Is PMS a mental or physical illness?

• Position: Pre-menstrual syndrome

A decade ago, physicians and health care professionals were disputing the reality of pre-menstrual syndrome (PMS), with many dismissing it as a psychosomatic manifestation. Now, although most accept PMS as a valid health problem, there is new debate in the wake of a push by the American Psychiatric Association to declare PMS a mental. rather than physical, disorder.

If PMS is reclassified as a psychiatric disorder, it could spell bad news for proper assessment of the condition by making females even more reluctant to seek treatment, warns Norma Leslie, director of the Women's Health Education and Counseling Center, University of Oklahoma Health Sciences Center. "The studies which have been done are not conclusive as to whether PMS is a psychological or a hormonal condition. My personal opinion is that, while the symptoms are generally caused by a hormonal imbalance, there is a subset of women with severe PMS who also have poor coping and communication skills. In this particular group, PMS symptoms can manifest themselves in ways similar to a mental disorder, such as verbal abuse, violent behavior, extreme irritability, and depression. I often recommend counseling as part of an over-all treatment plan for these patients."

PMS affects as many as 50% of women, most frequently those in their, 30s. About 10% may experience symptoms severe enough to disrupt their normal activities. These include bloating, aching, breast pain, headaches, weight gain, uncontrollable anger, anxiety. and depression. They typically manifest...