternative survey method that might take these sorts of things better into account, by allowing respondents to define sub-units within their responses, and allowing respondents to rank the relative importance of answers within each sub-unit. Obviously by passing more of the analytic work to respondents, this would make the surveys more dependent on the respondents' reasoning than on my reasoning, but given the weakness of correlation-based research, that might be a compromise we're going to have to accept.
I guess the right thing to do would be to split your data into an exploratory set and a validation set, and promise not to look at the validation set except to test your top hypotheses.
You're right, I read your comment lazily and didn't properly take onboard your concerns. I really like the subunit splitting, although I'm not sure I share your intuition that having the participants choose the granularity level is the right solution — it's not clear why they'd do a better job than you would simply by aggressively subuniting everything beforehand. It would be interesting to try both approaches for the same questions on random subsets of your cohort, and qualitatively see what kind of difference it makes to the responses.
The big issue with aggressively splitting is that the one thing that's worse than lumping too much together is splitting things that were actually related, because it's really really hard to reconnect them again.
To some extent that can be mitigated by a very complex model that allow multiple different levels of lumping and splitting, but the more complex the model is, the more data-hungry it becomes.
I'm surprised that 38% of (cis-female) ACX readers believe in the supernatural, I would have assumed that number to be way lower.
Is this a case of this community having a higher standard for what counts as non-supernatural than the general population or something?
Edit: Checked the full results in the survey. 28% has 2+ in the believes in the supernatural question 31% is some level of religious or spiritual so I guess this community is just more religiously/spiritually diverse than I was expecting it to be.
"Rational" does not necessarily imply "materialist," no matter how much some people would like to redefine it as such. Rationality requires that conclusions follow logically from premises, nothing more. It is a process for processing your data, but it cannot provide the data that you are processing.
A belief in or disbelief of materialism is an axiom, one of the inputs to the process of rational reasoning. Therefore, it's perfectly reasonable for people who reject the axiom of materialism to take an interest in a community of rational thinkers.
More severe PMS coincides with higher adrenaline levels, and is linked to trauma history. This also presents physiological symptoms that people are able to track and observe with common wearable devices. This might be a causal factor towards other correlates.
I suspect that one person might classify as 'mild', another person might classify as 'severe' and vice versa and perhaps it says as much about as how somebody perceives such symptoms as to the actual symptoms themselves. I wonder if some women pay more attention to the timings of their mood changes than others. Some might see mood differences as more random uncorrelated fluctuations while others might seek an 'explanation' or pattern more.
Yes, I did not think I had PMS until I had a live-in partner to point it out in my 20's. Then I read through my old journal entries and realized I would get into exactly one really bad argument with my parents per month. They were too 2nd-wave feminist to even consider there might be a biological explanation so we just repeated the same patterns completely obliviously for 15 years...
I'm a little annoyed that post-menopausal women aren't included. I really mean a little annoyed, I'm not planning to go social justice on your ass. Are there just too few in the survey populations to be worth mentioning?
Anyway, moderate but real symptoms of pain and mood swings when I had periods, nothing debilitating. If I remember correctly, I answered the ACX survey as though I still had periods.
I'm pretty neurotic.
I believe in energy, but not so much in non-physical entities, and not at all in ideas about destiny or in intention controlling reality. I believe in rather naturalistic supernaturalism. Speaking of, I once did an energy manipulation which made PMS drain way and dissolve, but I never got it to work again.
I forgot to mention, I'd get somewhat more interested in music-- during my periods rather than before them if I remember correctly. Nothing dramatic, just more inclination to hum. I haven't seen anyone else mention anything like that.
I once had a virus or some sort of minor illness, that during which and for a little time after I couldn't abide to hear radio music with singing. I found the classical station more than usually soothing.
I've heard this mentioned in a podcast discussing side effects of hormonal birth control. In the introductory discussion, they were talking about the effects of women's normal hormonal cycle and mentioned that the pre-ovulatory phase tends to be characterized by a more gregarious mood and a bigger appetite for sensual delights such as music and dancing, whereas the post-ovulatory phase tends to be characterized by a more muted mood geared towards preparing for a potential pregnancy.
The readership here is titled strongly towards male/male-identifying, so I suppose these young'uns didn't expect enough women of mature years to be readers.
Probably not, which makes it even more important that we demand Representation or something 😁 We are an under-served minority! We demand more crochet patterns*, less statistical analysis!
The common denominator is that both phenomena are obviously true.
Of course getting your period affects your mood. Even if it doesn’t have hormonal effects on mood, it would be astonishing if regular bleeding and cramps didn’t exert at least a small pressure towards moodiness (the same way that I would be inclined to be cranky if I was unable to remove a stone from my shoe). Admitting this shows intellectual humility; denying it shows inability or unwillingness to connect obvious evidence out of intellectual pride.
Likewise, there is a spiritual reality to the universe, which exerts such a profound impact on the human soul (giving us beauty, morality and natural law, charity and grace, etc.) that denying its existence says more than anything that your self-knowledge is lacking and you would deny the hand in front of your face in order to assert your intellectual independence.
Of course this is only a theory, the intellectual pride thing; there could be other reasons why there is a group that fails to miss both obvious insights.
> Of course getting your period affects your mood. Even if it doesn’t have hormonal effects on mood, it would be astonishing if regular bleeding and cramps didn’t exert at least a small pressure towards moodiness
PMS is pre-menstrual syndrome: nasty mood swings that hit *before* the bleeding and cramps start up. Not every woman is affected by it. (I count my self very fortunate that my wife is not a PMSer!)
> Likewise, there is a spiritual reality to the universe, which exerts such a profound impact on the human soul (giving us beauty, morality and natural law, charity and grace, etc.) that denying its existence says more than anything that your self-knowledge is lacking and you would deny the hand in front of your face in order to assert your intellectual independence.
I think you could have made this comment without saying "I count myself very fortunate my wife isn't a PMSer."
The truth is, she probably is one, and it just doesn't manifest itself the same way for her as it does for women who become irritable. She does likely struggle with lower than normal mood and all that comes along with it, at least in some months.
People who have PMS are not inferior or undesirable. In fact, since PMS is a fairly ubiquitous experience, it's quite likely it serves some sort of biological/evolutionary purpose that we don't understand.
Thanks for supplying this information about his wife that he doesn't know. Also thanks for pointing out that your wife being in a bad mood is not unpleasant and in fact serves a very important biological function. I wouldn't have known that otherwise.
Of course. The theory is that anticipation of an unpleasant stimulus seems pretty darn likely to result in anticipatory bad mood. Can’t speak for others, but I know if I have an ugly day or two coming up, I’m more likely to feel bad about it. It’s not like emotions only occur during the immediate event they cause! And when the bad day happens, it’s often a relief to have it finally be there, no?
The truth is, one doesn't necessarily know when their period will come. You, and several of the commenters and (unfortunately) the author of the article, are assuming that periods come like clockwork, every 28 days, and PMS is therefore expected and is based in dread of having a period. But for many women in most months, and for ALL women in some months, periods are not regular. The majority of women have menstrual cycles that vary somewhere between 21 days to 35 days - which can change by the month and is not set in stone - and that is considered normal. Cycles that range 2-3 months are not "normal" per se but are extremely common, and longer cycles than that can happen as well due to PCOS, hypothalamic amenorrhea (cessation of ovulation due to low weight, poor diet, disease, or overexercise), or breastfeeding. There are women who don't get their periods for many months and years and yet still experience these mood swings prior to their period arriving. This is an observable event that exists outside of expectation of having it.
And while some women do keep a little calendar or track on their phone, more commonly we simply don't pay that much attention. We're busy living our lives, and our lives do not revolve around precisely where we are in the menstrual cycle. The mood-based symptoms show up regardless of whether or not we're paying attention to them. I didn't have a period for over a year because I was breastfeeding once, and I had a day where I just felt very crazy and out of control, to such an extent I even posted about it on social media, joking that I needed a trip to Rancho Relaxo, and my period arrived that afternoon. I did not spend over a year's time feeling bad in case my period came. And yet I did feel happier and calmer, again, without even knowing I had really been feeling negative prior to that.
I think you make a very great assumption that periods are "ugly". Women have them. We're used to them. They aren't uncommon to us or foreign or scary. We have them every month or two or so from the time we're little girls till we're middle aged women. Some of us have unpleasant periods, sure. Most of us don't. (Those who do track tend to track for sake of not being caught without supplies, and not out of this obsessive fear of "Oh no, my dreaded period is coming!!!")
Having my period is not something that I live in dread of at all whatsoever, I have very easy, short, well-mannered periods, yet I do still experience a low mood for at least a couple days at some point between ovulation and my period showing up. I would honestly rather have my period any time than have the low mood and irritability that I experience. So to assume that I have those extremely unpleasant feelings in dread of something that I don't mind and am completely accustomed to experience, really makes no sense whatsoever.
And the "bad day" is not just a day. People with unpleasant periods have them sometimes for 7-10 days, so the sense of relief that many women experience when their period arrives is not due to "it's nearly over". If anything, for many women, it's just beginning. By your logic, they should feel emotionally WORSE when their period comes, not remarkably better
I'm not sure who you are responding to or if you have confused some of the comments below with mine, but virtually none of the beliefs or arguments you have imputed to me here are ones I hold, and the ones that are direct references to my words make unwarranted assumptions about their meaning or mood.
It isn't "getting your period" that causes PMS. PMS happens BEFORE your period, and it can happen any time after ovulation (2 weeks before your period) through the time your period comes. Your period arriving typically brings a feeling of overall relief.
When I was getting a lot of hot flashes during menopause, I was irritable during them. I thought it was natural because I don't like being over-heated.
After a while, I started getting non-irritating hot flashes. It didn't seem like I was getting used to them, it's just that the irritability wasn't there. My impression is that the hot flashes and the irritability were both physical processes.
Is your belief in the supernatural falsifiable? Are there any sets of circumstances in which you would decide that the materialists were right all along?
On the opposite side, I as a materialist think I could be convinced. Not merely by angels materializing (my thought would be more like "seems like our physical description of physics is even more incomplete than I imagined, time to get to work building an angel collider"), but if magic gets us to Mars, and any attempt to understand it or put it into laws just makes it work less well then I might eventually throw the towel and decide to stop trying to understand the mechanism behind it and just accept it as a fundamental building block of reality. I place the odds of that happening rather low, though.
Why wouldn’t angels materializing (your word) simply lead you to believe that angels were in fact a material phenomenon that you didn’t understand all along?
I was (twenty years ago) a pure materialist, for many reasons, and have decided since that materialism fails to explain too much. If I could be convinced that meaning and design and idea did not exist, I suppose I could be convinced I am wrong: but this seems unlikely, having held the belief vehemently and watched it dissolve when approached by reality.
> Why wouldn’t angels materializing (your word) simply lead you to believe that angels were in fact a material phenomenon that you didn’t understand all along?
That would be my first guess, yes:
> Not *merely* by angels materializing (my thought would be more like "seems like our physical description of physics is even more incomplete than I imagined, time to get to work building an angel collider")
Again, the track record of rationality, the scientific method, physics is rather amazing (and btw the reason for a lot of utility in the world: before the industrial revolution, slavery in some way or other was a stable equilibrium).
The track record of rationality with regard to the human mind is less amazing. Emergent phenomena, blablabla. We don't know why some brains are smart, or depressed, or psychotic, or whatever. The best rationality can do with regard to our brains is warn us about all the ways in which they might not behave like rational agents would. All the fallacies in The Sequences, basically.
If I look at dualist alternatives to materialism, I notice that a lot of competing explanation thrive. If Christianity was so much better at explaining the inner working of the mind than other religions, it should outcompete these. Like heliocentric models with Newtonian mechanics totally outcompeted earlier geocentric models.
So I know that most spiritual explanations are at least partly wrong, and I also know that biases by people's beliefs shape their perception. This is not so bad for beliefs about the mass of the electron (but can be a problem even there, for a time), but absolutely fatal for falsifying any spiritual theories you have about your own mind. This also neatly explains why all the competing religions exist.
So rather than adopting beliefs about my mind whose predictiveness I could never test in a setting not dominated by well-known biases, I opt to not believe in spirituality. Yes, this leads to a HERE BE DRAGONS white spot in the place representing my brain on my map. Do I have consciousness or qualia or free will, or is that just an illusion? I don't know, and until someone proposes an objective experiment to test for these, I will not even consider these questions meaningful.
