Blog of the Society for Menstrual Cycle Research

Obvious Child: The Other Taboo

June 18th, 2014 by Holly Grigg-Spall

cervical mucus

 The recently released rom-com ‘Obvious Child’ has been discussed far and wide for its mature, sensitive and funny approach to the topic of abortion and yet I have not seen one comment on the fact that this movie also makes mainstream (and yes, funny) the topic of cervical mucus.

In the opening scene stand-up comedian Donna (played by real-life comedian Jenny Slate) is performing on stage at her local open mic night. She wraps up with a joke about the state of her underwear and how, she describes, her underpants sometimes look like they have “crawled out of a tub of cream cheese.”

She claims that they often embarrass her by looking as such during sexual encounters, something she feels is not sexy.

Of course, by “cream cheese” I immediately assumed Donna meant cervical mucus. Unless she is supposed to have a vaginal infection – which seeing as it is not discussed amongst the other myriad bodily function-centric conversations in the movie, I doubt to be the case – then it’s clear she is detailing her experience of cervical mucus.

Later on that night, when Donna meets and goes home with a guy, has sex and then wakes up in bed with him the following morning, she sees that her underwear is laying next to the guy’s head on the pillow. Not only that, but this is one of those situations she finds embarrassing as the underwear is actually covered in the aforementioned “cream cheese” or cervical mucus. She cringes, retrieves the underwear and hastily puts it back on under the covers.

At this scene we can assume that the presence of visible cervical mucus indicates that the character is in fact fertile at this time during the movie. Even if we didn’t know this movie was about unplanned pregnancy, perhaps we would know now. Apparently Donna is not on hormonal birth control, and she’s not sure if, in their drunkenness, they used a condom properly. So, I speculate, if Donna had known she was fertile and that the “cream cheese” in her underwear was actually one of the handy signs of fertility her body provides, then she may have taken Plan B and not had to worry about an abortion. But, then, of course, we wouldn’t have had the rest of this movie. We would have had a very different movie – a movie someone should also make.

But it goes to show how some body literacy might go a long way in helping women make more informed choices. The abortion sets her back $500 and causes some emotional turmoil. A dose of Plan B is cheaper and easier to obtain, although not without some side effects. Maybe even, we can speculate, if Donna had known she was fertile she might have avoided PIV sex that night.

It’s great to see a movie approach the choice of abortion as though it really were, well, a choice. But isn’t it interesting that in doing so it shows how women can be hampered in their choices by a lack of body literacy?

We often see women in movies discussing their “fertile time” in regards to wanting to get pregnant – and so meeting their husbands to have sex at the optimum time in usually funny, crazy scenarios. Sometimes we have seen women taking their temperature or using ovulation tests and calendars to figure this out. However, I think this might be the first mention of cervical mucus in cinema.

I had the honor of seeing this movie with longtime abortion rights and women’s health activist Carol Downer and getting to discuss it with her after. Carol pioneered the self-help movement and self-examination, adding much to our collective knowledge of our bodies.  

This is what she had to say:

“Home Made Menstrual Period for Game-Playing With Doctors”

May 14th, 2014 by Holly Grigg-Spall

(photo by Holly Grigg-Spall)

In the past few weeks I have been meeting with women’s health activist Carol Downer to collaborate on a new book. She shared with me a work published in 1969 that was a catalyst for her development of the self-help movement and feminist women’s health clinics – ‘The Abortion Handbook’ by Patricia Maginnis and Lana Clark Phelan – which is extremely hard to get hold of these days (Carol found her current copy on Ebay for a significant sum). This book has a strikingly contemporary tone- snarky, conversational, with a lot of black humor. It is also conspiratorial with very much an “us” (women) against “them” (medical establishment) tone. It’s something like ‘Sex and the Single Girl’ by Helen Gurley Brown, but with a recipe for a “home made hemorrhage” instead of a “fabulous dinner.”  That is, the writers outline ways in which women could circumvent the restrictions on abortion access of the time in creative, guerrilla-style ways in order to have a legal abortion. One of these is getting an IUD inserted in the early stages of pregnancy.

In an chapter entitled ‘The Loop Can Be Your Little Friend’ the writers provide women who have missed a period with a plan for persuading a doctor to insert an IUD, when, at the time, it was required that this be done during a woman’s menstruation, in part, it is claimed here, to ensure that an abortion would not be the outcome. Firstly the woman makes the appointment as soon as possible, not waiting for a pregnancy test to confirm, as, they say, she can always pull the IUD out herself later if she doesn’t want it as a contraceptive. Then:

“Buy some raw, fresh beef liver…dip your well-scrubbed forefinger into the blood on the raw liver and rub this bloody finger into your vaginal tract. Go way up, beyond your cervix, not just the opening. Menstrual blood collects in the back of the vagina, so be sure and put some there to make it look more authentic…if you wear a tampon, use a bit more blood before you insert it so there will be discoloration on the tampon. Do not remove the tampon before you see the doctor or loop-installer…if you use an external sanitary napkin, smear a bit of beef blood down the center of the napkin just as your natural menstrual flow would be distributed…not side-to-side and end-to-end like butter on bread.

