The Scientific Method and Ethical Treatment of Premenstrual Complaints

  • Elaine A. Blechman
  • Connie J. Clay


Many women seek help for premenstrual complaints and many practitioners are eager to sell them services. The quality of the medical and psychiatric services they receive is questionable, reflecting inadequate scientific knowledge about premenstrual complaints and unjustified acceptance by practitioners of unverified assumptions about etiology and treatment. In the legal arena as well, decisions are made regarding women with premenstrual complaints that are simply not supported by credible, empirical evidence. Here again, the problem is twofold: Premenstrual complaints have only recently become the target of methodologically rigorous scientific inquiry (see chapters by Halbreich & Endicott, O’Brien, Reid, Rubinow, Sampson, and Steiner & Haskett, this volume); as a result, relevant knowledge is limited. In addition, the courts have accepted assumptions about premenstrual complaints, some of which are unverified and some of which are inconsistent with available, albeit scarce, empirical evidence.


Psychosomatic Medicine Ethical Treatment Premenstrual Syndrome Premenstrual Symptom Primary Dysmenorrhea 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abplanalp, J. M., A. F. Donnelly, and L. M. Rose, 1979. Psycho-endocrinology of the menstrual cycle: 1. Enjoyment of daily activities and moods.Psychosomatic Medicine 41: 587–604.Google Scholar
  2. American Psychiatric Association, in press.Diagnostic and Statistical Manual of Mental Disorders(revised edition). Washington, D.C.Google Scholar
  3. Averill, J. and M. Rosen, 1972. Vigilant and nonvigilant coping strategies and psychophysiological stress reactions during the anticipation of electric shock.Journal of Personality and Social Psychology 23: 128–141.PubMedCrossRefGoogle Scholar
  4. Bäckström, T., D. Sanders, R. Leask, D. Davidson, P. Warner, and J. Bancroft, 1983. Mood, sexuality, hormones, and the menstrual cycle. II. Hormone levels and their relationship to the premenstrual syndrome.Psychosomatic Medicine 45: 503–507.Google Scholar
  5. Barlow, D. H., S. C. Hayes, and R. O. Nelson, 1984.The Scientist Practitioner: Research and Accountability in Clinical and Educational Settings. Pergamon Press, New York, NY.Google Scholar
  6. Bergsjo, P., H. Jenssen, and O. D. Vellar, 1975. Dysmenorrhea in industrial workers.Acta Obstetrica et Gynecologica Scandinavica 54: 255–259.CrossRefGoogle Scholar
  7. Blechman, E. A., 1984. Women’s behavior in a man’s world: Sex differences in competence. In: E. A. Blechman (Ed.),Behavior Modification with Women. Guilford Press, New York, NY.Google Scholar
  8. Blechman, E. A. and K. B. Brownell (Eds.), in press-a.Behavior Medicine with Women. Pergamon Press, New York, NY.Google Scholar
  9. Blechman, E. A. and K. B. Brownell, in press-b. Competence and physical hardiness. In: E. A. Blechman and K. B. Brownell (Eds.),Behavior Medicine with Women. Pergamon Press, New York, NY.Google Scholar
  10. Blechman, E. A., C. J. Clay, M. D. Kipke, and W. B. Bickel, in press. Premenstrual complaints. In: E. A. Blechman and K. B. Brownell (Eds.),Behavior Medicine with Women. Pergamon Press, New York.Google Scholar
  11. Brody, J. E., 1986. Treatment techniques vary for premenstrual syndrome.The New York Times,April 16, p. C-10.Google Scholar
  12. Chan, W. Y., 1983. Prostaglandins and nonsteroidal antiinflammatory drugs in dysmenorrhea.Annual Review of Pharmacological Toxicology 23: 131–149.CrossRefGoogle Scholar
  13. Chan, W. Y. and M. Y. Dawood, 1980. Prostaglandin levels in menstrual fluid of nondysmenorrheic and of dysmenorrheic subjects with and without oral contraceptive or ibuprofen therapy. In: B. Samuelsson, P. W. Ramwell, and R. Paoletti (Eds.),Advances in Prostaglandin and Thromboxane Research, Vol. 8. Raven Press, New York, NY.Google Scholar
  14. Chan, W. Y., M. Y. Dawood, and F. Fuchs, 1979. Relief of dysmenorrhea with the prostaglandin synthetase inhibitor ibuprofen: Effect on prostaglandin levels in menstrual fluid.American Journal of Obstetrics and Gynecology 135: 102–108.PubMedGoogle Scholar
