Blog of the Society for Menstrual Cycle Research

that time of the month can sneak up on you

August 31st, 2012 by Alexandra Jacoby

Running late again, I chose the first friend I saw and asked her to help me with my monthly blog post – what should I write about? I asked, not that I expected an answer.

…She leaned in and said: How about –

Those Times

Y’know those times when your period just takes over, becomes your whole life. When it starts all of a sudden, and you need to.  get a tampon.  from somewhere.  or to just to get to a bathroom.

When you have to leave NOW.

But no one can notice.
No one can know. 

Why do we have to pussyfoot around it?

I need a tampon.

Why am I apologizing for that?

I’m a woman. My body makes babies.

This is part of how it happens.

I don’t understand.

 

…Like those tampon ads where they show you how it’s small enough that no one will know.

We’re supposed to hide it.

Why?

 

O, I know – it’s because we’re supposed to be crazy when we’re on our periods, right?

 

…Also, just last night we were talking about mikvahs. It came up while talking with an Israeli friend, who’s pregnant; we got to talking about religion, and women, and gender roles.

 

…And actually, with another friend: we were talking about those times when you get your period, and use it to get past the early stage of the relationship, where you always have sex whenever you see each other.

You let him know that you have your period, and so: no sex tonight.
And then, you do something else together.

 

What if he’s into having sex after all? I asked.

Well, now that’s interesting. That’s new information.

[smile]

Test passed?

Maybe.

 

…Then we got to talking about boyfriends and periods and men actually saying that they don’t want to see tampons, or know about your period. Really?

Noted.
That’s information, too.

 

…And, how sex is wet and messy, and so how is menstrual blood outside the scope?

Right!
I know!

 

At this point, we were interrupted. There were three of us in the conversation by then, talking over each other.

One story led to another.
Stories, questions, sighing. And this sense that you’re not supposed to do any of this out loud. We were all intimate with that.

Who are we asking for permission?

For acceptance?

Why?

 

Talk among yourselves.
 
 

Fertility Charting Is the Way of the Future!

August 29th, 2012 by Kati Bicknell

The Quantified Self is the idea that by tracking things about your body you can live a happier and healthier life. Hardware devices like the Fitbit and Withings scale measure your daily activity and weight respectively so people can set and reach activity and weight goals. Apps like Lose It are tapping into this idea using a software-only approach: Lose it helps you lose weight, not by putting you on a diet, just by having you keep track of everything you eat. Every day you enter all the foods you eat into the app, and it tells you how many calories you consumed. You can also put in how much, and what type of exercise you did each day, and Lose It tells you how many calories you burned.  The result is you can see the amount of calories you burned, relative to the amount of calories you took in.

I have several friends who swear by this app. Lose it isn’t telling you anything you don’t know (eat less, and exercise more if you want to lose weight), but what it is doing is making it very easy for you to see how your actions are affecting your weight in a specific way on a daily and even moment by moment basis. In addition to achieving goals, quantifying the self leads to a sense of confidence and control where before there was confusion. And in doing so it makes us feel better.  This is the crux of the quantified self movement. Recording and analyzing everyday data can help us win at the game of life!

As my friend Lauren Bacon has pointed out, fertility charting fits right in to the Quantified Self movement. Women who chart their fertility record their waking body temperature, cervical fluid viscosity, and other data each day, and over the course of each menstrual cycle get a detailed picture of their reproductive health, and sometimes more!

Kindara Screen Shot © Kindara 2012

Cervical fluid viscosity is a proxy for estrogen level. Basal body temperature is a proxy for progesterone.  And as any high school student can tell you, hormones are powerful influencers of how we feel, think and act, and why our bodies do the things they do.  Just imagine if your menstrual cycle, and all the fluids, feelings and fluctuations that went along with it were no longer a mystery.  Imagine knowing just what was going on, and why.

