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A Complex Negotiation:
Women’s Experiences of Naming
and Not Naming Premenstrual Distress
in Couple Relationships
Julie Mooney-Somers, BSc, PhD
Janette Perz, BA, PhD
Jane M. Ussher, BA, PhD, DipClinPsyc
ABSTRACT. Recent research has demonstrated the importance of fam-
ily relationships in women’s experience of premenstrual changes, their
construction of these changes as “PMS.” However, the discursive pro-
cess by which women take up the subject position of “PMS” sufferer
through the explicit naming of “PMS” to an intimate partner has re-
ceived little research attention. Drawing on 60 individual interviews
with Australian women, conducted between 2004 and 2006, we exam-
ined accounts of naming “PMS” in intimate relationships, women’s ex-
planations for naming or not naming, their experiences of their partner
naming them as premenstrual. The analysis process identified an over-
arching theme of naming “PMS,” which was made up of three themes:
naming to explain; “PMS” becoming the only explanation for distress;
“PMS” as not a legitimate explanation for distress. The findings suggest
Julie Mooney-Somers is affiliated with National Centre in HIV Epidemiology and
Clinical Research, University of New South Wales, St. Vincent’s Medical Centre,
376 Victoria Street, Darlinghurst, NSW 2010, Australia (E-mail: jmooneysomers@
nchecr.unsw.edu.au).
Janette Perz (E-mail: j.perz@uws.edu.au) and Jane M. Ussher (E-mail: j.ussher@
uws.edu.au) are affiliated with Gender Culture and Health Research: PsyHealth,
School of Psychology, University of Western Sydney, Locked Bag 1797, Penrith
South DC, NSW 1797, Australia.
Address correspondence to: Julie Mooney-Somers at the above address.
Women & Health, Vol. 47(3) 2008
Available online at http://wh.haworthpress.com
© 2008 by The Haworth Press. All rights reserved.
doi: 57
10.1080/03630240802134134
that clinicians need to be aware of women’s complex, often ambivalent,
experiences of naming “PMS” within their relationships, when working
with women, couples, seeking treatment or support for premenstrual
distress. doi: [Article copies available for a fee from
The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:
<docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com>
© 2008 by The Haworth Press. All rights reserved.]
KEYWORDS. Premenstrual distress, PMS, relationships, cultural con-
struction, Positioning Theory
INTRODUCTION
Much of feminist research conceptualizes premenstrual change and dis-
tress as a material-discursive-intrapsychic phenomenon, in which the so-
cial and cultural context is central to understanding how premenstrual
change is constructed and experienced by women (Ussher, 2000). Many
women experience premenstrual changes in emotion or behavior, due to
a combination of corporeal, environmental, relational, and psychological
factors, but this change is not inevitably a source of distress, or positioned
as a pathology, as Premenstrual Syndrome (PMS) (Ussher, 2006). Seeking
to explicate the cultural context which is implicated in this positioning, ex-
aminations of popular culture, self-help texts and medical discourse repeat-
edly demonstrate a dominant and coherent construction of premenstrual
change as “PMS” (Chrisler & Caplan, 2002; Cosgrove & Riddle, 2003;
Markens, 1996; Ussher, 2006). This comprises a negative construction of
the “PMS” sufferer as “irrational, emotional and out of control” (Chrisler &
Caplan, 2002, p. 286), with premenstrual change characterized as a pathol-
ogy caused by hormones that can “cause strained relationships, feelings
of despair and worthlessness” (Markens, 1996, p. 46). These construc-
tions render women’s bodies and premenstrual emotional experiences as
pathological and “PMS” as something medical intervention both can and
should “fix.” Moreover, because “PMS” is seen as an underlying pa-
thology, it is framed as an individual problem that a woman brings to
her relationships and interactions with the world.
However, premenstrual change is not experienced in a vacuum; it is
negotiated and experienced in the context of relationships, and the re-
sponses of a woman’s partner can play a significant role in both the emer-
gence of premenstrual distress, and the construction of this distress as
“PMS” (Ussher, 2002, 2003a; Ussher, Perz, & Mooney-Somers, 2007).
58 WOMEN & HEALTH
10 .10 8 0/0 3 63 0 2 4 0 802 1 3 4 1 34
Women seeking treatment for premenstrual distress often report disrup-
tion to intimate relationships (Hammond, 1988; Robinson & Swindle,
2000; Steege, Stout, & Rupp, 1988), and an association between pre-
menstrual distress and relationship discord has been established by a
number of studies (Coughlin, 1990; Frank, Dixon, & Grosz, 1993; T. A.
Hamilton, 1988; Ryser & Feinauer, 1992; Siegel, 1986; Winter, Ash-
ton, & Moore, 1991; Wright, 1986). In women’s narratives, emotional
reactivity is often only labeled as “PMS” when it is outwardly expressed
in relationships, or “PMS” is described as the expression of problems in
relationships that are usually repressed (Ussher, 2003a). However, the
discursive process by which a woman takes up the position of “PMS”
sufferer through the explicit naming of herself as such has received little
research attention.
