Blog of the Society for Menstrual Cycle Research

Saturday Surfing: Midsummer Edition

July 31st, 2010 by Elizabeth Kissling
  • Two from Leslie Botha:
    • Another method of period elimination, endometrial ablation, is marketed as easy-breezy menstrual suppression, claiming “64% reduction in women reporting pain” and “71% reduction in women reporting a lack of self-confidence”. (Note the happy ladies dressed all in white on NovaSure’s website.)
    • Yet another period-tracking app for dudes: FloJuggler is designed for men to track periods of multiple ladies – girlfriends, mom, wife, boss. Surprisingly, the slogan is not “For men who are afraid of women”.
  • The FDA warns that women using Evamist, a spray formulation of estradiol, should stay away from children and pets. Adverse effects include “premature puberty, nipple swelling, and breast development in girls, and breast enlargement in boys” and similar effects in canines.
  • The new, improved version of the female condom is being aggressively promoted in Washington, D.C., to prevent the spread of HIV.
  • Apparently some viewers of the ITV soap Emmerdale were upset when the phrase “jam rags” appeared on a blackboard shopping list.

Reproductive Coercion

July 29th, 2010 by Elizabeth Kissling

In our May 28 “Saturday Surfing” round-up of recommended reading, we highlighted Lynn Harris’ essay for The Nation about new research on “reproductive coercion”: the alarming frequency with which young men try to get their partners pregnant, often by sabotaging birth control methods. Yesterday, GritTV with Laura Flanders interviewed Harris and Elizabeth Miller, the researcher who conducted the study, about the phenomenon and public health responses.

Exercise for dysmenorrhea?

July 26th, 2010 by Elizabeth Kissling

Women have long been advised that exercise is among the best pain relievers for painful periods. But a new Cochrane Review (also published in July, 2010, issue of Obstetrics & Gynecology) indicates that research confirming that advice is inconclusive.

Yet, the data on exercise and dysmenorrhea are quite limited, and only one clinical trial met review standards. The main outcome measure was the change in The MOOS Menstrual Distress Questionnaire (MDQ) after three cycles of treatment. The MDQ is commonly used in menstrual cycle research (and also commonly criticized). Exercise was found to improve MDQ scores within three cycles. This Cochrane review offers some preliminary, although not robust, evidence for the effectiveness of exercise in the treatment of dysmenorrhea.

So if exercise helps your period pain, keep it up!

Saturday Surfing: Lazy Days of Summer Edition

July 24th, 2010 by Elizabeth Kissling

New Technology, Same Mistakes

July 22nd, 2010 by Elizabeth Kissling

Screen shot from iOvulation appWe’ve written previously about some of the apps for tracking menstruation and PMS, but this new iPhone/Pad app for tracking ovulation is problematic.

iOvulation is an application that calculates the time of ovulation and generates your personal fertility calendar. Simply enter the length of your menstrual cycle and the date of your last period, and iOvulation will calculate your fertile days.

The web site suggests it useful both for trying to conceive and for trying to prevent conception. However, I wouldn’t recommend the latter, as its algorithm appears to predict ovulation based on dates of menstruation: “The ovulation dates are calculated based on normal menstruation calculation logic for women having regular periods.”

In other words, it perpetuates what Toni Weschler, author of Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement and Reproductive Health and Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body, labeled the two biggest myths about menstruation in this interview with Scarleteen: (1) the idea that ovulation occurs on Day 14, and (2) A normal menstrual cycle is 28 days.

Also of interest is how squeamish the creators appear to be about sex and reproduction: the web site refers to “unprotected i*********e” and notes that the probability of conception is calculated “based on your ovulation time and other factors such as lifespan of the egg and s***m”. (For those of you unaccustomed to the practice of concealing obscenity with asterisks, that’s “intercourse” and “sperm”.)

As someone who studies and teaches sociolinguistics and writes about menstruation, I’ve seen a lot of euphemistic language over the years. But marking intercourse and sperm as unfit for print is a first.

