Why is the ‘nasty woman’ stereotype devastating for people with PMDD?

PMDD article

We don’t like angry women. We don’t like angry cis women, we don’t like angry people assigned female at birth, and we don’t like angry individuals who we perceive to look or act like women even if they identify as non-binary or as male. We just don’t like angry women. And often what this really means is we, as a society, do not like it when women reach out beyond special criteria we have set for them. Angry, happy, weepy, chatty, clever, impassioned, or unmoved. Whatever the mood, someone, somewhere will be rolling their eyes or foaming at the mouth and muttering ‘women!’.

Certain whitewashed, toothless period dramas would have us believe that women were modest, subordinate, wilting creatures right up until the 1960s and the birth of the mini-skirt. Yet women have been making society uncomfortable with their ideas and their talking and their contributions since…always.

In 1798, Richard Polwhele published a poem entitled ‘Unsex’d Females’, calling out women writers for defying ‘nature’s law’ with their political ideas and racy sex lives. Essentially, he’s whining about Mary Wollstonecraft and how her and her fellow female political thinkers thwarted feminine ideals by speaking up alongside their male counterparts. Polwhele sought to silence these women with the oldest trick in the book: by calling them out for being unwomanly, ‘unsex’d’.

Pohwhele was not the first and will not be the last to attempt to dismiss and undermine women in this way. Cut to 2009 and we saw lawyers, members of the press, and colleagues label US Supreme Court judge Sonia Sotomayor “a terror on the bench,” “nasty,” “overly aggressive,” and “a bit of a bully”, despite the fact that linguistic studies show she uses the same conversational tactics as the average male Supreme Court judge.

Dianne Abbot’s skills as a politician are undermined not only through sexist comments but by thinly veiled racism — shockingly, she received 10 times more abuse than any other woman MP in the run up to the 2017 election.

In 2011 David Cameron told the then Shadow Chief Secretary to the Treasury, Angela Eagle, to ‘calm down dear’, and, in a more recent example, Donald Trump interrupted Hilary Clinton, while she was speaking in the presidential debate, to call her a ‘nasty woman’.

The problem is worse for women of colour, who are forced to fight against a tide of misogynoir and the stereotype of the ‘angry black woman’. Dianne Abbot’s skills as a politician are undermined not only through sexist comments but by thinly veiled racism — shockingly, she received 10 times more abuse than any other woman MP in the run up to the 2017 election.

So what has this all got to do with PMDD and the health of women and individuals assigned female at birth? PMDD (Premenstrual Dysphoric Disorder) is a hormone-based mood disorder that causes stretches of depression, mood swings and a host of other symptoms in the fortnight leading up to menstruation.

PMDD impacts the lives of an estimated 3-8% of people who menstruate of reproductive age, with an estimated 18% of cases leading to suicidal ideation.1 Even so, the majority of those with the condition report struggling to get adequate treatment while others feel they are not taken seriously and many suffer for decades without support. They believe —or are told— that their symptoms are ‘normal’ PMS. By far one of the most talked about symptoms among the PMDD community are the visceral, uncontrollable rages, and the destructive impact they have on their lives and relationships with loved ones.

A group of people living with PMDD agreed to open up to me about their experiences. One describes the reality of living with PMDD as “leading a ‘normal’ life until about 5 days before my period – then it’s as if I need an exorcism, as if I have become possessed”. Having completed training as a yoga teacher, they use breath work and other techniques to try to remain calm and in control but then something switches. “I lose all control of my own actions and reactions,” they say. “Its wrath sneaks up fast and vicious and usually with the smallest of triggers.”

Another, Lynda, says, “From when I bleed until ovulation I love, laugh, smile, and achieve. From ovulation until the next bleed I have to retreat, brace myself, weather the storm of psychological distress until its time to live again.” A third person simply says, “I say it’s like I’m Mrs. Jekyll and Mrs. Hyde!”

“I lose all control of my own actions and reactions. Its wrath sneaks up fast and vicious and usually with the smallest of triggers.”

With these symptoms occurring in such distinct patterns it should be relatively simple to recognise and diagnose PMDD. However, there is little awareness of the disorder and many go years, even decades without the support they need. This is in part due to the fact that the symptoms of PMDD, particularly the wild mood swings and plummeting depressions, play into those age-old stereotypes that have been deployed against people who menstruate for hundreds of years. These exhausting, destructive symptoms are being dismissed as ‘womanly’ outbursts rather than being flagged as signs of a treatable disorder.

Even once receiving a diagnosis it can be hard to open up about the realities of living with PMDD. The feminist movement has spent literally hundreds of years fighting against the harmful stereotypes of women as irrational, unpredictable creatures living at the whims of their reproductive systems. Even now, there is still a tendency to lean away from having discussion about hormones and the menstrual cycle.

And when the subject is breached in the mainstream media the result is rarely nothing more nuanced than the image of a woman wrapped in a duvet devouring ice cream. As a result, there is understandably a real reluctance to admit the impact PMDD has on the lives of those who have it for fear of the repercussions.

One woman who reached out to an online group I am part of recently excused herself from a meeting on a day she knew she would be highly vulnerable to mood swings. As a result she was harshly reprimanded. Yet her only other choice would have been to roll the dice and hope not to have an outburst at her colleagues. And what then? She would have run the risk of appearing unprofessional and ‘hysterical’.

So what is the solution? Well for a start we need to push for a better understanding not only of PMDD but the entire menstrual cycle. There are many people who menstruate out there with their own set of invisible struggles.

We need more funding and more research into this area. Medical and mental health professionals need a deeper knowledge of the impact of the menstrual cycle on everyday lives, and better training to distinguish between typical hormonal shifts and disorders like PMDD. Sex education needs to be part of the curriculum for every school, and needs to include young people of all genders in discussions about hormones and the menstrual cycle.

We have to stop treating menstruation and related issues as being something trivial and ridiculous. The more we can foster a general level of understanding about this topic throughout society, the better off we will all be. Parents, partners and friends will know how better to support loved ones. Workplaces will have well-informed policies for how to accommodate their employee’s needs. Individuals will be empowered to look after themselves and ask for help if they need it. And, beyond this, we will be one step further in dismantling those ugly, hateful stereotypes that continue to be used to silence the women of the world.

Page last updated April 2018

Olive Mackintosh-Lowe

Olive Mackintosh-Lowe is a London-based writer and activist. You can follow her campaign to raise awareness and improve treatment of PMDD via @FightPMDD. You follow her on Twitter via @OliveMLowe and on Instagram via @oliveldn. For more information on her work you can email Olive at omlowe@hotmail.co.uk.

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  1. Pilver, C.E., Premenstrual dysphoric disorder as a correlate of suicidal ideation, plans, and attempts among a nationally representative sample, Social Psychiatry and Psychiatric Epidemiology, March 2014, vol 48, issue 3, pp 437-446