The act of naming or not naming her emotions or behavior as “PMS”
to her partner is an important part of the process by which a woman
adopts or resists the subject position “PMS” sufferer. Moreover, the
adoption of this position is an ongoing process in which a woman can
position herself in this way in relation to a specific incident or time, in
one cycle but not another, at one period of time in her life but not an-
other (Chrisler & Caplan, 2002; Ussher, 2002). Naming herself as
premenstrual to an intimate partner is, thus, an act likely to be performed
again and again. This process is best understood through Positioning
Theory, as described by Davies and Harré (1990), where positioning is
seen as “the discursive process whereby selves are located in conversa-
tions as observably or subjectively coherent participants in jointly pro-
duced story lines” (p. 48). The subject position of “PMS” sufferer is
made available by discourses such as those relating to reproduction,
women’s bodies, and mental illness (Ussher, 2003b). This subject posi-
tion is taken up by the individual woman when she identifies to her-
self that the behavioral or emotional changes she is experiencing are
“symptoms” of “PMS”; she can also take up this subject position in re-
lation to others, when she names herself as “premenstrual.” Equally,
women can be positioned as a “PMS” sufferer by others when they name
her as such, in that “what one person says positions another” (Davies &
Harré, 1990, p. 48). The implication of Positioning Theory, is that how
we position ourselves, or are positioned by others, “produce(s) social
and psychological realities” (p. 48). It is this process that we are con-
cerned with in this paper: women self-positioning, or being positioned
by a partner, as a “PMS” sufferer, and the social and psychological real-
ities produced by these acts.
Mooney-Somers, Perz, and Ussher 59
Self-help texts encourage women to tell others they are premen-
strual (Chrisler & Caplan, 2002), and the use of family and couple ther-
apy has been advocated by clinicians and researchers (Jones, Theodos,
Canar, Sher, & Young, 2000; McDaniel, 1988; Ussher, 2003a), yet, why
women choose to name “PMS” to their partner, or not, is little under-
stood. Cosgrove and Riddle (2003) suggest that women are strongly ex-
pected to explain behavior or emotions that are deemed to be outside
the normal conventions of femininity: the calm, controlled, coping wife
and mother, who is always available to care for others, regardless of her
own needs and concerns (Ussher, 2006). Some evidence also suggests
that women regard being able to label their experience of premenstrual
changes as “PMS” as an important part of validating their experience and
recognizing it as a serious biomedical condition (Lee, 2002; Raitt &
Zeedyk, 2000). However, whether or not women receive validation
through this act has received little attention. Indeed, research is lacking
on the consequences of naming premenstrual change as “PMS”; an act
that positions women within cultural constructions that many feminists
argue construe women’s bodies and emotional distress as pathological.
Research conducted in Iceland reported that others labeling women as
“premenstrual” can be a negative experience, acting as to demean and
belittle women, or as one woman described, a way for men to “divert at-
tention away from their own incompetence” (Sveinsdóttir, Lundman, &
Norberg, 2002, p. 417).
Our research aimed to examine the development, experience and con-
struction of premenstrual symptoms across a range of relationship types
and contexts. This project examined women’s accounts of naming pre-
menstrual change as “PMS” in intimate relationships, their explanations
for naming, or not naming, and their experiences of partner naming.
These are, fundamentally, issues of why women choose to take up or re-
sist the subject position “PMS” sufferer in the context of intimate rela-
tionships, and the consequences of this positioning for women.
METHOD
Design, Recruitment, and Participants
We employed interview data from a large mixed method study de-
signed to explore the construction, experience and development of pre-
menstrual distress across different relationship types and contexts.
We recruited women who self-identified as experiencing premenstrual
60 WOMEN & HEALTH
distress, via the media, women’s health centers, community groups and
social organizations. To be eligible for the study women had to be self-
identified as a “PMS sufferer,” aged 18 or older, not pregnant or lactat-
ing (or had been within the last 12 months), and not taking psychotropic
medication. Women self-screened for eligibility; we provided the eli-
gibility criteria to women on the information sheet given before they
completed a questionnaire or participated in an interview. We excluded
women who subsequently indicated, either in their questionnaire re-
sponses or in their interview, that they did not meet all criteria.
The final questionnaire sample comprised 327 women, and of these
60 women participated in an individual interview. Women indicated on
their completed questionnaire if they were interested in participating in
an individual or group interview. Selection for the individual interview
sample was purposive. We sought a good representation of women in
relationships with women, as we wanted to explore the experiences of
non-heterosexual women, and women with children, including same-
gender couples with children. We also selected women to represent a
range of premenstrual distress using the levels of distress indicated in
women’s questionnaire responses.
Procedure
We conducted 60 semi-structured interviews between 2004 and 2006.