  15. Chan, W. Y., M. Y. Dawood, and F. Fuchs, 1981. Prostaglandins in primary dysmenorrhea. American Journal of Medicine 70: 535–540.Google Scholar
  16. Chan, W. Y., F. Fuchs, and A. M. Powell, 1983. Effects of naproxen sodium on menstrual prostaglandins and primary dysmenorrhea.Journal of Obstetrics and Gynecology 61: 285–291.Google Scholar
  17. Chan, W. Y. and J. C. Hill, 1978. Determination of menstrual prostaglandin levels in nondysmenorrheic and dysmenorrheic subjects.Prostaglandins 15: 365–375.PubMedCrossRefGoogle Scholar
  18. Chesney, M. A. and D. L. Tasto, 1975a. The development of the menstrual symptom questionnaire.Behavior Research and Therapy 13: 237–244.CrossRefGoogle Scholar
  19. Chesney, M. A. and D. L. Tasto, 1975b. The effectiveness of behavior modification with spasmodic and congestive dysmenorrhea.Behavior Research and Therapy 13: 245–253.CrossRefGoogle Scholar
  20. Clark, A. and D. N. Ruble, 1978. Young adolescents’ beliefs concerning menstruation.Child Development 49: 231–234.CrossRefGoogle Scholar
  21. Coppen, W. R. and N. Kessel, 1963. Menstruation and personality.British Journal of Psychiatry 109: 711–721.PubMedCrossRefGoogle Scholar
  22. Cox, D. J., 1977. Menstrual symptom questionnaire: Further psychometric evaluation.Behavior Research and Therapy 15: 506–508.CrossRefGoogle Scholar
  23. Cox, D. J. and R. G. Meyer, 1978. Behavioral treatment parameters with primary dysmenorrhea.Journal of Behavioral Medicine 1: 297–309.PubMedCrossRefGoogle Scholar
  24. Csapo, A. 1., 1980. A rationale for the treatment of dysmenorrhea.Journal of Reproductive Medicine 25: 213–221.PubMedGoogle Scholar
  25. Dalton, K., 1969.The Menstrual Cycle. Pantheon Books, New York, NY.Google Scholar
  26. Dawood, M. Y., 1981. Dysmenorrhea and prostaglandins: Pharmacological and therapeutic considerations.Drugs 22: 42–56.PubMedCrossRefGoogle Scholar
  27. Endicott, J., U. Halbreich, S. Schacht, and J. Nee, 1981. Premenstrual changes and affective disorders.Psychosomatic Medicine 43: 519–529.PubMedGoogle Scholar
  28. Englander-Golden, P. and G. Barton, 1983. Sex differences in absence from work: A re interpretation.Psychology of Women Quarterly 8: 185–188.CrossRefGoogle Scholar
  29. Fordyce, W. E., A. H. Roberts, and R. A. Sternback, 1985. The behavioral management of chronic pain: A response to critics.Pain 22: 113–125.Google Scholar
  30. Halbert, D. R. and L. M. Demers, 1978. A clinical trial of indomethacin and ibuprofen in dysmenorrhea.The Journal of Reproductive Medicine 21: 219–222.PubMedGoogle Scholar
  31. Halbert, D. R., L. M. Demers, and D.E.D. Jones, 1976. Dysmenorrhea and prostaglandins.Obstetrical and Gynecological Survey 31: 77–81.PubMedCrossRefGoogle Scholar
  32. Halbreich, U. and J. Endicott, 1982. Classification of premenstrual syndromes. In: R. C. Friedman (Ed.),Behavior and the Menstrual Cycle. Marcel Dekker, New York, NY.Google Scholar
  33. Halbreich, U. and J. Endicott, 1985. Methodological issues in studies of premenstrual changes.Psychoneuroendocrinology 10: 10–32.CrossRefGoogle Scholar
  34. Halbreich, U., J. Endicott, and J. Nee, 1983. Premenstrual depressive changes.Archives of General Psychiatry 40: 535–542.PubMedCrossRefGoogle Scholar
  35. Hoes, M. J., 1980. The chronopathology of premenstrual psychopathology.Medical Hypotheses 6: 1063–1075.PubMedCrossRefGoogle Scholar
  36. Janbu, T., P. Lokken, and B. Nesheim, 1979. Effect of acetylsalicyclic acid, paracetamol and placebo on pain and blood loss in dysmenorrheic women.Acta Obstetrica et Gynecologica Scandinavica 87: 81–85.CrossRefGoogle Scholar
  37. Janiger, O., R. Riffenburgh, and R. Kersh, 1972. Cross cultural study of premenstrual symptoms.Psychosomatics 13: 226.PubMedGoogle Scholar
  38. Kistner, R. W., 1971.Gynecology, Principles, and Practices. Year Book Medical Publishers, Chicago, IL, pp. 584–587.Google Scholar
  39. Mccance, R. A., M. C. Luff, and E. E. Widdowson, 1937. Physical and emotional peridocity in women.Journal of Hygiene 37: 571–605.PubMedCrossRefGoogle Scholar
