“Please, I’m Going To Murder Someone!” — (also known as P.M.S.)

A new patient, who clearly looked anxious and irritated, sat down across from me at my consultation desk. “I cannot take it anymore — -either my husband is going to kill me, or I am going to kill him!” I took a moment to decide whether this was going to become a police matter. I often have women, in all stages of peri- and post-menopausal despair, describing similar relationship dilemmas. This woman, however, was only 32. Intrigued, but feeling safe, I encouraged her to go on….(A full background history of the situation is the best way to get a handle on the current issues). “Every month, like clockwork, for a few days out of the month, I become like another person”, she said. “I can’t sleep, I’m anxious, I get bloated, my breasts are sore, I get short tempered. My family cannot stand me (and I can’t stand them). I don’t even recognize myself! Then my period comes, and I feel better, and I’ll have a few good weeks — -then, the whole scenario happens again.”

It was as if she opened the medical book and turned to the page labelled PMS — Premenstrual Syndrome. This is a syndrome that is fairly well recognized by those in my specialty. It has been discussed at least for the last 100 years, but the formal recognition and diagnosis was first described in detail by Dr Robert Frank at The New York Academy of Medicine in the 1930’s. From then…