Robyn Stein DeLuca: The good news about PMS

Prevodilac: Ivana Krivokuća Lektor: Mile Živković

How many people here have heard of PMS?

Koliko ljudi ovde je čulo za PMS?

Everybody, right?

Svi, zar ne?

Everyone knows that women go a little crazy

Svi znaju da žene malo polude

right before they get their period,

neposredno pred svoju menstruaciju,

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

da ih menstrualni ciklus izbacuje na neizbežni hormonski rolerkoster

of irrationality and irritability.

iracionalnosti i razdražljivosti.

There's a general assumption

Postoji opšta pretpostavka

that fluctuations in reproductive hormones cause extreme emotions

da promene reproduktivnih hormona izazivaju ekstremne emocije

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

i da je velika većina žena pod uticajem toga.

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

E pa, ja sam ovde da bih vam rekla da naučni dokazi kažu

neither of those assumptions is true.

da nijedna od tih pretpostavki nije istinita.

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

Ovde sam da bih vam iznela dobre vesti o PMS-u.

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

Ali najpre, pogledajmo koliko je čvrsto ideja o PMS-u

is entrenched in American culture.

učvršćena u američkoj kulturi.

If you examine newspaper or magazine articles,

Ako pregledate novine ili članke u časopisima,

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

videćete koliko je široko prihvaćeno da svi dobijaju PMS.

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

U članku u magazinu Redbuk pod nazivom "Vi: bez PMS-a",

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

čitaocima je saopšteno da između 80 i 90 posto žena pati od PMS-a.

L.A. Muscle magazine warned its readers

Magazin L.A. Masl je upozorio svoje čitaoce

that 40 to 50 percent of women suffer from PMS,

da 40 do 50 posto žena pati od PMS-a,

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

i da on igra veliku ulogu u mentalnom i fizičkom zdravlju žene,

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

a pre nekoliko godina, čak je i Vol Strit Žurnal

ran an article on calcium as a treatment for PMS,

objavio članak o kalcijumu kao leku za PMS,

asking its female readers,

postavljajući pitanje svojim čitateljkama:

"Do you turn into a witch every month?"

"Da li se pretvarate u vešticu svakog meseca?"

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

Na osnovu svih ovih članaka, pomislili biste da mora da postoji

gomila istraživanja koja potvrđuju svojstvo rasprostranjenosti PMS-a.

verifying the widespread nature of PMS.

However, after five decades of research,

Međutim, nakon pet decenija istraživanja,

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

nema čvrste saglasnosti oko definicije, uzroka,

the treatment, or even the existence of PMS.

lečenja, niti samog postojanja PMS-a.

As most commonly defined by psychologists,

Kako psiholozi najčešće opisuju,

PMS involves negative behavioral, cognitive and physical symptoms

PMS podrazumeva negativne simptome u ponašanju, kognitivne i fizičke simptome

from the time of ovulation to menstruation.

od ovulacije do menstruacije.

But here's where it gets tricky.

Ali evo gde postaje zamršeno.

Over 150 different symptoms have been used to diagnose PMS,

Preko 150 različitih simptoma je korišćeno za dijagnostifikovanje PMS-a,

and here are just a few of those.

a ovo su samo neki od njih.

Now, I want to be clear here.

Da razjasnim.

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

Ne kažem da žene ne dobijaju neke od ovih simptoma.

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

Ono što hoću da kažem je da dobijanje nekih od ovih simptoma

doesn't amount to a mental disorder,

ne čini mentalni poremećaj,

and when psychologists come up with a disorder

i kada psiholozi smisle poremećaj

that's so vaguely defined,

koji je tako neodređeno definisan,

the label eventually becomes meaningless.

etiketa na kraju postane besmislena.

With a list of symptoms this long and wide,

Sa ovoliko dugom i širokom listom simptoma,

I could have PMS, you could have PMS,

ja bih mogla da imam PMS, vi biste mogli imati PMS,

the guy in the third row here could have PMS,

čovek u trećem redu ovde bi mogao da ima PMS,

my dog could have PMS. (Laughter)

moj pas bi mogao da ima PMS. (Smeh)

Some researchers said you had to have five symptoms.

Neki istraživači kažu da morate da imate pet simptoma.

Some said three.

Neki kažu tri.

