Blog of the Society for Menstrual Cycle Research

“Think Before You Pink”

October 1st, 2010 by Laura Wershler

breast cancer actionIt’s October again: breast cancer awareness month.  Women’s magazines are featuring stories about breast cancer, charitable events all over North America are raising money for breast cancer research, and retailers are urging you to shop to cure breast cancer.  

Read those stories, run for the cure, but – at the behest of Breast Cancer Action - think before you pink.  National chains and brand names aside, some of the more questionable vendors, hawking wares to consumers, leave one wondering how breast cancer became such ”big business”.  Who will want a cure, or effective prevention strategies, if it will mean putting a lot of people out of work? Including manufacturers who make mammography machines, and pharmaceutical companies that focus on breast cancer drugs.

Breast Cancer Action positions itself as ”the watchdog of the breast cancer movement“. They are the only national breast cancer organization in the United States that does not accept money from any source that profits from breast cancer. Their position on shopping in support of breast cancer awareness is clear:

Think Before You Pink™, a project of Breast Cancer Action, launched in 2002 in response to the growing concern about the number of pink ribbon products on the market. The campaign calls for more transparency and accountability by companies that take part in breast cancer fundraising, and encourages consumers to ask critical questions about pink ribbon promotions.

This October, consider carefully how you will demonstrate your breast cancer awareness.  “After all”, as Breast Cancer Action notes, “ if shopping could cure breast cancer, it would be cured by now.”

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Libido and the Pill

September 7th, 2010 by Laura Wershler
Laura Berman, Ph. D.

Laura Berman, Ph. D.

It’s great to see celebrity sexpert Laura Berman, Ph. D. – frequent Oprah TV guest, Oprah radio host, and (according to her website) world renowned sex and relationship expert - talk truth about the effect of the birth control pill on women’s libido.

In the September 2010 issue of Parenting magazine, Dr. Berman acknowledges that the pill can lower libido and clearly explains the mechanisms for this.  So far so good. What bothers me is her advice to moms experiencing this problem.

Happily, there are solutions, short of becoming celibate. Here are four options— talk to your doctor to see if any of them might be right for you.

Her recommendations include two alternative forms of hormonal contraception –  the Nuvaring and the Mirena IUD, the hormone-free IUD, and a sterilization method called Essure that scars the fallopian tubes to prevent sperm reaching egg.

Granted, all are legimate alternatives to the pill.  But the message sent, yet again, is that women who don’t want to get pregnant or remain celebate must depend on drugs, foreign objects inserted into the uterus, or sterilization.  If nothing else is mentioned, then nothing else must be trustworthy.

It has become all too typical for sexual healthcare providers to ignore the needs of women seeking information, support and services to use non-hormonal, non-invasive methods of birth control confidently and effectively.  This was a golden opportunity for Dr. Berman to talk about the ever effective condom, the new FemCap cervical barrier, and the growing interest amongst American women in Fertility Awareness Methods, which though wildly misunderstood by most in the medical and sexual health community have proven effectiveness equal to the pill.

Kudos to Laura Berman for telling the truth about the pill and libido.  Many sexual health care providers are not this open about the libido lowering effects of oral contraceptives.  Check out the comments at this May 2010 discussion at Jezebel.com about the subject.

Now I urge Berman to take on the challenge of providing information and support for women who are ready to turn the page on hormonal and invasive birth control methods.  For some women it will be the only way to achieve the better sex and intimacy at any age she promises on her website.



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Tonight’s the Night: Listen to Seeing RED

June 14th, 2010 by Laura Wershler

Tonight’s the night, Monday, June 14th, to tune in as CBC Radio airs Part One of: Seeing RED: A Cultural History of Menstruation This two part documentary concludes next Monday, June 21st. If you miss the original broadcast, which you can listen to online at 9:00 PM in all time zones (choose the program IDEAS) you will be able to link to the podcast at any time convenient to you as of Tuesday, June 15th.  SHAA SEP 07 029

Introduction to the documentary:

They are misfits. Witches. Children. Just a few of the labels used to portray menstruating women over time. The Bible has described the bleeding woman as undergoing “customary impurity”. In the Middle Ages, it was thought that women menstruated to release “sexual overflow”. Their counterparts in the Victorian era were told that a period would deplete their body’s precious resources. Twentieth century feminists worked hard to reclaim menstruation as a vital and positive part of womanhood. IDEAS producer Mary O’Connell explores menstruation from a cultural and historical perspective.

Several members of the Society for Menstrual Cycle Research were interviewed for this documentary. We invite our readers to listen to the program and share their thoughts and comments.    (Photo by Laura Wershler of Bleedy, the Period Puppet, created by Bree Horel at a Menstrual Arts and Crafts event held by Sexual Health Access Alberta.)

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Teens Using the Rhythm Method? It’s Time for Body Literacy

June 8th, 2010 by Laura Wershler

Cycle SavvyTeen sex: More use rhythm method for birth control.

