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Traditionally, explanations for premenstrual symptomatology have focused on the individual woman as the site of difficulties, and as the sole target of intervention. In contrast, from the perspective of a material-discursive-intrapsychic model, this paper will focus on the ways in which ‘PMS’ is experienced, constructed and dealt with in family relationships. Drawing on in-depth narrative interviews conducted with women with moderate to severe premenstrual symptoms, it is argued that ‘PMS’ is closely tied to relationship difficulties and responsibilities; familial expectations and attributions for women's behaviour provide a discursive context for behaviour and emotions to be positioned as ‘PMS’; and that the ongoing self-silencing and pathologization of women's emotions in families are key attributes of ‘PMS’. This suggests that a consideration of relationship issues should be central to any assessment or intervention for premenstrual symptoms, and conversely, that attention should be given to premenstrual exacerbation of relationship difficulties in family or couples therapy.