TEDxSBU
Robyn Stein DeLuca: The good news about PMS
蘿繽·史坦·德路卡: 經前症候群的好消息
Filmed:
Readability: 5.6
1,503,033 views
每個人都知道大部分的女性在月經前會有點發神經，而且她們的生育荷爾蒙導致情緒大幅波動。但是不對：經前症候群的科學共識極少。心理學家蘿繽·史坦·德路卡說，科學對經前症候群的定義、起因、治療，甚至這個病到底存不存在都還沒有共識。她探索我們對此病已知或未知的部分，並探索為什麼這個眾所皆知的迷思流傳久遠。
Robyn Stein DeLuca - Psychologist
Robyn Stein DeLuca asks, What do we really know about PMS? Full bio
Robyn Stein DeLuca asks, What do we really know about PMS? Full bio
Double-click the English transcript below to play the video.
00:13
How many people here have heard of PMS?
0
1110
4319
有多少人聽過經前症候群 (PMS)？
00:17
Everybody, right?
1
5429
1486
大家都聽過，對吧？
00:18
Everyone knows that women
go a little crazy
go a little crazy
2
6915
2484
大家都知道女人在月經來之前
00:21
right before they get their period,
3
9399
2871
會有點發神經，
00:24
that the menstrual cycle throws them
onto an inevitable hormonal roller coaster
onto an inevitable hormonal roller coaster
4
12270
4188
月經週期讓她們坐上
無可避免的荷爾蒙導致的
無可避免的荷爾蒙導致的
00:28
of irrationality and irritability.
5
16458
2693
不理性與易怒的雲霄飛車。
00:31
There's a general assumption
6
19151
1788
有個很普遍的說法，
00:32
that fluctuations in reproductive hormones
cause extreme emotions
cause extreme emotions
7
20939
4919
說生殖荷爾蒙波動
會造成極端的情緒，
會造成極端的情緒，
00:37
and that the great majority of women
are affected by this.
are affected by this.
8
25858
3533
而且絕大部分婦女都受此影響。
00:41
Well, I am here to tell you
that scientific evidence says
that scientific evidence says
9
29391
2759
嗯，我在這裡告訴大家
科學證據顯示
科學證據顯示
00:44
neither of those assumptions is true.
10
32150
2419
這兩個說法都不對。
00:46
I'm here to give you
the good news about PMS.
the good news about PMS.
11
34569
3223
我要在這裡宣布
經前症候群的好消息。
經前症候群的好消息。
00:50
But first, let's take a look
at how firmly the idea of PMS
at how firmly the idea of PMS
12
38572
3670
但首先來看一下
經前症候群這個說法
經前症候群這個說法
00:54
is entrenched in American culture.
13
42242
2392
有多麼深植於美國文化。
00:56
If you examine newspaper
or magazine articles,
or magazine articles,
14
44634
3576
如果你檢視報章雜誌的文章，
01:00
you'll see how widely assumed it is
that everyone gets PMS.
that everyone gets PMS.
15
48210
4342
你就會發現大家都以為
每個人都有經前症候群。
每個人都有經前症候群。
01:04
In an article in the magazine Redbook
titled "You: PMS Free,"
titled "You: PMS Free,"
16
52552
5388
女性雜誌《紅書》有篇文章標題為：
「妳！從經前症候群釋放吧！」
「妳！從經前症候群釋放吧！」
01:09
readers were informed that between 80
to 90 percent of women suffer from PMS.
to 90 percent of women suffer from PMS.
17
57940
5580
文章告訴讀者約有八九成的女性
為經前症候群所苦。
為經前症候群所苦。
01:15
L.A. Muscle magazine warned its readers
18
63520
2731
倫敦保健食品雜誌則警告讀者
01:18
that 40 to 50 percent of women
suffer from PMS,
suffer from PMS,
19
66251
3274
有四到五成的婦女
為經前症候群所苦，
為經前症候群所苦，
01:21
and that it plays a major role
in women's mental and physical health,
in women's mental and physical health,
20
69525
4644
而且這還在女性的身心健康
扮演重要角色，
扮演重要角色，
01:26
and a couple of years ago,
even the Wall Street Journal
even the Wall Street Journal
21
74169
2991
而在幾年前，甚至華爾街日報
01:29
ran an article on calcium
as a treatment for PMS,
as a treatment for PMS,
22
77160
3185
也有篇文章在談
鈣質如何治療經前症候群，
鈣質如何治療經前症候群，
01:32
asking its female readers,
23
80345
2055
並這樣問其女性讀者，
01:34
"Do you turn into a witch every month?"
