Robyn Stein DeLuca: The good news about PMS

Prevoditelj: Ivan Balić Recezent: Ivan Stamenković

How many people here have heard of PMS?

Koliko vas je čulo za PMS?

Everybody, right?

Svi, je li tako?

Everyone knows that women go a little crazy

Svi znamo da žene malo polude

right before they get their period,

neposredno prije mjesečnice,

that the menstrual cycle throws them onto an inevitable hormonal roller coaster

da ih menstrualni ciklus baci u hormonalni ringišpil

of irrationality and irritability.

nerazumnosti i živčanosti.

There's a general assumption

Postoji opća pretpostavka

that fluctuations in reproductive hormones cause extreme emotions

da promjene u reproduktivnim hormonima uzrokuju intenzivne osjećaje

and that the great majority of women are affected by this.

i da je velika većina žena pogođena time.

Well, I am here to tell you that scientific evidence says

Pa, ja sam tu da vam kažem da znansveni dokazi govore

neither of those assumptions is true.

da nijedna od ovih pretpostavki nije točna.

I'm here to give you the good news about PMS.

Ja sam tu da vam prenesem dobre vijesti o PMS-u

But first, let's take a look at how firmly the idea of PMS

Ali prvo, pogledajmo koliko je ideja o PMS-u

is entrenched in American culture.

ukorijenjena u američku kulturu.

If you examine newspaper or magazine articles,

Ako proučite novine ili članke u časopisima

you'll see how widely assumed it is that everyone gets PMS.

primjetit ćete koliko je raširena ideja da svaka žena ima PMS

In an article in the magazine Redbook titled "You: PMS Free,"

U jednom članku u časopisu Redbook s naslovom "Ti: Bez PMS-a,"

readers were informed that between 80 to 90 percent of women suffer from PMS.

čitatelji su saznali da između 80 i 90 posto žena pati od PMS-a.

L.A. Muscle magazine warned its readers

L.A. Muscle časopis upozorava svoje čitatelje

that 40 to 50 percent of women suffer from PMS,

da između 40 i 50 posto žena pati od PMS-a,

and that it plays a major role in women's mental and physical health,

i da on ima važnu ulogu u mentalnom i fizičkom zdravlju žena,

and a couple of years ago, even the Wall Street Journal

a prije nekoliko godina, čak je i Wall Street Journal

ran an article on calcium as a treatment for PMS,

objavio članak o kalciju kao sredstvu borbe s PMS-om

asking its female readers,

pitajući svoje čitateljice,

"Do you turn into a witch every month?"

"Pretvarate li se u vješticu svaki mjesec?"

From all these articles, you would think there must be a mountain of research

Promatrajući sve ove članke, zaključujete da sigurno postoji hrpa istraživanja

verifying the widespread nature of PMS.

koja potvrđuju ovu široko poznatu prirodu PMS-a

However, after five decades of research,

Međutim, nakon pet desetljeća istraživanja

there's no strong consensus on the definition, the cause,

ne postoji opća suglasnost, o definiciji, uzroku,

the treatment, or even the existence of PMS.

liječenju, ili čak postojanju PMS-a.

As most commonly defined by psychologists,

Kako ga najčešće definiraju psiholozi,

PMS involves negative behavioral, cognitive and physical symptoms

PMS podrazumijeva negativno ponašanje, kognitivne i fizičke simptome

from the time of ovulation to menstruation.

od vremena ovulacije do menstruacije

But here's where it gets tricky.

Ali evo gdje postaje zamršeno,

Over 150 different symptoms have been used to diagnose PMS,

Preko 150 različitih simptoma je korišteno za dijagnozu PMS-a,

and here are just a few of those.

a ovo su samo neki od njih.

Now, I want to be clear here.

Želim biti jasna ovdje.

I'm not saying women don't get some of these symptoms.

Ne kažem da žene nemaju neke od ovih simptoma

What I'm saying is that getting some of these symptoms

Ono što govorim je da postojanje nekih od ovih simptoma

doesn't amount to a mental disorder,

ne znači i mentalni poremećaj,

and when psychologists come up with a disorder

i kada psiholozi detektiraju poremećaj

that's so vaguely defined,

koji je tako nejasno definiran,

the label eventually becomes meaningless.

to obilježje konačno postaje besmisleno.