Interviews focused on women’s experience of premenstrual change in re-
lation to other individuals, that is, in the context of intimate, family, social
and work relationships. The interviewer began by asking women to de-
scribe how they were when they had “PMS,” and then explored how this
varied across the various relational contexts. The interviews ranging in
duration from 45 to 90 minutes, were digitally recorded and transcribed
prior to analysis. Transcription of interviews adhered to the follow-
ing conventions: (.) indicated a pause; underlining indicated words
or phrases which were stressed; capitals indicated shouting or loud-
ness; italics indicated whispering; [. . .] indicated part of transcript was
omitted. Laughter, crying, interruptions, or explanations that were not
part of the interview, were included in square brackets. For readabil-
ity, punctuation was added, and unfinished utterances, ums and ahs, and
repeated phrases, were omitted from the extracts cited here.
The Human Research Ethics Committee at the University of Western
Sydney and the Ethics Committee at Relationships Australia (a research
partner) granted ethics approval for the study. All participants signed a
consent form, and we have used pseudonyms to ensure confidentiality.
Mooney-Somers, Perz, and Ussher 61
Analysis
Analysis followed what Stenner has termed a “thematic decomposi-
tion” (1993, p. 114), a close reading which attempts to separate a given
text into coherent themes or narratives which reflect subject positions
allocated to, or taken up by, a person (Davies & Harré, 1990). This meth-
od is a version of thematic analysis and follows the processes recently
outlined by Braun and Clarke (2006). Two of the authors (J. M. S. and
J. U.) conducted the initial process of coding and identification of
themes on separate subsets of transcripts. This involved each researcher
coding a different set of transcripts through reading and rereading and
then line by line coding. Regular meetings were held to discuss emerg-
ing codes and themes, and consistency between the researchers in the
analysis of the texts. The research team then examined the codes for
themes and patterns related to the construction and experience of pre-
menstrual change in the context of relationships, a process that also in-
volved collapsing some themes and identifying new ones. The whole
data set was then coded using this coding schedule. In this paper, we ex-
plore one of the main themes identified in the analysis process: Naming
“PMS.” To indicate commonality of themes, we have indicated the ap-
proximate proportions of women who reported each theme.
Throughout this paper, we have employed the term “PMS” to refer to
the dominant socio-cultural construction in which the emotional and be-
havioral changes that can occur in the phase leading up to menstruation
are framed as symptoms of “PMS,” usually understood to result from
hormonal changes in the woman’s body. We have utilized scare quotes
around the term “PMS” to clearly demarcate our use of this term as a
construction drawn on by the women we interviewed and their partners,
and to distinguish it from the clinical or other standardized diagnosis of
Premenstrual Syndrome or Premenstrual Dysphoric Disorder.
RESULTS
The interview sample consisted of 60 women; most interviewees
were partnered (80%). Sixty-six percent of women were currently in an
intimate relationship with a man and 33% were currently in a relation-
ship with a woman. The average age of women in the interview sample
was 34 years, with ages ranging from 22 to 48. Half the women inter-
viewed reported having children (47%), with heterosexual women more
likely to have children (60%) than lesbian women (25%). The majority
62 WOMEN & HEALTH
of participants were Anglo-Australian, in full-time education, part-time
or full-time employment, and were resident in an urban location in one of
Australia’s two largest cities. This echoes the experience of most Aus-
tralians–three quarters of Australians live in urban areas, with 85% of
these living in one of the country’s eight capital cities (Australian Bu-
reau of Statistics, 2006).
An overarching theme of naming “PMS” was made up of three sub-
themes: naming to explain,“PMS” becoming the only explanation for
distress, and “PMS” as not a legitimate explanation for distress. These
three themes cut across accounts of women self-positioning as a “PMS”
sufferer and naming this to a partner, self-positioning as a “PMS” suf-
ferer but not naming this to a partner, and partners naming women as a
“PMS” sufferer (whether the woman positioned herself in this way
or not).
Two-thirds of the women described naming “PMS” to their partners
by explicitly referring to “PMS” and the premenstrual phase, such as
“my periods are coming,” or implicitly, such as “it’s almost that time.”
Naming “PMS” to an intimate partner invariably followed a women
identifying a change in her own behavior or emotions, and then posi-
tioning this as a “symptom” of “PMS.” The changes most often associ-
ated with naming “PMS” were outwardly orientated, such as irritability,
anger, reactivity, or irrationality. For example, in the following extract
from Fiona:
I’d usually tell him that, you know (.) I’m you know, if I was irra-
tional, I like to be able to say, “Look, I think I’m a bit irritable,” or
whatever, “because you know, it’s almost that time.”
Many of the women (approximately half of the sample, but the ma-
jority of lesbian relationships), also reported a partner naming their be-
havior or emotional state as “PMS,” often before the woman had named
it herself or self-identified as being currently premenstrual. Naming was
usually in the form of a question–“Are you?” “Is it that time?”–allowing
women to take up, or resist, the position of “PMS” sufferer. Echoing the
pattern in women’s self-naming, women described partner naming as
triggered by a change in the woman’s usual behaviors or emotions; as
Eleanor described in her interview:
He would say, “Oh, it’s that time coming up, isn’t it?” So I guess
it was evident in me that, you know, I would get a little bit more
Mooney-Somers, Perz, and Ussher 63
tense, a bit short, that sort of thing. Whereas normally I’m pretty
easy going.