(Sorry if this makes you feel sick, but this whole business nauseates us. We’d like to get out of this whole trickery business, and we will, just as soon as doctors get out of the abortion business so all this planned deception can stop)

Be sure to smear your vaginal interior lightly also, as this napkin-evidence may be removed by a nurse, and it would be hard to explain you nice, bloodless vagina after that bloody napkin. For heaven’s sake, don’t douche before adding your bloody, dramatic “proof of period.” Keep yourself naturally revolting and smelly to get even for this humiliation.”

Once the IUD is installed the writers suggest the woman go about exercising vigorously, swimming, horse back riding, dancing, moving pianos and having sex in order to help the IUD act as a fertilized embryo remover. They conclude:

“This has worked many times for desperate women lacking money for proper medical care, and who hadn’t the stomach for self-surgery. It is certainly worth a trial. Except for your spiritual humiliation for being forced to deception, it is certainly harmless to you physically.”

Reading this I was reminded of how today we see menstrual activists stain white jeans with fake menstrual blood to confront the menstrual taboo in public or create accessories like the Stains by Chella Quint, that are an attachable fake period of sorts, in order to question the need to be secretive about this natural bodily function. On the television show ‘Nashville’ a main character used animal blood to fake a miscarriage for the observation of her husband in order that he remain married to her (it’s complicated, but a great show, you should check it out!). I was also reminded of the study from 2012 that claimed 38% of women have used having their period as a way to avoid an activity they did not want to do at the time. 20% said they have used their period as an excuse not to go into work. The study did not show how many women are actually having their period when they do this or how many are pretending to be having their period.

Depo Provera and menstrual management

April 8th, 2014 by Holly Grigg-Spall

Melinda Gates speaking at the London Summit on Family Planning; Photograph courtesy Wikimedia Commons

A few weeks back I did an interview with Leslie Botha regarding the distribution of Depo Provera to women in developing countries. Recently Leslie shared with me an email she received from someone working in a family planning clinic in Karnataka, India. He described how he was providing the Depo Provera injection to women and finding that, after they stopped using it, they were not experiencing menstruation for up to nine months. He asked for advice – “what is the procedure to give them normal monthly menses….is there any medicine?”

I have written previously about one potential problem of providing women with Depo Provera – the possibility of continuous spotting and bleeding that would not only be distressing with no warning that this might happen and no medical support, but could also be difficult to navigate in a place with poor sanitation or with strong menstrual taboos. As women in developed countries are so very rarely counseled on side effects of hormonal methods of contraception, it seems unlikely women in developing countries receive such information. As we know, some women will instead experience their periods stopping entirely during use of the shot and, as we see from this email and from the comments on other posts written for this blog, long after use.

In this context I find it interesting that the Gates Foundation’s programs for contraception access have a very public focus on Depo Provera. The method was mentioned again by Melinda Gates in a recent TED interview and when she was interviewed as ‘Glamor magazine Woman of the Year’ the shot was front-and-center of the discussion of her work. Yet the Foundation also funds programs that provide support for menstrual management and sanitation.  Continuous bleeding from the shot, or cessation of bleeding altogether, would seem to be an important connecting factor between these two campaigns.

Much has been written on the menstrual taboo in India and how this holds women back. In the US we have come to embrace menstrual suppression as great for our health and our progress as women. We see menstruation as holding women back in a variety of ways. However, in India could lack of menstruation also be seen as a positive outcome? Instead of dealing with the menstrual taboo with expensive programs that provide sanitary products and education, might suppressing menstruation entirely be seen as a far more cost-effective solution? It may seem like a stretch, but I am surprised this has not been brought up during debates about the need for contraceptive access in developing countries. Yet of course, the menstrual taboo may well extend to absence of menstruation – a woman who does not experience her period might also be treated suspiciously or poorly.

When Melinda Gates says women “prefer” and “request” Depo Provera I always wonder whether that’s after they’ve been told how it works (perhaps described as a six-month invisible contraception) or after they’ve had their first shot or after they’ve been on it for two years and then, via FDA guidelines, must find an alternative? How much follow up is there? As the self-injectable version is released widely how will women be counseled? Gates argues that the invisibility of the method is part of the draw as women do not have to tell their partners they are using contraception, but what happens when they bleed continuously or stop entirely?

It seems to me like there might be a real lack of communication – both between medical practitioners and their patients, drug providers and the practitioners, and those who fund these programs with everyone involved. It is often argued that the risks of pregnancy and childbirth in developing countries justify almost any means to prevent pregnancy – including the use of birth control methods that cause health issues. How much feedback are groups like the Gates Foundation getting on women’s preferences if they seem to be so unaware of the potential problems, even those that would greatly impact their wider work?

Is the birth control pill a cancer vaccine?