Hot Flash—Progesterone is an Effective Alternative to Estrogen

July 19th, 2010 by Elizabeth Kissling

Guest post by Jerilynn Prior, Centre for Menstrual Cycle and Ovulation Research

hot flash hellIt’s been two weeks since Chris Hitchcock and I returned from San Diego’s recent Endocrine Society meetings. We are feeling incredibly happy with the success of our protracted, intense commitments to a controlled trial of oral micronized progesterone (marketed in the USA and Canada as Prometrium®) for night sweats and hot flushes/flashes. At the Endocrine Society we presented the first-ever trial showing that the molecularly identical progesterone by mouth is effective treatment for vasomotor symptoms (VMS = hot flushes/flashes and night sweats)(1). We were also invited to present our data at an Endocrine Society-sponsored press conference.

Why did a scientific study require so much from us? First, this trial started in 2003 as the initial scientific venture of the newly founded Centre for Menstrual Cycle and Ovulation Research–thus CeMCOR’s reputation became tied to this trial. Second, despite concerted efforts, we were never able to obtain peer reviewed funding for this study—we successfully supported it with individual private donations. Finally, because of the “estrogen myth” and its corollary negatives about progesterone, I wanted to gain additional accurate information about how Prometrium® works in women’s cardiovascular system from this same study. For that reason we decided to enroll only very healthy women who were within 1-10 years since their final flow—they had to be non-smokers, without obesity, diabetes, or high blood pressure, and further to have normal measured waist circumference, blood pressure, cholesterol, and fasting blood sugar levels. Therefore many women were interested but few were eligible.

Late last fall when we broke to code on this study, we were ecstatic to discover that our trial was highly successful. After only three months’ therapy with Prometrium® (300 mg at bedtime daily) the 127 (of 133 randomized) women’s vasomotor symptoms score (VMS Score, combination of number of flushes times their intensity during the day and during sleep) was decreased by about 60% on progesterone compared to less than 30% decrease on placebo.

In early June we learned the answer to another important question: Does progesterone effectively treat intense VMS? The answer is yes! Although less than half all the treatment-seeking women in our study met the FDA’s criteria for more than 50 moderate-intense VMS/week, the 30 women who did who were randomized to Prometrium® showed significantly more improvement in hot flushes than did women on placebo.

What were the reactions to this news? Some local doctors said they already knew that progesterone was good for VMS! Others people were curious, or skeptical but many realized the importance of providing women with an effective alternative to estrogen for VMS. Other reactions were predictable—many questions about whether this couldn’t really be explained, somehow, by estrogen (Prometrium® is converted into estrogen—not!). And there were several questions about side effects and alleged serious health risks from progesterone (wrongly attributed because of confusion of progesterone with synthetic progestins). Happily I was able to respond that participants had no serious negative effects—more placebo-treated than Prometrium®-treated women dropped out before completion. And it is likely that in estrogen-treated women progesterone decreases breast cancer risk rather than increasing it as medroxyprogesterone does (2). Because of Prometrium®’s significant sleep benefit (3), some women who entered the trial sleep-deprived experienced short-lived morning drowsiness. But the estrogen myth-related mood, bloating, weight gain, migraine headaches, and breast tenderness did not occur.

An epic journey for me, Chris, and CeMCOR ends in triumph. Now that the dust has settled, I am so grateful that CeMCOR’s many researchers over the last six years dedicated themselves to a world class trial, that local donors made the trial possible, and that the Prometrium® and placebo were provided by Schering Canada (for the first two years) and subsequently by the world-wide manufacturer, Besins Healthcare of Belgium.

Saturday Surfing

July 17th, 2010 by Elizabeth Kissling

What we’re reading this week:


The Red Scare: Blood Rituals

July 16th, 2010 by Elizabeth Kissling

Red Scare illustration from Whore! MagazineAnyone else seen the premier issue of Whore! Magazine (Fast, Feminist, and Feminine) yet? My copy arrived yesterday and while I haven’t read the whole thing yet, I’m enjoying the quality of the writing and the production values.

I’m also pleased to see a positive story about menstruation in a magazine, in Tracy Merlau’s essay, “The Red Scare”. It’s short, sentimental essay about adolescence and menarche, and the sadness of the nearly complete absence of any public recognition, let alone celebration, of menarche for girls in the U.S.

Recommended.