With a list of symptoms this long and wide,

Sa ovako širokim i dugačkim popisom simptoma,

I could have PMS, you could have PMS,

Moguće je da ja imam PMS, da vi imate PMS

the guy in the third row here could have PMS,

dečko u trećem redu može imati PMS

my dog could have PMS. (Laughter)

moj pas može imati PMS. (Smijeh)

Some researchers said you had to have five symptoms.

Neki istraživači tvrde da treba imati pet simptoma

Some said three.

Neki kažu tri.

Other researchers said that symptoms were only meaningful

Drugi istraživači tvrde da simptomi nešto znače

if they were highly disturbing to you,

jedino ako vas jako uznemiruju,

but others said minor symptoms were just as important.

a drugi govore da su manji simptomi jednako važni.

For many years, because there was no standardization

Dugi niz godina, zbog nepostojanja standardizacije

in the definition of PMS,

kod definiranja PMS-a

when psychologists tried to report prevalence rates,

kada su psiholozi pokušali izvijestiti o stopi rasprostranjenosti

their estimates ranged from five percent of women

njihove procjene su se protezale od 5 posto žena

to 97 percent of women,

do 97 posto žena,

so at the same time almost no one and almost everyone had PMS.

tako da u isto vrijeme skoro nitko nije imao PMS, ali i skoro svi.

Overall, the weaknesses in the methods of research on PMS have been considerable.

Općenito, nedostaci u metodama istraživanja PMS-a su bili značajni.

First, many studies asked women to report their symptoms retrospectively,

Mnoga istraživanja su tražila žene da svoje simptome retrospektivno poredaju

looking to the past and relying on memory,

gledajući u prošlost i oslanjajući se na sjećanja

which is known to inflate reporting of PMS

za što je poznato da izvješće o PMS-u učini prenapuhanim.

compared to what's called prospective reporting,

u usporedbi sa onim što se naziva prospektivno izvješće,

which involves keeping a daily log of symptoms

koje uključuje svakodnevni unos simptoma u dnevnik

for at least two months in a row.

u razdoblju od najmanje 2 mjeseca zaredom

Many studies also exclusively focused on white, middle-class women,

Mnoge studije su se usredotočile isključivo na bjelkinje, iz srednje klase

which makes it problematic to apply study findings to all women.

zbog čega je problematično primijeniti rezultate istraživanja na sve žene.

We know there's a strong cultural component to the belief in PMS

Znamo da postoji snažna kulturološka sastavnica u vjerovanju postojanja PMS-a

because it's nearly unheard of outside of Western nations.

zato što se za njega gotovo i ne zna izvan zapadnih zemalja.

Third, many studies failed to use control groups.

Treće, mnoga istraživanja nisu uspjela koristiti kontrolne grupe

If we want to understand the specific characteristics

Ako želimo razumjeti posebne karakteristike

of women who have PMS,

žena koje imaju PMS,

we need to be able to compare them to women who don't have PMS.

moramo biti u mogućnosti usporediti ih sa ženama koje nemaju PMS.

And finally, many different types of questionnaires were used

I na kraju, korišteno je puno različitih vrsta upitnika

to diagnose PMS, focusing on different symptoms,

za dijagnoziranje PMS-a, koji su se usredotočili na različite simptome.

symptom duration and severity.

simptome trajanja i jačine.

To do reliable research on any condition,

Kako bi proveli pouzdano istraživanje bilo kojeg stanja,

scientists must agree on the specific characteristics

znanstvenici se moraju složiti oko specifičnih karakteristika

that make up that condition

koje uzrokuju to stanje

so they're all talking about the same thing,

tako da svi govore o istoj stvari

and with PMS, this has not been the case.

a kod PMS-a to nije bio slučaj.