March 11th, 2014 by Holly Grigg-Spall

I’d given up reading the comments on online articles for the good of my mental health when a small slip last week steeled my resolve. In response to an article exploring the arguments made by “birth control truthers” a concerned father decided to have his say, taking the defensive arguments put forward by those in opposition to these “truthers” to their only logical conclusion:

“Perhaps we should market contraceptive pills as hormonal supplements to reduce cancer risk instead of as “contraception”? After all, it is only in modern times that women have hundreds of menstrual cycles throughout their lives. Even up until 1800 it was common for women to be either pregnant or lactating throughout much of their short lives.

The body simply wasn’t built to handle so many menstrual cycles, which raises the risk for cancer.

Who could argue with taking supplements to prevent cancer?

This may sound strange, but I am seriously considering putting my 11 year-old daughter on the pill (with no placebo) just for the health benefits. I just have to convince my wife first who is a little shocked by the idea…”

I cannot count how many times I have heard that the birth control pill “prevents cancer” – specifically “preventing” ovarian and endometrial cancer.  In the last few months I have seen references to this benefit explained less and less so as a “lowered risk” and more and more so as a “preventative” action.  I think this is significant as the word “prevent” suggests that the pill guarantees you will not get these forms of cancer. And yet, to remark that the pill is counted as a carcinogenic substance by WHO – due on the increased the risk of breast and cervical cancers – will get you tagged as a “truther.”

What is interesting, of course, is that despite the “cancer protecting” benefits of pregnancy, and early pregnancy at that, we do not see women encouraged to get pregnant in order to lower their risk of ovarian cancer.  Criticism of child-free women does not generally include comments about their lax attitude towards their own health. The risk goes down further with every pregnancy and further still with breast feeding, especially breast feeding for a long period of time after birth. Women who have children young, and multiple children, have a lower risk of breast cancer than women who have no children or children after 30. Yet we see more talk of women having “too many” children at an age that is “too young” – in fact I was contacted via Twitter by someone who read this piece and who saw, in the comments, that one woman who uses natural family planning admitted to both liking the method and having 14 children. This admission disgusted the person who contacted me, even when I pointed out that it seemed the woman had very much chosen to have those 14 children.

It seems the people who are advocating prescription of the pill for cancer prevention purposes are not advocating women have children earlier, more children, or consider breast feeding for the good of their own health – in fact two of the loudest critics of my “birth control truther” book are vehemently against pregnancy and breast feeding being part of women’s lives (Amanda Marcotte and Lindsay Beyerstein). The risks of the pill are frequently compared to the health risks associated with pregnancy and child birth,  but we don’t often hear women say they are choosing to not have children to avoid putting their health at risk for nine or so months.

Which leads me to this article in the LA Times that suggested nuns should also be on the birth control pill for its cancer-protecting abilities:

“And are the pills really unnatural? Our hunter-gatherer ancestors had their babies four or five years apart, because of long intervals of breastfeeding. As a result of that and their shorter life spans, they had as few as 40 menstrual cycles in a lifetime, while a modern woman can have 400. Though we can’t claim that today’s pills are perfect, their use is certainly less unnatural than enduring the hormone turmoil of hundreds of menstrual cycles.

Lookin’ for them reds everywhere – on menstrual leave

January 14th, 2014 by Holly Grigg-Spall

By MichaelBueker (Own work) [CC-BY-3.0],
via Wikimedia Commons

Last year Russian lawmaker and LDPR party member Mikhail Degtyaryov proposed that women have two days paid leave from their work when they are menstruating.

“During that period [of menstruation], most women experience psychological and physiological discomfort,” said Degtyaryov.

He also argued that pain from menstruation causes heightened fatigue, reduced memory and efficiency at work, and emotional discomfort.

NBC, amongst other sources, reported this news as a sign of Russia’s move towards more conservative social politics.

“Scientists and gynecologists look on difficult menstruation not only as a medical, but also a social problem,” Degtyaryov explained.

Responses to this across feminist media and others ranged from shocked to outraged.

I argue in my book ‘Sweetening the Pill’ that the emphasis on constant and consistent productivity and on quantity over quality of work is hard on everyone, not just women, and not just when they’re menstruating. As technology makes it so we can be available at all times, we therefore have to be available at all times. Dave Eggers’ novel ‘The Circle’ satirizes this pressure to be “on” brilliantly, making for an exhausting read in itself.

Our desire to miss out on the time when we might be pre-disposed to slow down – our period – by taking drugs that let us keep up the consistency in all ways is symptomatic of a wider cultural emphasis on inhuman work expectations.

SMCR’s own Margaret Stubbs pointed out in an interview with Yahoo! Shine – why can’t women just take sick days when they’re menstruating, if they want?

However, most US employers do not provide paid sick days, and those that do limit the number significantly. A sick day often needs to be used for a doctor’s appointment, a family emergency, or just to catch up on myriad other duties. A policy that attributes additional sick days (and if we’re talking two days per month that means A LOT of additional sick days) doesn’t seem such a bad idea to me at this point.