24
82400
2089
「妳每個月都變成巫婆嗎？」
01:36
From all these articles, you would think
there must be a mountain of research
there must be a mountain of research
25
84989
3877
有這麼多文章你可能會想，
一定有如山般鐵證
一定有如山般鐵證
01:40
verifying the widespread nature of PMS.
26
88866
3924
能驗證經前症候群的普遍性。
01:44
However, after five decades of research,
27
92790
3158
然而，經過五十年的研究，
01:47
there's no strong consensus
on the definition, the cause,
on the definition, the cause,
28
95948
4071
眾人對經前症候群的
定義、起因、療法，
定義、起因、療法，
01:52
the treatment, or even
the existence of PMS.
the existence of PMS.
29
100019
4141
甚至到底是否存在
都沒有強烈共識。
都沒有強烈共識。
01:56
As most commonly defined by psychologists,
30
104160
3153
心理學家最常用的定義是，
01:59
PMS involves negative behavioral,
cognitive and physical symptoms
cognitive and physical symptoms
31
107313
4969
經前症候群會使人
從排卵開始到月經來其間，
從排卵開始到月經來其間，
02:04
from the time of ovulation
to menstruation.
to menstruation.
32
112282
2926
陷入負面的行為、
認知、及身體症狀，
認知、及身體症狀，
02:07
But here's where it gets tricky.
33
115208
2212
但這就是詭異的地方了。
02:09
Over 150 different symptoms
have been used to diagnose PMS,
have been used to diagnose PMS,
34
117420
5241
已有超過 150 種不同的症狀
被拿來診斷經前症候群，
被拿來診斷經前症候群，
02:14
and here are just a few of those.
35
122661
2090
這裡只是其中幾種。
02:16
Now, I want to be clear here.
36
124751
1881
那，我要澄清一下。
02:18
I'm not saying women don't get
some of these symptoms.
some of these symptoms.
37
126632
3366
我不是說婦女不會有這些症狀。
02:21
What I'm saying is that
getting some of these symptoms
getting some of these symptoms
38
129998
2624
我要說的是有這些症狀
02:24
doesn't amount to a mental disorder,
39
132622
2879
並不等於妳精神異常，
02:27
and when psychologists
come up with a disorder
come up with a disorder
40
135501
3321
心理學家提出某種失調病症，
02:30
that's so vaguely defined,
41
138822
2286
卻定義模糊不清，
02:33
the label eventually becomes meaningless.
42
141108
3483
這樣的標籤最終會失去意義。
02:36
With a list of symptoms
this long and wide,
this long and wide,
43
144591
2972
有這麼洋洋灑灑的症狀表，
02:39
I could have PMS, you could have PMS,
44
147563
2763
我可能會得經前症候群，
你可能也會，
你可能也會，
02:42
the guy in the third row here
could have PMS,
could have PMS,
45
150326
2554
第三排的男生也會得經前症候群，
02:44
my dog could have PMS.
(Laughter)
(Laughter)
46
152880
2693
連我的狗都會得到經前症候群。
（笑聲）
（笑聲）
02:48
Some researchers said
you had to have five symptoms.
you had to have five symptoms.
47
156193
2668
有些研究員說你得要有五種症狀，
02:50
Some said three.
48
158861
1565
有些人說三種就好。
02:52
Other researchers said that symptoms
were only meaningful
were only meaningful
49
160426
2856
還有些研究員說那些症狀
要在非常困擾妳時才有意義。
02:55
if they were highly disturbing to you,
50
163282
1834
02:57
but others said minor symptoms
were just as important.
were just as important.
51
165116
3553
但也有人說輕微的症狀也很重要。
03:00
For many years, because
there was no standardization
there was no standardization
52
168669
2902
多少年了，因為沒有統一
03:03
in the definition of PMS,
53
171571
2089
定義經前症候群，
03:05
when psychologists tried
to report prevalence rates,
to report prevalence rates,
54
173660
3065
當心理學家試著報出患病率，
03:08
their estimates ranged
from five percent of women
from five percent of women
55
176725
2787
他們的估計範圍是
5% 到 97% 的婦女有這個病症，
03:11
to 97 percent of women,
56
179512
2298
03:13
so at the same time almost no one
and almost everyone had PMS.
and almost everyone had PMS.
57
181810
5828
意思是同一時間，幾乎沒有人
或幾乎所有人都有經前症候群。
或幾乎所有人都有經前症候群。
03:19
Overall, the weaknesses in the methods
of research on PMS have been considerable.
of research on PMS have been considerable.