  40. Michael, R. P., R. W. Bonsall, and M. Kutner, 1975. Volatile fatty acids, “copulins,” in human vaginal secretions.Psychoneuroendocrinology 1: 153–163.PubMedCrossRefGoogle Scholar
  41. Miller, S. M., 1979. Coping with impending stress: Psychophysiological and cognitive correlates of choice.Psycho physiology 16: 572–581.Google Scholar
  42. Moos, R. H., 1968. The development of a Menstrual Distress Questionnaire.Psychosomatic Medicine 30: 853–867.PubMedGoogle Scholar
  43. Most, A. F., N. F. Woods, G. K. Dery, and B. M. Most, 1981. Distress associated with menstruation among Israeli women.International Journal of Nursing Studies 18: 61–71.PubMedCrossRefGoogle Scholar
  44. Parlee, M. B., 1974. Stereotypic beliefs about menstruation: A methodological note on the Moos Menstrual Stress Questionnaire and some new data.Psychosomatic Medicine 36: 229–240.PubMedGoogle Scholar
  45. Parlee, M. B., 1982. Changes in moods and activation levels during the menstrual cycle in experimentally naive subjects.Psychology of Women Quarterly 7: 119–131.CrossRefGoogle Scholar
  46. Patterson, G. R. and J. B. Reid, 1984. Social interactional processes within the family: The study of moment-by-moment family transactions in which human social development is imbedded.Journal of Applied Developmental Psychology 5:237–262.CrossRefGoogle Scholar
  47. Reid, R. L., 1985. Premenstrual Syndrome. In: J. M. Leventhal (Ed.),Current Problems in Obstetrics, Gynecology and Fertility, Vol. 8. Year Book Medical Publishers, Chicago, IL, pp. 2–57.Google Scholar
  48. Reid, R. L. and S. C. Yen, 1981. Premenstrual syndrome.American Journal of Obstetrics and Gynecology 139: 85–104.PubMedGoogle Scholar
  49. Ruble, D. N., 1977. Premenstrual symptoms: A re interpretation.Science 197: 291.PubMedCrossRefGoogle Scholar
  50. Scambler, A. and G. Scambler, 1985. Menstrual symptoms, attitudes, and consulting behavior.Social Science Medicine 20: 1065–1068.CrossRefGoogle Scholar
  51. Seligman, M.E.P., 1968. Chronic fear produced by unpredictable (unsignalled) electric shock.Journal of Comparative and Physiological Psychology 66: 402–411.PubMedCrossRefGoogle Scholar
  52. Shangold, M. M., S. Aksel, D. W. Schomberg, and C. B. Hammond, 1976. Plasma prostaglandin F2a levels in dysmenorrheic women.Fertility and Sterility 27: 1171–1175.PubMedGoogle Scholar
  53. Sibergeld, S., N. Brost, and E. P. Nobel, 1971. The menstrual cycle: A double-blind study of symptoms, mood, and behavior, and biochemical variables using Enovid and placebo.Psychosomatic Medicine 33: 411–428.Google Scholar
  54. Society for Menstrual Cycle Research, 1986 (Winter). Task Force report on guidelines for menstrual cycle research.Newsletter 2: 1–2.Google Scholar
  55. Svennerund, S., 1959. Dysmenorrhea and absenteeism: Some gynaecological and medicosocial aspects.Acta Obstetrica Gynecologica Scandinavica 38 (Suppl. 2): 5–16.Google Scholar
  56. Taylor, J. W., 1979. The timing of menstruation-related symptoms assessed by a daily symptom rating scale.Acta Psychiatrica Scandinavica 60: 87–105.PubMedCrossRefGoogle Scholar
  57. Vila, J. and H. R. Beech, 1980. Premenstrual symptomatology: An interaction hypothesis.British Journal of Social and Clinical Psychology 19: 73–80.PubMedCrossRefGoogle Scholar
  58. Widholm, O., 1979. Dysmenorrhea during adolescence.Acta Obstetrica Gynecologica Scandinavica 87: 61–66.CrossRefGoogle Scholar
  59. Wood, C., L. E. Larsen, and R. Williams, 1979. Menstrual characteristics of 2,343 women attending the Shepard Foundation.Australia and New Zealand Journal of Obstetrics and Gynecology 19: 107–110.CrossRefGoogle Scholar
  60. Wood, N. F., A. Most, and G. K. Dery, 1982. Prevalence of perimenstrual symptoms.American Journal of Public Health 72: 1257.CrossRefGoogle Scholar
  61. Ylikorkala, O. and M. Dawood, 1978. New concepts in dysmenorrhea.American Journal of Obstetrics and Gynecology 130: 833–847.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Elaine A. Blechman
    • 1
  • Connie J. Clay
    • 1
  1. 1.Montefiore Medical CenterAlbert Einstein College of MedicineBronxUSA

Personalised recommendations