Other researchers said that symptoms were only meaningful

Drugi istraživači kažu da su simptomi značajni

if they were highly disturbing to you,

samo ako vas veoma ometaju,

but others said minor symptoms were just as important.

dok drugi kažu da su manji simptomi podjednako važni.

For many years, because there was no standardization

Godinama, pošto nije bilo standardizacije

in the definition of PMS,

definicije PMS-a,

when psychologists tried to report prevalence rates,

kada su psiholozi pokušali da naprave izveštaj

their estimates ranged from five percent of women

o stopi rasprostranjenosti, njihove procene su se kretale

to 97 percent of women,

od pet posto žena do 97 posto žena,

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

tako da istovremeno skoro da niko nije imao PMS i skoro svi su ga imali.

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

Sve u svemu, nedostaci metoda istraživanja PMS-a su bili znatni.

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

Prvo, mnoge studije su tražile od žena

da pričaju o svojim simptomima retrospektivno,

looking to the past and relying on memory,

osvrćući se na prošlost i oslanjajući se na pamćenje,

which is known to inflate reporting of PMS

za šta je poznato da uvećava izveštavanje o PMS-u

compared to what's called prospective reporting,

u odnosu na ono što se naziva prospektivno izveštavanje,

which involves keeping a daily log of symptoms

koje podrazumeva vođenje dnevnika simptoma

for at least two months in a row.

najmanje dva uzastopna meseca.

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

Mnoge studije su se takođe fokusirale isključivo na belkinje srednje klase,

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

zbog čega je problematično dovoditi u vezu nalaze studija sa svim ženama.

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

Znamo da postoji snažna kulturna komponenta u verovanju o PMS-u

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

jer skoro da je nepoznat izvan zapadnih zemalja.

Third, many studies failed to use control groups.

Treće, mnogim studijama nedostaje korišćenje kontrolnih grupa.

If we want to understand the specific characteristics

Ako želimo da razumemo specifične 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 da ih uporedimo sa ženama koje nemaju PMS.

And finally, many different types of questionnaires were used

I konačno, mnogo različitih vrsta upitnika je korišćeno

to diagnose PMS, focusing on different symptoms,

u dijagnostikovanju PMS-a, fokusirajući se na različite simptome,

symptom duration and severity.

trajanje i ozbiljnost simptoma.

To do reliable research on any condition,

Da bi obavili pouzdano istraživanje o bilo kom stanju,

scientists must agree on the specific characteristics

naučnici se moraju složiti oko specifičnih karakteristika

that make up that condition

koje sačinjavaju 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.

što nije bio slučaj sa PMS-om.

However, in 1994,

Međutim, 1994. godine,

the Diagnostic and Statistical Manual of Mental Disorders,

Dijagnostički i statistički priručnik za mentalne poremećaje,

known as the DSM, thankfully --

poznat kao DSM, srećom -

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

takođe je i priručnik za profesionalce u oblasti mentalnog zdravlja -

they redefined PMS as PMDD,

redefinisali su PMS kao PMDD,

Premenstrual Dysphoric Disorder.

predmenstrualni disforični poremećaj.

And dysphoria refers to a feeling of agitation or unease.

Disforija se odnosi na osećaj uznemirenosti ili nelagodnosti.

And according to these new DSM guidelines,

Prema ovim novim DSM smernicama,

in most menstrual cycles in the last year,

u većini menstrualnih ciklusa tokom proteklih godinu dana,

at least five of 11 possible symptoms

najmanje pet od 11 mogućih simptoma

must appear in the week before menstruation starts;

moraju se javiti u nedelji pre početka menstruacije,

the symptoms must improve once menstruation has begun;

simptomi se moraju poboljšati kada menstruacija otpočne,

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

i moraju potpuno nestati nedelju dana po završetku menstruacije.

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

Jedan od tih simptoma mora biti sa ove liste četiri ponuđenih:

marked mood swings, irritability, anxiety, or depression.

izražene promene raspoloženja, razdražljivost, anksioznost ili depresija.

The other symptoms could come from the first slide

Drugi simptomi mogu biti neki od onih sa prvog slajda

or from those on the second slide,

ili od onih na drugom slajdu,

including symptoms like feeling out of control

uključujući simptome kao što su osećaj gubitka kontrole

and changes in sleep or appetite.

i promene sna ili apetita.