It was an odd headline for an Associated Press story on the 86 page report on teen sexual activity just released by the Centre for Disease Control and Prevention. Not all that relevant to the broader subject of the study on which the report is based: Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, National Survey of Family Growth 2006-2008. If you’re interested, it is a fascinating read.

But it was the headline and this excerpt from the story that caught my attention:

About 17 percent of sexually experienced teen girls say they had used the rhythm method – timing their sex to avoid fertile days to prevent getting pregnant. That’s up from 11 percent in 2002.

They may have been using another form of birth control at the same time. But the increase is considered worrisome because the rhythm method doesn’t work about 25 percent of the time, said Joyce Abma, the report’s lead author. She’s a social scientist at the CDC’s National Center for Health Statistics.

You can’t study what you don’t understand. The study authors demonstrate their lack of knowledge about natural birth control methods by the question they asked study participants:  Have you ever used rhythm or safe period by calendar to prevent pregnancy?

There are many brands of natural birth control. Some , like the Rhythm and Calendar methods, are not effective. No proponent of Natural Family Planning (NFP) or Fertility Awareness Based Methods (FABM), which have effectiveness rates as high as 99.4 percent, would recommend them.  Yet this study does nothing to differentiate between these methods of natural birth control, thereby confusing the public, the study results and themselves.

It’s high time researchers studied up on natural birth control methods if they want to include questions about them in a study on the contraceptive practices of teens or adults.

Until they do, I suggest anyone interested in the sexual and reproductive health of teen girls start buying copies of Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body.  This book can help our daughters acquire the life skill of body literacy – to understand the mysteries of their menstrual cycles and how this knowledge can serve them well as they make decisions about their sexual and reproductive health and lives.

 

 

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SMCR Bloggers Respond to ACOG’s Homage to the Pill

May 20th, 2010 by Laura Wershler

MenstruationResearch.org – Today, during an email exchange among the Society for Menstrual Cycle Research blogging team, research-advocacy experts on the menstrual cycle spoke out in response to the unbridled passion for the pill expressed by members of the American College of Obstetricians and Gynecologists at their 58th Annual Clinical Meeting. Amidst the hoopla surrounding the 50th anniversary of the pill, it must be noted that not all experts believe the pill to be an unequivocally positive contribution to women’s health and well-being that those quoted in the ACOG media release purport it to be.



“The pill has literally changed the world, and it was a primary stimulus to the women’s movement of the 60s. It has done far more for women’s rights than any legislation that has been passed and should be recognized as the great emancipator of women.”


Mark S. DeFrancesco, MD, MBA, Cheshire, CT
Secretary Elect, The American College of Obstetricians and Gynecologists

“When the pill first came out, young unmarried women had to fight for the right to take it. Now, they have to fight for the right NOT to take it. Overhyped as medicine’s gift to women’s health, by mostly male gynecologists who have never taken the drug, the pill has become an almost forced right of passage – the “standard of care” treatment for being a girl. Emancipation or subjugation? Ask the young women who face coercion and control by their doctors when they ask for support to use non-hormonal methods of birth control.”

Laura Wershler, Sexual Health and Reproductive Rights Advocate,
Executive Director, Sexual Health Access Alberta


“Birth control pills provide women with many non-contraceptive benefits, including cycle control, cancer prevention, and pain relief. They have been an integral part of women’s health.”

Scott D. Hayword, MD
Mt. Kisco, NY
Chair, District II, The American College of Obstetricians and Gynecologists

“Birth control pills provide women with many risks in exchange for contraception, including blood clots, stroke, breast, cervical, and liver cancers, diminished libido, and mood disorders. They have been instrumental in activating the women’s health movement, as feminists
demanded responses to these risks.”

Elizabeth Kissling, Ph.D.
President, Society for Menstrual Cycle Research


“I have often thought that the birth control pill should be called a hormone regulation pill because its use and impact have been so much broader than contraception alone. The pill has certainly improved reproductive control, but the impact on menstrual regulation has been very important for women, from adolescence to menopause.”


Jeanne A. Conry, MD, PhD
Roseville, CA
Chair, District IX, The American College of Obstetricians and Gynecologists

“I’m so happy to have The Pill called “a hormone regulation pill” because that is the way it is currently used by many physicians, and some women. It is used to cover up the far-apart cycles of anovulatory androgen excess (also known as PCOS) but doesn’t promote ovulation. The Pill is used to treat heavy bleeding in teenagers, but doesn’t restore her own balance of estrogen and progesterone. It is used for menstrual cramps when ibuprofen or other non-steroidal is more effective and has no suppressive effect. It is used to treat premenopausal osteoporosis when the evidence suggests it causes rather than prevents subsequent fragility fractures.

In short–the Pill has become the major non-surgical tool of gynecology.”

Jerilynn C. Prior, MD, FRCPC
Professor of Endocrinology / Department of Medicine
Centre for Menstrual Cycle and Ovulation Research
University of British Columbia

“The introduction and rapidly accepted, widespread adoption of oral contraceptives among women of reproductive age drastically reduced women’s fear of unplanned pregnancy in ways their mothers and grandmothers never knew. The pill has allowed women to take different roles in all aspects of their lives—career, education, travel, and a host of other beneficial ways.”