However, in 1994,

Međutim, 1994.,

the Diagnostic and Statistical Manual of Mental Disorders,

Dijagnostički i Statistički Priručnik Mentalnih Poremećaja

known as the DSM, thankfully --

poznat kao (DSM), srećom --

it's also the manual for mental health professionals --

također je priručnik za stručnjake mentalnog zdravlja --

they redefined PMS as PMDD,

oni su redefinirali PMS u PMDD

Premenstrual Dysphoric Disorder.

Premenstrualni disforični poremećaj

And dysphoria refers to a feeling of agitation or unease.

A disforija se odnosi na osjećaj uzrujanosti i nelagode.

And according to these new DSM guidelines,

Prema novim uputstvima DSM-a, (Dijagnostički i Statistički Priručnik Mentalnih Poremećaja)

in most menstrual cycles in the last year,

u većini menstrualnih ciklusa prošle godine

at least five of 11 possible symptoms

najmanje 5 od 11 mogućih simptoma

must appear in the week before menstruation starts;

mora se pojaviti u tjednu prije nego menstruacija započne;

the symptoms must improve once menstruation has begun;

simptomi se moraju pojačati nakon što menstruacija započne;

and the symptoms must be absent the week after menstruation has ended.

i simptomi ne smiju postojati tjedan dana nakon što je menstruacija završila

One of these symptoms must come from this list of four:

Jedan od tih simptoma mora biti sa popisa ova četiri:

marked mood swings, irritability, anxiety, or depression.

značajne promjene raspoloženja, živčanost tjeskoba, ili depresija.

The other symptoms could come from the first slide

Ostali simptomi mogu biti sa prvog slajda

or from those on the second slide,

ili sa drugog slajda

including symptoms like feeling out of control

uključujući simptome poput osjećaja gubitka kontrole

and changes in sleep or appetite.

i promjene u spavanju ili apetitu.

The DSM also required now that the symptoms

Također DSM sada propisuje da simptomi

should be associated with clinically significant distress --

trebaju biti povezani sa klinički značajnim neraspoloženjem --

there should be some kind of disturbance in work

treba postojati neka vrsta smetnje u radu

or school or social relationships --

ili u školi ili socijalnim vezama --

and that symptoms and symptom severity should now be documented

i ti simptomi i jakost simptoma sada trebaju biti dokumentirani

by keeping a daily log for at least two cycles in a row.

vodeći dnevnik za najmanje dva ciklusa zaredom.

And finally, the DSM required that the emotional disturbance

I na kraju, DSM nalaže da emocionalni poremećaj

should be more than simply an exacerbation of an already existing disorder.

mora biti više od jednostavnog pogoršanja zbog već postojećeg poremećaja.

So scientifically speaking, this is an improvement.

Znanstveno govoreći, ovo je poboljšanje.

We now have a limited number of symptoms,

Sada imamo ograničen broj simptoma,

and a high impact on functioning that's required,

i velik utjecaj na funkcioniranje koji je nužan,

and the reporting and timing of symptoms have both become very specific.

i bilježenje i vremenski okvir simptoma su postali vrlo specifični.

Well, using this criteria

Dakle, koristeći ove kriterije

and looking at most recent studies,

i gledajući najnovija istraživanja,

we see that on average,

primjećujemo da u prosjeku,

three to eight percent of women suffer from PMDD.

tri do osam posto žena pati od PMDD-a.

Not all women, not most women,

Niti sve žene, niti mnoštvo žena,

not the majority of women, not even a lot of women:

niti većina žena, čak ni puno žena:

three to eight percent.

tri do osam posto.

For everyone else, variables like stressful events or happy occasions

Za sve ostale, varijable poput stresnih događaja ili veselih prigoda

or even day of the week

ili čak dan u tjednu

are more powerful predictors of mood than time of the month,

snažnije utječu na raspoloženje, nego razdoblje u mjesecu,

and this is the information the scientific community has had

i ovo je informacija koju znanstvena zajednica posjeduje

since the 1990s.

od 1990-ih.

In 2002, my colleagues and I published an article

Moji kolege i ja smo 2002. g. objavili članak

describing the PMS and PMDD research,

koji opisuje istraživanje PMS-a i PMDD-a,

and several similar articles have appeared in psychology journals.

i nekoliko sličnih članaka se pojavilo u novinama psihološke tematike

The questions is, why hasn't this information trickled down to the public?