By recording your daily fertility signs a whole world of possibility opens up for you! While it’s true that fertility charting can be, and often is used to achieve or prevent pregnancy, the benefits of it don’t stop there. Fertility charting can answer important questions about our ovulation, luteal phase, cycle health, thyroid function and more.  I have friends who have finally figured out the root of several food allergies, from charting their fertility.  I myself have learned that a diet high in animal fat keeps my cycles regular. One reason I’m so excited about what we’re doing at Kindara is that as more and more women start quantifying their fertility, we’ll start to generate new knowledge about fertility for the benefit of humankind, creating a virtuous feedback loop that will help each woman feel calm and confident with her fertility in her specific situation.

I envision a future where more and more women are taking an active role in their own health care with fertility charting.  How about you? If you’re currently charting your cycle, tell us in the comments what you’ve learned so far, and how it’s changed your life!

Musings on Menopause and Heart Disease

August 27th, 2012 by Paula Derry

A recent article by Swift et al. looked at the effects of aerobic exercise on heart health. Midlife women with high blood pressure were assigned to one of three exercise groups—a program of exercise that met National Institutes of Health (NIH) guidelines, one that was half the amount of exercise recommended by the NIH, or one that was 150% of the NIH recommendations. The study did not examine who actually got heart disease. Instead, the researchers looked at the ability of arteries to function normally, which is a precursor to disease. Specifically, the researchers measured one component of artery health called “flow mediated dilation” (FMD)—the ability of arteries to respond normally to changes in blood flow by dilating (getting larger), which is one indicator of “endothelial (the inner lining of the artery) function.” The authors found that aerobic exercise improved flow mediated dilation. The amount of exercise was not important—the authors suggest that once some minimum amount of exercise exists, improvements will occur. They also found that women with problems benefited from exercise, but not those with normal FMD.

Well, I have to admit this isn’t an area of my expertise. I’m not going to evaluate how solid the methodology was, how close to normal the improvements brought the women, compare these results with the entire body of knowledge, all of which are important to really understanding the import of a study. However, I’d like to share some musings that the article triggered.

First, the article assumes that menopause and the menopausal transition increase a woman’s chances of getting heart disease by modifying her precursors and risk factors. The title of the article is: “The Effect of Different Doses of Aerobic Exercise Training on Endothelial Function in Postmenopausal Women With Elevated Blood Pressure”. The introduction states that their research is important because menopause is associated with worsening of heart disease risk factors. However, they are not studying postmenopausal women. They are studying overweight, sedentary women with high blood pressure who are old enough to be postmenopausal. It used to be more commonly stated, as though it is a fact, that menopause increases a woman’s chances of getting actual heart disease. However, this assertion does not appear to be supported by the facts. A recent paper in the British Medical Journal concluded that aging rather than menopause was key: “Heart disease mortality in women increased exponentially throughout all ages, with no special step increase at menopausal ages”. In 2011, the American Heart Association issued the Effectiveness-based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update. These guidelines include a long list of risk factors and suggestions for how to prevent disease, such as modifying lifestyle factors like cholesterol and inactivity. Menopause is not included as a risk factor and is mentioned in just one sentence in the document. The line of research that has now arisen which states with equal certainty that risk factors and precursors to heart disease increase with the menopausal transition thus must be looked at critically. Do these changes in precursors really co-vary with menopause? Do they lead to actual disease? How important are they relative to other factors leading to heart disease, like aging or lifestyle?

The article does not, however, suggest that these menopause-related precursors and risk factors doom women to increased heart disease risk. Indeed, the point of the article is that they can be modified through lifestyle changes, here, aerobic exercise. A lifestyle change that can increase health seems like a good thing. However, what also did strike me was something about the meaning of a healthy lifestyle. Sometimes healthy lifestyle is presented as though it is something that is “added on” to normal daily life. Sometimes it’s almost analogous to a medical prescription—take 20 minutes of exercise daily. However, in the article the women who benefited, in terms of improved endothelial function, were the women who had abnormal function. The authors found that a small amount of exercise did the trick, with no additional benefit from increased exercise. So is it that supplementary exercise cured the problem, or was the problem an abnormal lifestyle deficient in exercise? As an analogy, if I don’t have enough vitamin C I might get a disease called scurvy, because my body needs vitamin C. Once I meet my body’s need, I won’t get the disease, I don’t need twice the requirement. The 2008 federal guidelines recommend that adults up to age 65 will get substantial health benefits from two and a half hours a week of moderate aerobic physical activity. Examples of moderate activity are gardening, walking briskly, ballroom dancing, shoveling snow, and stair walking. Maybe the idea is that our bodies need to move, and if we deny them a minimum amount of movement we have an unhealthy lifestyle. Maybe physical movement and activity are bodily needs, along with other components of a healthy diet and lifestyle.