58
187638
6692
整體來看，經前症候群的
研究方法缺陷相當多。
研究方法缺陷相當多。
03:26
First, many studies asked women
to report their symptoms retrospectively,
to report their symptoms retrospectively,
59
194330
5637
第一，許多研究要求
婦女回溯她們的症狀，
婦女回溯她們的症狀，
03:31
looking to the past and relying on memory,
60
199967
2717
靠著記憶回想過去，
03:34
which is known to inflate reporting of PMS
61
202684
3181
大家都知道這個方法會大量增加
經前症候群的報告數據，
經前症候群的報告數據，
03:37
compared to what's called
prospective reporting,
prospective reporting,
62
205865
3365
較之於所謂的前瞻性研究，
03:41
which involves keeping
a daily log of symptoms
a daily log of symptoms
63
209230
2196
要受試者每天記錄症狀
03:43
for at least two months in a row.
64
211426
2438
至少連續兩個月。
03:45
Many studies also exclusively focused
on white, middle-class women,
on white, middle-class women,
65
213864
4969
許多研究也只專注在
白人中產階級婦女，
白人中產階級婦女，
03:50
which makes it problematic
to apply study findings to all women.
to apply study findings to all women.
66
218833
4646
如果將研究結果應用在
全部婦女會成為問題。
全部婦女會成為問題。
03:55
We know there's a strong
cultural component to the belief in PMS
cultural component to the belief in PMS
67
223479
4038
我們知道相信經前症候群與否
有很強的文化要素，
有很強的文化要素，
03:59
because it's nearly unheard of
outside of Western nations.
outside of Western nations.
68
227517
3622
因為這在西方國家以外
幾乎是聞所未聞。
幾乎是聞所未聞。
04:03
Third, many studies failed
to use control groups.
to use control groups.
69
231139
4261
第三，許多研究沒有設控制組。
04:07
If we want to understand
the specific characteristics
the specific characteristics
70
235400
2810
如果我們想要瞭解
有經前症候群婦女的特性，
04:10
of women who have PMS,
71
238210
1520
04:11
we need to be able to compare them
to women who don't have PMS.
to women who don't have PMS.
72
239730
4202
我們必須要將她們與
沒有經前症候群的女性比較。
沒有經前症候群的女性比較。
04:15
And finally, many different types
of questionnaires were used
of questionnaires were used
73
243932
3228
最後是，使用太多不同型態的問卷
04:19
to diagnose PMS, focusing
on different symptoms,
on different symptoms,
74
247160
4010
來診斷經前症候群，
專注在不同的症狀，
專注在不同的症狀，
04:23
symptom duration and severity.
75
251170
2653
症狀持續多久及多嚴重。
04:25
To do reliable research on any condition,
76
253823
3111
要對任何病症做出可靠的研究，
04:28
scientists must agree
on the specific characteristics
on the specific characteristics
77
256934
2949
科學家必須先商定
會造成此病症的特性，
04:31
that make up that condition
78
259883
1753
04:33
so they're all talking
about the same thing,
about the same thing,
79
261636
2113
這樣大家見解才會一致，
04:35
and with PMS, this has not been the case.
80
263749
3436
但是對經前症候群
卻不是這樣研究的。
卻不是這樣研究的。
04:39
However, in 1994,
81
267185
2276
然而，在 1994 年
04:41
the Diagnostic and Statistical Manual
of Mental Disorders,
of Mental Disorders,
82
269461
3668
精神疾病診斷與統計手冊，
04:45
known as the DSM, thankfully --
83
273129
2299
俗稱 DSM，還好這麼短——
04:47
it's also the manual
for mental health professionals --
for mental health professionals --
84
275428
3878
這也是身心科專家的手冊——
04:51
they redefined PMS as PMDD,
85
279306
3924
他們重新定義 PMS 成 PMDD，
04:55
Premenstrual Dysphoric Disorder.
86
283230
3018
經前不悅症。
04:58
And dysphoria refers to
a feeling of agitation or unease.
a feeling of agitation or unease.
87
286248
5944
不悅指的是煩躁不安的感覺。
05:04
And according to these new DSM guidelines,
88
292192
3460
根據這些新的經前不悅症準則，
05:07
in most menstrual cycles in the last year,
89
295652
3227
在過去一年大部分的月經週期中，
05:10
at least five of 11 possible symptoms
90
298879
3251
至少有五種 11 個可能出現的症狀，
05:14
must appear in the week
before menstruation starts;
before menstruation starts;
91
302130
3692
在月經來潮前一星期內出現；
05:17
the symptoms must improve
once menstruation has begun;
once menstruation has begun;
92
305822
3367
這些症狀在月經來潮後就改善；
05:21
and the symptoms must be absent
the week after menstruation has ended.
the week after menstruation has ended.
93
309189
4742
而且這些症狀要在
月經結束一週內消失。
月經結束一週內消失。
05:27
One of these symptoms must come
from this list of four:
from this list of four:
94
315101
3328
一定要有下列四種症狀之一：
05:30
marked mood swings, irritability,
anxiety, or depression.
anxiety, or depression.
