Menstrual Myth Busting by Sally King interrogates the diagnostic label of premenstrual syndrome (PMS) to expose sexist assumptions within medical research and practice. Introducing the book below, she challenges the concept of the “hormonal” premenstrual woman, arguing it’s time we eradicate these harmful stereotypes that remain prevalent in medical and popular discourse.
Menstrual Myth Busting: The Case of the Hormonal Female. Sally King. Policy Press. 2025.
The next time somebody describes a woman’s mood, behaviour, symptom, or condition as “hormonal” I strongly suggest you ask, “which hormone?” and “which study demonstrated a causal link?”.
Contrary to popular (and even medical) opinion, female prevalent health conditions are not caused by the “female” sex hormones. For instance, no direct causal link between either oestrogen or progesterone has ever been demonstrated in relation to PMS (Premenstrual Syndrome), PMDD (Premenstrual Dysphoric Disorder), morning sickness, peri-natal depression, or most peri-menopausal symptoms (in fact, oestrogen appears to protect our health and may contribute to cis women’s longer average life spans). Importantly, there is also no significant difference in circulating female sex hormone levels between those who experience debilitating symptoms during these key reproductive events and the majority of us who do not.
What is more, alternative evidence-based factors in women’s health are typically absent from medical and lay discourses on these topics (e.g., inflammation, iron deficiency/anaemia, underlying health conditions, poor social support, trauma experiences, and poverty).
Of course, the word “hormonal” also exists as a minimising/undermining euphemism for a woman’s mood or behaviour, especially if it challenges established gender norms. Indeed, as others have previously argued, the “hormonal female” is simply the contemporary iteration of the “hysterical female” gender stereotype. It perpetuates the biological-essentialist myth used over the past few centuries to justify gender inequalities in education, health, work, pay, political agency, and leadership.
So how and why do such widespread “hormonal” discourses (and associated gender myths) persist in the face of so much contradictory data?
This is what I try to demonstrate in my new book, “Menstrual Myth Busting: The Case of the Hormonal Female”. The book uses the example of PMS, to reveal the way in which gender and racial myths limit medical knowledge and practice regarding women’s health.
The first chapter provides a short primer in menstrual physiology beyond its hormonal coordination, to enable readers to engage with the rest of the book. You will learn all sorts of things that we should have been taught at (med) school but were not. For instance, why we menstruate given that 98 per cent of mammals do not, the abortifacient (not pro-pregnancy) function of periods, and the inflammatory nature of healthy reproductive processes.
I argue that the reason why we are not taught this stuff is largely due to pro-natalist influences within society and, thus, within science, too. Crucially, however, if all we are taught is that “the female (reproductive) body is hormonal” [in apparent unfounded contrast to male bodies], it’s little wonder that damaging gender myths continue to impact our health and lives.
Until we are taught more comprehensive reproductive physiology, including established sex differences in immune system function (to help us survive pregnancy), I fear we are destined to keep on getting it wrong.
The second chapter is a comprehensive summary of the biomedical and critical feminist literature on menstrual health and medicine. It focuses on the medical preoccupation of “blaming femininity itself” for the female prevalence of certain symptoms and health conditions. Taking a symptom-based approach also allows me to make an original argument about the unintentional perpetuation of gender myths in both literatures, as being partly due to a lack of (known) alternative physiological explanations. First, the womb was perceived as being the main/only physiological difference between the binary sexes, now it is our reproductive hormones… Until we are taught more comprehensive reproductive physiology, including established sex differences in immune system function (to help us survive pregnancy), I fear we are destined to keep on getting it wrong.
The second part of the book is based on my doctoral research, which compared expert (biomedical and critical feminist) and lay descriptions of PMS with the available population data regarding cyclic symptoms. The idea being that if participant descriptions did not match the available data, they must have been influenced by something else (i.e., unscientific discourses).
Chapter three outlines my research questions and the Critical Realist Discourse Analysis methodology applied to the interview data. This information is probably of most interest to fellow researchers, but it is also crucial to ‘show the working” when sharing findings that may challenge personal and professional beliefs.
The shocking discovery that even gynaecologists (let alone students, teachers, GPs and research scientists outside of fertility/menstrual health) are not taught healthy menstrual physiology beyond its hormonal coordination, is ultimately what prompted me to write this book.
Chapters four to seven outline the four main discursive themes identified in my PMS study. Each theme is described and supported by some fantastic participant quotes and the implications are summarised in a handy ‘so what?” section at the end of each chapter.
In short, the themes are “Mind over matter- the psychologisation of premenstrual changes”; “snatch 22 – premenstrual changes as simultaneously ‘normal’ and ‘debilitatin’g”; “The Curse-femininity as debility”; and “Black Box; the unknown/mysterious female reproductive body”. It was this last theme that prompted me to review the menstrual physiology content of several of the top medical textbooks available in the UK. The shocking discovery that even gynaecologists (let alone students, teachers, GPs and research scientists outside of fertility/menstrual health) are not taught healthy menstrual physiology beyond its hormonal coordination, is ultimately what prompted me to write this book.
We need to systematically improve reproductive health literacy, for all, right now.
The final chapter offers a short conclusion but is really more of a call to action. It explains how the four discursive themes identified overlap with three core gender stereotypes more than the available empirical evidence regarding cyclic symptoms. The “all in her mind”, “femininity as debility” and “mysterious female (reproductive) body” tropes combine to (unintentionally) reproduce the myth of the “hormonal/hysterical female” in expert and lay descriptions of PMS.
This is why we need to systematically improve reproductive health literacy, for all, right now. If not, I fear female patients, especially those who are also subject to compounding racist myths and misconceptions, will continue to face disbelief in, and the inadequate treatment of, their physical and emotional pain for centuries to come.
This post gives the views of the authors, not the position of the LSE Review of Books blog, or of the London School of Economics and Political Science.
Image credit: Pixel-Shot on Shutterstock.
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