BACKGROUND: Many women consult general practitioners each year, seeking treatment for premenstrual syndrome. This qualitative study presents evidence of women's own perceptions of this problem, which may assist in the provision of individualized health care. AIM: To explore women's constructions of premenstrual syndrome using grounded analysis. METHOD: A qualitative, semi-structured interview study carried out in Northern Ireland. Thirteen women were interviewed individually. Thereafter, 33 women participated in group discussions. Five health visitors then commented individually on the findings. RESULTS: Seven themes emerged from the analysis. These themes suggested that women tend to view the menstrual cycle holistically and that premenstrual syndrome is regarded as debilitating by only a small minority of women. Participants indicated an awareness of the intra- and inter-personal variability of menstrual experience. They were ambivalent about menstruation, viewing it as natural but, at the same time, unnatural in terms of day-to-day existence. 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 menstruation only to selected men, mainly partners, primarily in the interests of educating them. Women viewed menstruation as potentially disempowering by virtue of its uncontrollability, and felt that both a positive attitude and 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 markedly from those as presented in medical textbooks and research literature: secondary sources that have significantly impacted upon general practitioners' 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 traditional randomized controlled trials.
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