95
318429
5248
顯著的情緒起伏、
易怒、焦慮或憂慮。
易怒、焦慮或憂慮。
05:35
The other symptoms could come
from the first slide
from the first slide
96
323677
2832
其他的症狀則可能是
第一張幻燈片
第一張幻燈片
05:38
or from those on the second slide,
97
326509
2137
或第二張幻燈片所列出的，
05:40
including symptoms like
feeling out of control
feeling out of control
98
328646
2623
包括失控的感覺，
05:43
and changes in sleep or appetite.
99
331269
3669
睡眠或食慾改變。
05:46
The DSM also required now
that the symptoms
that the symptoms
100
334938
3877
經前不悅症還必須有
05:50
should be associated with
clinically significant distress --
clinically significant distress --
101
338815
4180
具臨床意義的明顯困擾——
05:54
there should be some kind
of disturbance in work
of disturbance in work
102
342995
2833
對工作、學校或社交
05:57
or school or social relationships --
103
345828
2925
產生一定程度的影響——
06:00
and that symptoms and symptom severity
should now be documented
should now be documented
104
348753
3506
出現的症狀及其嚴重性
必須記錄下來，
必須記錄下來，
06:04
by keeping a daily log
for at least two cycles in a row.
for at least two cycles in a row.
105
352259
4017
至少連續兩個週期每天做記錄。
06:08
And finally, the DSM required that
the emotional disturbance
the emotional disturbance
106
356276
3855
最後，經前不悅症的情緒困擾，
06:12
should be more than simply an exacerbation
of an already existing disorder.
of an already existing disorder.
107
360131
5758
其嚴重性應大於
原有失調的放大效應。
原有失調的放大效應。
06:17
So scientifically speaking,
this is an improvement.
this is an improvement.
108
365889
2786
所以從科學角度說，
這是很大的進步。
這是很大的進步。
06:20
We now have a limited number of symptoms,
109
368675
2647
我們現在得到有限數量的症狀，
06:23
and a high impact on functioning
that's required,
that's required,
110
371322
3576
要對生活功能產生強烈衝擊，
06:26
and the reporting and timing of symptoms
have both become very specific.
have both become very specific.
111
374898
5456
而且對症狀的描述
及發生時間講得很明確。
及發生時間講得很明確。
06:32
Well, using this criteria
112
380354
2810
嗯，使用這個標準
06:35
and looking at most recent studies,
113
383164
2146
並看一下最近的研究，
06:37
we see that on average,
114
385310
1615
我們看到平均
06:38
three to eight percent of women
suffer from PMDD.
suffer from PMDD.
115
386925
5965
有百分之三到八的女性
為經前不悅症所苦。
為經前不悅症所苦。
06:44
Not all women, not most women,
116
392890
2580
不再說是所有的女性，
多數的女性，
多數的女性，
06:47
not the majority of women,
not even a lot of women:
not even a lot of women:
117
395470
2770
也不是大部分的女性，
更不是很多女性：
更不是很多女性：
06:50
three to eight percent.
118
398240
2686
是百分之三到八。
06:52
For everyone else, variables
like stressful events or happy occasions
like stressful events or happy occasions
119
400926
4957
對其它女性，變因像是
壓力很大的事件或開心的場合，
壓力很大的事件或開心的場合，
06:57
or even day of the week
120
405883
2044
甚至今天是星期幾
06:59
are more powerful predictors of mood
than time of the month,
than time of the month,
121
407927
4085
都比月經更能預測情緒，
07:04
and this is the information
the scientific community has had
the scientific community has had
122
412012
3440
而這是自 1990 年代開始
科學界就有的資料。
科學界就有的資料。
07:07
since the 1990s.
123
415452
1530
07:08
In 2002, my colleagues and I
published an article
published an article
124
416982
2740
2002 年，我與幾個同事
發表了一篇論文
發表了一篇論文
07:11
describing the PMS and PMDD research,
125
419722
3134
講述經前症候群
與經前不悅症的研究，
與經前不悅症的研究，
07:14
and several similar articles have appeared
in psychology journals.
in psychology journals.
126
422856
4273
還有幾篇類似的論文
也發表在心理學期刊上。
也發表在心理學期刊上。
07:19
The questions is, why hasn't this
information trickled down to the public?
information trickled down to the public?
127
427129
4411
問題是，為什麼這樣的資訊
還沒有流入大眾？
還沒有流入大眾？
07:23
Why do these myths persist?
128
431540
3576
為什麼這些迷思依然存在？
07:27
Well, certainly the onslaught
of messages that women receive
of messages that women receive
129
435116
3297
嗯，顯然女性長時間
從書籍、電視、電影及網路
從書籍、電視、電影及網路
07:30
from books, TV, movies, the Internet,
that everyone gets PMS
that everyone gets PMS
130
438413
5144
接收到的一波波消息，
都說每個人都有經前症候群，
都說每個人都有經前症候群，
07:35
go a long way in convincing them
it must be true.
it must be true.