Weekend Links: The Uterus Is Not Magic, and Rape is Rape Edition

August 25th, 2012 by Elizabeth Kissling

Like everyone else, we’ve been overwhelmed this week (to say the least) with the news of Rep. Todd Akin (Missouri) and his belief in the mAgIc *~uTeRuS.

An Apple A Day . . .

August 24th, 2012 by Heather Dillaway

My most recent apple!

Everybody knows “an apple a day keeps the doctor away.” Or at least we teach our kids this saying.
It turns out now “an apple a day keeps menopause woes away,” at least according to the Red Hot Mamas’ website, and some other recent news posts. Apples (along with many other fruits and vegetables) apparently help us fight (lessen) menopausal symptoms, and other websites advocate apple cider vinegar to help with menopausal symptoms. Not to mention these things help with weight gain and other chronic health conditions as we age.

 

Apples help alleviate PMS symptoms too, apparently. A “PMS Comfort” Website even has a Cinnamon Baked Apple recipe for women to make when they need to relieve PMS symptoms. From a perusal of these websites, it seems one of the things apples can do is reduce bloating and swelling.

 

To some extent I’m skeptical: what makes an apple better than a blueberry or a nice cold glass of water? I guess this simply reminds us that diet definitely matters at all stages of our reproductive life cycles. This also harks back to Paula Derry’s recent post about how the environment affects our bodies and what we put our bodies through matters, and Kati Bicknell’s latest post about the impacts of eating meat on fertility. What we put into our bodies matters too.

I guess it’s true that an apple a day is a good thing. But, how did the apple get some much hype anyway? Seriously, if there is one fruit that has become part of our daily lexicon it is the apple. . . . Adam and Eve’s apple, Johny Appleseed, Mom and Apple Pie, the Big Apple, the poison apples from from Snow White, you’re the apple of my eye, you’re sweet as apple pie, an apple for the teacher, an apple a day keeps the doctor away …. I guess it was a matter of time before apples made it to PMS and menopause.

In a fertility flap? Five things you need to know

August 22nd, 2012 by Laura Wershler

Your fertility is not a deep, dark mystery only your doctor can unravel. It’s yours to own, understand and manage. Forget the ticking biological clock, it’s the wrong metaphor. Fertility ebbs and flows, like the phases of the moon. It’s about the cycle – not the clock.

Are you wondering about your fertility status? Will you be able to have a baby when you want to?

Seems these questions are on the rise for 20- and 30-something women who are finally getting the message that putting off motherhood may not be a good idea. Recent news stories report that young adults don’t know the facts of fertility decline and overestimate the success of reproductive technologies.

But as the message gets through, the response makes my eyes roll.

Judith Timsom, one of my favorite columnists, recently pondered the fertility fears many young women are having.  Among them:

A third woman, turning 30, with a committed partner and a great job, made fertility sound like the new “f” word as she glumly remarked to a friend ,“My doctor told told me my fertility just dropped 50 per cent. Crap.”

This is crap. It misrepresents how fertility works. Timson writes that “young women – and men – are crying out for more factual, emotionally neutral information on how their fertility works.”  Forgive me if I, and at least 700,000 others – the number of people who have purchased Toni Weschler’s  Taking Charge of Your Fertility since it was first published in 1995 shake our heads in frustration.