There was something of an echo of the Cold War in the reaction to this news. It was partly America’s faith in work as a cure-all that positioned it in opposition to the communists.

Yes, menstrual leave is not entirely unproblematic as a proposal, within the context. Apparently, according to Wikipedia at least, the LDPR party is worryingly nationalistic (any Russian readers please feel free to correct me on this). But some of the reactions suggested a pride in the American way of long hours and little vacation time. As I find myself saying at least once a week as a British person living in Los Angeles – take a look at the economically solid, recession-surviving countries like Germany and Australia for some good reasons why that pride is misplaced.

Sometimes it seems many women are so busy establishing the lack of difference between themselves and men that they find it hard to be truly honest about the experience – possibly painful, possibly tiring – that they are going through when they get their period. See Chris Bobel’s great post about suffering in silence for more on this. She suggests that discomfort during menstruation should indeed be a “social problem” of a kind.

If we are only valued for our productive output then menstrual leave will always be seen as dead time. It will then be more about getting women out of the office when their productivity is low and they may become a burden, than it is about valuing the potential benefits of the leave for the woman.

I admit that this is old news, and well-discussed elsewhere, but what prompted me to write a post is the desire to share more widely this great piece of writing over at the Irish Feminist Network by Barbara Scully. She discusses a BBC documentary that showed a British woman’s experience of a menstrual hut in a tribal community. Just as the capitalists saw the communists as backward, we sometimes too willingly believe our way of organizing things is the most progressive, most modern, most sophisticated. Perhaps we’re not always right.

Etiquette for menstruation

November 19th, 2013 by Holly Grigg-Spall

Photo courtesy of sweeteningthepill.com

Recently I was fortunate enough to be asked to lend an excerpt of my recently released book to the UK Sunday Times Style magazine. The mostly fashion-centric Style magazine is not really known for its edginess or risk-taking (except perhaps in the realm of shoe and make-up choices) and so I was happily surprised when the editor told me that the subject matter discussed in my book that she happened to find most interesting was, in fact, menstruation. I had expected her to want to focus on condoms perhaps, or just my personal story, but no, she was keenly interested in what I wrote about periods.

The argument I make in my book is that how we feel about hormonal birth control is inextricably linked to how we feel about menstruation. In a sense, many of the newer methods of hormonal birth control, as well as the newer uses (running packets of pills together, prescriptions for cramps or heavy bleeding) show an effort to get rid of the period completely, rather than just hide it away. I also discuss in the book, briefly, menstruation activism. However, I do defer to the far better work done by the likes of SMCR’s own Chris Bobel who writes on this topic with far more knowledge (not to mention wit).

You can read the feature in full here at my website (it’s otherwise behind an online pay wall and frankly I’m pleased to rob Rupert Murdoch of a few pounds by making it freely available).

In the end, the feature was not exactly an excerpt from my book – more so it was quotes from the book mixed with quotes from a long interview with the editor. Therefore I didn’t quite know what would be published in the magazine. The finished piece covered a range of controversial topics seen here at re:Cycling regularly – menstrual outing, reusable femcare products, the potential health benefits of ovulation…

If the high point of my career was getting the word “patriarchy” into the notoriously right-wing British tabloid The Daily Mail, I think I had another peak seeing this sentence in the Style (notorious for its high priced designer fashion spreads) – “This movement believes the act of stopping and hiding our periods with hormonal contraceptives and sanitary products is a mark of corporate ownership of our bodies.” I take great pride in also getting a discussion of menstrual extraction on to Style’s pages, and therefore onto the breakfast table of approximately one million British people – “an entire period’s worth of menstrual blood could be removed in a few hours instead of being experienced over days.” Well, if we can have Page 3, why not menstrual extraction?

The editor who did such a great job on this piece was Fleur Britten and in a funny twist of fate I realized, during our conversations, that in my first full time working position after college, at the publishing company Debrett’s in London, I worked as a production assistant on one of her books – Etiquette for Girls. At that time controversy surrounded Fleur’s section on the proper etiquette for one-night stands (I think it was something about getting out quickly, quietly, but leaving a nice handwritten note). So, it made me smile to see her skewer the etiquette of menstruation in the opening paragraph of this piece: “Many women are bored with having to take a whole handbag into the ladies rather than carry a tampon in their hand. Men say “I’m going to take a dump,” but we don’t say, “I’m just going to change my tampon.””

When I was carrying the proofs of Fleur’s book to the printers back some seven years ago, little did I know we would be conspiring to get the British public to say “I am menstruating” today over tea and toast.

Essentialism and experience

August 26th, 2013 by Holly Grigg-Spall

My forthcoming book ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control’ began to take shape on the pages of this blog and much of the process of its development was spurred on by the work of members of SMCR. As such, it seems only fitting, with the release date of September 7th soon here, to share for my post this month an excerpt and to say thank you for the support of this community. I hope to have added something of interest and value to this on-going conversation.