I strongly suspect some of this is due to reporting bias. When studies of PMS and PMDD are conducted, it's apparently best practice (I found this out just now, investigating a hypothesis of my own) to use prospective rather than retrospective reporting, because the latter leads to substantial inflation. In one paper (https://doi.org/10.53260/GREM.212016) that looked at this specifically, "The MDQ [Menstrual Distress Questionnaire] total scores in the retrospective trial were significantly greater compared with those recorded in the prospective late-luteal trial (p < 0.001). The average value of the overestimation was 23.7 ± 35.0%." This is among currently menstruating women; among women who have to reach further back in their memory (due to menopause, pregnancy, breastfeeding, contraception, sterilization, or disease) it's probably higher. And this includes less subjective measures than mood. On a scale from 0 - 5 (more on the MEDI-Q here https://doi.org/10.1080/09513590.2023.2227275), mood swings specifically dropped from a mean of 3.00 to 2.15. This study has limitations that would lead you to expect some underreporting in the prospective phase but the problem seems well-established, insofar as lots of people agree that it exists.
Being aware and accurately assessing that your mood is subject to hormonal influence due to your menstrual cycle is not the same thing as believing and reporting that your mood is subject to hormonal influence, and there are probably type II-ish errors as well--women who do get more irritable or sad in before they menstruate, but who haven't really noticed or thought about it much. All of the reasons people might pay more or less attention to, reflect on, track, or put labels on their own emotions are potential confounds.
Fertility counselor here. Most women experience PMS between and before their period, not when their period arrives. This can vary (even in the same woman) from happening right after ovulation, a week after ovulation, or right before their periods arrive - that is a solid 2 week swing that is NOT a woman socially conditioned to "feel bad around when their period comes".
Many women also have irregular menstrual cycles at least part of the time, and do not know when their period will arrive. Yet they still experience mood swings even when they do not know their period is coming. (One time I didn't have my period for many months due to breastfeeding, and one day out of the blue I felt literally insane - jittery, upset, anxious over everything, and I had no idea why - and my period arrived that afternoon. I had no expectation of that happening, I just felt weird and upset for no explainable reason.) Again, this does not support social conditioning because women with irregular cycles are not expecting their periods to come at a particular place in time, but ARE experiencing largely negative mood swings regardless of any expectation.
If PMS arrives unpredictably for most women all the time, and for ALL women at least some of the time, not concurrent with the period arriving but beforehand, and in a way that is not directly linked to a calendar date, then there is simply no way that PMS is psychosomatic.
Doctors have found that many health issues are linked to "neuroticism" including many that are provably true. Some speculate that this may be because neurotic people have more inflammation or different hormonal profiles due to stress, that neurotic people sleep poorly and their overall health/mental health suffers, or it may be that there's a separate element causing or contributing to PMS and neuroticism. I think jumping right to an assumption that PMS is psychosomatic on the basis of such a link is quite a stretch and is honestly a bit weird.
Agreed. I tend to feel a bit weepy right before my period (I am, in general, not a tearful person, so it’s always pretty noticeable), and it’s a reliable symptomatic indicator I can use to predict my period even when experiencing irregular cycles, almost as reliable as my thermal shift and comparably or perhaps more reliable than cervical mucus.
It can be very reliable, and can be a marked change from not only one's normal behavior, but even things that a person truly wants and values in their lives.
I have had dozens of clients who, even after spending many months or even years and thousands of dollars trying to get pregnant, and who were very invested in the process, would suddenly decide they didn't want any more children at all. Sometimes they'd even hope for a negative pregnancy test. Then only a couple days later, they'd change their mind again. Over time I observed that this change of heart always, literally always fell during the period of time between ovulation and their period arriving, and once their period came they wanted to try for a baby again. I now baffle and amaze clients when they come to me saying they don't want to try, by asking them where they are in their cycle and predicting it correctly 100% of the time. Whenever there is the dramatic, inexplicable change of heart, it has been a PMS thing that resolved when a new cycle began.
Pain medicine specialist here. Yeah, the term psychosomatic is not helpful, especially as used to imply that reported physical symptoms are somehow not real. Of course, symptoms are self-reported by definition, and a significant factor in the self-report of symptoms is what you might call coping style. For example, ‘catastrophizing’ is a studied variable shown to increase reported suffering from chronic pain. So, you can see how bad PMS by self-report and self-identified neuroticism could be in the same mental frame ballpark.
We also use the term ‘external locus of control,’ as a coping style with high symptom report. So, it’s interesting to (wildly) speculate how bad PMS symptoms, neuroticism, and belief in the supernatural might have some mental framing in common.
By the way, this all comes across as pejorative towards those with a high symptom burden from medical problems. But it shouldn’t. Reporting symptoms is a solicitation for support from your group, and is clearly an adaptive behavior. The word psychosomatic mainly exists for practitioners frustrated by a patient reporting a high symptom burden for which they don’t have a cure.
And yet, many people, particularly women, who go in seeking help for symptom resolution, are treated dismissively by medical professionals because of that framing. "Psychosomatic" means something to people and practitioners assign it (or "functional illnesss" or "somatic illness" or "conversion disorder", whatever they're calling "hysteria" this week) too freely and judge their patients accordingly. Outside of medicine, almost universally women with health issues, including mental illness, are treated with disdain by family, romantic partners, bosses, and society at large as having overactive imaginations, being overly dramatic, attention seeking, etc. I don't really think it's fair to expect women to then accept claims that "this isn't meant to be pejorative" when everyone they encounter does, in fact, treat them as if it's pejorative.
Thus I find the "wild speculation" in the pages of this blog to be less interesting than frustrating. I've read dozens of articles on here that were scrupulously researched, with every i dotted and every t crossed, every line of argument followed to the most thorough and thoughtful degree, and then this notion just thrown out there based on an online survey, without that careful framing that I expect from this author. Why is this one topic just accepted at face value without that careful exploration and framing?
I found out that my SO's answer on "do you get PMS symptoms that affect your mood?" is 1 and she complains often and has visited doctors often in past about the condition. Looks like lying.
If speaking about painful PMS and belief in supernatural is not socially desirable, then some individuals who like to lie might conceal they have both.
Might want to check on other params where people like to lie: weight and number of sexual partners. Others?
Excellent comment. I think the devil in the details is WHY people responded as they did, not "does this mean PMS is fake" where many of the commenters are headed.
I strongly suspect this correlates to being a Highly Sensitive Person (hsp). This is a scientific term not meant as sarcasm, not saying that's a bad thing at all.
> Now 72% of people with PMS self-describe as neurotic, compared to only 45% without. Aella writes more about this here, and sebjenseb confirms here. I’m less weirded out by this one, because you can imagine that people feel neurotic because of PMS symptoms, but it’s still a surprisingly strong effect.
You can imagine that, though you could imagine a handful of other causations for that particular correlation. If you Google "what causes PMS symptoms," the general consensus that emerges is "we don't know, but it's probably some sort of hormonal imbalance." What causes those hormonal imbalances? We don't know.
Is it possible that they're not feeling neurotic because of PMS symptoms, but rather that they're getting PMS because of their neurosis, or because of the same underlying cause?
I agree with your ultimate attribution, but I have to point out: we know *exactly* what causes hormonal "imbalance" over the menstrual cycle! This is very well characterized and we know the much of the whys and hows as well as the whats wheres and whens. Do any people seriously think that we need to invoke extra hormonal weirdness on top of the very well accounted for monthly cycles of estrogen and progesterone to explain PMS symptoms, or is "hormonal imbalance" the kind of thing people autocomplete when they are confused in medicine like "chemical imbalance" is in psychiatry?
Reading these comments, I think a pretty high percentage of people who are responding here have no idea how the monthly cycle even works and it shows in their comments.
There is no "imbalance", just women's bodies working exactly as they're supposed to.
A thing that can happen around here, and other places where people like to talk about real world phenomena at high levels of abstraction, is that they become distracted by the beauty of their logic. Facts which can be checked (so boring) get debated (much fun) instead. Conclusions which only hold under the assumptions of some thought experiment get exported to other lines of reasoning without a label that says "Warning! Contents derived under pressure," and people so motivated can take them to their team's home base. What some people treat as a machine for generating interesting ideas, others treat as a veridical epistemic process.
What if whether you get mood-related symptoms due to hormonal fluctuations is less about the hormonal fluctuations themselves and more about your ability to regulate your emotions, a releasing-mechanism like interaction effect?
The reason I suspect this is the sky-high prevalence of postpartum depression and psychosis in unmedicated women with bipolar disorder. Almost uniquely among the mental illnesses, bipolar disorder has about equal prevalence in men and women. For this reason we don't really think hormones have anything to do with causing the disorder in the first place. But bipolar women appear to be much more sensitive to their own hormonal fluctuations. They have higher rates of PMS and PMDD (which, technically, probably, they shouldn't get diagnosed with, but they meet the inclusion criteria at higher rates) and, as mentioned, have a curious tendency to land in the hospital not so long after giving birth. (I don't think this can be chalked up to any kind of social performance, internalized or otherwise--post-partum psychosis is not widely known about, even among bipolar women, and having homicidal feelings about your baby because the rapture is coming and you don't want them to suffer through the second coming is very not conforming to expectations. If you don't already believe it, and you don't want to look into the literature supporting it, phenomena like this should increase your credence that hormones can affect mood quite a bit!) Treating bipolar with medication reduces endorsement of PMS symptoms, and, by a large margin, postpartum psychopathology. (For awhile I would take a slightly higher dose of lithium in the week before I menstruated specifically to control the irritability that I struggle with chronically but could really get out of hand then.)
Sebastian Jensen had a charming graphic that proposed an additive effect of hormones on, uh, craziness level, but I'm thinking more of an interaction effect, as mentioned, and I wouldn't be surprised if women with other disorders that have a mood dysregulation or subpar executive function component (ADHD, BPD, substance use/behavioral addiction) also have higher rates of mood issues with PMS.
The extent to which "poor emotional regulation" and "believing in ghosts and witches" might associate I'll leave to others' speculation.
"and having homicidal feelings about your baby because the rapture is coming and you don't want them to suffer through the second coming is very not conforming to expectations"
Having homicidal feelings about your baby for any reason is not conforming to expectations. Having homicidal feelings about your baby and narrativizing them into a story involving the most popular religion in your area /is/ conforming to expectations, and this is part of a broader phenomenon--that psychotic experiences are cross-culturally similar at the perceptual level, but the content the experiencer's mind generates to integrate and explain them tends to be culture-specific. I wanted to highlight this distinction because I think it cuts through some of the confusion about culture-bound syndromes in general. Not making a novel point, just a reminder that culture-boundness isn't a dichotomous variable that applies to categories just-as we've delineated them in contemporary western medicine and psychiatry. PMS symptom attribution can be culture-bound and influenced by all kinds confounders without it being the case that women are conjuring mood abberations from a quiet sea.
Postpartum disturbance is also clearly observable in animals, who I'd suggest are unlikely to he acting in such a way due to social suggestibility. I've seen female animals who clearly developed something like post partum psychosis after birth, with hyper vigilance, violent behaviour, and sometimes infanticide as a result.
We are perfectly fine accepting that women experience huge hormonal and chemical shifts after birth which encourage nurturing behaviour, generate feelings of love etc etc. It's very odd that we're simultaneously so sceptical about other sorts of hormonal influences on behaviour, particularly in situations where there is observably a significant shift in hormones happening.
Also very interesting how many people accept that men's lower testosterone levels as they age would definitely affect their mood and that it's a medical condition they should be treated for, and yet a fairly dramatic hormonal shift that women experience every month possibly affecting mood is viewed with such skepticism.
Anyone read Charles Taylor? My theory would be that the correlation of supernatural/PMS is that both are correlated with having a more “porous” as opposed to “buffered” sense of self.
Firstly, I'd submit that the set of people likely to follow Aella are not the same as the mass of the general population, so there is probably a higher chance that for those who do believe in non-conventional views will also believe in energy fields healing or whatever.
Second, what is understood by the supernatural? We covered this already in regards to the survey, but "I believe in God but not ghosts or energy healing" - is that belief in the supernatural or not?
