Exploring PMS is a great idea, but The Period Brain can be simplistic

The Period Brain
Sarah Hill Vermilion (UK); Harvest (US)

During my time living at home, my mother would always notice when my period was about to start: I would rummage through snack provisions more often and my mood would shift. I distinctly remember the chaos that ensued when she mistakenly bought chicken breasts instead of thighs on a night I was set to cook.

These reactions are emblematic of premenstrual syndrome (PMS), a prevalent issue highlighted in the book The Period Brain: The new science of why we PMS and how to fix it. Author Sarah Hill, known for her insights on the impact of birth control on mental health, explores ways to alleviate PMS, particularly emphasizing lifestyle modifications.

For many years, women’s health has been overlooked by researchers, and Hill, with her background in evolutionary psychology and a position leading a health and relationships lab at Texas Christian University, is in a prime position to address these gaps. Yet, at times, her conclusions seem insufficient.

She posits that PMS may partly result from dietary recommendations suggesting women have an average intake of around 2000 calories, contrasting with findings that point to an increase of 140 calories needed during the luteal phase—which aligns with when PMS typically manifests. Hill claims that adherence to these guidelines leads to cravings and food fixation, culminating in binge eating that exacerbates symptoms.

However, on a more personal note, I don’t know many women who meticulously track their caloric intake to that level, nor do I know anyone who would forgo a snack of 140 calories—less than you’d find in a handful of veggies and hummus—if they felt it necessary. This suggests a potential oversimplification from Hill regarding PMS triggers.

Despite referencing numerous studies, Hill often lacks specifics on sample sizes and durations of interventions, which are crucial for assessing the validity of research findings, especially since smaller sample sizes risk overlooking significant genetic variability.

The role of genetics in PMS is minimally addressed. Though specific PMS-related genes remain unidentified, it’s worth noting that the condition appears more frequently among identical twins compared to fraternal twins, suggesting a genetic component. Likewise, genetics play a role in various menstrual cycle aspects, including duration and onset of menopause, indicating that PMS could eventually be linked genetically.

Hill makes several recommendations for symptom relief which include various unverified supplements, increased sunlight exposure, or changing exercise routines throughout the menstrual cycle (though the latter may have merit). It would be beneficial for her to consider that the severe challenges faced by many might stem more from genetic factors than just lifestyle choices.

I concur with Hill regarding the necessity for more in-depth studies throughout different phases of the menstrual cycle to better comprehend their effects on drug metabolism and the body’s reaction to psychological therapies. Furthermore, acknowledging that our mood fluctuations may be a natural reaction to hormonal variations might aid in managing them—perhaps some foresight could have helped avoid my own ‘chicken-gate’ situation.

While The Period Brain didn’t grant me any groundbreaking strategies for alleviating PMS, every publication centered on women’s health contributes to diminishing the stigma surrounding conditions like PMS and could inspire further research, which is undoubtedly a positive outcome.