Pitanje je, zašto ova informacija nije došla do javnosti?

Why do these myths persist?

Zašto ovi mitovi opstaju?

Well, certainly the onslaught of messages that women receive

Pa, zasigurno navala poruka koje žene primaju

from books, TV, movies, the Internet, that everyone gets PMS

iz knjiga, sa televizije, iz filmova i s interneta da svi dobivaju PMS

go a long way in convincing them it must be true.

traje jako dugo i uvjerava ih da je to zasigurno istina

Research tells us that the more a woman believes that everyone gets PMS,

Istraživanja nam govore da što više žena vjeruje da sve ostale dobivaju PMS

the more likely she is to erroneously report that she has it.

veća je šansa da će pogrešno tvrditi da ga i ona ima.

Let me tell you what I mean by "erroneously."

Reći ću vam što mislim pod pojmom "pogrešno"

You might ask her, "Do you have PMS?"

Možda ćete ju pitati: "Imate li PMS?"

and she says yes,

i ona će reći da,

but then, when you have her keep a daily log

ali, kada 2 mjeseca vodi dnevnik

of psychological symptoms for two months,

o psihološkim simptomima

no correlation is found between her symptoms

ne postoji povezanost između njezinih simptoma

and time of the month.

i razdoblja u mjesecu

Another reason for the persistence of the PMS myth

Još jedan razlog opstojnosti mita o PMS-u

has to do with the narrow boundaries of the feminine role.

ima veze sa tijesnim granicama uloga žene.

Feminist psychologists like Joan Chrisler

Feministički psiholozi poput Joan Chrisler

have suggested that taking on the label of PMS

sugeriraju da prihvaćanje obilježja PMS-a

allows women to express emotions that would otherwise be considered unladylike.

dozvoljava ženama da iskažu emocije koje bi se inače tumačile neotmjenima.

The near universal definition of a good woman

Skoro pa opća definicija dobre žene je

is one who is happy, loving, caring for others,

da je to ona koja je sretna, puna ljubavi, brižna

and taking great satisfaction from that role.

i uživa u toj ulozi.

Well, PMS has become a permission slip to be angry, complain, be irritated,

Pa, PMS je postao dozvola za ljutnju, prigovaranje, živčanost

without losing the title of good woman.

bez gubljenja titule dobre žene.

We know that the variables in a woman's environment

Znamo da varijable u ženinu okruženju

are much more likely to cause her to be angry than her hormones,

imaju veći utjecaj na stvaranje ljutnje nego njezini hormoni.

but when she attributes anger to hormones,

ali kada ljutnju pripiše hormonima,

she's absolved of responsibility or criticism.

ona se rješava odgovornosti ili kritike.

"Oh, that's not who she is. It's out of her control."

"Oh, nije ona takva inače. To je izvan njene kontrole."

And while this can be a useful tool, it serves to invalidate women's emotions.

Iako ovo može biti koristan alat, služi obezvređivanju ženskih emocija.

When people respond to a woman's anger

Kada ljudi na ljutnju žene reagiraju

with the thought, "Oh, it's just that time of the month,"

mišlju: "Oh, ono vrijeme u mjesecu je,"

her ability to be taken seriously or effect change is severely limited.

mogućnost da ju shvate ozbiljno ili da utječe na promjenu je jako ograničena

So who else benefits from the myth of PMS?

Dakle, tko još ima koristi od mita o PMS-u?

Well, I can tell you that treating PMS

Pa, mogu vam reći da je liječenje PMS-a

has become a profitable, thriving industry.

postao profitabilna, rastuća industrija.

Amazon.com currently offers over 1,900 books on PMS treatment.

Amazon.com trenutno nudi preko 9.000 knjiga o liječenju PMS-a.

A quick Google search will bring up a cornucopia

Brza pretraga na Google-u pokazat će izobilje

of clinics, workshops and seminars.

klinika, radionica i seminara.

Reputable Internet sources of medical information

Ugledni internetski izvori medicinskih informacija

like WebMD or the Mayo Clinic list PMS as a known disorder.

poput WebMD ili Mayo Clinic navode PMS kao poznati poremećaj

It's not a known disorder, but they list it.