131
443557
3633
已經說服她們這是事實。
07:39
Research tells us that the more
a woman believes that everyone gets PMS,
a woman believes that everyone gets PMS,
132
447190
5170
研究人員告訴我們女性愈相信
每個人都有經前症候群的說法，
每個人都有經前症候群的說法，
07:44
the more likely she is
to erroneously report that she has it.
to erroneously report that she has it.
133
452360
3908
她就愈有可能錯誤地說她自己有。
07:48
Let me tell you what I mean
by "erroneously."
by "erroneously."
134
456268
2276
我解釋一下我說「錯誤」的意思。
07:50
You might ask her, "Do you have PMS?"
135
458544
2726
你可能問她，妳有經前症候群嗎？
07:53
and she says yes,
136
461270
1343
她說有，
07:54
but then, when you have her
keep a daily log
keep a daily log
137
462613
2418
但之後，在你要她每天記錄
07:57
of psychological symptoms for two months,
138
465031
2399
精神症狀兩個月後，
07:59
no correlation is found
between her symptoms
between her symptoms
139
467430
3274
她的症狀與月經找不到關連性。
08:02
and time of the month.
140
470704
1792
08:05
Another reason for
the persistence of the PMS myth
the persistence of the PMS myth
141
473016
4369
另一個經前症候群迷思
持久不衰的理由
持久不衰的理由
08:09
has to do with the narrow boundaries
of the feminine role.
of the feminine role.
142
477385
3461
與狹隘的女性角色範圍有關。
08:12
Feminist psychologists like Joan Chrisler
143
480846
2648
女性主義心理學家
如喬安克萊斯勒提出，
如喬安克萊斯勒提出，
08:15
have suggested that
taking on the label of PMS
taking on the label of PMS
144
483494
3992
把自己貼上經前症候群的標籤，
08:19
allows women to express emotions that
would otherwise be considered unladylike.
would otherwise be considered unladylike.
145
487486
5433
讓女性能表達原本會被
視為不嫻淑的情緒。
視為不嫻淑的情緒。
08:24
The near universal definition
of a good woman
of a good woman
146
492919
3391
幾乎放諸四海皆準的好女人定義
08:28
is one who is happy, loving,
caring for others,
caring for others,
147
496310
3528
是快樂、慈愛、對人充滿愛心，
08:31
and taking great satisfaction
from that role.
from that role.
148
499838
2856
並且對這樣的角色很滿足。
08:34
Well, PMS has become a permission slip
to be angry, complain, be irritated,
to be angry, complain, be irritated,
149
502694
5152
經前症候群已經成為
能生氣、抱怨、煩躁，
能生氣、抱怨、煩躁，
08:39
without losing the title of good woman.
150
507846
3368
卻不會失去好女人頭銜的同意書。
08:43
We know that the variables
in a woman's environment
in a woman's environment
151
511214
4040
我們知道女性的環境中有很多變數
08:47
are much more likely to cause her
to be angry than her hormones,
to be angry than her hormones,
152
515254
3460
比荷爾蒙更容易讓她生氣，
08:50
but when she attributes anger to hormones,
153
518714
2856
但是當她將怒氣歸咎於荷爾蒙，
08:53
she's absolved
of responsibility or criticism.
of responsibility or criticism.
154
521570
2767
她就免於責任，也免除了責難。
08:56
"Oh, that's not who she is.
It's out of her control."
It's out of her control."
155
524337
3453
喔，她平常不是那樣的。
她控制不了。
她控制不了。
08:59
And while this can be a useful tool,
it serves to invalidate women's emotions.
it serves to invalidate women's emotions.
156
527790
6616
儘管這可以當作有用的工具，
實際上卻否定了女性的情緒。
實際上卻否定了女性的情緒。
09:06
When people respond to a woman's anger
157
534406
2721
在大家對女性的怒氣
09:09
with the thought, "Oh,
it's just that time of the month,"
it's just that time of the month,"
158
537127
2995
用「喔，大姨媽來了」
這樣的想法來回應時，
這樣的想法來回應時，
09:12
her ability to be taken seriously
or effect change is severely limited.
or effect change is severely limited.
159
540122
5358
她被人認真看待
或有效改變的機會就大受限制。
或有效改變的機會就大受限制。
09:17
So who else benefits from the myth of PMS?
160
545480
3987
那麼還有誰會從
經前症候群迷思中得利？
經前症候群迷思中得利？
09:21
Well, I can tell you that treating PMS
161
549467
2044
我可以告訴你們治療經前症候群
09:23
has become a profitable,
thriving industry.
thriving industry.