The following themes–naming to explain,“PMS” becoming the only
explanation for distress, and “PMS” as not a legitimate explanation for
distress–represent the reasons women gave for naming or not naming
“PMS” to a partner, as well as the positive and negative consequences
of self and partner naming.
Naming to Explain
Naming “PMS” to explain vulnerability and access support. One-
third of women described naming “PMS” as a way of letting their partner
know they were feeling different from usual. This action permitted a wom-
an to talk about how she was feeling, which as one woman commented,
allowed her partner to be “aware of it. So I guess, it’s just maintaining
that communication about it” (Kathryn). In many cases, emotional and
practical support resulted from a woman letting a partner know she was
currently premenstrual; that is, premenstrual changes were positioned
as causing a woman to be vulnerable or overwhelmed and thus in need
of additional support from her partner. A similar pattern was apparent in
women’s accounts of their partner naming “PMS,” with the provision of
emotional reassurance, physical comfort and domestic support a com-
mon outcome. This was the case in the majority of accounts of partner
naming from women in lesbian relationships; for example, Bec de-
scribed how her partner’s naming of “PMS” offered it as an explanation
for her distress and allowed her partner to offer support:
The month before I had a nervous breakdown from PMT [pre-
menstrual tension], I was just all over the place, I was just like, “I
don’t know what’s going on, I don’t know what’s wrong with me,
I think I’m having a nervous breakdown,” and she goes, “Oh I
think you’re PMT-ing” and I’m like, “Oh God it couldn’t be that, it
couldn’t be that, it’s so simple!” But yeah she was very (.) nice I
suppose and you know, “Don’t worry I’ll fix it up.”
A minority of women in heterosexual relationships, approximately
one tenth of the sample, provided similar positive accounts of their part-
ner offering “PMS” as an explanation for their distress: “Oh he usually
comes and gives me a cuddle and says, ‘oh don’t worry about it, yeah,
64 WOMEN & HEALTH
it’s that time of the month’” (Maggie). Women in heterosexual relation-
ships more often described partner naming as an ambivalent experience
(one-third of the sample). In the following extract, Danni described her
partner naming her as premenstrual, an action that resulted in her being
relieved of her domestic responsibilities. This naming also brought in to
play negative cultural constructions of “PMS” and of the premenstrual
woman as incapable and unreliable; meanings that positioned Danni as
childish and in need of supervision:
[Interviewer: “Go and sit on the sofa, you’ve got PMS,” how does
that make you feel?] a little bit relieved that I don’t have to cook
dinner (.) it annoys me [laugh]. Yeah, I mean. you know, I am re-
lieved that I don’t have to do it, any excuse at that time to do noth-
ing is fine by me, but (.) it sort of feels like you’re shooed away,
like you’re a total, (.) not invalid but you’re incapable of (.) even
doing basic tasks sometimes like, you almost feel like a child, “Be-
have yourself or you’ll have to go and sit in the bedroom,” you
know what I mean? [. . .] I feel as though I’m being managed.
Naming “PMS” to explain reactivity and moderate relationship
conflict. Naming “PMS” as an explanation for a change in behavior or
emotion was positioned by many women, approximately half the sam-
ple, as functioning to allow their partner to modify their responses to
premenstrual mood or behavior–usually irritability, reactivity and an-
ger. Here, naming “PMS” could explain a woman’s irritability with
her partner or a reduction in her ability to tolerate stressors she nor-
mally coped with. This could mean, for example, a woman explicitly
warning her partner not to raise issues during her premenstrual phase:
“He knows when it’s PMS time to back off when I say, ‘back off.’ If
there’s issues that cause problems in our relationship he knows that
then is not the time to bring it up” (Gillian). This strategy of naming re-
quires women to take up the dominant construction of the premen-
strual woman as irrational, reactive, and unable to control herself and
her emotions. This appeared to be productive for some women, who
reported that their partner tried to be less reactive or backed off, during
their premenstrual phase. For others, however, it produced undesir-
able and uncomfortable consequences. Susannah described naming
herself as having “PMS” as making her feel vulnerable in relation to
her partner. Her request that he make allowances for her or excuse her
Mooney-Somers, Perz, and Ussher 65
behavior during her premenstrual phase was experienced by her as
giving him power–it puts him in a “better position”:
I find it kind of, very unfair that every month I have to say to my
partner “no I’m, it’s the week that I’m getting my bad days so, you
know, I’m just telling you now” it’s a bit embarrassing and it’s a
bit like, it gives him, like it puts him to better position.
Women gave accounts of naming themselves as premenstrual follow-
ing a particular incident with their partner, as a way of offering an apol-
ogy for a change in the woman’s behavior, for example in the following
extract from Mary:
I go back to him and say, you know, “I’m sorry I think I’ve got
PMS,” and that I usually wouldn’t respond like that, so I kind of feel
like I do go back and I justify my behavior when I reflect on certain
things.
