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Women Behaving Badly?

Female Troubles

Natural Alternatives Also Work continued...

In its marketing materials, Lilly draws a sharp distinction between PMS and PMDD, but others say the line is blurry, and that PMDD -- if it exists at all -- is really at the extreme end of a continuum representing the normal range of women's physiologic responses to hormonal variations.

"We need to give more credit to women for knowing what's going on in their own mind and bodies, and here we have a situation in which we have data quite conclusively showing that in this case women often do not know -- because it's OK for women to be crabby and because women don't allow themselves room to be sad, even if there are sad circumstances," Stotland says.

"And because psychiatric disorders are stigmatized, people who have just plain depression may not want to deal with that, and they have a tremendous tendency to blame it on PMS," she tells WebMD. "The dangers are that because women's hormonal changes happen to be in cycles, we forget that hormones have impact on men, and one might even say that we're neglecting men in that sense."

She notes that teenage boys tend to be at highest risk for driving accidents -- a fact reflected in their high insurance rates -- and that the adolescent surge of testosterone is probably to blame. No one, yet, however, is suggesting that teenage boys take hormone-adjusting drugs to keep them -- and other drivers -- safe.

"So which is worse: being crabby or being run over?" she asks.

Nevertheless, Stotland agrees that for a small subset of women who meet the very strict and serious symptom criteria for having PMDD, Sarafem probably helps. She also acknowledges that drugmakers have a right to make a buck.

"I have nothing against that. We live in a capitalist society in which we leave it to the pharmaceutical companies to develop nearly all the drugs, and any time they have a drug that's good for something, especially if it is for something especially widespread like the flu, they're going to try and get people to use that medication," she says.

But in this case, Behrendt worries, the desire to wring the maximum profit out of a product may have led the pharmaceutical company to put the cart before the horse.

"In terms of PMDD, I think the evidence speaks for itself," she tells WebMD. "Prozac's patent was running out, and suddenly a new disorder appeared -- PMDD -- that changed the classification to mental disorders. So with that a new class was formed, a new market was formed, and a new patent was formed."

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