162
551511
4481
已成為有利可圖、蓬勃發展的行業。
09:27
Amazon.com currently offers
over 1,900 books on PMS treatment.
over 1,900 books on PMS treatment.
163
555992
6780
亞馬遜網站最近放了超過
1,900 本治療經前症候群的書。
1,900 本治療經前症候群的書。
09:34
A quick Google search
will bring up a cornucopia
will bring up a cornucopia
164
562772
2461
在谷歌上隨便找找就能找到
一籮筐的診所、專討或研討會。
09:37
of clinics, workshops and seminars.
165
565233
3738
09:40
Reputable Internet sources
of medical information
of medical information
166
568971
2903
聲譽良好的醫療資源網站
09:43
like WebMD or the Mayo Clinic
list PMS as a known disorder.
list PMS as a known disorder.
167
571874
4760
如網路醫師或梅奥醫院
將經前症候群列為已知的病症。
將經前症候群列為已知的病症。
09:48
It's not a known disorder,
but they list it.
but they list it.
168
576634
2507
這並不是已知的病症，
但他們將其列為之一。
但他們將其列為之一。
09:51
And they also list the medications that
physicians have prescribed to treat it,
physicians have prescribed to treat it,
169
579141
3971
他們也列出醫師開出的治療藥物，
09:55
like anti-depressants or hormones.
170
583112
2936
如抗憂鬱劑或荷爾蒙。
09:58
Interestingly, though, both websites
say that the success of medication
say that the success of medication
171
586048
5724
但很有意思的是，兩個網站都說
治療經前症候群的藥物
成效因不同女人而異。
成效因不同女人而異。
10:03
in treating PMS symptoms
vary from woman to woman.
vary from woman to woman.
172
591772
4087
10:07
Well, that doesn't make sense.
173
595859
1731
這沒道理。
10:09
If you've got a distinct disorder
with a distinct cause,
with a distinct cause,
174
597590
2634
如果你得了某種很明確的病症
起因也很明確，
起因也很明確，
10:12
which PMS is supposed to be,
175
600224
1950
經前症候群就被歸為此類，
10:14
then the treatment should bring
improvement for a great number of women.
improvement for a great number of women.
176
602174
3808
那麼應該會在大部分
女性身上看到治療成效。
女性身上看到治療成效。
10:17
This has not been the case
with these treatments,
with these treatments,
177
605982
2554
但是這些治療藥物並非如此，
10:20
and FDA regulations say that
for a drug to be deemed effective,
for a drug to be deemed effective,
178
608536
4110
美國食品藥物管理局的法規說
某種藥物要視為有效，
某種藥物要視為有效，
10:24
a large portion of the target population
179
612646
2067
必須在大部分的目標族群身上
10:26
should see clinically
significant improvement.
significant improvement.
180
614713
3158
看到有臨床意義的改善。
10:29
So we have not had that at all
with these so-called treatments.
with these so-called treatments.
181
617871
4016
我們還沒有在這些
所謂的治療法上看到這點。
所謂的治療法上看到這點。
10:33
However, the financial gain
of perpetuating the myth
of perpetuating the myth
182
621887
4313
然而，延續此項迷思，
10:38
that PMS is a common mental disorder
183
626200
3001
即經前症候群是常見、
可治療的精神病症，
可治療的精神病症，
10:41
and is treatable is quite substantial.
184
629201
4069
所得到的經濟利益相當可觀。
10:45
When women are prescribed
drugs like anti-depressants or hormones,
drugs like anti-depressants or hormones,
185
633270
3454
如果婦女接受藥物
如抗憂鬱劑或荷爾蒙，
如抗憂鬱劑或荷爾蒙，
10:48
medical protocol requires that they have
physician follow-up every three months.
physician follow-up every three months.
186
636724
5109
醫療計畫常規要求她們
必須每三個月回診一次。
必須每三個月回診一次。
10:53
That's a lot of doctor visits.
187
641833
1973
這可是相當大量的就醫次數。
10:55
Pharmaceutical companies
reap untold profits
reap untold profits
188
643806
2508
製藥公司賺進數不清的利潤，
10:58
when women are convinced
they should take a prescribed medication
they should take a prescribed medication
189
646314
3924
就因為女人接受她們必須
在生育年齡吃處方藥的說法。
11:02
for all of their child-bearing lives.
190
650238
2902
11:05
Over-the-counter drugs like Midol
191
653140
2624
非處方藥物如止經痛藥
「美多」甚至宣稱
「美多」甚至宣稱
11:07
even claim to treat PMS symptoms
like tension and irritability,
like tension and irritability,
192
655764
4412
可以治療經前症候群症狀，
如緊張及易怒，
如緊張及易怒，
11:12
even though they only contain
a diuretic, a pain reliever
a diuretic, a pain reliever
193
660176
3993
即使藥物成分只有利尿劑、止痛藥
11:16
and caffeine.