The DSM also required now that the symptoms

DSM takođe sada traži da simptomi

should be associated with clinically significant distress --

budu u vezi sa klinički značajnom uznemirenošću -

there should be some kind of disturbance in work

treba da postoji neka vrsta smetnji u radu

or school or social relationships --

ili školi ili društvenim odnosima -

and that symptoms and symptom severity should now be documented

i ti simptomi i njihova ozbiljnost sada treba da budu dokumentovani

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

vođenjem devnika tokom najmanje dva uzastopna ciklusa.

And finally, the DSM required that the emotional disturbance

I konačno, DSM postavlja zahtev da emotivna uznemirenost

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

treba da bude više od jednostavnog pogoršanja već postojećeg poremećaja.

So scientifically speaking, this is an improvement.

Tako da je ovo napredak, naučno govoreći.

We now have a limited number of symptoms,

Sada imamo ograničeni broj simptoma,

and a high impact on functioning that's required,

potreban je visok uticaj na funkcionisanje,

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

a izveštavanje i uvremenjenost simptoma su postali veoma konkretno ustanovljeni.

Well, using this criteria

Dakle, koristeći ove kriterijume

and looking at most recent studies,

i pregledajući najskorija istraživanja,

we see that on average,

vidimo da u proseku,

three to eight percent of women suffer from PMDD.

tri do osam procenata žena pati od PMDD-a.

Not all women, not most women,

Ne sve žene, ne najveći broj žena,

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

ne većina žena, čak ne ni puno žena:

three to eight percent.

tri do osam procenata.

For everyone else, variables like stressful events or happy occasions

Za sve ostale, varijable kao što su stresni događaji ili radosne prilike

or even day of the week

ili čak i dan u nedelji

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

snažnije predviđaju raspoloženje nego oni dani u mesecu,

and this is the information the scientific community has had

a to je informacija koja je prisutna u naučnoj zajednici

since the 1990s.

od '90-ih godina.

In 2002, my colleagues and I published an article

2002. godine, moje kolege i ja smo objavili časopis

describing the PMS and PMDD research,

opisujući istraživanja PMS-a i PMDD-a,

and several similar articles have appeared in psychology journals.

i nekoliko sličnih članaka se pojavilo u psihološkim časopisima.

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

Postavlja se pitanje, zašto ovaj podatak nije dopreo do javnosti?

Why do these myths persist?

Zašto ovi mitovi opstaju?

Well, certainly the onslaught of messages that women receive

Pa, svakako da navala poruka koje žene dobijaju

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

iz knjiga, sa televizije, filmova, interneta, da svi dobijaju PMS

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

ima uspeha u njihovom ubeđivanju da to mora biti istinito.

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

Istraživanja nam govore da što više žena veruje da svi dobijaju PMS,

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

veća je verovatnoća da će pogrešno izveštavati da ga ima.

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

Da vam objasnim šta mislim pod time "pogrešno".

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

Možda ćete je upitati: "Da li imaš PMS?"

and she says yes,

i ona kaže da,

but then, when you have her keep a daily log

ali potom, kada zatražite da vodi dnevnik

of psychological symptoms for two months,

psihičkih simptoma tokom dva meseca,

no correlation is found between her symptoms

nikakva korelacija neće biti pronađena između njenih simptoma

and time of the month.

i onih dana u mesecu.

Another reason for the persistence of the PMS myth

Drugi razlog za istrajnost mita o PMS-u

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

ima veze sa uskim granicama ženske uloge.

Feminist psychologists like Joan Chrisler

Feministički psiholozi poput Džoane Krisler

have suggested that taking on the label of PMS

su iznosili tvrdnju da preuzimanje etikete PMS-a

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

omogućava ženama da izraze osećanja

koja bi inače bila smatrana nedostojnim jedne dame.

The near universal definition of a good woman

Gotovo univerzalna definicija dobre žene

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

je da je to ona koja je vesela, puna ljubavi i brige za druge,

and taking great satisfaction from that role.

i nalazi veliko zadovoljstvo u toj ulozi.

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

PMS je postao dozvola da bude ljuta, da negoduje, bude iritirana,

without losing the title of good woman.

a da pri tom ne izgubi titulu dobre žene.