Third, I think I would agree that there is a cultural element to expectations around menstruation, and that may indeed affect how women approach it. For instance, I never heard of the term "cramps" and only encountered it as American slang in books and movies, and famously the name of a rock band, and then later online, and eventually found out what it meant specifically. I was *very* surprised to find out that there seemed to be an entire set of expectations and activities around menstruation if you were American; you got 'cramps' which were not just ordinary stomach or muscle cramps of the kind anyone might get, these were specific period pains; these were supposed to be debilitating to the extent that there was specific for women painkillers (Midol) and conventions such as hot water bottles to the abdomen, taking to your bed, etc.
So far as I knew, I had none of this. Did I get period pains? Well yeah, of course, at times - just like every other woman. Did I get the American version of having periods? Not that I knew. Now, looking back on it, probably I did but I didn't have either the vocabulary or the expectations around it.
Enter PMS when I'm in my 20s or so as a topic coming to public notice. Again, did I consider I got PMS? No.
Did I get more moody/irritable etc. around the time of having my period? Yes. Do I believe in the supernatural (for a limited definition of that?) Also yes.
I think this had much more to do with my particular hormonal levels (I always had very heavy flow) and nothing to do with cultural or religious expectations, though. While I was vaguely aware of the term "the curse", this did not give me expectations that my period would, or should, be painful or debilitating, and believing in God or the fairies had nothing to do with how I experienced each month.
So the relationship from the survey questions is curious, but I don't think strongly connected. A society where the majority of people are religious, or raised in religious families, even weakly so, is going to have a lot of women who believe in 'the supernatural', even if that's the horoscopes/crystals/Wicca/spiritual not religious sort of belief, and that will mean an overlap anyway with "women who have PMS" regardless.
I think the cultural American expectations around menstruation may have more to do with it, but I have no idea how those arose. I'd look into when ads for pain relievers specifically for period pains began, because I think if you have a couple of generations of women who are raised on "this is specifically for women, it's specifically for period pains, that means I should expect periods to be painful" and they see "every month Mom has to take these and go to bed with a heat patch or hot water bottle", there is much more likelihood to be both the expectation of PMS and persuading oneself into "this pain isn't just a pain, it's PMS".
What was your experience of period pains if not cramping? My (English) wife experiences her periods as cramps, and I've never heard anyone describe them as other than as cramps or a dull ache — but my generation's been so thoroughly Americanised that perhaps that's not surprising.
Regarding levels of pain — I do think this varies a lot. My wife considers herself to have comparatively manageable periods, but our friend who has recurrent endometriosis has a dreadful time (and finds heat packs and hot water bottles absolutely crucial) despite being hard as nails and very reluctant to show weakness in general.
I was lucky in that I never got pains, or if I did, they were mild - my sister did have bad pains at times, but we never used the term "cramps" because that really does seem to be the American version.
Mostly, if it was uncomfortable, it was numbness and I realise that sounds odd - how can lack of feeling be uncomfortable? But it was like the entire lower abdomen to genital area just seized up, as it were, and was no longer responsive as normal; a bit like the feeling before pins and needles hits after you've put pressure on a nerve.
Mostly (to share too much information) just heavy flow, lots of clots and messiness and going through menstrual pads like nobody's business (tampons just were not up to the job).
Really interesting, thanks for sharing. I didn't realise the physical experience of periods was quite so variable — I knew the pain and flow varied but I'd never heard of numbness. The heaviness sounds awful, and I imagine I'd have been constantly worried about leaking. I'm sure that's something you don't miss!
I'm conflating about thirty-odd years worth of experience, it wasn't always that bad, but the times when "oh damnation, don't tell me that happened" did happen do tend to stick out and so stick in the memory.
Not going to lie, going through menopause is a separate pain in the backside, but it's worth it to have it all finished with.
> We covered this already in regards to the survey, but "I believe in God but not ghosts or energy healing" - is that belief in the supernatural or not?
I would say that it depends on the predictions you make about reality.
A deist who believes God created the world and does not interfere with will mostly have identical predictions as an atheist.
From my understanding, the biggest supernatural thing many theists believe in are miracles. This could range from a more defensive "God sometimes messes with the world, but always in deniable ways" to stronger claims of "a scientist testing the effectiveness of asking a saint for a cure would find a real saint significantly more effective over a made-up placebo saint in double-blind randomly controlled trials".
I also have pretty mild periods, and don't remember what I said on the survey, but probably that I don't get PMS, though my husband says I do seem grumpy before a period, and buys me chocolate without being asked.
I knew a woman in college with very bad cramps, such that she would lay around looking sad about it for a week, and she also had extremely vivid dreams (I can't remember my dreams), but that was only one anecdote. I had an IUD put in once, after giving birth. The doctor said something about possible cramps, like a period; it was awful and was removed within a week, so that's how I model people with bad cramps now. Not necessarily worse than, say, early contractions, but more kind of vague, aimless, and yucky, such that I felt less willing to tolerate it.
Generally I have pretty mild sensations and emotions -- husband said that when I went in after eight hours or so of contractions, but rated the pain as "probably 6," that I should have just gone ahead and rated it higher, since they just wanted to know if it was really labor or not (and it was, baby came the next day and I was full term). Anecdotally, it does seem like the women I've known who talk a lot about things like PMS, chronic pain, and really intense, debilitating emotions (such as the ones experiencing political PTSD or complex PTSD from their slightly shitty families), and read things like "The Body Keeps the Score," are also interested in things like Tarot, crystals, astrology, vague higher powers, and whatnot. I'm not entirely sure what to make of it, though.
The suggestibility hypothesis is interesting because some, but not all, aspects of PMS seem to be cultural specific.
For instance, in Anglo countries, craving chocolate is associated with PMS. While in East Asian cultures, women with PMS are known to feel abnormally cold. These types of trends led some feminists in the late 20th century to assume that all PMS symptoms were cultural-bound. But beyond some cultural-specific examples, the general PMS profile seems to be pretty consistent: bloating, headache, fatigue, irritability — mostly mild, but the severity varies throughout a woman's life and among different women. Women who experience high rates of PMS also report having more severe post-partum and menopause symptoms (also related to drops in estrogen and progesterone) — it would be surprising if this didn't relate to any inherent mood changes.
So there's something going on physiologically with PMS, but it also seems to rack up these cultural-bound associations. Overdetecting trends, or psychosomatically manifesting them (e.g. "I crave chocolate during this particular time of the month"), seems like a similar phenomenon to the overdetection of trends in horoscopes, etc.
As a woman who experiences PMS (and doesn't believe in the occult):
- It's quite humbling to notice strong feelings, especially negative ones towards others, which I can't explain, and then realize it's been almost two weeks since I ovulated. When this happens, I consciously choose to wait about 48 hours and only engage with the feelings if they don't go away.
- This experience is as a periodic (pun intended) reminder of how strange the concept of "me" is.
- While I think some aspects of PMS might be cultural, based on my experience, other anecdotal evidence and understanding how the hormonal cycle works, I think there is a clear basis for biological causes of PMS.
- I didn’t notice any PMS symptoms while I was on hormonal contraception.
- I think I experience productivity peaks during ovulation, but I wouldn't be terribly surprised if this turned out to be largely psychosomatic.
I suspect that female readers of this blog are less likely to experience strong PMS compared to the general population for three reasons: 1. They may naturally experience fewer hormonal/mood shifts, making them more analytical. 2. They might be too much in their heads to notice it. 3. They are more likely to be on the pill.
I’m not sure which factor is the most significant.
I haven’t yet seen reliable data on women’s mood and productivity relative to their menstrual cycle, specifically data that considers whether they are on any form of hormonal contraception. Even some pretty good studies from period-tracking apps do not collect this information, which makes the data less informative (https://www.lesswrong.com/posts/fnCz8S6PocTxpB2ie/menstrual-cycle-effects-clue-study-summary-and-commentary). Again, self-reporting and self-fulfilling prophecies might be an issue.
From my experience, getting off the pill seemed to increase both my average mood and its variance; I'm happy most of the time, occasionally super happy, but sad and confused during PMS. While on the pill, my mood felt mostly the same without ups or downs.
I think the effects are quite individual, and for some women, the pill might act like a transhumanist-like intervention, improving mood and period symptoms with few drawbacks.
Next time, I'd like to see the data how being on a pill relates to self-reported happiness, anxiety, etc.
I know Scott has written previously about PMS not appearing to be 'internalized social expectations', and I have what I believe to be an interesting anecdote that may support this. I'm still breastfeeding my 13-month-old baby and just had my first menstrual period since before conceiving. There was no way to know exactly when it was coming - I've felt random cramps intermittently for the last few months, and my son is eating slightly less, so I had a hunch it was coming, but with my eldest, I didn't menstruate until I weaned him completely.
However, last week, I was having a moody day, and found myself in the evening thinking "everything is awful, I'm useless, my career is doomed, I'm a joke, I should give up." These are very uncommon thoughts for me - I'm usually quite optimistic and reasonable. It was so uncommon, and such a specific feeling - sudden, crushing hopelessness - that I knew it was PMS and told my partner I'd be getting my first period in over a year two or three days later. And I did!
I suppose there is a chance that there is an unconscious response to the hormonal changes which induces the socially learned behavior of feeling hopeless - in the same way that my son getting hungrier led me to snack more unconsciously to provide more milk without really consciously realizing in the moment either that he was eating more, or I was. But the crushing hopelessness is such a specific and unusual feeling for me that I think it may be directly caused by hormonal fluctuations, and I find this anecdote really rules out a psychosomatic response for me.
Oh, and I don't explicitly believe in a lot of occult stuff, but I do believe in some large cosmic mystery situation - that there are big, important things we don't understand, and I'm thus reluctant to rule out a lot of things, including occultish stuff.
There's such a range of experiences with breast feeding and periods. They say breastfeeding is not effective birth control, but maybe it's bimodal. Would be interesting to see in a future survey how women who breastfed, or pumped, how frequently and for how long, sae their periods and ovulation return affected.
Oh wow, I had the exact same experience (related above.) I felt so anxious I was climbing the walls and my period came later that day. Hadn't had one in over a year from breastfeeding.
I am not sure that an ACX survey is the best way to get solid data on the link between believing in the supernatural and PMS.
First, the ACX readership is very skeptic, 71% replied with an emphatic No (1) when asked about the supernatural, with half of the remainder replying 2, which I would parse as "not really but I try to keep an open mind". Less than 10% replied anything affirmative, i.e. 4-5. Counting all the people who did not deny the supernatural in the harshest possible terms as Believers does not really cut reality at its joints in my opinion.
Then there is the fact that the readership is overwhelmingly male biologically. Only 12% are female. This is uncomfortably close to the Lizardman constant.
I am not an expert on female physiology (understatement of the year, there), but from my understanding not every woman menstruates. Hormonal birth control, being outside a certain age window, pregnancy, breastfeeding and probably a zillion medical conditions seem all likely reasons why some of the cis-female readers might not have their period, and hence also not get PMS. In the public results, I see no question about that, so it is impossible to control for that.
While the trend observed by Aella is clearly visible in the data, this does not mean that we can trust the ACX survey data to be good in the first place.
Furthermore methodically, I think that if you have answers to two questions on a scale then the natural way to compute correlations would be to first plot them into a two-dimensional histogram (with 5 times 5 bins), then do a linear correlation a la Pearson.
If you have answers to a question like the supernatural which are distributed like this:
1: 71.8%
2: 14.2%
3: 5.5%
4: 4.7%
5: 0.39%
(from the overall responses)
then each answer has an average information content of 1.36 bits. If you now lump two to five together, your information content per answer is only 0.86 bits -- less than two thirds.
In a way, mapping {1,2,3,4,5} using identity is just as arbitrary a decision as mapping 1 to zero and everything else to one, but throwing out information does not seem like good practice to me.
(I know that the answer to that is to download the data and analyse it myself. Of course, the only statistics tool I actually know how to use is ROOT, which is terrible even when used for physics. There is probably a scipy package or something though.)
I remember being uncertain how to answer the PMS question on the survey, due to the wording ("do you get PMS symptoms that affect your mood?"). PMS does affect my mood, but in a positive direction. I tend to feel energized and confident in the few days before my period, or more accurately, the few days before the week when I'm supposed to get my period according to the birth control pills. I don't always actually bleed that week, probably because I'm in my late 40's.