194
664169
1974
及咖啡因。
11:18
Now, far be it from me to argue
with the magical powers of caffeine,
with the magical powers of caffeine,
195
666143
3436
那麼，我沒立場爭論
咖啡因的神奇力量，
咖啡因的神奇力量，
11:21
but I don't think reducing tension
is one of them.
is one of them.
196
669579
4365
但我也不認為咖啡因
有減輕緊張的效用。
有減輕緊張的效用。
11:25
Since 2002, Midol has marketed
a Teen Midol to adolescents.
a Teen Midol to adolescents.
197
673944
6566
自 2002 年起，美多開始
銷售「婷美多」給青少女。
銷售「婷美多」給青少女。
11:32
They are aiming at young girls early,
198
680510
2830
他們早早把目標對準年輕少女，
11:35
to convince them that everyone gets PMS
and that it will make you a monster,
and that it will make you a monster,
199
683340
4245
說服她們每個人都會得經前症候群，
而且這會讓妳變成大怪物，
而且這會讓妳變成大怪物，
11:39
but wait, there's something
you can do about it:
you can do about it:
200
687585
2279
但是等一下！妳還有救的！
11:41
Take Midol and you will be
a human being again.
a human being again.
201
689864
3062
吃下美多妳就變回人了！
11:44
In 2013, Midol took in 48 million dollars
in sales revenue.
in sales revenue.
202
692926
6524
2013 年，美多的銷貨收入
為四千八百萬美金。
為四千八百萬美金。
11:51
So while perpetuating the myth of PMS
has been lucrative for some,
has been lucrative for some,
203
699450
4650
所以延續經前症候群迷思
除了成為某些人吸金的工具外，
除了成為某些人吸金的工具外，
11:56
it comes with some serious
adverse consequences for women.
adverse consequences for women.
204
704100
4220
還為婦女帶來嚴重的不良後果。
12:00
First, it contributes
to the medicalization
to the medicalization
205
708320
2554
第一，它使女性的生育健康醫療化。
12:02
of women's reproductive health.
206
710874
2670
12:05
The medical field has a long history
of conceptualizing
of conceptualizing
207
713544
3204
醫界有著很長的歷史
將女性的生育過程
將女性的生育過程
12:08
women's reproductive processes
as illnesses that require treatment,
as illnesses that require treatment,
208
716748
5410
視為疾病、需要治療的概念，
12:14
and this has come at many costs,
including excessive Cesarean deliveries,
including excessive Cesarean deliveries,
209
722158
4110
而這已造成許多花費，
包括過多的剖腹產、
包括過多的剖腹產、
12:18
hysterectomies and prescribed
hormone treatments
hormone treatments
210
726268
2710
子宮切除術、及開出荷爾蒙治療藥，
12:20
that have harmed rather than enhanced
women's health.
women's health.
211
728978
4027
而藥物的傷害大於增進婦女健康。
12:25
Second, the PMS myth also contributes
to the stereotype of women
to the stereotype of women
212
733675
4830
第二，經前症候群迷思也是造成女性
12:30
as irrational and overemotional.
213
738505
3366
易怒及過度情緒化的刻板印象原因。
12:33
When the menstrual cycle is described
as a hormonal roller coaster
as a hormonal roller coaster
214
741871
3739
一旦月經週期被形容為
荷爾蒙雲霄飛車，
荷爾蒙雲霄飛車，
12:37
that turns women into angry beasts,
215
745610
2820
把女性變成氣呼呼的野獸，
12:40
it becomes easy to question
the competence of all women.
the competence of all women.
216
748430
4345
我們就很容易質疑女性的能力。
12:44
Women have made tremendous strides
in the workforce,
in the workforce,
217
752775
2819
婦女在工作場合的地位
已有極大的進步，
已有極大的進步，
12:47
but still there's a minuscule number
of women at the highest echelons
of women at the highest echelons
218
755594
4063
但是仍然只有極少數的女性
處在政府或企業的高層職位，
12:51
of fields like government or business,
219
759657
2740
12:54
and when we think about
who makes for a good CEO or senator,
who makes for a good CEO or senator,
220
762397
4946
而且每次我們考慮什麼樣的人
可稱為好的執行長或參議員，
可稱為好的執行長或參議員，
12:59
someone who has qualities like
rationality, steadiness, competence
rationality, steadiness, competence
221
767343
5119
具有理性、穩健、能力等條件的人
13:04
come to mind,
222
772462
1509
就會在腦中浮現，
13:05
and in our culture, that sounds more
like a man than a woman,
like a man than a woman,
223
773971
3541
在我們的文化，那些條件
聽起來更符合男人而非女人，
聽起來更符合男人而非女人，
13:09
and the PMS myth contributes to that.