What women need is body literacy, the know-how to observe, chart and interpret our menstrual cycle events so that we – not the doctor, not the lab tech – can confirm our fertility status. Yes, it’s called fertility awareness, and, since the late 60s, millions  of women world-wide, including me – a bonafide pro-choice feminist, have used this life skill to both avoid and achieve pregnancy.

If you’re worried about your fertility, here are five things you need to know:

  1. You can learn to observe and chart three key signs of fertility: a) fertile cervical mucus b) basal body temperature shift  c) adequate luteal phase, or number of days from ovulation to next period.
  2. If you use hormonal contraception (HC), you have been infertile for as long as you’ve been using it. When you stop HC, your body has to establish healthy ovulatory menstrual cycles before you become fertile. Health and environmental factors may impact this process. Factor recovery time into your baby plans.
  3. If you began using HC as a teenager for heavy bleeding, painful periods  or irregular cycles chances are your reproductive system has not fully matured. When you quit HC this maturation process will resume. Depending on the method you used, it could take months before you have ovulatory, fertile cycles. Be patient. Holistic Reproductive Health Practitioners can assist in recovering fertility.
  4. If you began using HC for PCOS or endometriosis, expect symptoms to resume when you stop. The Centre for Menstruation and Ovulation Research describes treatments that manage PCOS  and endometriosis while helping to preserve fertility.
  5. Fertility is individually, not statistically, determined. It can ebb and flow from cycle to cycle. Diet, stress, travel and trauma can result in anovulatory, or infertile, cycles. When it comes to getting pregnant, the more you know about your own menstrual cycle, the better.

Fertility awareness is empowering, but Toni Weschler says that in her decades long experience she has repeatedly seen the sense of excitement that women feel evolve into anger. “Women want to know why they weren’t taught this when they were teenagers.”

The young women Judith Timson writes about have yet to acquire this knowledge. When they do, will they be angry enough to teach their own daughters? Weschler has a book for them, too - Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body Fertility isn’t a mystery if you know where to look for the clues.

“Excited” to Reach Menopause? Really?

August 16th, 2012 by Heather Dillaway

Big news this week: Sinead O’Connor announces she is excited to be reaching menopause and looks forward to her first hot flash. News stories in the Daily Mail and a celebrity gossip magazine called Female First characterize her as ready to “embrace” this new life stage, unafraid of aging or bodily changes. They also make sure to tell us in the same breath that most other women dread this life stage. It is almost as if the reason that this is news is that it is absolutely amazing that a woman can feel positively about menopause. Comments on this article reaffirm the fact that this is absolutely amazing and that most women hate it, with one person even suggesting that menopause is “God’s revenge on women for being the superior race.”
Really?
I find plenty of women telling me they are happy to reach this life stage. Sure, the symptoms suck sometimes (maybe even for years). But, this doesn’t mean they dread all of the changes in their bodies or that they hate their bodily changes. And it doesn’t mean they dread aging. I think Sinead O’Connor is probably more representative of the ways in which many women are thinking about menopause than not. Or at the very least there is a sizable portion of the female population who feels like O’Connor as they reach this life stage. To characterize menopause as normally terrible and O’Connor as “outlandish,” “eclectic” and “quirky” in the same breath as telling us that she is excited about menopause just reifies negative cultural discourse on this reproductive transition. This does nothing positive for women.
What IS positive, though, is that we are even hearing about Sinead O’Connor’s take on menopause. And I argue that she is not as weird in her views on menopause as she seems.

Cosmo’s Menstrual Politics

August 14th, 2012 by David Linton

Saniya Ghanoui and David Linton

How peculiar are the sexual politics of Cosmopolitan magazine?!?! We previously noted the editorial avoidance of menstrual sex, but let’s take a look at their most recent ride on the menstrual cycle.

On one hand, Cosmo aspires to liberate women from sexual repression into a world of ever better orgasms and perpetual youth and beauty. On the other hand, it ceaselessly stokes anxiety and insecurity with its constant twin emphasis on pleasing “him” and urging the purchase of the latest Big Thing. Occasionally, in an effort to demonstrate concern for women’s health there appears a reference to some aspect of the menstrual cycle.

