A qualitative investigation of women's perceptions of premenstrual syndrome: implications for general practitioners

Background. Many women consult general practitioners each year, seeking tre atment for premenstrual syndrome. This qualitative study presents evidence of women's own perceptions of this problem, which may assist in the provisi on of individualized health care. Aim. To explore women's constructions of premenstrual syndrome using ground ed analysis. Method. A qualitative, semi-structured interview study carried out in North ern Ireland. Thirteen women were interviewed individually. Thereafter, 33 w omen participated in group discussions. Five health visitors then commented individually on the findings. Results. Seven themes emerged from the analysis. These themes suggested tha t women tend to view the menstrual cycle holistically and that premenstrual syndrome is regarded as debilitating by only a small minority of women. Pa rticipants indicated an awareness of the intra- and inter-personal variabil ity of menstrual experience. They were ambivalent about menstruation, viewi ng it as natural but, at the same time, unnatural in terms of day-to-day ex istence. Talking to other women served two functions, first by providing a yardstick against which to evaluate their own experiences, and secondly by providing support and advice. In contrast, women tended to talk about menst ruation only to selected men, mainly partners, primarily in the interests o f educating them. Women viewed menstruation as potentially disempowering by virtue of its uncontrollability, and felt that both a positive attitude an d the use of a range of remedies were important for women wishing to become empowered with respect to this aspect of their lives. Conclusions. Women's own constructions of premenstrual syndrome differ mark edly from those as presented in medical textbooks and research literature: secondary sources that have significantly impacted upon general practitione rs' attitudes towards this condition. The provision of a range of treatment options, including support groups, is suggested, on the basis of evidence gathered using qualitative methods, as likely to be viewed by women as more appropriate than offering treatment based on the evidence provided by trad itional randomized controlled trials.