……

Women often discuss menstruation and birth as happening to them, rather than as part of them and their experience. Emily Martin remarks in ‘The Woman in the Body’ that women often see their self as separate to their body. Women’s central image is that “your body is something your self has to adjust to or cope with” and therefore, Martin concludes,“your body needs to be controlled by your self.”

Martin explores the idea that women did not fit into the structure of the jobs that were open to them in industrialized society. These jobs most often required monotony, routine and repetition. Although in reality no more suited to men than they were women, it was women that were judged as innately unable to succeed in such positions due on the constantly changing and supposedly unpredictable nature of their physical state.

As Martin states, “Women were perceived as malfunctioning and their hormones out of balance,” especially when experiencing PMS and menstruation, “rather than the organization of society and work perceived as in need of transformation to demand less constant discipline and productivity.”

The rigidity of society was forcefully imposed on women as it was on men. For all, both men and women, it is inhumane but it was women that were required to adapt in a more dramatic and overt way. Men are viewed as naturally given to the industrious and disciplined way of life demanded of them and the structure of society is built on these assumed capabilities.

If we admit that women do change through the month, that we do menstruate, experience PMS, have differing moods week to week, we fear that this admission will be used as justification for negative judgment.

Martin counters the feminist refrain of “biology is not destiny”; “I think the way out of this bind is to focus on women’s experiential statements – that they function differently during certain days. We could then perhaps hear these statements not as warnings of the flaws inside women that need to be fixed, but as insights into flaws in society that need to be addressed.”

The idea that men are otherwise unchanging is falsified. Men also experience hormonal changes with studies suggesting they experience a cycle daily that is equivalent to the monthly cycle of women as well as changes in hormone levels across their lifetimes.

Women’s “experiential statements” as Martin describes them are often silenced in the discourse surrounding hormonal contraceptives. It is a betrayal of the feminist cause to speak out with openness about the side effects of the pill.

When Yaz and Yasmin were released the marketing strategy co-opted the idea of word of mouth. In a commercial women were seen passing along the “secret” of these new drugs with their host of beneficial yet superficial side effects. Receiving messages of increased physical attractiveness as the result of a drug that many women were using anyway, only a different brand, increased the transference of this experience from one woman to the next.

In the face of such powerful manipulation, what place does a skillfully worded informational insert have in women’s decision making process? The time of the Nelson Pill Hearings was a very different to today.

Naomi Wolf mentions the pill briefly in ‘The Beauty Myth.’ She remarks that it was originally marketed as a drug to keep women “young, beautiful and sexy,” concepts parallel to those promoted by Bayer through its contemporary advertising. Wolf quotes, in the context of the beauty industry, John Galbraith, “Behavior that is essential for economic reasons is transformed into social virtue.”

Giving birth in ditches

July 30th, 2013 by Holly Grigg-Spall

The second week of July began with a post at The Daily Beast titled ‘Are Tampons Anti-Feminist’ and ended with my own post for Dame ‘5 Facts About Menstrual Suppression.’ In between there was ‘Not Everything is a Feminist Issue for Chissakes,’ and ‘I Do Not Think Tampons Are Anti-Feminist, for Chrissakes.’ Meanwhile, towards the end of that week, women were having their tampons and pads confiscated by security guards at the Texas Senate as they entered to protest the proposed ban on abortions after 20 weeks. It was a perfect storm for a debate around menstrual shame.

With notable foresight the first article mentioned ends with, “For women who can’t break the silence, there are other ways to protest. Just ask DiFranco. “I didn’t really have much to say/the whole time I was there,” she sings in “Blood in the Boardroom,” “so I just left a big brown bloodstain/on their white chair.”” Later, women at the Texas Senate shared responses that were similar to this statement (“No tampons allowed? Guess we’ll just have to bleed all over the seats” and “Maybe it’s time for a bleed-in”), although there were an equal number remarking on their feelings of humiliation and horror at having their tampons and pads exposed in public.

Somehow, along the way, these threads of discussion were merged – if we’re considering tampons as anti-feminist, or menstrual shame culture as anti-feminist more accurately, then surely what we’re saying is that women should just bleed all over their furniture and clothing, right? Right?

Texas native and high-profile feminist writer Amanda Marcotte weighed in on the debate: “I used to joke that anti-choicers would start considering bans on menstruation,” she wrote.

I would argue that between menstrual shame culture and the pharmaceutical industry we have a “ban on menstruation” of a kind already.

When asked why it was necessary to keep tampons and pads “private” anyway and why it was that confiscating them in public was being discussed as a power move on the part of the Senate employees, she responded with:

“I’m not afraid to be a urinating human being, but I also don’t just go pee on the street corner. One can want to go about without blood on their clothes and not be ashamed of being female. I promise.”

And then, after some attempts at reasoning, “Convinced. I am going to pee freely now, and anyone who says no is just down on me for having a urethra.”

