Illustration: Cathy Wilcox
PREMENSTRUAL distress is largely a myth, and women who experience it usually have their blokes to blame.
So says Jane Ussher, professor of women's health psychology at the University of Western Sydney, who says couples therapy is a potential treatment for severe cases of premenstrual moodiness.
''The notion that the majority of women are mad or bad once a month is a myth,'' she says.
But doubting the moody blood blues is a hard row to hoe for a female academic. After years of inciting female colleagues to anger by ''denying their experience'', Professor Ussher has carefully honed her argument.
Now she says women clearly experience physical changes and discomfort around menstruation. But although many believe the hype, only a tiny minority - between 1.5 and 5 per cent - experience premenstrual mood changes, such as depression, anger or irritability, which can affect relationships.
In an angrily received article for the website The Conversation, she said a Canadian review of 47 scientific studies found ''only 15 per cent reported increased negative mood premenstrually''.
In 40 per cent of the studies there was no association between mood and the menstrual cycle and 40 per cent reported negative mood in the premenstrual and menstrual phases.
The fact that premenstrual syndrome appears to be an exclusively Western ailment adds to the picture of it as a cultural construct. Women studied in China, India and Hong Kong either don't report negative moods premenstrually or don't attribute them to PMS, she says.
''What many women are doing is self-silencing for three weeks a month, trying to be good, trying to be nice to everybody, trying to cope,'' the professor says.
But in the fourth week, they have a ''socially sanctioned reason … to be angry and cranky''.
Their periodic ''understandable reaction to the stresses'' is invariably dismissed as PMS, so the cycle of self-silencing and frustration begins again.
She says severe cases of monthly moodiness are more common among women in their mid-30s or older with multiple responsibilities, ''working hard to deadlines, with kids at home, cooking the dinner'', and in women with relationship difficulties, or whose partners provide little understanding and support.
Professor Ussher does not blame men but does say ''the partner's response to the woman is very important in terms of how she copes - but also the cause of the premenstrual anger and irritation is really the partner''.
Unless, perhaps, the partner is a woman. A study by Professor Ussher and a colleague, Janette Perz, of 15 lesbians and 10 of their partners found where there was ''partner empathy'', premenstrual changes were less distressing and the women coped better.
Premenstrual distress can be reduced with ''psychological interventions'' to help women manage their stress and express their feelings throughout the month, says Professor Ussher.
Blaming menstruation for women's moods goes back to Plato and Hippocrates. The term ''premenstrual tension'' was coined in the 1930s and made popular in the 1950s.