Would intensification of feelings/emotions explain this? I would bet there's a correlation between intensification and religious/supernatural beliefs (many people are religious because of some emotional religious experience they had/continue to have). Single data point: my wife has pretty bad PMS and also has very expressive emotions.
From personal experience, I'm going to vote for hormones. My cycle was very unpredictable for a while and I would have a day of being really upset and most, often leading to a right with my husband, and it would be the day before the period came. Since it was irregular, I wasn't expecting to feel bad in anticipation of my regular expected period.
> 19% of women without pre-menstrual symptoms believed in the supernatural, compared to 39% of women with PMS. I can’t do chi-squared tests in my head, but with 1,074 votes this looks significant. Weird!
You got similar results, probably because both of you are drawing disproportionately from rationalists or rationalist-adjacent groups, who are less likely to believe in ghosts and spirits. I don't have a good hypothesis for why this correlation would exist all, though.
First thought was skepticism. People that are especially skeptical of aliens and ghosts are skeptical of PMS. But my hunch is if you ran it back with something like climate change, PMS-skeptics would not be global warming skeptics. So second guess is tribal affiliation. I'd wager PMS skeptics are more likely to believe that Russia colluded with Donald Trump in 2016.
The matter of whether period pains in the abdomen are cramps which resemble muscle cramps is interesting-- I got some pain, but it was more generic than what I experience with muscle cramps. Muscle cramps are clearly localized, and their distinguishing feature is that trying to move in a way the muscle cramp doesn't like is quite painful, and some other movement might release the cramp, or maybe the cramp just needs time to let go.
Those abdominal pains weren't related to movement, at least not for me. I don't know if I would have called them cramps except that cramps was the usual name.
You don't want to dichotomize variables. This loses information and statistical precision. Use a regression model, which also allows you to control for other things. Plots are your friend, SPSS is not. Any LLM will write this kind of basic analysis code for you in R/Python.
I've been suspecting for a while now that Aella's survey style of asking "Do you A? || Do you B?" is flawed. It attracts responders who believe there is a correlation between the two. Second, her surveys are very opt-in and people see the question before they opt in, which I think attracts people who find their answers an interesting fact about themselves.
I'm not surprised by this. People who are more stressed out have more need of religion and spirituality to deal with the stress. My understanding is religiosity is negatively correlated with income. PMS and neuroticism seem like poverty in that they produce more need of the kind of succor people use religion and spirituality for. This would be true whether or not the PMS was psychosomatic.
If PMS is mainly suggestion, that implies people keep really good track of their periods, and so know "this is when I should be upset". I have a tracking app, really dread being caught short at work, and yet I still sometimes forget when it's coming. I can often predict my period by the way I'm feeling (particularly regarding sleep), so this feels like the wrong order of cause and effect for PMS to have a high proportion of suggestibility.
I'd be interested to know if PMS correlates with cramps, and then if chronic pain correlates with belief in the supernatural. From the people I know, people going through things (bereavement, illness, etc) are often more religious. That's one potential causal link I can think of.
Unrelated: there's not much actual research on periods, I'd be very interested in a follow-up survey about periods. I would happily help draft or just participate in some questions.
How does psychosomatic joint mobility work. The joints range is clearly visible isnt. Does the psychosomatic case just bend the joint farther than its supposed to and therefore dislocates it regularly? (Psychosomatically suppressing the pain)
Or is it that the non mobile ppl dont bend the joint as far as it can actually go because they are convinced it cant?
This is anecdotal, but I know a woman who gets mentally wrecked by all big hormonal changes. This has included puberty, pregnancy, all her menstrual periods and now menopause. She takes antidepressants to cope. For women like her, PMS is absolutely real.
One thing that would have been good to do is to reverse the polarity of the questions for half of respondents (agree (0)->disagree(10) for half, disagree(0)->agree(10)), so that you could eliminate individual biases in how people use the scale (which was taught as a real thing back when I was in Cog Sci grad school, though how knows if it survived the replication crisis).
Basically, you have a whole lot of seemingly random measures all correlating with each other on a 0-10 no-to-yes scale. One way that can happen is if some people use teh edges of teh scale more than others, so one person gives more 8s on everything while another gives more 6s, despite their actual states of belief being pretty much identical.
Not saying this is definitely the answer, but when you get weird results on a single instrument it's always good to think about the instrument itself and look for alternate ways to measure the phenomena.
I would say that the common variable for me among experiencing PMS/PMDD, being involved in "spooky stuff" (like ghosts, cryptids, and true crime) and being neurotic is definitely being neurodivergent (Aspergers, ADHD).
It's pretty well known at this point that there is a huge overlap between ADHD/ASD and more severe PMS symptoms. The internal sensitivity to hormonal changes is pretty much exactly the same as sensitivity to external stimuli like temperature and sound (and research shows that hormonal changes during PMS increase sound and smell sensitivity).
I wouldn't say I believe in ghosts as much as I'm "interested" in ghosts (i.e., I'm culturally spooky rather than religiously spooky). I recently went to a ghost hunting event and the vast majority of attendees were neurodivergent women skeptics. Experiencing and then debunking spooky experiences is a great hobby if you have sensory issues and prefer to go to events in the dark, with soft ambient music, and sit in silence rather than talk to people, and then go home and obsessively research mapping/measurement techniques and the history of old buildings.
Scott, my wife hated this post and was very angry about it for several reasons:
1. this isn't up to your usual standards of rigor because of
a. not even doing a literature search for prior research
b. half-assed analysis of unrepresentative online surveys
2. seems disrespectful of women to suggest that their monthly illness is all in their head (or worse, due to their gullibility) especially when combined with (1).
I see some merit in those objections, but not in her third objection which was basically conflating the mental symtoms of pms with the directly observable physical symptoms of mensturation and strawmanning you as suggesting women were just making that up. Then suggesting the entire blog was just gussied-up 19th century attitudes about race and gender. I try to push back when she says that kind of thing but this kind of post makes my job harder and is not a worthwhile way to spend your weirdness points.
(I used to be such an edgelord I never thought I'd be chastising you for wasting your weirdness points).
This is a really poorly worded question. I took it to include physical PMS symptoms of sufficient severity to impact mood. It seems it was meant to apply only to mood impacts nominally independent of physical symptoms?
Do these surveys provide definitions?
- cramps yes, mood swings no?
- energy is natural ... but also supernatural?
I admit I was startled to see that typo, on a doctor’s blog.
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.
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.
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.
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.)
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.
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!
Aack, sorry, brain collision from writing about posting a poll.
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.)
Upvoting this.
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?
To be woman is to be red! Lol.
Aleve is the great friend of women. No need for agony!
Oh, to live in a world where Aleve is enough for everyone!
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.
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.
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!
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.
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.
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!
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.
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.
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!
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.
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!
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.
> 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.
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?
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".)
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!
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 😣
How is blood loss not being painful support for the idea that menstruation will necessarily be painful because it involves blood loss?
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.
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 …
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.
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."
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.
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.
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).
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.
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).
> 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."
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.
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?"
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.
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.
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.
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?"
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...)
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.
The lunar month is 29.5 days, not 28.
Yeah, that's why it's such an interesting data point. Dude is overclocking the moon. ;)
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?
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.
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.
Never had pms, never didn't believe in God (if that is what is considered supernatural beliefs here). 80% trait neuroticism. 84% openness.
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.
"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".)
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.
This. The confounder is the finding.
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?
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.
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.
I read the book review and I have replied here: https://www.astralcodexten.com/p/survey-results-pms-symptoms/comment/54880274?r=1fn40
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.
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.
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.
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.
Certain types of birth control are FDA approved for treatment of PPMD ( a more extreme form of PMS) so presumably it reduces risk.
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.
CTRL+F PMS in https://www.astralcodexten.com/p/book-review-the-geography-of-madness for more on this.
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".
Tomorrow you'll start seeing ghosts.
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.
PMS (or at least PMS reporting, so take with salt) is highly culturally specific located, hence the penis thieves analogy (or, anorexia).
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".
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".
Psychosomatic does not mean "not real." (if that is where you were going with that)
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.
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.
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.
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.
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.
Right. At least Scott isn't. But yeah, it is like they don't know many women.
I think we can reject that hypothesis. This is a rationalist blog!
The only solution is to work up a theory that heterosexual men aren't really attracted to women, it's all social pressure.
Easy to demonstrate. A simple poll showing a high correlation between desiring female companionship and yarning for societal approval
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.
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...
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?
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.
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...)
Psychogenic seems like a good replacement for psychosomatic. It is marginally less often confabulated with "it's all in your head".
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.
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.
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?
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.
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 ??
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.
Yes for age. Haven't checked education level.
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!
After age, I would think the biggest potential confounder might be birth control usage?
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.
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.
Yeah, this seems like the obvious explanation and I'm confused why people don't just attribute it to this and move on.
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.
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
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)
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.
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.
Wouldn't it be stranger if a significant shift in hormonal balance *didn't* produce any symptoms?
Exactly. People have been trained to see PMS as "an imbalance" - and several comments to that effect have been made here - without taking into consideration that childbearing-age women's hormones are supposed to be shifting back and forth every menstrual cycle. High in estrogen during the first part of the month, high in progesterone the second part of the month, with a brief rise in estrogen and drop again 7 days after ovulation, and prior to the period arriving, both hormones plummet. It would be indeed strange if these hormonal shifts didn't have at least some psychological effects; they certainly have physical effects.
When it happens to men no one doubts it. No one says that "Roid Rage" is psychosomatic - that men have "read online that steroids make them cranky and so are acting that out" I mean the entire notion is ludicrous on the face of it. It's clearly caused by hormone levels, and men have noticed that low testosterone also causes some psychological symptoms for them alleviated by taking testosterone supplements.
Sometimes things that are natural and even beneficial are still unpleasant. When I work out, my muscles hurt afterwards, but that doesn't mean something is wrong when that happens.
Yes, precisely. Thanks for elaborating so clearly.
I've even seen people talk as if the entire cyclical phenomenon is caused by estrogen. Like just the presence of estrogen in someone's system (e.g. via taking estrogen orally at a consistent level) leads to these symptoms, somehow in a cyclical way. People also tend to assume it's high estrogen that causes pms, and don't realise that estrogen is lower during their period.
So what do you make of the large number of people who do not report PMS symptoms?
A mixture. For some people it won't cause symptoms, for some it will be mild and they won't notice it, for some the pattern might not be obvious. And some may be on the pill and so not experiencing the same shift.
But a verifiable shift in hormones is happening; that's just what the menstrual cycle is. We know those hormones can affect mood. I don't know why we would default to the assumption that any perceived changes are psychosomatic when there's a measurable physical change happening.
Yes! Women who've had a suddenly-curtailed pregnancy, perhaps more so the older the woman, can attest to a similar drop into a pit.
This makes 100% sense to me if we look at pms less as a fully psychosomatic condition and more as something that will be mediated by sensitivity (physical, cognitive, some neuropsychological in-between) to pain, discomfort and even just change. The best measure for that I can think of is Big5 N -- called neuroticism but in fact related more to how intensely people experience "negative" emotions, not necessarily "being neurotic" in the psychopathology sense.
It seems to me though that self reported "being neurotic" and "proper actual N" will be correlated (maybe highly) because humans as such are oversensitive to threats.
So -- still hypothesising -- regardless of "actual" intensity of PMS (assuming it's even a thing), women with higher N will be more likely to notice it, and report it.
The idea that higher N will also influence beliefs in the supernatural feels (irrationally and intuitively) plausible, if we accept the premise that delusional beliefs (beliefs in things that don't exist NOT SHARED BY OTHERS IN THE COMMUNITY/SOCIETY - that's the take used for example in WHO psychosis protocol), paranoia, anxiety, other fear-related conditions are all part of the same bundle related to higher sensitivity to threat signals, then it also sticks.
Obligatory introspective anecdata: when asked if I experienced PMS when menstruating "naturally", I had trouble even remembering if I had it. I suspect it would have needed to be very very bad for me to notice and register. Then my brain broke post-menopause as a result of one traumatic experience that sensitised me to body-malfunction and now I notice every twinge and ache and any change. Was I still menstruating, I'd probably notice subtle changes I'd not have even registered 10-15 years ago.
This is a terrible question for self-reporting, as it’s going to pick up noise from different women’s theory of the self.