224
777512
3658
經前症候群迷思正是助長的原因。
13:13
Psychologists know that
the moods of men and women
the moods of men and women
225
781170
3169
心理學家知道男人與女人的情緒
13:16
are more similar than different.
226
784339
2833
更趨相似而非相異。
13:19
One study followed men and women
for four to six months
for four to six months
227
787172
4063
一項研究追蹤男人與女人
四到六個月，
四到六個月，
13:23
and found that the number
of mood swings they experienced
of mood swings they experienced
228
791235
3065
發現兩性經歷心情起伏的次數
13:26
and the severity of those mood swings
were no different.
were no different.
229
794300
3854
及其嚴重性並沒有不同。
13:30
And finally, the PMS myth
keeps women from dealing
keeps women from dealing
230
798154
4203
最後，經前症候群迷思
不讓女性處理
不讓女性處理
13:34
with the actual issues
causing them emotional upset.
causing them emotional upset.
231
802357
4017
造成他們心煩意亂的真正原因：
13:38
Individual issues like
quality of relationship or work conditions
quality of relationship or work conditions
232
806374
4425
個人因素如
人際關係品質或工作環境，
人際關係品質或工作環境，
13:42
or societal issues like racism or sexism
or the daily grind of poverty
or the daily grind of poverty
233
810809
4504
或社會因素如種族歧視、
性別歧視或貧窮的磨難，
性別歧視或貧窮的磨難，
13:47
are all strongly related to daily mood.
234
815313
3344
都與每天的情緒有很大的關係。
13:50
Sweeping emotions under the rug of PMS
235
818657
3763
以經前症候群當藉口
逃避情緒問題，
逃避情緒問題，
13:54
keeps women from understanding
the source of their negative emotions,
the source of their negative emotions,
236
822420
3852
只是讓女人更難瞭解
她們負面情緒的來源，
她們負面情緒的來源，
13:58
but it also takes away the opportunity
to take any action to change them.
to take any action to change them.
237
826272
5368
同時也拿走讓她們
以行動來改變情緒的機會。
以行動來改變情緒的機會。
14:03
So the good news about PMS
238
831640
2829
所以經前症候群的好消息
14:06
is that while some women get some symptoms
because of the menstrual cycle,
because of the menstrual cycle,
239
834469
4736
是有些女人的確因
月經週期而有某些症狀，
月經週期而有某些症狀，
14:11
the great majority don't
get a mental disorder.
get a mental disorder.
240
839205
3553
但大部分的女人並不
因此而得了神經病。
因此而得了神經病。
14:14
They go to work or school,
take care of their families,
take care of their families,
241
842758
3227
她們照常工作、上學、照顧家庭，
14:17
and function at a normal level.
242
845985
2299
以正常的水準行使職責。
14:20
We know the emotions and moods
of men and women
of men and women
243
848284
3227
我們知道男人與女人的情緒及心情
14:23
are more similar than different,
244
851511
1951
更趨相似而非相異，
14:25
so let's walk away from
the tired old PMS myth of women as witches
the tired old PMS myth of women as witches
245
853462
5620
所以讓我們從陳腐的
經前症候群迷思中走出，
經前症候群迷思中走出，
不再視女性為巫婆，
而能接受絕大部分女性
而能接受絕大部分女性
14:31
and embrace the reality of high emotional
and professional functioning
and professional functioning
246
859097
4848
每天都過著高情緒
及高專業功能生活的事實。
及高專業功能生活的事實。
14:35
the great majority of women
live every day.
live every day.
247
863945
3204
14:39
Thank you.
248
867149
2276
謝謝。
14:41
(Applause)
249
869425
2112
（掌聲）
ABOUT THE SPEAKER
Robyn Stein DeLuca - PsychologistRobyn Stein DeLuca asks, What do we really know about PMS?
Why you should listen
Robyn Stein DeLuca is a Research Assistant Professor in the Department of Psychology at Stony Brook University where she's taught Women's Studies through the lenses of psychology and healthcare for over fifteen years. DeLuca studies the psychology of pregnancy, including postpartum depression and the psychosocial consequences of cesarean delivery. For two years, she was the Executive Director of the Women in Science and Engineering (WISE) program at Stony Brook. In 2015, DeLuca received a graduate certificate in Religious Studies and Education from the Harvard Divinity School. She teaches and speaks often about the role of women in Judaism, Christianity, and Islam.
More profile about the speakerRobyn Stein DeLuca | Speaker | TED.com