The most recent example occurs in the June 2012 issue whose cover, under a hot photo of the rock star Pink, announces that inside you can learn, “Why your Period Makes You Cra-a-zy”. Off the bat, the cover recirculates the tired notion that the period is responsible for some kind of transformation, turning a woman into a crazy person. The use of an extra “a” emphasizes the word in a way that enhances its meaning, thus the period causes almost an abnormal form of craziness. There’s also a lovely irony to this cover. Pink is dressed in a vibrant solid-red dress that counters her pale skin and hair. She pulls up one side of outfit as she claws her dress and her expression is meant to show a “tough girl” side to her personality. It’s as if the cover alludes to notions of craziness, as caused by the period, via the image of Pink.

The article does seem to contain practical advice for those who experience some level of discomfort prior to getting their period. The five suggestions include topics such as diet, exercise, orgasms, coffee, and laughter. Unfortunately, embedded in the nuggets of advice one finds relentless reinforcements of age-old prejudices, stereotypes, and negative perspectives. Even the opening page, which sets up the piece, is titled “Beat the PMS Brain Haze” and shows a woman whose head is slightly out of focus and fading into a cloud. In case you miss the point, a sentence beside her head states, “It’s hard to function when your head is in the clouds”. In larger type under the title the message is reinforced, “It’s when you feel so foggy, you can barely choose between a lemon and a lime for your diet soda”.

The next two pages of suggestions comprise a litany of ways to cope with the “annoying symptom”, “hormonal cloud”, “haze”, and “PMS coma” that leave women “easily overwhelmed, stressed out, forgetful and indecisive”, Women are told to “cancel everything that’s optional”, “snack on yummy oatmeal” to “make up for the PMS brain drain”, “ask your guy to rub your back”, and have “a dose of caffeine”.

As published in June 2012 issue of Cosmopolitan

What is obvious about the article and the tips that are meant to keep women “sane”, insinuating that one may be insane while PMSing, is the way in which each bit of advice is meant to fix some frustrating characteristic that is either caused or heightened by PMS. Thus, the message is that women have an extra hindrance they must overcome in order to have a peaceful week leading up to their period. In order to solve the problem Cosmo advises some simple changes, such as having a cup of coffee, to more radical ones like changing or canceling items on your schedule. What the latter puts forward is the idea that PMS is such a hindrance that one must change one’s weekly agenda in order to function normally. While it is true that some may have discomfort during PMS and desire extra time to relax, to completely cancel or modify a weekly schedule suggests a level of wealth or leisure that is in the realm of fantasy.

Despite the appearance that the article is simply a pleasant set of suggestions, it turns out that the three pages are actually a lead into a fourth page on the right side so the connection can’t be missed, consisting of the latest ad for Tampax Radiant tampons. In design and placement the ad blends perfectly with the article so as to flow, as it were, directly from the pre-menstrual days into the period itself with Tampax waiting there to fill the need.

There has been a lot written in recent years about the blurring of lines between editorial content and advertising but the only blurring in this case is the unintentional design of the first page of the piece which is purposely shot out of focus to visually illustrate how women must feel as their hormones debilitate them.

Furthermore, the ad purposely counters all the frustrations exhibited in the previous three pages. The ad promotes the “invisible” period, thanks to this specific tampon, that has “leakguard technology” and a “discreet resealable wrapper.” All of these characteristics are meant to ease irritations associated with the period. And why wouldn’t a woman want to have her aggravations eliminated, especially after reading three pages of problems associated with PMS? It seems the message is that since there isn’t a menstrual product (outside of drugs) that can ease PMS, at least the period can be eased by this tampon.

No Weekend Links?

August 11th, 2012 by Elizabeth Kissling

That’s right — no weekend links today. I’m traveling this week and have limited internet access. Please peruse our archives in lieu of new links this week, and look forward to new weekend links later this month.