Anecdotally, I’ve encountered women who clearly experience mood/behavioural changes when they’re pre-menstrual but insist they don’t (in one instant, only realising after it was pointed out to them). If they’d answered the survey, they’d have been no||no.
I think the root of this is lots of people (especially men, but plenty of women) have a worldview in which the mind isn’t influenced by the condition of the body. This very easily leads to people thinking they don’t get PMS because it would never occur to them that this was a thing. This could very easily apply to whole cultures, explaining away the culture-bound theory if the idea isn’t floating around in that culture.
The real comparison questions should be “Do you react differently to non-food related situations when you’re hungry?” or “How much are your thoughts affected by chemical processes in your body?”
The second of these correlations isn’t surprising, as if you accept you’re “neurotic” you accept your cognition isn’t purely rational. Belief in ghosts is more of a stretch, but does suggest a massive gulf in worldview which should come up all over the place.
Yes, this. Noticing PMS requires a moderate degree of self-awareness ("I am in a bad mood today" rather than "everyone is being a jerk to me today") and executive function / observational skills / pattern recognition (noticing the correlation with it happening shortly before a period, which is more difficult and requires more attention and observation than if it happened during).
I would expect some kind of U-shaped curve, with the least neurotic women not getting PMS, the most neurotic not realising if they get it, and only those in the middle self-reporting it.
(I don't experience it AFAIK, so I guess I don't know which of those two extremes I'm in...)
do more self-aware people believe in the supernatural, then?
This matches my experiences, too. There are people who, even if they have an intellectual understanding of the mechanism, for whatever reason don't want to admit that their mind is affected by their body. I'll omit a discussion of the ways in which predictable hormone cycles are used as a fully general excuse to devalue a person's thoughts and opinions. But there's a difference between people who can notice what's happening and compensate in the moment, people who notice what's happening, let it have its way, but then deal with it afterwards, and people who either don't notice or don't want to notice, and who insist even afterwards that their emotions are entirely an appropriate response to the outside world, and have nothing whatsoever to do with the state of their body.
That last category of people seems especially likely to believe in things like "there must be a reason I feel like this" rather than "I'm probably just imagining things". And who knows, maybe it has some benefits, in keeping them from talking themselves out of noticing very real patterns.
"This is bad practice and for exploratory purposes only"
One thing I've been thinking a lot about is *why* it's bad practice. Obviously there's the p-hacking/multiple comparisons issue, but the alternative to testing lots of correlations is to use solid theory to decide which correlations to test, and that requires a place for the theory to come from. If that place doesn't ultimately ground out in correlations, then where does it ground out?
Over time, I've come up with some answers to this:
* The unit of analysis is a big issue. If you correlate over people, then you shatter any connections that might have been observed at a smaller unit of analysis, e.g. if the periods coincide with some other thing.
* Root causes of phenomena often have high skewness (because skewness tends to diffuse away as you go down through the causal chains, so non-root-causes tend to have lower skewness). If you have a fixed set of quantitative or semi-quantitative questions in a survey, then it's hard to observe information with high skewness, because the highly skewed variables that are relevant vary a lot from person to person. On the other hand, if you looked qualitatively at a single individual, it would be more obvious.
* Correlation adjusts for the variance in both the predictor and the outcome, but it is easier for causality to flow from variables with high variance to variables with low variance than vice versa. Thus one should focus the analysis on variables with especially high variance.
I'm currently working on an alternative survey method that might take these sorts of things better into account, by allowing respondents to define sub-units within their responses, and allowing respondents to rank the relative importance of answers within each sub-unit. Obviously by passing more of the analytic work to respondents, this would make the surveys more dependent on the respondents' reasoning than on my reasoning, but given the weakness of correlation-based research, that might be a compromise we're going to have to accept.
I guess the right thing to do would be to split your data into an exploratory set and a validation set, and promise not to look at the validation set except to test your top hypotheses.
Sure, if overfitting is your strongest constraint. But I'm raising some additional approaches that might be more relevant.
You're right, I read your comment lazily and didn't properly take onboard your concerns. I really like the subunit splitting, although I'm not sure I share your intuition that having the participants choose the granularity level is the right solution — it's not clear why they'd do a better job than you would simply by aggressively subuniting everything beforehand. It would be interesting to try both approaches for the same questions on random subsets of your cohort, and qualitatively see what kind of difference it makes to the responses.
The big issue with aggressively splitting is that the one thing that's worse than lumping too much together is splitting things that were actually related, because it's really really hard to reconnect them again.
To some extent that can be mitigated by a very complex model that allow multiple different levels of lumping and splitting, but the more complex the model is, the more data-hungry it becomes.
I'm surprised that 38% of (cis-female) ACX readers believe in the supernatural, I would have assumed that number to be way lower.
Is this a case of this community having a higher standard for what counts as non-supernatural than the general population or something?
Edit: Checked the full results in the survey. 28% has 2+ in the believes in the supernatural question 31% is some level of religious or spiritual so I guess this community is just more religiously/spiritually diverse than I was expecting it to be.
"Rational" does not necessarily imply "materialist," no matter how much some people would like to redefine it as such. Rationality requires that conclusions follow logically from premises, nothing more. It is a process for processing your data, but it cannot provide the data that you are processing.
A belief in or disbelief of materialism is an axiom, one of the inputs to the process of rational reasoning. Therefore, it's perfectly reasonable for people who reject the axiom of materialism to take an interest in a community of rational thinkers.
More severe PMS coincides with higher adrenaline levels, and is linked to trauma history. This also presents physiological symptoms that people are able to track and observe with common wearable devices. This might be a causal factor towards other correlates.
See the following links and twitter discussion.
https://pubmed.ncbi.nlm.nih.gov/9858034/
https://x.com/mgoldingmd/status/1393508177455452162
https://x.com/captain_mrs/status/1542748142843711488
Here's one testable story which would explain it away via a confound:
rural -> religious -> supernaturalism
rural -> religious -> not on the Pill -> PMS symptoms
I think religion was asked about directly on the survey, so you wouldn't need to look at rural-ness as a proxy.
I suspect that one person might classify as 'mild', another person might classify as 'severe' and vice versa and perhaps it says as much about as how somebody perceives such symptoms as to the actual symptoms themselves. I wonder if some women pay more attention to the timings of their mood changes than others. Some might see mood differences as more random uncorrelated fluctuations while others might seek an 'explanation' or pattern more.
Yes, I did not think I had PMS until I had a live-in partner to point it out in my 20's. Then I read through my old journal entries and realized I would get into exactly one really bad argument with my parents per month. They were too 2nd-wave feminist to even consider there might be a biological explanation so we just repeated the same patterns completely obliviously for 15 years...
Regarding the initial Aella poll, here's an online calculator results (after plausible rounding):
"The chi-square statistic is 41.3771. The p-value is < .00001. The result is significant at p < .05."
Maybe ask a gynecologist
I'm a little annoyed that post-menopausal women aren't included. I really mean a little annoyed, I'm not planning to go social justice on your ass. Are there just too few in the survey populations to be worth mentioning?
Anyway, moderate but real symptoms of pain and mood swings when I had periods, nothing debilitating. If I remember correctly, I answered the ACX survey as though I still had periods.
I'm pretty neurotic.
I believe in energy, but not so much in non-physical entities, and not at all in ideas about destiny or in intention controlling reality. I believe in rather naturalistic supernaturalism. Speaking of, I once did an energy manipulation which made PMS drain way and dissolve, but I never got it to work again.
I forgot to mention, I'd get somewhat more interested in music-- during my periods rather than before them if I remember correctly. Nothing dramatic, just more inclination to hum. I haven't seen anyone else mention anything like that.
I once had a virus or some sort of minor illness, that during which and for a little time after I couldn't abide to hear radio music with singing. I found the classical station more than usually soothing.
I've heard this mentioned in a podcast discussing side effects of hormonal birth control. In the introductory discussion, they were talking about the effects of women's normal hormonal cycle and mentioned that the pre-ovulatory phase tends to be characterized by a more gregarious mood and a bigger appetite for sensual delights such as music and dancing, whereas the post-ovulatory phase tends to be characterized by a more muted mood geared towards preparing for a potential pregnancy.
Thanks.
This is Crone/Hag Erasure, Nancy, and we should not stand for it! 😀
https://en.wikipedia.org/wiki/Crone
The readership here is titled strongly towards male/male-identifying, so I suppose these young'uns didn't expect enough women of mature years to be readers.
I think there actually may not be many older women.
Probably not, which makes it even more important that we demand Representation or something 😁 We are an under-served minority! We demand more crochet patterns*, less statistical analysis!
*Not really
There may be more than you suspect; they may just be unwilling to publicly identify as such.
You may be right, but I don't think we show up in the surveys. On the other hand, those are also incomplete.
Okay, I’ll bite the bullet that no one else will.
The common denominator is that both phenomena are obviously true.
Of course getting your period affects your mood. Even if it doesn’t have hormonal effects on mood, it would be astonishing if regular bleeding and cramps didn’t exert at least a small pressure towards moodiness (the same way that I would be inclined to be cranky if I was unable to remove a stone from my shoe). Admitting this shows intellectual humility; denying it shows inability or unwillingness to connect obvious evidence out of intellectual pride.
Likewise, there is a spiritual reality to the universe, which exerts such a profound impact on the human soul (giving us beauty, morality and natural law, charity and grace, etc.) that denying its existence says more than anything that your self-knowledge is lacking and you would deny the hand in front of your face in order to assert your intellectual independence.
Of course this is only a theory, the intellectual pride thing; there could be other reasons why there is a group that fails to miss both obvious insights.
> Of course getting your period affects your mood. Even if it doesn’t have hormonal effects on mood, it would be astonishing if regular bleeding and cramps didn’t exert at least a small pressure towards moodiness
PMS is pre-menstrual syndrome: nasty mood swings that hit *before* the bleeding and cramps start up. Not every woman is affected by it. (I count my self very fortunate that my wife is not a PMSer!)
> Likewise, there is a spiritual reality to the universe, which exerts such a profound impact on the human soul (giving us beauty, morality and natural law, charity and grace, etc.) that denying its existence says more than anything that your self-knowledge is lacking and you would deny the hand in front of your face in order to assert your intellectual independence.
Agree 100% on this one.
I think you could have made this comment without saying "I count myself very fortunate my wife isn't a PMSer."
The truth is, she probably is one, and it just doesn't manifest itself the same way for her as it does for women who become irritable. She does likely struggle with lower than normal mood and all that comes along with it, at least in some months.
People who have PMS are not inferior or undesirable. In fact, since PMS is a fairly ubiquitous experience, it's quite likely it serves some sort of biological/evolutionary purpose that we don't understand.
Thanks for supplying this information about his wife that he doesn't know. Also thanks for pointing out that your wife being in a bad mood is not unpleasant and in fact serves a very important biological function. I wouldn't have known that otherwise.
>pre-menstrual
Of course. The theory is that anticipation of an unpleasant stimulus seems pretty darn likely to result in anticipatory bad mood. Can’t speak for others, but I know if I have an ugly day or two coming up, I’m more likely to feel bad about it. It’s not like emotions only occur during the immediate event they cause! And when the bad day happens, it’s often a relief to have it finally be there, no?
The truth is, one doesn't necessarily know when their period will come. You, and several of the commenters and (unfortunately) the author of the article, are assuming that periods come like clockwork, every 28 days, and PMS is therefore expected and is based in dread of having a period. But for many women in most months, and for ALL women in some months, periods are not regular. The majority of women have menstrual cycles that vary somewhere between 21 days to 35 days - which can change by the month and is not set in stone - and that is considered normal. Cycles that range 2-3 months are not "normal" per se but are extremely common, and longer cycles than that can happen as well due to PCOS, hypothalamic amenorrhea (cessation of ovulation due to low weight, poor diet, disease, or overexercise), or breastfeeding. There are women who don't get their periods for many months and years and yet still experience these mood swings prior to their period arriving. This is an observable event that exists outside of expectation of having it.
And while some women do keep a little calendar or track on their phone, more commonly we simply don't pay that much attention. We're busy living our lives, and our lives do not revolve around precisely where we are in the menstrual cycle. The mood-based symptoms show up regardless of whether or not we're paying attention to them. I didn't have a period for over a year because I was breastfeeding once, and I had a day where I just felt very crazy and out of control, to such an extent I even posted about it on social media, joking that I needed a trip to Rancho Relaxo, and my period arrived that afternoon. I did not spend over a year's time feeling bad in case my period came. And yet I did feel happier and calmer, again, without even knowing I had really been feeling negative prior to that.