Hot Flashes: Now Especially for Fat Ladies

July 14th, 2010 by Elizabeth Kissling
Photo of art by Czarnobyl by Flickr user urbanartcore.eu || CC 2.0

Photo of art by Czarnobyl by Flickr user urbanartcore.eu || CC 2.0

Since yesterday, although it seems longer, my RSS reader has been clogged with links to news reports about a UCSF study in which some women who lost weight found that their hot flashes diminished. Of course, that’s not what the headlines say. Here’s a sample of some of the titles of current stories about this study on Google news:

  • Hot Flash Relief: Weight Loss Works, What Doesn’t? (US News & World Report)
  • Bad hot flashes? Try dropping a few pounds (MSNBC.com)
  • Losing weight may ease menopause symptoms (NBC13.com)
  • Symptoms of Menopause Can Be Relieved by Weight Loss (Health News)
  • Weight Loss Helped Overweight And Obese Women Reduce Hot Flushes (Medical News Today)

OK, that’s enough – see the trend? Suddenly weight loss is the cure for hot flashes. But in the actual study – which was about urinary incontinence, not menopause -141 women provided researchers with data about their hot flash symptoms six months after the study began. Sixty-five of the 141 women said they were less bothered by their hot flashes six months after participating in the weight loss program, 53 reported no change, and 23 women reported a worsening of symptoms.

Look at those numbers again, more slowly this time: 65 of 141 women who participated in a weight loss program were less bothered by hot flashes after six months. That’s 46% of the women – less than half – who found relief. Almost as many reported no change in symptoms, so why is this being touted as a successful intervention?

Because the women lost weight. Most of the news reports of this research stop just short of fat-shaming, but I submit that is exactly why this study is getting so much media attention. Even though it is well-established that diets do not work, even if you call them a “lifestyle change” or “a whole new way of eating”, and that the BMI (Body Mass Index) is useless as a gauge of health. In fact, fat is not a measure of health. But why pass up an opportunity to shame women about their bodies?

Saturday Surfing: Heat Wave edition

July 10th, 2010 by Elizabeth Kissling

Teens and the IUD

July 8th, 2010 by Elizabeth Kissling


Art by Flickr user Buhny | CC 2.0

Art by Flickr user Buhny | CC 2.0

A new study published in the Journal of Obstetrics and Gynecology has found that adolescents are usually able to tolerate the Mirena® IUD rather well. The mean age of girls in this British study was 15.3 years, and they were prescribed the Mirena® for painful and/or heavy periods that did not respond to oral medications. 93.4% of girls in the study (45 young women) reported “significant improvement” within four months. The researchers conclude “that Mirena is a well tolerated and effective alternative for heavy periods±dysmenorrhoea in adolescents who do not respond to oral therapy.”


So will this finding make it easier for young women to obtain an IUD if they’d like it for birth control, now that there is evidence that it is well tolerated?

The ‘Change of Life’ is More than Biology

July 7th, 2010 by Elizabeth Kissling
Photo by Ed Yourdon | CC 2.0

Photo by Ed Yourdon | CC 2.0

I hope my colleague Heather Dillaway feels at least at little vindicated when she reads this: A new study in the Journal of Health Psychology reports that social and psychological factors have the biggest influence upon women´s sexual behavior during menopause, rather than biological changes such as declining hormone levels. While most published research on menopause–especially about sex and sexuality with respect to menopause–is conducted within a biomedical framework, Sharron Hinchliff, Merryn Gott, and Christine Ingleton talked to women about their experiences. (Radical!)

They found that almost all of the women in their study had experienced changes in their sex lives, but they attributed these changes to external factors, such as caring for ill or elderly relatives, low sexual desire from their partners, issues of relationship quality, as well as to perceived changes in levels of hormones. (I appreciate the researchers’ qualifier of perceived changes, as most women never have their hormone levels measured.)

The researchers concluded that women go through many lifestyle changes at mid-life, only some of which are biological. Psychological and social factors, as well as the increasing medicalization of menopause, affect their sexuality just as powerfully.

Somehow, this study isn’t getting anywhere near the publicity of the ‘new blood test for menopause’ study received last week.

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.