Naming in this context positions the women’s distress, and the dispute
between her and her partner, as caused by “PMS,” ensuring that it is not
positioned as caused by a conflict between the woman and her partner, by
the woman’s partner, or by a problem or dissatisfaction in the woman’s
life. This was common in accounts from women in lesbian relationships,
who without exception presented it as a positive experience. As Linda
explained:
She certainly understands and so if I was to turn around, you know
after a couple of times, you know I might be snappy for half a day
and then I finally sort of realize that I’m like that, (.) I will say to her,
“look I’m really sorry,” and it’s actually better then. And then she’ll,
she’ll just take it in her stride. Not a problem. [Interviewer: What
does that, what do you think giving her that piece of information
does?] (.) well it actually makes, (.) it allows her to understand that
it’s not her.
Women often reported that their female partners expressed a sense of
relief on hearing that “PMS” was the issue: “It’s almost as though it’s a
relief that there’s a reason for it” (Pip).
The largely positive outcomes of naming premenstrual distress to in-
timate partners represented one experience of naming described by
66 WOMEN & HEALTH
women in their interviews. The following two themes present more am-
bivalent, and often explicitly negative, experiences.
“PMS” Becoming the Only Explanation for Distress
Naming her behavior as premenstrual, whilst not denying the impor-
tance of the issue to which she was responding, is a complex negotia-
tion, and represented a considerable concern in the majority of accounts
from women in heterosexual relationships. In the following extract–a
relatively rare one in accounts from women in heterosexual relation-
ships–Eleanor successfully named “PMS” whilst maintaining a space
within the relationship to talk about the issue that was the focus of her
distress:
I’ve probably said, “Gee, I’ve blown up on that. I’m not happy
about the issue, but I’ve reacted in a way that really wasn’t justi-
fied to react that way.” And, yes, I have. I mean, not as an excuse,
but as a (.) Yes, I’ve reacted wrong (.) about the reaction rather
than the issue. [. . .] But an issue still needs to be dealt with sepa-
rate to why you reacted to it.
The risk for women in naming “PMS” to their intimate partner is that
once “PMS” becomes available as an explanation for their behavior, it
will become the only explanation. We can see this in the following ex-
tract in which Maggie described limiting “PMS” as the explanation for
her being upset by suggesting to her partner that he also bore some re-
sponsibility, “but you know you’ve probably said the wrong thing,”
something her partner did not accept and shifted the focus, and the re-
sponsibility, back to “PMS” and Maggie herself:
After about two or three hours, I’ll come back and say “Look, you
know what it’s like, this time of the month. I didn’t really mean
to say that,” most of the time, that’s what I do, yeah, “but you
know you’ve probably said the wrong thing,” but yeah, most of the
time (.) [Interviewer: And what does he do, does he say “oh that’s
alright”] Oh most of the time he does, but sometimes he goes,
“Well you know, you should do something about this PMS.”
A fear that “PMS” will become the only explanation, thus dismissing
women’s emotions or the issues to which they are reacting, was also a
common explanation given by women for not naming “PMS” to their
Mooney-Somers, Perz, and Ussher 67
partners, an account present in one-third of the sample, and the majority
being heterosexual relationships. For Celia, introducing “PMS” into the
post-dispute discussion with her partner would make it available as an
explanation for the dispute, something she avoided because she feared it
would trivialize both her reaction and the issue itself:
I’ve never, ever suggested that PMS or anything like that might be
a trigger for me going off. I think it’s because (.) I don’t want to
trivialize some of the issues that come up during this time by say-
ing, “Oh, it’s just that I had PMT.” [. . .] He’s triggered a reaction
in me, and it’s (.) PMT has exacerbated my reaction, I don’t want
to trivialize my reaction by saying, “Oh, it’s just that I had PMT,”
it’s really important that if he had crossed the boundaries (.) that
that be addressed and not trivialized.
Thus, other issues, whether they are relationship issues or issues re-
lated to the woman’s partner, can be dismissed by a partner framing a
woman’s distress as just “PMS”–a disempowering outcome made pos-
sible by women naming “PMS” in their interaction with their partner.
This also applied to women’s experiences of partners naming their
“PMS”; for Mary, her partner naming “PMS” meant: “my feelings in re-
lation to certain issues aren’t being recognized enough or they’re being
condensed into, ‘you’ve got PMS, this is being irrational.’ ” Thus, not
only can a partner offering “PMS” as the explanation for a woman’s dis-
tress dismiss it, it can also indicate a partner feels no action is required.
Only approximately one-tenth of interviewees, drew contrasts with pre-
vious relationships, both heterosexual and lesbian, in which the naming
of premenstrual change as “PMS” was negative, in contrast to their cur-
rent relationship. As Sheridan remarked, “It (PMS) had been named in
past relationships, I think, as well, but I don’t at all feel attacked now.”
The possibility that a partner was dismissing their distress as just
“PMS” was the source of women’s ambivalence in accounts of partners
naming ‘PMS’ in approximately one-quarter of the accounts. In the fol-
lowing extract, Merrin described how her partner naming her “PMS”
was helpful as it prompted her to engage in self-care; it could also be
experienced by her as dismissing and minimizing:
He’ll have already noticed, but (.) depending on my own, (.) where
I’m at, sometimes that’s a good way of then me checking in and
then doing, going to some sort of self-care around that. (.) Or if
his timing is wrong and then I’ll experience that as some sort of
68 WOMEN & HEALTH
minimization of what I’m what I’m saying [. . .] if I’m making a
complaint or I’m asking for something, and he hears that that as ir-
ritation, rather than a legitimate request [Interviewer: Okay.] then
he might, rather than attending to what I’m saying, he would see
that as more about, “Oh it must be that time of the month.”