Nije poznati poremećaj, ali oni ga navode

And they also list the medications that physicians have prescribed to treat it,

I oni također navode lijekove koje su liječnici prepisali za liječenje,

like anti-depressants or hormones.

poput antidepresiva ili hormona.

Interestingly, though, both websites say that the success of medication

Interesantno, obje stranice tvrde da uspjeh lijekova

in treating PMS symptoms vary from woman to woman.

u liječenju PMS-a varira od žene do žene.

Well, that doesn't make sense.

Pa, to nema smisla.

If you've got a distinct disorder with a distinct cause,

Ako imaš jasan poremećaj sa jasnim uzrokom,

which PMS is supposed to be,

što bi PMS i trebao biti

then the treatment should bring improvement for a great number of women.

onda bi liječenje trebalo poboljšati stanje velikom broju žena.

This has not been the case with these treatments,

Ovo nije bio slučaj sa ovim liječenjem,

and FDA regulations say that for a drug to be deemed effective,

i FDA propisi govore da veliki dio ciljane populacije mora vidjeti

a large portion of the target population

značajna klinička poboljšanja

should see clinically significant improvement.

kako bi se lijek smatrao učinkovitim.

So we have not had that at all with these so-called treatments.

Dakle ništa od toga nismo imali u ovim takozvanim liječenjima.

However, the financial gain of perpetuating the myth

Međutim, financijska dobit u održavanju mita

that PMS is a common mental disorder

da je PMS uobičajen mentalni poremečaj

and is treatable is quite substantial.

i da je izlječiv je prilično pozamašna.

When women are prescribed drugs like anti-depressants or hormones,

Kada ženama propišu lijekove poput antidepresiva ili hormona

medical protocol requires that they have physician follow-up every three months.

medicinski protokol zahtjeva da imaju liječnički pregled svaka 3 mjeseca.

That's a lot of doctor visits.

To je puno posjeta doktoru.

Pharmaceutical companies reap untold profits

Farmaceutske tvrtke ubiru neopisive profite

when women are convinced they should take a prescribed medication

kada su žene uvjerene da trebaju uzimati propisane lijekove

for all of their child-bearing lives.

tijekom cijelog reprodukcijskog razdoblja.

Over-the-counter drugs like Midol

Lijekovi bez recepta poput Midola

even claim to treat PMS symptoms like tension and irritability,

čak tvrde da liječe simptome poput napetosti i živčanosti,

even though they only contain a diuretic, a pain reliever

iako sadrže samo diuretik, analgetik

and caffeine.

i kofein.

Now, far be it from me to argue with the magical powers of caffeine,

Daleko od toga da ću ja raspravljati o čarobnim moćima kofeina

but I don't think reducing tension is one of them.

ali smatram da smanjenje napetosti nije jedna od njih

Since 2002, Midol has marketed a Teen Midol to adolescents.

Od 2002., Midol promovira Teen Midol adolescentima.

They are aiming at young girls early,

Ciljaju na mlade djevojke vrlo rano,

to convince them that everyone gets PMS and that it will make you a monster,

da ih uvjere da svatko dobiva PMS i da će ih učiniti čudovištima.

but wait, there's something you can do about it:

ali čekaj, postoji nešto što možeš poduzeti u vezi toga:

Take Midol and you will be a human being again.

Uzmi Midol i opet ćeš biti ljudsko biće

In 2013, Midol took in 48 million dollars in sales revenue.

U 2013., Midol je ostvario 48 milijuna dolara prinosa od prodaje,

So while perpetuating the myth of PMS has been lucrative for some,

Iako je održavanje mita o PMS-u unosno za neke,

it comes with some serious adverse consequences for women.

dolazi do ozbiljnih štetnih posljedica za žene.

First, it contributes to the medicalization

Prvo, to pridonosi medikalizaciji

of women's reproductive health.

ženskog reproduktivnog zdravlja.

