Premenstrual Syndromes : PMS and PMDD - Rutuja :: The site ...

2 THE PREMENSTRUAL SYNDROMES
The second was also Italian; Giovani da Padua in the
16th century described fairly clearly a link between
menstruation and depression.
Finally, Halbreich quotes the English physician James
Cowles Prichard, who wrote:
Some females at the period of the catamenia
undergo a considerable degree of nervous excitement,
morbid dispositions of mind are displayed
by them at these times, a wayward and capricious
temper, excitability in the feelings, moroseness in
disposition, a proneness to quarrel with their
dearest relatives and sometimes a dejection of
mind approaching to melancholia.
What could be closer to this as a description of PMS,
published in 1837? 6
Ian Brockington’s work on menstrual psychosis7 is
another valuable source of historical information. In it,
he quotes the works of JE Hitzig, Briere de Boismont,
and Richard von Krafft-Ebing.
In 1828, Hitzig described menstrual mood disorder
in relation to an acquittal for filicide. Having been condemned
to death for drowning her child, a mother
confided in a fellow prisoner that she experienced inexplicable
symptoms before and during her period. Following
medical observation of this and various physical
phenomena, she was acquitted.
Briere de Boismont described four cases of premenstrual
psychosis and described the relationship between
menstruation and surexcitation or overstimulation and
agitation:
Surexcitation: 8 synonymes: agitation, bouillonnement,
délire, ébullition, échauffement, effervescence,
exaltation, fièvre.
Brockington quotes frequently the seminal work of
Richard von Krafft-Ebing, 8 in which he described 60
cases of menstrual psychosis.
FROM PMT TO DALTON’S PMS:
PREMENSTRUAL TENSION
Robert Tilden Frank (1875–1949) 1 was a New York
gynecologist who graduated from Harvard and subsequently
worked in Columbia University and as chief of
the gynecological service at Mount Sinai Hospital in
New York. In 1931 he described for the first time the
condition premenstrual tension in a paper read at the
Academy of Medicine, New York:
My attention has been increasingly directed to a
large group of women who are handicapped by
premenstrual disturbances of a manifold nature.
It is well known that normal women suffer varying
degrees of discomfort preceding the onset of menstruation.
Employers of labour take cognisance of
this fact and make provision for the temporary
increased fatigability, irritability, lack of concentration
and attacks of pain. In another group of
patients the symptoms complained of are of sufficient
gravity to require rest in bed for one or
two days. In this group particularly, pain plays a
prominent role. There is still another class of
patients in whom grave systemic disorders manifest
themselves predominantly during the premenstrual
period.
Frank suggested initially that an excess of ovarian
estrogen (due to diminished excretion) was the underlying
cause, and he went on to illustrate this with cases –
some of which were treated by irradiation of the
ovaries, presumably resulting in a radiation menopause.
Jeliffe (1906) had hinted at this previously in a report in
the New York State Journal of Medicine (cited in
Halbreich), 5 but it was Frank who brought the subject
and its probable link with the ovarian cycle to the
attention of the medical world. Frank clearly was the
first to describe premenstrual tension but, at the same
time, Karen Horney, a German psychoanalyst who
moved to the USA in the early 1930s, described (independently
from Frank) ‘Die pramenstruellen Verstimmungen’
in 1931. 9 She highlighted the disappearance
of symptoms with the onset of menstruation and its
recurrent nature. She attributed the symptoms to estrogenic
hormone from the ovary but recognized that this
was related to the corpus luteum.
Between Frank’s publication and the writings of
Katherina Dalton in 1953, many theories were developed
and proposed for the etiology, including antidiuretic
hormone, hormone allergy, deficiency of various vitamins
and minerals (including potassium, calcium, and
magnesium), hypoglycemia/insulin excess, estrogen/
progesterone imbalance, pelvic congestion, ‘menotoxin’,
progesterone deficiency, and salt and water retention,
and of course there were many purely psychological
theories. It is not appropriate to discuss every one of
these: those that are important are discussed in other
chapters of this book, whereas those which are less
important can be found in the editor’s (P.M.S.O.) earlier
textbook, Premenstrual Syndrome. 10
FROM PMS TO THE AMERICAN
PSYCHIATRIC ASSOCIATION’S PMDD
In 1950, Morton was first to advocate the (subsequently
disproved) theory of progesterone deficiency