I think you make a very great assumption that periods are "ugly". Women have them. We're used to them. They aren't uncommon to us or foreign or scary. We have them every month or two or so from the time we're little girls till we're middle aged women. Some of us have unpleasant periods, sure. Most of us don't. (Those who do track tend to track for sake of not being caught without supplies, and not out of this obsessive fear of "Oh no, my dreaded period is coming!!!")
Having my period is not something that I live in dread of at all whatsoever, I have very easy, short, well-mannered periods, yet I do still experience a low mood for at least a couple days at some point between ovulation and my period showing up. I would honestly rather have my period any time than have the low mood and irritability that I experience. So to assume that I have those extremely unpleasant feelings in dread of something that I don't mind and am completely accustomed to experience, really makes no sense whatsoever.
And the "bad day" is not just a day. People with unpleasant periods have them sometimes for 7-10 days, so the sense of relief that many women experience when their period arrives is not due to "it's nearly over". If anything, for many women, it's just beginning. By your logic, they should feel emotionally WORSE when their period comes, not remarkably better
I think women's relationships to their periods can be very different, with a lot depending on culture and religion.
I'm not sure who you are responding to or if you have confused some of the comments below with mine, but virtually none of the beliefs or arguments you have imputed to me here are ones I hold, and the ones that are direct references to my words make unwarranted assumptions about their meaning or mood.
It isn't "getting your period" that causes PMS. PMS happens BEFORE your period, and it can happen any time after ovulation (2 weeks before your period) through the time your period comes. Your period arriving typically brings a feeling of overall relief.
See my response to Bob Frank.
what do you define "spiritual reality" as?
I am a Christian.
When I was getting a lot of hot flashes during menopause, I was irritable during them. I thought it was natural because I don't like being over-heated.
After a while, I started getting non-irritating hot flashes. It didn't seem like I was getting used to them, it's just that the irritability wasn't there. My impression is that the hot flashes and the irritability were both physical processes.
It’s certainly possible. I have no opinion.
Is your belief in the supernatural falsifiable? Are there any sets of circumstances in which you would decide that the materialists were right all along?
On the opposite side, I as a materialist think I could be convinced. Not merely by angels materializing (my thought would be more like "seems like our physical description of physics is even more incomplete than I imagined, time to get to work building an angel collider"), but if magic gets us to Mars, and any attempt to understand it or put it into laws just makes it work less well then I might eventually throw the towel and decide to stop trying to understand the mechanism behind it and just accept it as a fundamental building block of reality. I place the odds of that happening rather low, though.
Why wouldn’t angels materializing (your word) simply lead you to believe that angels were in fact a material phenomenon that you didn’t understand all along?
I was (twenty years ago) a pure materialist, for many reasons, and have decided since that materialism fails to explain too much. If I could be convinced that meaning and design and idea did not exist, I suppose I could be convinced I am wrong: but this seems unlikely, having held the belief vehemently and watched it dissolve when approached by reality.
> and have decided since that materialism fails to explain too much
...like what?
> Why wouldn’t angels materializing (your word) simply lead you to believe that angels were in fact a material phenomenon that you didn’t understand all along?
That would be my first guess, yes:
> Not *merely* by angels materializing (my thought would be more like "seems like our physical description of physics is even more incomplete than I imagined, time to get to work building an angel collider")
Again, the track record of rationality, the scientific method, physics is rather amazing (and btw the reason for a lot of utility in the world: before the industrial revolution, slavery in some way or other was a stable equilibrium).
The track record of rationality with regard to the human mind is less amazing. Emergent phenomena, blablabla. We don't know why some brains are smart, or depressed, or psychotic, or whatever. The best rationality can do with regard to our brains is warn us about all the ways in which they might not behave like rational agents would. All the fallacies in The Sequences, basically.
If I look at dualist alternatives to materialism, I notice that a lot of competing explanation thrive. If Christianity was so much better at explaining the inner working of the mind than other religions, it should outcompete these. Like heliocentric models with Newtonian mechanics totally outcompeted earlier geocentric models.
So I know that most spiritual explanations are at least partly wrong, and I also know that biases by people's beliefs shape their perception. This is not so bad for beliefs about the mass of the electron (but can be a problem even there, for a time), but absolutely fatal for falsifying any spiritual theories you have about your own mind. This also neatly explains why all the competing religions exist.
So rather than adopting beliefs about my mind whose predictiveness I could never test in a setting not dominated by well-known biases, I opt to not believe in spirituality. Yes, this leads to a HERE BE DRAGONS white spot in the place representing my brain on my map. Do I have consciousness or qualia or free will, or is that just an illusion? I don't know, and until someone proposes an objective experiment to test for these, I will not even consider these questions meaningful.
I strongly suspect some of this is due to reporting bias. When studies of PMS and PMDD are conducted, it's apparently best practice (I found this out just now, investigating a hypothesis of my own) to use prospective rather than retrospective reporting, because the latter leads to substantial inflation. In one paper (https://doi.org/10.53260/GREM.212016) that looked at this specifically, "The MDQ [Menstrual Distress Questionnaire] total scores in the retrospective trial were significantly greater compared with those recorded in the prospective late-luteal trial (p < 0.001). The average value of the overestimation was 23.7 ± 35.0%." This is among currently menstruating women; among women who have to reach further back in their memory (due to menopause, pregnancy, breastfeeding, contraception, sterilization, or disease) it's probably higher. And this includes less subjective measures than mood. On a scale from 0 - 5 (more on the MEDI-Q here https://doi.org/10.1080/09513590.2023.2227275), mood swings specifically dropped from a mean of 3.00 to 2.15. This study has limitations that would lead you to expect some underreporting in the prospective phase but the problem seems well-established, insofar as lots of people agree that it exists.
Being aware and accurately assessing that your mood is subject to hormonal influence due to your menstrual cycle is not the same thing as believing and reporting that your mood is subject to hormonal influence, and there are probably type II-ish errors as well--women who do get more irritable or sad in before they menstruate, but who haven't really noticed or thought about it much. All of the reasons people might pay more or less attention to, reflect on, track, or put labels on their own emotions are potential confounds.
Fertility counselor here. Most women experience PMS between and before their period, not when their period arrives. This can vary (even in the same woman) from happening right after ovulation, a week after ovulation, or right before their periods arrive - that is a solid 2 week swing that is NOT a woman socially conditioned to "feel bad around when their period comes".
Many women also have irregular menstrual cycles at least part of the time, and do not know when their period will arrive. Yet they still experience mood swings even when they do not know their period is coming. (One time I didn't have my period for many months due to breastfeeding, and one day out of the blue I felt literally insane - jittery, upset, anxious over everything, and I had no idea why - and my period arrived that afternoon. I had no expectation of that happening, I just felt weird and upset for no explainable reason.) Again, this does not support social conditioning because women with irregular cycles are not expecting their periods to come at a particular place in time, but ARE experiencing largely negative mood swings regardless of any expectation.
If PMS arrives unpredictably for most women all the time, and for ALL women at least some of the time, not concurrent with the period arriving but beforehand, and in a way that is not directly linked to a calendar date, then there is simply no way that PMS is psychosomatic.
Doctors have found that many health issues are linked to "neuroticism" including many that are provably true. Some speculate that this may be because neurotic people have more inflammation or different hormonal profiles due to stress, that neurotic people sleep poorly and their overall health/mental health suffers, or it may be that there's a separate element causing or contributing to PMS and neuroticism. I think jumping right to an assumption that PMS is psychosomatic on the basis of such a link is quite a stretch and is honestly a bit weird.
Agreed. I tend to feel a bit weepy right before my period (I am, in general, not a tearful person, so it’s always pretty noticeable), and it’s a reliable symptomatic indicator I can use to predict my period even when experiencing irregular cycles, almost as reliable as my thermal shift and comparably or perhaps more reliable than cervical mucus.
It can be very reliable, and can be a marked change from not only one's normal behavior, but even things that a person truly wants and values in their lives.
I have had dozens of clients who, even after spending many months or even years and thousands of dollars trying to get pregnant, and who were very invested in the process, would suddenly decide they didn't want any more children at all. Sometimes they'd even hope for a negative pregnancy test. Then only a couple days later, they'd change their mind again. Over time I observed that this change of heart always, literally always fell during the period of time between ovulation and their period arriving, and once their period came they wanted to try for a baby again. I now baffle and amaze clients when they come to me saying they don't want to try, by asking them where they are in their cycle and predicting it correctly 100% of the time. Whenever there is the dramatic, inexplicable change of heart, it has been a PMS thing that resolved when a new cycle began.
Pain medicine specialist here. Yeah, the term psychosomatic is not helpful, especially as used to imply that reported physical symptoms are somehow not real. Of course, symptoms are self-reported by definition, and a significant factor in the self-report of symptoms is what you might call coping style. For example, ‘catastrophizing’ is a studied variable shown to increase reported suffering from chronic pain. So, you can see how bad PMS by self-report and self-identified neuroticism could be in the same mental frame ballpark.
We also use the term ‘external locus of control,’ as a coping style with high symptom report. So, it’s interesting to (wildly) speculate how bad PMS symptoms, neuroticism, and belief in the supernatural might have some mental framing in common.
By the way, this all comes across as pejorative towards those with a high symptom burden from medical problems. But it shouldn’t. Reporting symptoms is a solicitation for support from your group, and is clearly an adaptive behavior. The word psychosomatic mainly exists for practitioners frustrated by a patient reporting a high symptom burden for which they don’t have a cure.
And yet, many people, particularly women, who go in seeking help for symptom resolution, are treated dismissively by medical professionals because of that framing. "Psychosomatic" means something to people and practitioners assign it (or "functional illnesss" or "somatic illness" or "conversion disorder", whatever they're calling "hysteria" this week) too freely and judge their patients accordingly. Outside of medicine, almost universally women with health issues, including mental illness, are treated with disdain by family, romantic partners, bosses, and society at large as having overactive imaginations, being overly dramatic, attention seeking, etc. I don't really think it's fair to expect women to then accept claims that "this isn't meant to be pejorative" when everyone they encounter does, in fact, treat them as if it's pejorative.
Thus I find the "wild speculation" in the pages of this blog to be less interesting than frustrating. I've read dozens of articles on here that were scrupulously researched, with every i dotted and every t crossed, every line of argument followed to the most thorough and thoughtful degree, and then this notion just thrown out there based on an online survey, without that careful framing that I expect from this author. Why is this one topic just accepted at face value without that careful exploration and framing?
I found out that my SO's answer on "do you get PMS symptoms that affect your mood?" is 1 and she complains often and has visited doctors often in past about the condition. Looks like lying.
If speaking about painful PMS and belief in supernatural is not socially desirable, then some individuals who like to lie might conceal they have both.
Might want to check on other params where people like to lie: weight and number of sexual partners. Others?
Excellent comment. I think the devil in the details is WHY people responded as they did, not "does this mean PMS is fake" where many of the commenters are headed.
Oh I realize that I don't understand what exactly is meant by 'PMS'
I strongly suspect this correlates to being a Highly Sensitive Person (hsp). This is a scientific term not meant as sarcasm, not saying that's a bad thing at all.
> Now 72% of people with PMS self-describe as neurotic, compared to only 45% without. Aella writes more about this here, and sebjenseb confirms here. I’m less weirded out by this one, because you can imagine that people feel neurotic because of PMS symptoms, but it’s still a surprisingly strong effect.
You can imagine that, though you could imagine a handful of other causations for that particular correlation. If you Google "what causes PMS symptoms," the general consensus that emerges is "we don't know, but it's probably some sort of hormonal imbalance." What causes those hormonal imbalances? We don't know.
Is it possible that they're not feeling neurotic because of PMS symptoms, but rather that they're getting PMS because of their neurosis, or because of the same underlying cause?
I agree with your ultimate attribution, but I have to point out: we know *exactly* what causes hormonal "imbalance" over the menstrual cycle! This is very well characterized and we know the much of the whys and hows as well as the whats wheres and whens. Do any people seriously think that we need to invoke extra hormonal weirdness on top of the very well accounted for monthly cycles of estrogen and progesterone to explain PMS symptoms, or is "hormonal imbalance" the kind of thing people autocomplete when they are confused in medicine like "chemical imbalance" is in psychiatry?