The notion of timing in the above extract was a common feature in
women’s descriptions of partner naming, highlighting the fact that in-
dividual women’s experiences of their partner naming “PMS” were
not static. Further demonstrating the complexities of a partner naming
“PMS” was Eleanor’s description of her experience of the same act of
partner naming shifting from an initial negative response whilst she was
in the premenstrual phase, to a more positive experience when she re-
flected on it later:
If you look at that now and, you know you think, (.) and it’s a good
thing, and you think, “Gee, they do really know me. Isn’t that lovely
that they’re so in touch with me and how I feel?” [Interviewer:
Okay] But when you’re in that state and someone’s saying that to
you, that’s where I’m saying, you’re looking at it like, “How dare
they present me with that as an excuse? I’m actually angry.”
Some women, approximately one-third of the sample, reported their
partner did not name “PMS” despite being aware the woman was cur-
rently in her premenstrual phase, because they were aware that naming
“PMS” could be experienced as dismissing the woman’s feelings. Again,
this was an issue of timing, with partners often naming “PMS” at a later
time; something we can see in the following extract from Caroline:
He knows not to bring it up at the time, because it is probably a
touchy subject then, yes, so he will say it, we will talk about it after-
wards, but at the time I think he just tries to steer clear and brings me
a cup of tea.
“PMS” as Not a Legitimate Explanation for Distress
At the other end of the spectrum from “PMS” becoming the only ex-
planation for women’s distress, were descriptions of male partners not
accepting “PMS” as an explanation for women’s distress at all. This
theme did not emerge in any accounts from women in lesbian relation-
ships, but was present in approximately one-quarter of the heterosexual
Mooney-Somers, Perz, and Ussher 69
women’s accounts. The fear that their partner would not take their pre-
menstrual experiences seriously or recognize it as “PMS” was also an
important reason cited by heterosexual women for never naming “PMS”
to a partner. During her interview, Jackie talked about her need for time
to herself when she was premenstrual, describing an occasion when she
watched a DVD instead of getting dinner ready as an example. This
strategy was initially presented as relatively unproblematic: Jackie got
what she needed and experienced her partner as accepting. Later in the
interview this became a more complicated issue, when Jackie suggested
her partner’s acceptance was contingent on his not knowing it was
“PMS” he was accepting.
It wouldn’t be legitimate. It’s not like, “She has a cold, she’s not
feeling well.” Or, you know, “She’s broken her leg, and she can’t
walk.” You know, it (.) “She’s just not in a good mood today.” Emo-
tions [. . .] it’s not a legitimate sickness. [. . .] if you’ve got PMS,
well, you know, that’s not so good, but, you know, keep going.
This comparison of “PMS” with “real” illness or disability was some-
thing that came up regularly in the interviews, with women reporting they
felt “PMS” was not accepted by others as a time when a woman may not
be functioning at her usual level. Having a cold or a broken leg, in con-
trast, was positioned as being able recognizable and appropriate allow-
ances made; as Joyce commented, “it would be so much easier just to
be in a wheelchair and people to understand, without having to explain
anything.” The comparisons offered in women’s accounts were all rec-
ognized medical conditions, visually apparent disabilities and, perhaps
crucially, not exclusive to women. In contrast, “PMS” was positioned as
lacking externally conferred legitimacy, which for Jackie meant her ex-
perience and naming of “PMS” would not be sufficient for her partner:
You know if I had some proof that this is an actual medical condi-
tion that all women suffer from. Well, most, I can’t account for all
women, but if I do, most women must (.) Then it makes it a bit
more believable.
The dismissal of premenstrual change, or denial that premenstrual
distress was a serious issue for women, and a common feature of nega-
tive experiences of partners naming PMS; it was present in one-quarter
of the accounts from women in heterosexual relationships. As Lillian
commented,
70 WOMEN & HEALTH
I think sometimes when, what gets me is he’ll go, “Oh she’s got
PMS,” or “Here we go again,” well just those “well here we go
again” words is enough to send me off sometimes and I’ll just, “oh
yeah bloody hell you know it’s alright for you, you don’t have to
go through all this.”
For a small proportion of the heterosexual women, approximately
one-eighth of the sample, a partner naming PMS went beyond the mere
dismissal of their distress. As in Elaine’s case: “he used to sort of egg
me on a little bit, like he’d say, he’d make comments like ‘oh you’re
premenstrual’, or ‘who am I talking to today’ sort of thing, like I was
schizophrenic or something, and I, and that would make me even more
agitated and upset.”