The medical field has a long history of conceptualizing

Medicinsko polje ima dugu povijest gledanja

women's reproductive processes as illnesses that require treatment,

na ženski reproduktivni proces, kao na bolesti koje zahtijevaju liječenje,

and this has come at many costs, including excessive Cesarean deliveries,

i to je došlo na naplatu,uključujući pretjeran broj poroda carskim rezom,

hysterectomies and prescribed hormone treatments

histeroktomiju i propisane tretmane hormonima

that have harmed rather than enhanced women's health.

koji su više pogoršali nego poboljšali zdravlje žena.

Second, the PMS myth also contributes to the stereotype of women

Drugo, mit o PMS-u također pridonosi sterotipizaciji žena

as irrational and overemotional.

kao iracionalnih i preemotivnih.

When the menstrual cycle is described as a hormonal roller coaster

Kada se mesntrualni ciklus opisuje kao hormonalni ringišpil

that turns women into angry beasts,

koji pretvara žene u bijesne zvijeri,

it becomes easy to question the competence of all women.

kompetntnost svih žena lako postaje upitna

Women have made tremendous strides in the workforce,

Žene su ostvarile ogroman napredak u radnoj snazi,

but still there's a minuscule number of women at the highest echelons

ali još uvijek je premalen broj žena na najvišim pozicijama,

of fields like government or business,

primjerice u vladama ili poslovnom svijetu,

and when we think about who makes for a good CEO or senator,

i kada razmislimo o tome tko može bit dobar upravitelj ili senator,

someone who has qualities like rationality, steadiness, competence

netko tko ima kvalitete poput racionalnosti, odlučnosti, kompetitivnosti

come to mind,

prvo padaju na um

and in our culture, that sounds more like a man than a woman,

i u našoj kulturi to više zvuči kao muškarac nego kao žena

and the PMS myth contributes to that.

i mit o PMS-u pridonosi tome.

Psychologists know that the moods of men and women

Psiholozi znaju da raspoloženja žena i muškaraca

are more similar than different.

imaju više sličnosti nego razlike.

One study followed men and women for four to six months

U jednom istraživanju žene i muškarci su praćeni četiri do šest mjeseci

and found that the number of mood swings they experienced

i utvrđeno je da je broj promjena raspoloženja koje su doživjeli

and the severity of those mood swings were no different.

i da razlika u jakosti tih promjena nije postojala

And finally, the PMS myth keeps women from dealing

I na kraju, mit o PMS-u odvlaći žene od suočavanja

with the actual issues causing them emotional upset.

sa pravim problemima koji uzrokuju emocionalnu uznemirenost.

Individual issues like quality of relationship or work conditions

Individualni problemi poput kvalitete veze ili radnih uvjeta

or societal issues like racism or sexism or the daily grind of poverty

ili društveni problemi poput rasizma ili seksizma, svakodnevna borba sa siromaštvom

are all strongly related to daily mood.

su jako povezani sa dnevnim raspoloženjem.

Sweeping emotions under the rug of PMS

Metenje emocija pod tepih PMS-a

keeps women from understanding the source of their negative emotions,

odvlači žene od razumijevanja izvora njihovih negativnih emocija,

but it also takes away the opportunity to take any action to change them.

ali također oduzima priliku za poduzimanje akcije da ih se promijeni.

So the good news about PMS

Tako da su dobre vijesti o PMS-u

is that while some women get some symptoms because of the menstrual cycle,

da dok nek žene imaju neke simptome zbog menstrualnog ciklusa,

the great majority don't get a mental disorder.

velika većina nema mentalni poremečaj.

They go to work or school, take care of their families,

One idu na posao ili u školu, brinu o svojoj obitelji

and function at a normal level.

i funkcioniraju na normalnoj razini.

We know the emotions and moods of men and women

Znam da su emocije i raspoloženje žena i muškaraca

are more similar than different,

više slične nego različite,

so let's walk away from the tired old PMS myth of women as witches

zato odbacimo umorni, stari mit PMS-a o ženama vješticama

and embrace the reality of high emotional and professional functioning

i prihvatimo stvarnost visoko emocionalnog i profesionalnog funkcioniranja

the great majority of women live every day.

koju velika većina žena proživljava svaki dan.

Thank you.

Hvala vam.

(Applause)

(Pljesak)