Never mind that they weren’t confiscating toilet paper, available and publicly displayed in the Senate bathrooms.

Elsewhere she suggested that those who were questioning our acceptance of the menstrual hygiene industry’s messages were just “weirdos.”

Marcotte: “I just want once to make a tampon joke without the weirdos who think women should bleed freely for “feminism” coming at me.”

Response: “Do these people have jobs? Or couches?”

Marcotte: “I have no idea. I just assume it’s part of that crunchy fake feminism that thinks women should give birth in ditches, too.”

I don’t think many women are going to argue that we bleed on our couches and clothes because, considering the statistics on division of housework, it’s definitely women who are going to have to clean that up. And if doing laundry isn’t anti-feminist, well, I don’t know what is.

Elsewhere the writer of ‘Not Everything is a Feminist Issue…’ Erin Gloria Ryan, another high-profile feminist writer, when directed to re:Cycling as a source of knowledge on the issue responded with “Ill read it (the blog) aloud at my next fun social gathering filled with normal people.”

Whether it’s from lack of awareness of the history of oppression of women via their bodies or whether it’s just another symptom of the corporate/capitalist feminism that dominates the mainstream, these are the women considered to be representative of the whole.

I relay the details of this interesting week not to depress, but to galvanize.

I, for one, am proud to be a weirdo, an abnormal person, a crunchy feminist, a fake feminist, oh and a miserable enemy of uteri everywhere, a bitch, and a…err…fish.

The Other Dangers of Yasmin and Yaz

July 2nd, 2013 by Holly Grigg-Spall

Recently, in a piece for the Ms. Magazine blog, re:Cycling’s Elizabeth Kissling remarked on the lack of media coverage of serious safety issues with the popular birth control pill brands Yaz and Yasmin. Of the coverage there has been, little has looked beyond the significant number of injuries and deaths caused by blood clots to the potential dangers held in the negative psychological impact of these drugs, an impact that it appears a large number of women may have experienced.

As I read the stories of women who had suffered strokes or gone blind, I wondered how many women using Yaz or Yasmin had also been driven close to death, or perhaps even died, due to the depression the pills can provoke.

I decided to interview Dr Jayashri Kulkarni at Australia’s Monash University, one of the few people researching into this area, to find out more. As a practicing psychiatrist Dr Kulkarni treats women with mental health issues as well as leading research studies into this possible root cause of psychological problems.

Of the potential for these pills to create suicidal tendencies in users Dr Kulkarni says, “We have seen amongst women using these oral contraceptives a profound lowered self-esteem which causes them to lose perspective, misinterpret comments, and feel like no one would notice, or the world would be better off, if they weren’t around anymore. We’ve seen suicide attempts.

Dr Kulkarni is undertaking both a large-scale national and international survey of women’s subjective experiences with Yaz, Yasmin, as well as the Mirena IUD, Depo Provera shot, and Implanon implant and a smaller scale in-clinic study of the impact of oral contraceptives like Yaz and Yasmin on women over a three month period. The psychological impact is not what she calls “major depression” but instead a “sub-clinical depression” wherein women experience a mood change that impacts their relationships, work, and overall happiness.

“This depressive syndrome has a spectrum of symptoms. We tend to think depression just means sadness, but it can present as fuzzy headedness, inability to multitask, guilt, irritability, anxiety, and in behavioral changes like the development of obsessive compulsive disorders. Women experience a change in perspective that makes them magnify issues that occur in their lives, be that a slight weight gain or an argument with a partner, into feelings of worthlessness. It can also cause impulsivity, making the woman suicidal.”

At her clinic Dr Kulkarni describes treating a mother who found it difficult to let her children go to school for fear something would happen to them and another who became transfixed with the idea that her partner was cheating, and so called his phone repetitively to check on him. She believes that the provoked anxiety can display itself clearly as panic attacks, but it can also appear as paranoia and agoraphobia. When taken off Yasmin and Yaz these women returned to their previous state with a healthy perspective.

The Depo Provera shot and Implanon implant have shown in the research to also cause particularly profound depression. For women who have a history of mental health issues or have environmental factors that make them more vulnerable to mental health issues, these methods have been seen to provoke serious negative changes in mood.

Dr Kulkarni’s hypothesis is this: “Low estrogen pills and progesterone-only methods seem to cause depression at the highest rate. In our research we’ve seen women respond better to higher dose estrogen and natural progesterones. Clinical studies on animals have shown progesterone in a low dose causes increased anxiety, but conversely in a high dose it alleviates anxiety.” Her findings will be published later this year in full.

At present Dr Kulkarni treats her patients by changing their hormonal birth control method with her research in mind, a practice she believes to be generally successful. She prescribes new pill Zoely to patients who have responded badly to other brands. Zoely (which contains 2.5 mg of nomegestrol acetate and 1.5 mg of 17-beta-estradiol) was refused approval by the FDA for the US in 2011.

