Breaking the cycle: a psychological approach to supporting premenstrual syndrome patients.

The issue of premenstrual syndrome (PMS) is one that is very close to my heart – I suffered from it for 35 years until the onset of the menopause, and I regularly receive letters from women whose life problems are underpinned by premenstrual stress. Happily, the medical profession has taken huge strides forward in recent years not only in acknowledging the syndrome, but also in diagnosing and treating it. We are in a hugely better place than when I began to menstruate and my general practitioner told me that since I had admitted that my appalling pain level would still leave me capable of leaving my bed in case of fire, he wouldn't be prescribing me any painkillers! However, there are still few cohesive models of the psychological structure of PMS. It is labelled as a physiological condition, and the anxiety, depression, anger and guilt that women suffer, along with the devastation that suffering wreaks on couples and families, are seen as inexorably linked to physiology and treated mainly by medical treatment. I’m not underestimating the sterling work done with PMS sufferers by the therapeutic community; but in the medical profession we don’t seem to hold a cohesive model of how we can use ‘mental approaches’ to help PMS patients as we do with, for example, patients who need to stop smoking or lose weight.