Medicalising menstruation: the case of premenstrual dysphoric disorder and DSM 5

Shimu Khamlichi
The phenomenon of 'premenstrual syndrome' has attracted considerable attention during the early half of the twentieth century. Over the years, medical researchers and physicians have concluded that premenstrual changes could cause women severe distress and impair their ability to function at work and at home. In 1994, the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association 1994) used the term 'premenstrual dysphoric disorder' (PMDD) to refer to these
more » ... refer to these premenstrual changes. At present, PMDD is being proposed for inclusion as a new category in DSM 5, due for release in May 2013. This inclusion means women who experience premenstrual changes could be classified with a mental disorder. This study aimed to explore how premenstrual changes evolved from a normal biological fact of life into a psychiatric disorder. The study examined the way premenstrual changes have been constructed in psychiatric and psychological literature. The study was informed by a critical realist epistemology and adopted a Foucauldian discourse analysis methodology. The study took a genealogical approach to explore the discursive and nondiscursive practices that have influenced the medicalisation of premenstrual changes in DSM. The study found three interrelated 'truths' about women's premenstrual changes that have been produced and disseminated by psychiatrists and psychologists to reify PMDD as a psychiatric problem. Psychiatrist and psychologists have drawn on the discourses of science and medicine to render these constructions or 'truths' intelligible. The literature focused primarily on negative mood changes and failed to consider positive premenstrual experiences that many women report. The literature did not consider premenstrual experiences from a nonbiomedical perspective and neglected the role that relational, social, economic, cultural and structural factors play in contributing to or exacerbating premenstrual experiences. This means that the published research has exc [...]
doi:10.15123/pub.3495 fatcat:tb6xmufpdzaq5bd4rhvbs5dmy4