DISCUSSION
Premenstrual changes are material-discursive-intrapsychic phenomena,
associated with cyclical changes in the body, the material circumstances
of a woman’s life, her mode of appraisal and coping with emotional or
behavioral change, and the discursive context within which such changes
are labeled as “PMS.” Building on previous research demonstrating the
importance of intimate relationships for understanding the emergence
and construction of premenstrual distress (Ussher, 2002, 2003a; Ussher
et al., 2007), this analysis focused on the ways in which the explicit
naming of “PMS” in intimate relationships functioned to construct and
explain premenstrual changes. That women reported naming themselves,
as premenstrual with little additional information being communicated,
suggests that naming “PMS” to a partner was a kind of shorthand, rely-
ing on a woman and her partner to having a shared construct of “PMS,”
usually the dominant cultural constructions of “PMS” which posi-
tion the premenstrual woman as being overwhelmed, vulnerable, and
emotional, or as reactive, irritable, angry, and lacking control. As a re-
sult, telling a partner she had “PMS” was often sufficient to produce a
shift in a partner’s behavior–providing support to a woman who was
feeling vulnerable or overwhelmed, or tolerating reactivity by not pro-
voking arguments or raising relationships issues during the premenstrual
phase. The same pattern was also seen in women’s positive accounts
of partner naming. In this way, naming “PMS” and taking up the posi-
tion of “PMS” sufferer was a positive and productive act. However,
women also described uncomfortable or undesired outcomes resulting
Mooney-Somers, Perz, and Ussher 71
from taking up the position, or being positioned as, a “PMS” sufferer,
as it implied the woman was not responsible for herself, or was like a
child, incompetent, and needed to be managed. Echoing the findings of
this study, women in Lee’s (2002) study reported similar feelings of
ambivalence, with many choosing not to label their experiences as
“PMS” as a result. Indeed, it has been argued that taking up the position
of “PMS” sufferer means taking on a broader construction of woman as
“emotional, unstable, and frail” (Raitt & Zeedyk, 2000, p. 121).
The notion of women splitting off unacceptable or atypical emotions
and behaviors during the premenstrual phase by positioning them as
not-me, thus framing the non-premenstrual self as the real-me is well-
documented (Chrisler & Caplan, 2002; Cosgrove & Riddle, 2003;
McDaniel, 1988; Ussher, 2004). A slightly different pattern was evident
in this analysis, with some women naming “PMS” to let their partners
know their distress was not their partner’s fault, with associated partner
relief at this attribution; that is, distress is split off from the relation-
ship. As already noted, this was particularly common in accounts from
women in lesbian relationships. Previous research findings demonstrate
that women are often concerned about the impact of their premenstrual
change on others (Elks, 1993), with many only seeing these premenstrual
changes as problematic–and framing them as “PMS”–when emotions
are outwardly expressed and thus likely to affect their family or partner
(Ussher, 2003a). The ways in which the label “PMS” is deployed with-
in relationships through explicit naming by a woman or her partner, and
how this positioning functions within the relationship, are important is-
sues of which clinicians working with women seeking treatment for
premenstrual distress need to be aware (McDaniel, 1988). Further re-
search is needed here to explore both partners’ experiences of women’s
premenstrual changes, and how couples negotiated these changes to-
gether, for example through case study analysis.
Clear and consistent differences were observed between experiences of
naming from women in lesbian relationships and those in heterosexual re-
lationships, with the former giving an overwhelmingly positive account of
partner naming and of partners responding to women self-naming. Echoing
previous accounts (Mooney-Somers, Ussher, & Perz, 2006; Ussher et al.,
2007), it appeared that male partners’ constructions and understandings
of “PMS,” as well as idealized representations of femininity which po-
sition premenstrual change as sign of pathology, played an important
role in women’s experiences of premenstrual changes in heterosexual
relationships. This difference in women’s accounts of naming “PMS” to
male or female partners suggests that a focus on women’s experiences
72 WOMEN & HEALTH
of premenstrual distress within lesbian and heterosexual relationships
would be a productive line of inquiry for future research.
An undesirable outcome of naming described by many women in
heterosexual relationships was that once “PMS” became an explanation
for their premenstrual emotions, behaviors or reactions, it could become
the only explanation. In this context, the naming of women’s behavior
as “PMS” threatened to negate the individual woman’s experience, such
that alternative meanings of her emotion or behavior–meanings that
may be uncomfortable or undesirable for her partner, or require rela-
tionship work–disappear. Some women described this as resulting in a
denial of the negative emotion they were feeling, or the issue they were
raising. We also saw that some women experienced their partner nam-
ing “PMS” as allowing their partner to deny any responsibility for an
issue that emerged premenstrually, because it was just “PMS.” Similar
findings have been reported in other studies (Sveinsdóttir et al., 2002;
Ussher, 2002). The dismissal of women’s experiences as just “PMS”
was not only an undesired outcome of naming, and the most common
negative experience of a partner explicitly naming “PMS,” it was also a
primary reason cited by women not to position feelings or behavior as
“PMS.” The consequences of this dismissal, reported in previous re-
search, include feeling misunderstood or unsupported, and feelings of
guilt or blame for not being able to control their emotions (Ussher,
2002), often leading to an increased sense of incompatibility with a part-
ner (Siegel, 1986). Naming their experiences as “PMS” then, may pro-
vide an opportunity for women to air grievances or emotions not usually
acceptable, something Elson (2002) described as a “redeployment” of the
reproductive body to meet women’s emotional needs. However, the la-
bel of “PMS” means that questions of legitimacy will always exist–are
these issues real or just “PMS” (Cosgrove & Riddle, 2003). A different
kind of legitimacy was a concern for women who described a partner’s
denial of “PMS” itself. These women cited the fear that their premen-
strual distress would not be taken seriously, not accepted as an expla-
nation at all, as the primary reason not to name, as well as a negative
outcome of partner naming. It has been suggested that an understanding
partner is one who accepts the woman’s self-positioning as a “PMS”
sufferer, and offers support as a result (Ussher et al., 2007), with those
not accepting the explanation of “PMS” being seen as “insensitive or ig-
norant” (Chrisler & Caplan, 2002, p. 290). We can see then, how the rela-
tionship between the naming of “PMS” and relationship disruption or
satisfaction is reciprocal and complex.
