Research and theory related to female reproduction: implications for clinical psychology

Reproduction has been proposed as a cause of debilitation and psychological disturbance for centuries, recently reified through the three reproductive syndromes, the premenstrual syndrome, postnatal depression and the menopausal syndrome. The evidence for the existence of these syndromes is critically reviewed, and the different aetiological theories examined, with particular reference to biological and psychological theories. It is argued that whilst bio-medical therapies presently dominate the literature, their efficacy is questionable owing to the lack of clear evidence for a hormonal substrate underlying symptomatology. Psychological interventions are reviewed, and multifactorial or individualized interventions recommended for adoption by clinical psychologists. The role of preventative work, through education, information provision and development of self-help strategies, is discussed. It is concluded that whilst menstruation, childbirth and the menopause do not inevitably have a deleterious effect on women, and the validity of the reproductive syndromes may be questioned, reproduction does act as a salient source of attribution and is a possible contributory factor to distress. Reproduction thus needs to be considered by clinical psychologists, but not privileged above other factors which may contribute to difficulties which individual women may experience.