When Breastfeeding Isn’t Best

August 8th, 2012 by Elizabeth Kissling

Paula Modersohn-Becker (Public domain), via Wikimedia Commons

Let me say up front that I have limited direct experience with adoption. Some members of my extended family have adopted children, another has given up an infant for adoption, and I have friends who have adopted children, and other friends who are adopted. It was one of those adopted friends who pointed me to this uncritical article from last fall about the practice of adoptive mothers ‘learning’ to breastfeed.

I’ve placed learning in scare quotes because this article isn’t about adoptive mothers developing a skill. It’s about taking high-risk drugs so that they can have the experience of breastfeeding their adopted children, even though they will be unable to produce enough breastmilk to nurse exclusively. But by taking combined oral contraceptives continuously for several months (which, contrary to the popular belief asserted in the article, does not “trick the body into thinking it’s pregnant”) and following up with domperidone, an antiemitic drug which sometimes has the side effect of causing lactation — even in men — some adoptive mothers are able to force their bodies to lactate.

What’s so terrible about this, you may be wondering. Domperidone isn’t approved by the FDA for use in the US, even for its intended purpose in treating nausea and vomiting, so it is usually purchased by ordering from other countries. The FDA, however, has not been silent about domperidone: The agency has issued multiple safety alerts, advising healthcare professionals and breastfeeding women NOT to use the drug. Although the amount bioavailable to the infant is small, domperidone is excreted in breastmilk.

The hormones in the birth control pill are also excreted in breast milk, and are suspected to promote growth of breast cancers, if not actually cause them. (And who can forget that immortal bit of testimony from the Nelson Pill hearings in 1970, “Estrogen is to cancer what fertilizer is to wheat”?)

I appreciate the desire of new moms to bond with their babies, I really do. But if you’re willing to take these kinds of risks with your own health and your baby’s, I have to wonder if your desire to breastfeed is really about the relationship with your child.

HALLMARK – When you care enough to send the very . . . ??

August 6th, 2012 by David Linton

Hallmark greeting cards and related trinkets have long exemplified wholesome, up-tempo, Norman Rockwell-styled sentimentality, often packaged in clichéd verses and trite images of puppies, kittens, flowers, babies, sunsets and other references guaranteed to elicit a smile, a tear, or a warm glow. However, as rude humor has spread its influence, expressed most vividly and viciously in celebrity roasts and the Comedy Central show, Tosh .0, Hallmark was not to be left behind. A visit to the racks of cards, books, and novelties at your local card shop reveals a wide variety of snarky items offering cheap shots at a wide variety of groups, hobbies, and practices.

Not Guilty by Reason of Menopause

Among them are several items that attempt to poke fun at what are thought to be characteristics of women in some stage of the menstrual cycle, notably PMS or menopause. Setting aside the fact that the items perpetuate the common misuse of the term  menopause when what is meant is perimenopause, consider a small book presently on sale titled, Not Guilty by Reason of Menopause.

It is comprised of more than 50 pages, organized in double-page spreads, each of which offers a completion to the phrase, “You might be menopausal if. . .”

A few examples will suffice:

“. . . you think about the ‘til death do us part line in your wedding vows a little too often.”

“. . . you tell all your children they’re not your favorite.”

“. . . when your husband proposes a romantic vacation, you suggest ice fishing.”

Collectively, it amounts to an anthology of mean-spirited nastiness with little redeeming humor. Women are depicted as crazy, stupid, vicious, obese, and every other negative stereotype imaginable.

And with each insult women are expected to smile sweetly at being the butt of a bad joke. Of course, to express outrage or even mild annoyance with these sorts of put-downs is to risk of being accused of lacking a sense of humor or, worse yet, of being “politically correct,” the favored dismissive term of those who demand that their repugnant values are somehow benign or lacking in impact or intent.

We’ve come a long way from the days of 1910 when Hallmark was founded and especially from 1944 when the company adopted the slogan that is still theirs today, “When you care enough to send the very best.” In this case one might ask, “The very best of what?”

Female Condoms, Risks of NuvaRing, a Birth Control Party, Lavender for Menstruation, and More Weekend Links

August 4th, 2012 by Elizabeth Kissling

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.