The Truth About Skyla

June 4th, 2013 by Holly Grigg-Spall

Mirena Intra-uterine Device
Public domain image

Do women using the Mirena hormonal IUD have their period?

Does it suppress the hormone cycle for all women or just some?

How does it work to prevent pregnancy exactly?

It seems these questions can’t be answered even by the assumed experts. We are told the Mirena “partially” suppresses ovulation and that some women will bleed and some won’t bleed at all. Mostly we hear that the impact must be limited to the reproductive organs because the level of synthetic hormone used is so low.

In an article entitled ‘Mirena: The Other Side of the Story’, AAA Ewies, a consultant gynaecologist at a UK NHS hospital wrote, “The argument used that serum concentration of LNG is extremely low and that its influence on ovarian function is limited has been disputed recently by many investigators. Xiao et al. found that Mirena was associated with substantial systemic absorption of the synthetic progesterone and recorded levels equivalent to two synthetic progesterone-containing ‘minipills’ taken daily on a continuous basis. A study documented that 21% of Mirena users experienced progestogenic adverse effects. Wahab and Al-Azzawi reported that Mirena suppresses oestrogen production, inducing a clinical situation similar to a premature menopause in at least 50% of treated women”.

In an effort to cut through the confusion, Bayer Pharmaceuticals went ahead and released the Skyla hormonal IUD in February of this year. Skyla is smaller than the Mirena, lasts three instead of five years, but contains the same synthetic progesterone and is also 99% effective at preventing pregnancy.

It was interesting timing, considering the American Congress of Obstetricians and Gynecologists (ACOG) almost simultaneously released a recommendation that doctors provide the IUD (it didn’t specify if they meant the hormonal or copper device in the statement) as “first-line contraceptive options for sexually active adolescents”. Teens often struggle with heavier or painful periods and are far more likely to be offered the Skyla, which is said to lighten bleeding, than the Paragard copper IUD, which is thought to increase bleeding. Not to mention the Skyla costs significantly more, has a shorter span of use, and is backed by a Bayer’s marketing department. The Mirena has been advertised heavily since its release in 2001 and the aggressiveness of the campaign – with television commercials proclaiming Mirena would make a woman “look and feel great” – was reprimanded by the FDA.

As a consequence of this combination of the ACOG recommendation and the release of Skyla we have seen articles in recent weeks with headlines such as ‘Could New Skyla Contraception Help Women Reach For The Stars’ and yet more that worry over the lack of knowledge that is preventing doctors from providing the IUD to young women or preventing young women from asking for an IUD. There was a time when IUDs were only given to women who had already had children – in part because of concerns regarding the devices causing damage that led to infertility. The tone is always the same – why are they keeping this near-perfect sounding birth control choice from us? If it is an undercover marketing technique to get women riled up about their access to hormonal IUDs then that department of Bayer deserves a raise.

Some of the doctors may have not received the memo but others may be concerned about the mounting lawsuits regarding the serious physical side effects of the Mirena, or at least they should be. The production of Skyla appears to be a deliberate effort by Bayer to reach the teens and twenty-somethings market. Even Bitch magazine got in on the advertorial action last week linking through their website to a suspicious looking post that seemed much like a marketing placement. Most of the media coverage does not flag the difference between the hormonal IUD and the copper, blithely using the term “IUD” in the same way the phrase “birth control” is now synonymous with “hormonal birth control.”

Professor at the University of California at Riverside Chikako Takeshita outlines in her book, The Global Biopolitics of the IUD, the history of the IUD, from its coercive use in developing countries to its presentation as a convenient method for the modern woman in the US and Europe. “The ACOG recommendation and release of Skyla is clearly going to expand the market for these devices”, she states, “This normalizes the use of long-acting contraceptives. Such normalization makes the use of the devices a technological imperative. The idea is that if a solution, a technological fix, to the problem of unintended pregnancy exists then you must take it. It silences other ways to approach the problem. The IUD doesn’t fix the fundamental issue which is the lack of sex education for teenagers”.

Rather than seizing the ACOG recommendation as simply a victory in the war against the teen pregnancy “epidemic” we must look critically at the potential result. This may seem like the easy answer, but is it the right one?

Pill-pushers

January 19th, 2011 by Holly Grigg-Spall

yaz

In the LA Times earlier this month, under the banner ‘oddities, musings and news from the health world,’ came a rewritten press release masquerading as one of the above that stated ‘Birth control pills using 24-day regimen may be more effective.’ Firstly, just from the headline, it is clear that this is one of those tell-us-what-we-already-know stories that only serve to reveal the amount of money wasted on research that concludes the obvious. If a woman takes a pill more days a month than she does not, then she’s less likely to forget to take that pill. Plus the more pills you take, the more days of the year, the less likely your body will find an opportunity to ovulate. The article, and the study on which it is based, attempts to suggest that 24-day regimen pills are more effective for other reasons. Other reasons like those pills – or should we say pill, as there’s only one this is referring to, without actually being named as Yaz – contain drospirenone.