We know that the variables in a woman's environment

Znamo da će promenljive u sredini žene

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

pre dovesti do toga da se naljuti nego njeni hormoni,

but when she attributes anger to hormones,

ali kada ona pripiše ljutnju hormonima,

she's absolved of responsibility or criticism.

oslobađa se odgovornosti i kritikovanja.

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

"O, nije ona takva. To je izvan njene moći."

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

I dok ovo može biti korisno oruđe, služi poništavanju značaja osećanja žene.

When people respond to a woman's anger

Kada ljudi odgovore na bes žene

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

mišlju: "O, to su samo oni dani",

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

znatno biva ograničena njena mogućnost

da bude shvaćena ozbiljno ili utiče na promenu.

So who else benefits from the myth of PMS?

Ko još ima koristi od mita o PMS-u?

Well, I can tell you that treating PMS

Pa, mogu vam reći da je lečenje PMS-a

has become a profitable, thriving industry.

postalo profitabilan posao u usponu.

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

Amazon.com trenutno nudi preko 1 900 knjiga o lečenju PMS-a.

A quick Google search will bring up a cornucopia

Brza pretraga na Guglu će prikazati izobilje

of clinics, workshops and seminars.

klinika, radionica i seminara.

Reputable Internet sources of medical information

Pouzdani izvori medicinskih informacija na internetu

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

kao što su VebMD ili Klinika Mejo ubrajaju PMS u priznate poremećaje.

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

To nije priznati poremećaj, ali ga oni navode.

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

Takođe navode i lekove koje lekari prepisuju za njegovo lečenje,

like anti-depressants or hormones.

kao što su antidepresivi ili hormoni.

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

Zanimljivo je da oba sajta kažu da se uspešnost primene lekova

in treating PMS symptoms vary from woman to woman.

u lečenju simptoma PMS-a razlikuje od jedne do druge žene.

Well, that doesn't make sense.

Pa to nema smisla.

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

Ako imate određeni poremećaj sa određenim uzrokom,

which PMS is supposed to be,

što bi PMS trebalo da bude,

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

onda bi lečenje trebalo da dovede do poboljšanja kod velikog broja žena.

This has not been the case with these treatments,

To nije bio slučaj sa ovim tretmanima,

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

a propisi FDA (Uprave za hranu i lekove) kažu da, da bi se lek smatrao efikasnim,

a large portion of the target population

veliki deo ciljne populacije

should see clinically significant improvement.

bi trebalo da primećuje klinički značajno poboljšanje.

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

To uopšte nismo imali kod ovih takozvanih tretmana.

However, the financial gain of perpetuating the myth

Međutim, velika je finansijska dobit od održavanja mita

that PMS is a common mental disorder

da je PMS učestali mentalni poremećaj

and is treatable is quite substantial.

i da se može lečiti.

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

Kada se ženama prepišu lekovi kao što su antidepresivi ili hormoni,

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

medicinski protokol nalaže da dolaze na lekarske kontrole svaka tri meseca.

That's a lot of doctor visits.

To je mnogo poseta doktoru.

Pharmaceutical companies reap untold profits

Farmaceutske kompanije dobijaju neverovatnu zaradu

when women are convinced they should take a prescribed medication

kada su žene u ubeđenju da treba da uzimaju prepisane lekove

for all of their child-bearing lives.

tokom celog svog plodnog života.

Over-the-counter drugs like Midol

Lekovi u slobodnoj prodaji poput Midola

even claim to treat PMS symptoms like tension and irritability,

čak tvrde da leče i simptome PMS-a kao što su napetost i razdražljivost,

even though they only contain a diuretic, a pain reliever

iako sadrže samo diuretike, sredstva za ublaživanje bolova

and caffeine.

i kofein.

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

Daleko od toga da želim da ulazim u raspravu oko čarobnih moći kofeina,

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

ali ne bih rekla da je smanjenje napetosti jedna od njih.

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

Midol se od 2002. godine prodaje kao Tin Midol za adolescente.

They are aiming at young girls early,

Usmereni su na devojčice na ranom uzrastu,

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

kako bi ih ubedili da svi dobijaju PMS i da se od toga postaje čudovište,

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

ali čekajte, možete nešto preduzeti u vezi sa tim:

Take Midol and you will be a human being again.

uzmite Midol i ponovo ćete postati ljudsko biće.