Thank you! All of this, exactly.
Reading these comments, I think a pretty high percentage of people who are responding here have no idea how the monthly cycle even works and it shows in their comments.
There is no "imbalance", just women's bodies working exactly as they're supposed to.
A thing that can happen around here, and other places where people like to talk about real world phenomena at high levels of abstraction, is that they become distracted by the beauty of their logic. Facts which can be checked (so boring) get debated (much fun) instead. Conclusions which only hold under the assumptions of some thought experiment get exported to other lines of reasoning without a label that says "Warning! Contents derived under pressure," and people so motivated can take them to their team's home base. What some people treat as a machine for generating interesting ideas, others treat as a veridical epistemic process.
This makes a good deal of sense, thanks for taking the time to break it down to me.
What if whether you get mood-related symptoms due to hormonal fluctuations is less about the hormonal fluctuations themselves and more about your ability to regulate your emotions, a releasing-mechanism like interaction effect?
The reason I suspect this is the sky-high prevalence of postpartum depression and psychosis in unmedicated women with bipolar disorder. Almost uniquely among the mental illnesses, bipolar disorder has about equal prevalence in men and women. For this reason we don't really think hormones have anything to do with causing the disorder in the first place. But bipolar women appear to be much more sensitive to their own hormonal fluctuations. They have higher rates of PMS and PMDD (which, technically, probably, they shouldn't get diagnosed with, but they meet the inclusion criteria at higher rates) and, as mentioned, have a curious tendency to land in the hospital not so long after giving birth. (I don't think this can be chalked up to any kind of social performance, internalized or otherwise--post-partum psychosis is not widely known about, even among bipolar women, and having homicidal feelings about your baby because the rapture is coming and you don't want them to suffer through the second coming is very not conforming to expectations. If you don't already believe it, and you don't want to look into the literature supporting it, phenomena like this should increase your credence that hormones can affect mood quite a bit!) Treating bipolar with medication reduces endorsement of PMS symptoms, and, by a large margin, postpartum psychopathology. (For awhile I would take a slightly higher dose of lithium in the week before I menstruated specifically to control the irritability that I struggle with chronically but could really get out of hand then.)
Sebastian Jensen had a charming graphic that proposed an additive effect of hormones on, uh, craziness level, but I'm thinking more of an interaction effect, as mentioned, and I wouldn't be surprised if women with other disorders that have a mood dysregulation or subpar executive function component (ADHD, BPD, substance use/behavioral addiction) also have higher rates of mood issues with PMS.
The extent to which "poor emotional regulation" and "believing in ghosts and witches" might associate I'll leave to others' speculation.
Actually I want to elaborate on this a little:
"and having homicidal feelings about your baby because the rapture is coming and you don't want them to suffer through the second coming is very not conforming to expectations"
Having homicidal feelings about your baby for any reason is not conforming to expectations. Having homicidal feelings about your baby and narrativizing them into a story involving the most popular religion in your area /is/ conforming to expectations, and this is part of a broader phenomenon--that psychotic experiences are cross-culturally similar at the perceptual level, but the content the experiencer's mind generates to integrate and explain them tends to be culture-specific. I wanted to highlight this distinction because I think it cuts through some of the confusion about culture-bound syndromes in general. Not making a novel point, just a reminder that culture-boundness isn't a dichotomous variable that applies to categories just-as we've delineated them in contemporary western medicine and psychiatry. PMS symptom attribution can be culture-bound and influenced by all kinds confounders without it being the case that women are conjuring mood abberations from a quiet sea.
Postpartum disturbance is also clearly observable in animals, who I'd suggest are unlikely to he acting in such a way due to social suggestibility. I've seen female animals who clearly developed something like post partum psychosis after birth, with hyper vigilance, violent behaviour, and sometimes infanticide as a result.
We are perfectly fine accepting that women experience huge hormonal and chemical shifts after birth which encourage nurturing behaviour, generate feelings of love etc etc. It's very odd that we're simultaneously so sceptical about other sorts of hormonal influences on behaviour, particularly in situations where there is observably a significant shift in hormones happening.
Isn't it though? Very odd indeed.
Also very interesting how many people accept that men's lower testosterone levels as they age would definitely affect their mood and that it's a medical condition they should be treated for, and yet a fairly dramatic hormonal shift that women experience every month possibly affecting mood is viewed with such skepticism.
Anyone read Charles Taylor? My theory would be that the correlation of supernatural/PMS is that both are correlated with having a more “porous” as opposed to “buffered” sense of self.
Oh, boy. This is one of those vexed questions.
Firstly, I'd submit that the set of people likely to follow Aella are not the same as the mass of the general population, so there is probably a higher chance that for those who do believe in non-conventional views will also believe in energy fields healing or whatever.
Second, what is understood by the supernatural? We covered this already in regards to the survey, but "I believe in God but not ghosts or energy healing" - is that belief in the supernatural or not?
Third, I think I would agree that there is a cultural element to expectations around menstruation, and that may indeed affect how women approach it. For instance, I never heard of the term "cramps" and only encountered it as American slang in books and movies, and famously the name of a rock band, and then later online, and eventually found out what it meant specifically. I was *very* surprised to find out that there seemed to be an entire set of expectations and activities around menstruation if you were American; you got 'cramps' which were not just ordinary stomach or muscle cramps of the kind anyone might get, these were specific period pains; these were supposed to be debilitating to the extent that there was specific for women painkillers (Midol) and conventions such as hot water bottles to the abdomen, taking to your bed, etc.
So far as I knew, I had none of this. Did I get period pains? Well yeah, of course, at times - just like every other woman. Did I get the American version of having periods? Not that I knew. Now, looking back on it, probably I did but I didn't have either the vocabulary or the expectations around it.
Enter PMS when I'm in my 20s or so as a topic coming to public notice. Again, did I consider I got PMS? No.
Did I get more moody/irritable etc. around the time of having my period? Yes. Do I believe in the supernatural (for a limited definition of that?) Also yes.
I think this had much more to do with my particular hormonal levels (I always had very heavy flow) and nothing to do with cultural or religious expectations, though. While I was vaguely aware of the term "the curse", this did not give me expectations that my period would, or should, be painful or debilitating, and believing in God or the fairies had nothing to do with how I experienced each month.
So the relationship from the survey questions is curious, but I don't think strongly connected. A society where the majority of people are religious, or raised in religious families, even weakly so, is going to have a lot of women who believe in 'the supernatural', even if that's the horoscopes/crystals/Wicca/spiritual not religious sort of belief, and that will mean an overlap anyway with "women who have PMS" regardless.
I think the cultural American expectations around menstruation may have more to do with it, but I have no idea how those arose. I'd look into when ads for pain relievers specifically for period pains began, because I think if you have a couple of generations of women who are raised on "this is specifically for women, it's specifically for period pains, that means I should expect periods to be painful" and they see "every month Mom has to take these and go to bed with a heat patch or hot water bottle", there is much more likelihood to be both the expectation of PMS and persuading oneself into "this pain isn't just a pain, it's PMS".
What was your experience of period pains if not cramping? My (English) wife experiences her periods as cramps, and I've never heard anyone describe them as other than as cramps or a dull ache — but my generation's been so thoroughly Americanised that perhaps that's not surprising.
Regarding levels of pain — I do think this varies a lot. My wife considers herself to have comparatively manageable periods, but our friend who has recurrent endometriosis has a dreadful time (and finds heat packs and hot water bottles absolutely crucial) despite being hard as nails and very reluctant to show weakness in general.
I was lucky in that I never got pains, or if I did, they were mild - my sister did have bad pains at times, but we never used the term "cramps" because that really does seem to be the American version.
Mostly, if it was uncomfortable, it was numbness and I realise that sounds odd - how can lack of feeling be uncomfortable? But it was like the entire lower abdomen to genital area just seized up, as it were, and was no longer responsive as normal; a bit like the feeling before pins and needles hits after you've put pressure on a nerve.
Mostly (to share too much information) just heavy flow, lots of clots and messiness and going through menstrual pads like nobody's business (tampons just were not up to the job).
Really interesting, thanks for sharing. I didn't realise the physical experience of periods was quite so variable — I knew the pain and flow varied but I'd never heard of numbness. The heaviness sounds awful, and I imagine I'd have been constantly worried about leaking. I'm sure that's something you don't miss!
I'm conflating about thirty-odd years worth of experience, it wasn't always that bad, but the times when "oh damnation, don't tell me that happened" did happen do tend to stick out and so stick in the memory.
Not going to lie, going through menopause is a separate pain in the backside, but it's worth it to have it all finished with.
> We covered this already in regards to the survey, but "I believe in God but not ghosts or energy healing" - is that belief in the supernatural or not?
I would say that it depends on the predictions you make about reality.
A deist who believes God created the world and does not interfere with will mostly have identical predictions as an atheist.
From my understanding, the biggest supernatural thing many theists believe in are miracles. This could range from a more defensive "God sometimes messes with the world, but always in deniable ways" to stronger claims of "a scientist testing the effectiveness of asking a saint for a cure would find a real saint significantly more effective over a made-up placebo saint in double-blind randomly controlled trials".
I also have pretty mild periods, and don't remember what I said on the survey, but probably that I don't get PMS, though my husband says I do seem grumpy before a period, and buys me chocolate without being asked.
I knew a woman in college with very bad cramps, such that she would lay around looking sad about it for a week, and she also had extremely vivid dreams (I can't remember my dreams), but that was only one anecdote. I had an IUD put in once, after giving birth. The doctor said something about possible cramps, like a period; it was awful and was removed within a week, so that's how I model people with bad cramps now. Not necessarily worse than, say, early contractions, but more kind of vague, aimless, and yucky, such that I felt less willing to tolerate it.
Generally I have pretty mild sensations and emotions -- husband said that when I went in after eight hours or so of contractions, but rated the pain as "probably 6," that I should have just gone ahead and rated it higher, since they just wanted to know if it was really labor or not (and it was, baby came the next day and I was full term). Anecdotally, it does seem like the women I've known who talk a lot about things like PMS, chronic pain, and really intense, debilitating emotions (such as the ones experiencing political PTSD or complex PTSD from their slightly shitty families), and read things like "The Body Keeps the Score," are also interested in things like Tarot, crystals, astrology, vague higher powers, and whatnot. I'm not entirely sure what to make of it, though.
Why is a t-test being used on ordinal data? Am I missing something??
He bucketed the PMS and supernatural answers into yes/no bins, so it's categorical not ordinal.
The suggestibility hypothesis is interesting because some, but not all, aspects of PMS seem to be cultural specific.
For instance, in Anglo countries, craving chocolate is associated with PMS. While in East Asian cultures, women with PMS are known to feel abnormally cold. These types of trends led some feminists in the late 20th century to assume that all PMS symptoms were cultural-bound. But beyond some cultural-specific examples, the general PMS profile seems to be pretty consistent: bloating, headache, fatigue, irritability — mostly mild, but the severity varies throughout a woman's life and among different women. Women who experience high rates of PMS also report having more severe post-partum and menopause symptoms (also related to drops in estrogen and progesterone) — it would be surprising if this didn't relate to any inherent mood changes.
So there's something going on physiologically with PMS, but it also seems to rack up these cultural-bound associations. Overdetecting trends, or psychosomatically manifesting them (e.g. "I crave chocolate during this particular time of the month"), seems like a similar phenomenon to the overdetection of trends in horoscopes, etc.
As a woman who experiences PMS (and doesn't believe in the occult):
- It's quite humbling to notice strong feelings, especially negative ones towards others, which I can't explain, and then realize it's been almost two weeks since I ovulated. When this happens, I consciously choose to wait about 48 hours and only engage with the feelings if they don't go away.
- This experience is as a periodic (pun intended) reminder of how strange the concept of "me" is.
- While I think some aspects of PMS might be cultural, based on my experience, other anecdotal evidence and understanding how the hormonal cycle works, I think there is a clear basis for biological causes of PMS.
- I didn’t notice any PMS symptoms while I was on hormonal contraception.
- I think I experience productivity peaks during ovulation, but I wouldn't be terribly surprised if this turned out to be largely psychosomatic.