Bayer, the pharmaceutical company behind Yaz, has long implemented an aggressive marketing campaign in the promotion of its now number-one selling product. However, it has never before been able to claim that Yaz was more effective as birth control than any other pill on the market. This is one reason why the adverts emphasize other benefits – that Yaz is acne-clearing, reduces bloat. Originally Yaz was also suggested to improve a woman’s mood all-round, and reduce PMS-related anxiety and depression. The FDA had Bayer change that message, so that now Yaz can only be said to improve symptoms of PMDD, although the definition and existence of this syndrome is still in controversy. Birth control pills are hard to market when, until now, they could all only be said to be as effective at their primary objective – preventing pregnancy – as each other. There was no way to differentiate. It’s similar to the way bottled waters must strive to stand out from the crowd. Different pills do use different progestins, and these cause different side effects, and so women are often encouraged to swap from one to the next in avoidance of problems from breakthrough bleeding to depression. The synthetic oestrogen used is the same for all, but at different levels. A study that suggests Yaz is better at doing its actual job – aside from all the other suggested benefits, many of which have been overturned over time – is a boon for Bayer.

And an important boon, considering sales of Yaz have dropped since drospirenone was linked to the deaths and injuries of many young women, and has become the centre of hundreds of court cases against the company. Not to mention the web-based uproar over the negative impact Yaz has had on many women’s emotional and mental well-being.

That the study, or at least its promotion, leans heavily on the drospirenone as the cause of this effectiveness, and not just that the pill is taken for 24 days out of the 28 day cycle, and inactive pills are taken during the break thus producing more of a ritual and habit to pill-taking, than those brands that have a longer break, or no inactive pills, suggests that either this study was funded by Bayer – it was undertaken in Germany, and Bayer is a German company – or that Bayer is manipulating the study and paying off the researchers. That the statistics state that Yaz has a 2.1% failure rate after one year in comparison to a norm of 3.5%, and a 4.7% failure rate after four years in comparison to the 6.7% norm concretes that this difference is down to the method of pill-taking and not the drospirenone. After four years a woman is more likely to forget to take a pill here or there, the drospirenone level and impact remains the same and so cannot be the cause of the change in rate from one to four years. Only the method can be taken into account here.

Long Live The Difference

December 5th, 2010 by Holly Grigg-Spall

toiletcorbis The UK Daily Mail newspaper last week reported that a company in Norway required that its female employees wear a red bracelet when menstruating as a way to monitor the extra toilet breaks it is assumed they need at that time. Firstly, and aside from all the historical context for such stigmatization, it isn’t obvious why it would be assumed women having their period would need to visit the bathroom more often than normal. It certainly sounds like a thought from an ignorant male manager. Perhaps it is necessary to have one extra toilet break within the eight hours, two at most. Anyone who has worked in an office job knows that the bathroom is used for all manner of purposes other than for that it was designed – for taking a break from the monotony of office work, to take a break from the computer, to chat with a friend in private, to make a phone call, to organize a night out after work – by men and women.


If toilet breaks are such a hindrance to companies then the next logical step is statutory Seasonique for every new female employee.

Monitoring bathroom breaks has historical links to the monitoring of women in the workplace specifically. Emily Martin discusses in her book The Woman In The Body how women were thought incapable of working alongside men exactly because they menstruate – and their menstruation was the central example of their difference, and inferiority – and so the necessity for extra bathroom breaks once a month was said to be detrimental to the productivity of the factory – as opposed to the modern-day version, the office. But Martin points out that bathrooms were also the only space in which the women workers could be away from men and speak in private. This made bathroom breaks times for women to establish their own identity outside of the male-created, male-ruled environment and to connect with each other. I have written about this in more detail for my own blog, Sweetening The Pill.

In The Daily Mail article although ostensibly the source of outrage is the red bracelets, menstruation is lumped in with all the other bodily functions reserved for the toilet. It is interesting to see the difficulty the media has in placing menstruation within its understanding of human experience. That it is said women feel ‘justifiably humiliated’ and ‘insulted’ is not explored in any of the coverage, it is only accepted that it is right they feel this way because menstruation is private, and by private it is meant dirty, disgusting and needing to be hidden away. When people use the bathroom for urinating they don’t pretend they are only going in there to have a glass of water or sit down. Or in a way actually, they do and perhaps shame and the need for women to be disassociated from their bodies is the source of the mythology that has built up around women’s bathroom breaks – that they always go in pairs, that they stay in their a long time, that they are doing other things, anything other than urinating.

Miranda Gray writes in The Optimized Woman that menstruation should set women apart from men in a positive way, that women’s menstrual cycles and the changes that occur in their skills and talents across the month could be used to reinvent the work environment and the structure of the 9-5 working week to be more humane, and therefore more productive. She sees that the male-created working world needs to be made better for the sake of women and men, and that the cycle might present an alternative that allows humans to be human and does not expect them to behave as machines.

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.