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

2013. godine, Midol je zgrnuo 48 miliona dolara prihoda od prodaje.

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

Dok je mit o PMS-u bio unosan za neke,

it comes with some serious adverse consequences for women.

on donosi sa sobom neke ozbiljno nepovoljne posledice za žene.

First, it contributes to the medicalization

Kao prvo, doprinosi medikalizaciji

of women's reproductive health.

ženskog reproduktivnog zdravlja.

The medical field has a long history of conceptualizing

Polje medicine ima dugu istoriju konceptualizovanja

women's reproductive processes as illnesses that require treatment,

ženskih reproduktivnih procesa kao bolesti koja zahteva lečenje,

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

a uz ovo je išla određena cena,

uključujući suvišne porođaje carskim rezom,

hysterectomies and prescribed hormone treatments

histerektomije i prepisane hormonske tretmane

that have harmed rather than enhanced women's health.

koji su više naškodili nego što su poboljšali zdravlje žena.

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

Drugo, mit od PMS-u takođe doprinosi stereotipu o ženama

as irrational and overemotional.

kao iracionalnim i previše emotivnim.

When the menstrual cycle is described as a hormonal roller coaster

Kada se menstrualni ciklus opisuje kao hormonalni rolerkoster

that turns women into angry beasts,

koji pretvara žene u razjarene zveri,

it becomes easy to question the competence of all women.

postaje lako dovesti u pitanje kompetentnost svih žena.

Women have made tremendous strides in the workforce,

Žene su ostvarile izuzetan napredak u svetu rada,

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

ali još uvek je minimalan broj žena na najvišim instancama

of fields like government or business,

u oblastima kao što je vlada ili poslovanje,

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

i kada razmišljamo o tome ko bi bio dobar direktor ili senator,

someone who has qualities like rationality, steadiness, competence

neko da poseduje kvalitete kao što su racionalnost, stabilnost, kompetentnost

come to mind,

ko bi nam pao na pamet,

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

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

and the PMS myth contributes to that.

a mit o PMS-u doprinosi tome.

Psychologists know that the moods of men and women

Psiholozi znaju da su raspoloženja muškaraca i žena

are more similar than different.

u većoj meri slična nego što se razlikuju.

One study followed men and women for four to six months

Jedno istraživanje je pratilo muškarce i žene tokom četiri do šest meseci

and found that the number of mood swings they experienced

i pronašli su da se broj promena raspoloženja koje su doživeli

and the severity of those mood swings were no different.

i jačina tih promena raspoloženja nisu razlikovali.

And finally, the PMS myth keeps women from dealing

I najzad, mit o PMS-u sprečava žene da se suoče

with the actual issues causing them emotional upset.

sa stvarnim problemima koji im izazivaju emocionalnu uznemirenost.

Individual issues like quality of relationship or work conditions

Pojedinačni problemi kao što su kvalitet veze ili uslovi rada

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

ili društveni problemi poput rasizma i seksizma ili svakodnevica siromaštva

are all strongly related to daily mood.

su snažno povezani sa raspoloženjem tokom dana.

Sweeping emotions under the rug of PMS

Skrivanje emocija pod okriljem PMS-a

keeps women from understanding the source of their negative emotions,

sputava žene u razumevanju izvora svojih negativnih emocija,

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

ali takođe i oduzima mogućnost da preduzmu nešto kako bih ih promenile.

So the good news about PMS

Dakle, dobra vest o PMS-u

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

je da, dok pojedine žene dobijaju neke od simptoma zbog menstrualnog ciklusa,

the great majority don't get a mental disorder.

velika većina ne dobije mentalni poremećaj.

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

One idu na posao ili u školu, brinu se o svojim porodicama

and function at a normal level.

i funkcionišu na normalnom nivou.

We know the emotions and moods of men and women

Znamo da su osećanja i raspoloženja muškaraca i žena

are more similar than different,

više slična nego različita, pa hajde da se udaljimo

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

od starog istrošenog mita o PMS-u i ženama kao vešticama i prihvatimo stvarnost

and embrace the reality of high emotional and professional functioning

visokog emocionalnog i profesionalnog funkcionisanja

the great majority of women live every day.

sa kojima velika većina žena živi svakoga dana.

Thank you.

Hvala vam.

(Applause)

(Aplauz)