I suspect that female readers of this blog are less likely to experience strong PMS compared to the general population for three reasons: 1. They may naturally experience fewer hormonal/mood shifts, making them more analytical. 2. They might be too much in their heads to notice it. 3. They are more likely to be on the pill.
I’m not sure which factor is the most significant.
I haven’t yet seen reliable data on women’s mood and productivity relative to their menstrual cycle, specifically data that considers whether they are on any form of hormonal contraception. Even some pretty good studies from period-tracking apps do not collect this information, which makes the data less informative (https://www.lesswrong.com/posts/fnCz8S6PocTxpB2ie/menstrual-cycle-effects-clue-study-summary-and-commentary). Again, self-reporting and self-fulfilling prophecies might be an issue.
From my experience, getting off the pill seemed to increase both my average mood and its variance; I'm happy most of the time, occasionally super happy, but sad and confused during PMS. While on the pill, my mood felt mostly the same without ups or downs.
I think the effects are quite individual, and for some women, the pill might act like a transhumanist-like intervention, improving mood and period symptoms with few drawbacks.
Next time, I'd like to see the data how being on a pill relates to self-reported happiness, anxiety, etc.
Somewhat relatedly, I also enjoyed this write up about fertility drugs and their effect (n=1) on the mood: https://acesounderglass.com/2019/11/30/trip-report-fertility-drugs/
I know Scott has written previously about PMS not appearing to be 'internalized social expectations', and I have what I believe to be an interesting anecdote that may support this. I'm still breastfeeding my 13-month-old baby and just had my first menstrual period since before conceiving. There was no way to know exactly when it was coming - I've felt random cramps intermittently for the last few months, and my son is eating slightly less, so I had a hunch it was coming, but with my eldest, I didn't menstruate until I weaned him completely.
However, last week, I was having a moody day, and found myself in the evening thinking "everything is awful, I'm useless, my career is doomed, I'm a joke, I should give up." These are very uncommon thoughts for me - I'm usually quite optimistic and reasonable. It was so uncommon, and such a specific feeling - sudden, crushing hopelessness - that I knew it was PMS and told my partner I'd be getting my first period in over a year two or three days later. And I did!
I suppose there is a chance that there is an unconscious response to the hormonal changes which induces the socially learned behavior of feeling hopeless - in the same way that my son getting hungrier led me to snack more unconsciously to provide more milk without really consciously realizing in the moment either that he was eating more, or I was. But the crushing hopelessness is such a specific and unusual feeling for me that I think it may be directly caused by hormonal fluctuations, and I find this anecdote really rules out a psychosomatic response for me.
Oh, and I don't explicitly believe in a lot of occult stuff, but I do believe in some large cosmic mystery situation - that there are big, important things we don't understand, and I'm thus reluctant to rule out a lot of things, including occultish stuff.
There's such a range of experiences with breast feeding and periods. They say breastfeeding is not effective birth control, but maybe it's bimodal. Would be interesting to see in a future survey how women who breastfed, or pumped, how frequently and for how long, sae their periods and ovulation return affected.
Oh wow, I had the exact same experience (related above.) I felt so anxious I was climbing the walls and my period came later that day. Hadn't had one in over a year from breastfeeding.
As a happily married man I know better than to offer any opinion on a woman’s subjective experience.
The secret to a happy life is just say "Yes, dear" no matter what!
I am not sure that an ACX survey is the best way to get solid data on the link between believing in the supernatural and PMS.
First, the ACX readership is very skeptic, 71% replied with an emphatic No (1) when asked about the supernatural, with half of the remainder replying 2, which I would parse as "not really but I try to keep an open mind". Less than 10% replied anything affirmative, i.e. 4-5. Counting all the people who did not deny the supernatural in the harshest possible terms as Believers does not really cut reality at its joints in my opinion.
Then there is the fact that the readership is overwhelmingly male biologically. Only 12% are female. This is uncomfortably close to the Lizardman constant.
I am not an expert on female physiology (understatement of the year, there), but from my understanding not every woman menstruates. Hormonal birth control, being outside a certain age window, pregnancy, breastfeeding and probably a zillion medical conditions seem all likely reasons why some of the cis-female readers might not have their period, and hence also not get PMS. In the public results, I see no question about that, so it is impossible to control for that.
While the trend observed by Aella is clearly visible in the data, this does not mean that we can trust the ACX survey data to be good in the first place.
Furthermore methodically, I think that if you have answers to two questions on a scale then the natural way to compute correlations would be to first plot them into a two-dimensional histogram (with 5 times 5 bins), then do a linear correlation a la Pearson.
If you have answers to a question like the supernatural which are distributed like this:
1: 71.8%
2: 14.2%
3: 5.5%
4: 4.7%
5: 0.39%
(from the overall responses)
then each answer has an average information content of 1.36 bits. If you now lump two to five together, your information content per answer is only 0.86 bits -- less than two thirds.
In a way, mapping {1,2,3,4,5} using identity is just as arbitrary a decision as mapping 1 to zero and everything else to one, but throwing out information does not seem like good practice to me.
(I know that the answer to that is to download the data and analyse it myself. Of course, the only statistics tool I actually know how to use is ROOT, which is terrible even when used for physics. There is probably a scipy package or something though.)
I remember being uncertain how to answer the PMS question on the survey, due to the wording ("do you get PMS symptoms that affect your mood?"). PMS does affect my mood, but in a positive direction. I tend to feel energized and confident in the few days before my period, or more accurately, the few days before the week when I'm supposed to get my period according to the birth control pills. I don't always actually bleed that week, probably because I'm in my late 40's.
Would intensification of feelings/emotions explain this? I would bet there's a correlation between intensification and religious/supernatural beliefs (many people are religious because of some emotional religious experience they had/continue to have). Single data point: my wife has pretty bad PMS and also has very expressive emotions.
From personal experience, I'm going to vote for hormones. My cycle was very unpredictable for a while and I would have a day of being really upset and most, often leading to a right with my husband, and it would be the day before the period came. Since it was irregular, I wasn't expecting to feel bad in anticipation of my regular expected period.
> 19% of women without pre-menstrual symptoms believed in the supernatural, compared to 39% of women with PMS. I can’t do chi-squared tests in my head, but with 1,074 votes this looks significant. Weird!
I know you've pointed out that correlations often survive selection effects, but only 1/3 of respondents believe in the supernatural, which seems wildly out of line with the general population. E.g. https://news.gallup.com/poll/16915/three-four-americans-believe-paranormal.aspx or https://thehill.com/blogs/blog-briefing-room/4400922-americans-ghosts-aliens-devil-survey/
You got similar results, probably because both of you are drawing disproportionately from rationalists or rationalist-adjacent groups, who are less likely to believe in ghosts and spirits. I don't have a good hypothesis for why this correlation would exist all, though.
First thought was skepticism. People that are especially skeptical of aliens and ghosts are skeptical of PMS. But my hunch is if you ran it back with something like climate change, PMS-skeptics would not be global warming skeptics. So second guess is tribal affiliation. I'd wager PMS skeptics are more likely to believe that Russia colluded with Donald Trump in 2016.
The matter of whether period pains in the abdomen are cramps which resemble muscle cramps is interesting-- I got some pain, but it was more generic than what I experience with muscle cramps. Muscle cramps are clearly localized, and their distinguishing feature is that trying to move in a way the muscle cramp doesn't like is quite painful, and some other movement might release the cramp, or maybe the cramp just needs time to let go.
Those abdominal pains weren't related to movement, at least not for me. I don't know if I would have called them cramps except that cramps was the usual name.
You don't want to dichotomize variables. This loses information and statistical precision. Use a regression model, which also allows you to control for other things. Plots are your friend, SPSS is not. Any LLM will write this kind of basic analysis code for you in R/Python.
I've been suspecting for a while now that Aella's survey style of asking "Do you A? || Do you B?" is flawed. It attracts responders who believe there is a correlation between the two. Second, her surveys are very opt-in and people see the question before they opt in, which I think attracts people who find their answers an interesting fact about themselves.
I can't believe that no one's suggested the most parsimonious explanation: PMS is caused by evil spirits.
I'm not surprised by this. People who are more stressed out have more need of religion and spirituality to deal with the stress. My understanding is religiosity is negatively correlated with income. PMS and neuroticism seem like poverty in that they produce more need of the kind of succor people use religion and spirituality for. This would be true whether or not the PMS was psychosomatic.
If PMS is mainly suggestion, that implies people keep really good track of their periods, and so know "this is when I should be upset". I have a tracking app, really dread being caught short at work, and yet I still sometimes forget when it's coming. I can often predict my period by the way I'm feeling (particularly regarding sleep), so this feels like the wrong order of cause and effect for PMS to have a high proportion of suggestibility.
I'd be interested to know if PMS correlates with cramps, and then if chronic pain correlates with belief in the supernatural. From the people I know, people going through things (bereavement, illness, etc) are often more religious. That's one potential causal link I can think of.
Unrelated: there's not much actual research on periods, I'd be very interested in a follow-up survey about periods. I would happily help draft or just participate in some questions.
How does psychosomatic joint mobility work. The joints range is clearly visible isnt. Does the psychosomatic case just bend the joint farther than its supposed to and therefore dislocates it regularly? (Psychosomatically suppressing the pain)
Or is it that the non mobile ppl dont bend the joint as far as it can actually go because they are convinced it cant?
This is anecdotal, but I know a woman who gets mentally wrecked by all big hormonal changes. This has included puberty, pregnancy, all her menstrual periods and now menopause. She takes antidepressants to cope. For women like her, PMS is absolutely real.
She does believe in the supernatural.
One thing that would have been good to do is to reverse the polarity of the questions for half of respondents (agree (0)->disagree(10) for half, disagree(0)->agree(10)), so that you could eliminate individual biases in how people use the scale (which was taught as a real thing back when I was in Cog Sci grad school, though how knows if it survived the replication crisis).
Basically, you have a whole lot of seemingly random measures all correlating with each other on a 0-10 no-to-yes scale. One way that can happen is if some people use teh edges of teh scale more than others, so one person gives more 8s on everything while another gives more 6s, despite their actual states of belief being pretty much identical.
Not saying this is definitely the answer, but when you get weird results on a single instrument it's always good to think about the instrument itself and look for alternate ways to measure the phenomena.
I would say that the common variable for me among experiencing PMS/PMDD, being involved in "spooky stuff" (like ghosts, cryptids, and true crime) and being neurotic is definitely being neurodivergent (Aspergers, ADHD).
It's pretty well known at this point that there is a huge overlap between ADHD/ASD and more severe PMS symptoms. The internal sensitivity to hormonal changes is pretty much exactly the same as sensitivity to external stimuli like temperature and sound (and research shows that hormonal changes during PMS increase sound and smell sensitivity).
I wouldn't say I believe in ghosts as much as I'm "interested" in ghosts (i.e., I'm culturally spooky rather than religiously spooky). I recently went to a ghost hunting event and the vast majority of attendees were neurodivergent women skeptics. Experiencing and then debunking spooky experiences is a great hobby if you have sensory issues and prefer to go to events in the dark, with soft ambient music, and sit in silence rather than talk to people, and then go home and obsessively research mapping/measurement techniques and the history of old buildings.
I'm an ADHD specialist. PMS significantly more in ADHD which has emotional dysregulation as a core but not in diagnostic features symptom.
Scott, my wife hated this post and was very angry about it for several reasons:
1. this isn't up to your usual standards of rigor because of
a. not even doing a literature search for prior research
b. half-assed analysis of unrepresentative online surveys
2. seems disrespectful of women to suggest that their monthly illness is all in their head (or worse, due to their gullibility) especially when combined with (1).
I see some merit in those objections, but not in her third objection which was basically conflating the mental symtoms of pms with the directly observable physical symptoms of mensturation and strawmanning you as suggesting women were just making that up. Then suggesting the entire blog was just gussied-up 19th century attitudes about race and gender. I try to push back when she says that kind of thing but this kind of post makes my job harder and is not a worthwhile way to spend your weirdness points.
(I used to be such an edgelord I never thought I'd be chastising you for wasting your weirdness points).
"Do you get PMS symptoms that affect your mood?"
This is a really poorly worded question. I took it to include physical PMS symptoms of sufficient severity to impact mood. It seems it was meant to apply only to mood impacts nominally independent of physical symptoms?