Mooney-Somers, Perz, and Ussher 73
Our recruitment and participant selection procedures led to a number
of limitations of our design and findings. First, because we recruited
women who self-identified as experiencing “PMS,” our sample did not
include women who experienced premenstrual changes but did not label
them as “PMS.” This excluded women who may have framed premen-
strual emotionaland bodily changes as part of everyday life, not as signs
of disorder or a source of distress, and thus did not use the term “PMS.”
These women have been described as “false negatives” in previous re-
search (Hamilton & Gallant, 1990). Equally, our sample may have in-
cluded “false positives,” women who described themselves as having
“PMS,” but who would not meet standardized diagnostic criteria. Future
research could usefully examine the differences between these groups
in the construction and naming of both “PMS” and premenstrual changes.
Second, with the exception of the gender of women’s partners, we ex-
amined no other relationship variables. Relationship duration, the pres-
ence or absence of children, the subjective evaluation of relationship
quality, and women’s relationship history are issues that seem likely to
play an important role in women’s experiences of naming “PMS” and are
worthy of investigation. Some participants in our study were currently
in a relationship with a woman but had previously been in a relationship
with a male partner. A systematic examination of these women’s expe-
riences may provide a unique opportunity to examine the difference be-
tween self-identifying as a “PMS” sufferer to a male or female partner.
Third, due to the purposive nature of our sampling for the semi-struc-
tured interview, we may have included a sample that was not represen-
tative of women with regard to premenstrual changes, which may limit
the generalizability of our findings. A final limitation was the cultural
and linguistic homogeneity of our sample. Whilst detailed information
related to cultural and linguistic background was not collected, the sam-
ple was comprised overwhelmingly of white Anglo-Australians, and all
of the women interviewed had good English language skills. This was
due in part to recruitment and data collection methods–no attempt was
made to recruit non-English speaking women, and funding was unavail-
able for translation during the interviews. However, previously docu-
mented cross-cultural variations in the construction of premenstrual
changes (Chrisler & Caplan, 2002) suggest the meaning and experience
of naming “PMS” to a partner may be considerably different for women
of non-Western backgrounds, and future research should explore this
issue more directly.
74 WOMEN & HEALTH
CONCLUSION
The analysis presented in this paper strikes a note of caution for the
widespread therapeutic advice in self-help texts that women should tell
others they are premenstrual (Chrisler & Caplan, 2002), and clinicians
working with women seeking treatment for premenstrual distress need
to be aware of the issues raised here. The act of naming premenstrual
change as “PMS” to an intimate partner involves negotiation of the
dominant cultural constructions of “PMS” which can render women’s
emotions and women’s bodies pathological, and deny the validity of
women’s distress and the issues they are raising premenstrually. How-
ever, naming her own premenstrual distress as “PMS” can allow women
to receive much needed support, or explain reactivity such that it can be
contained by the woman and her partner. It is thus clear that there are
both costs and benefits for women who position themselves within
these dominant constructions. Women’s perceptions of their partner’s
understanding of “PMS,” perceptions of their own needs, the likelihood
of these needs being met by their partner if they name, and any likely
negative outcomes they risk through naming, were all factors that fea-
tured in women’s accounts of naming or not naming. Thus, we need to
be aware of how and why women name “PMS” to a partner, and why
they choose not to, when advocating women ask for support. We also
need to consider the ways in which women ask for support more glob-
ally; for example, is it necessary for women to frame their need for sup-
port as an exception limited to the premenstrual phase. Indeed, is it
always necessary for women to name “PMS?” When working clinically
with partners, it is important to explore constructions of “PMS” and the
ways in which women can experience the naming of “PMS” as support-
ive, dismissing, or demeaning. Interventions with couples seeking treat-
ment or support for premenstrual distress need to develop a shared
understanding of premenstrual change that does not negate the individ-
ual woman’s experience, render feelings of vulnerability or overwhelm
as pathological, or deny legitimate relationship issues.
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RECEIVED: 05/07/07
REVISED: 09/17/07
10/09/07
ACCEPTED: 10/11/07
Mooney-Somers, Perz, and Ussher 77
