Witches Every Month

Women who become impossible to live with for a few days each month are more to be pitied than blamed, and they are entitled to more help from the medical profession than they are getting, declared Dr. Erie Henriksen, a surgeon-gynecologist who is head of the University of Southern California's Department of Gynecology.

The women in point, whom he described as "part-time witches," are victims of premenstrual tension. Dr. Henriksen and his colleagues estimate that about one half of all their women patients between the age of 30 and menopause suffer from periodic witchiness. They classify them as grade-one, grade-two and grade-three witches, according to the severity of their symptoms. A grade-three witch, he said frankly, is a woman to be avoided on her bad days unless she gets effective treatment.

Pains from Head to Foot. For as long as a week before menstruation, such women may suffer from emotional tension, extreme nervousness, great irritability, easy fatigability, insomnia, headaches (often resembling migraine), vertigo, depression, abdominal bloating and swollen breasts, increased weight (up to 14 Ibs.), aching thighs, swollen feet, nausea and vomiting. No one woman is likely to have more than a few of these symptoms, but a few are enough to make her miserable and a source of misery to her long-suffering family. The symptoms usually disappear with dramatic suddenness at the beginning of menstruation.

Starting in the 1940s, a few doctors across the country decided that the abdominal bloating was the most discomfiting feature of these periodic attacks and tried treating it with diuretics. A standard treatment was to limit a patient's water intake to a quart a day, forbid her any table salt or food cooked with salt, and make her take ammonium chloride. This was unpleasant, and effective in only 40% of cases. In a few extreme cases, since the bloating seemed to be the result of an ovarian hormone disturbance, women were subjected to X-ray castration. "This," remarked Henriksen dryly, "was pretty rugged treatment."

"You're Just Nervous." Chief difficulty in the past has been that most women do not recognize their complaint for what it is. It creeps up on them gradually, beginning in their late 20s, and reaches a peak of severity around age 40. Others think of their premenstrual discomfort and depression as part of the price they must pay for womanhood. They try to dismiss it, but they do not succeed, and their families suffer as a result. Furthermore, said Henriksen, too many doctors do not understand it and are likely to give a tense, depressed patient a brush-off: "It's all in your head . . . You don't have enough work to keep your mind off yourself . . . You're just too nervous." In 18 years, Dr. Henriksen said, he has treated 400 patients suffering from premenstrual tension; in only one case did the referring physician mention it as the patient's specific complaint.

Dr. Henriksen has experimented with 25 different drugs, was getting good results in 40% of cases with Diamox. Then he tried the new mercurial diuretic, Neo-hydrin. "Our patients," he said, "now call it the turquoise miracle pill." They take it for a few days toward the end of each menstrual cycle for two or three months. It dries them out dramatically, causing a prompt loss of weight or, if taken in time, preventing the unwanted gain. Most patients can go two or three months without treatment before symptoms return. Dr. Henriksen reported the drug gives substantial relief in 90% of all cases. Only a few patients complain of nausea, and no other side effects have been reported with the light dosage (one to four tablets daily) prescribed. Husbands and children, said Dr. Henriksen, express more gratitude to him than do the families of women on whom he has operated for cancer.

Danger: Perfectionism. Dr. Henriksen grants that premenstrual tension is a little-understood complex of emotional and physical factors and that he is giving only symptomatic treatment. But this, he insists, is justified by the results. He does not think that premenstrual tension is the result of a hereditary tendency. But he has found it is common to see both mother and daughter suffer from it. In these cases, mother is invariably a perfectionist, and has imbued her daughter with her standards.

"In medicine," said Dr. Henriksen, "the word never is almost taboo. But I can safely say that we never see this disorder except in the group of so-called perfectionists."

To assess their Neohydrin results, Dr. Henriksen's team treated and studied a group of 200 patients for three years, checked this treatment with a blind placebo test. They have found that the dummy pills may work for one month --but not for longer. Their best guess as to why draining off excess water improves the emotional state: when the body is bloated, so is the brain. In support of this thesis they point out that there is direct evidence of pressure on the mechanism of sight: many women complain of fuzzy vision, which is relieved when they lose weight.

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