J. Craig Strafford, MD, MPH,
Gallipolis, OH
Vice President, The American College of Obstetricians and Gynecologists

“Women realize their full potential when they are supported in making informed decisions in all aspects of their lives. Indeed, oral contraception has enabled women to avoid unplanned pregnancies, but it has never been a risk-free option. While providers are eager to prescribe the pill, they are less eager to fully explain how hormonal contraception works and the side effects it carries. Until women have access to a full range of safe, affordable and accessible options, their freedom is compromised.”

Chris Bobel, Ph.D.
Chair and Associate Professor of Women’s Studies, University of Massachusetts-Boston

“The pill has revolutionized women’s health care. Obviously, the contraceptive benefits are paramount, but I have become a huge advocate for all of the non-contraceptive reproductive health benefits that the pill offers. Another advantage is that the pill has enjoyed incredible safety over its 50-year history.”

Douglas H. Kirkpatrick, MD, Denver, CO
Immediate Past President, The American College of Obstetricians and Gynecologists

“The Pill has its roots in a time much farther back than fifty years.
Historically the female body has been feared and the release of the
Pill fitted very easily into this history. Victorian doctors removed
women’s ovaries in response to many perceived female problems, and today doctors prescribe the Pill, shutting down ovulation. The Pill is not only prescribed for birth control – it is handed out to women with acne, PMS, irregular periods, heavy periods. Even light, regular periods are now considered enough of an inconvenience to warrant a long-term drug dependency. The Pill has developed into a medication for the disease of being female. In place of changing society, society decided to fix women. At a time when we are more concerned about what we eat, what we wear, what we use to clean the toilet than ever before, we are still celebrating millions of otherwise healthy women taking a powerful medication every day, for years.”

Holly Grigg-Spall, Journalist

“The advent of effective contraception was revolutionary, transforming, empowering, and a tremendous boost to women’s health. It continues to play a major role in the effort to achieve responsible reproductive health and choice for all women—a goal of every child being a wanted child delivered into a supportive and secure environment.”

James N. Martin, MD, Jackson, MS Secretary, The American College of Obstetricians and Gynecologists

“If the pill was as revolutionary, transforming and empowering as is suggested, then all women should be taking it from menarche to menopause, except when we are ready to have the “wanted child.” But we aren’t. Today, young women are ditching the pill in favor of non-hormonal methods, and still managing to achieve responsible reproductive health choices. As for the pill being ”a tremendous boost to women’s health” – I think not. Troublesome side effects, serious health concerns, and a growing interest in holistic approaches to health care are putting the pill in its proper place. One contraceptive choice that works for some women, some of the time.”

Laura Wershler, Sexual Health and Reproductive Rights Advocate,
Executive Director, Sexual Health Access Alberta


“The pill is probably the single biggest contribution to women’s health in our lifetime. Not only has it given women more control over their fertility, it has been successfully used to treat many gynecologic conditions such as dysmenorrhea, menometrohaggia, PMS, acne, PCOS, and endometriosis, enabling women to have a better quality of life.”


James A. Macer, MD, Pasadena, CA

Assistant Secretary Elect, The American College of Obstetricians and Gynecologists


“Long term safety data on the current patterns of use of the pill do not exist, and are not being collected. When first approved, the pill was available to married women, most of whom had children, and allowed them to space their families. Currently, the pill is most commonly used by childless young women, often during the teen years, and can extend for decades. The consequences of pharmaceutical suppression of the developing endocrine system (during the 12 years following the first period) have, to my knowledge, not been explored. For example, taking the pill interferes with bone acquisition, compromises the accumulation of bone density, and may compromise peak bone mass. Peak bone mass sets the bar for lifelong bone health. In a cohort expected to live into their 80’s, casual and enthusiastic use of the pill may be something society regrets half a century from now. There is a tendency to blame side effects on the bad old days, and to say that things are better now. But a recent large study confirmed blood clot risks with today’s “modern” formulations, and, more worryingly, these risks are amplified by obesity and smoking, both of which are more prevalent in modern populations.”


Christine L Hitchcock, PhD, Research Associate, Centre for Menstrual Cycle and Ovulation Research, and Clinical Assistant Professor, School of Population and Public Health, University of British Columbia

This ACOG statement furthers a broader message to young women that they should trust pharmaceutical menstrual rhythms over that of their own bodies and that they should trust clinical authority over their own authority. In and of itself, ceding their bodily authority, ownership and stewardship to medicine causes harm to women.

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The Society for Menstrual Cycle Research is a nonprofit, interdisciplinary research organization. Our membership includes researchers in the social and health sciences, humanities scholars, health care providers, policy makers, health activists, and students with interests in the role of the menstrual cycle in women’s health and well-being.

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Ultrasound Man:Birth Control Superhero

May 17th, 2010 by Laura Wershler

superheroYou know how most superheros become superheros because of exposure to some weird, intensified chemical or element? Take Peter Parker’s spider bite for example.

According to a story reported in various media, including International Planned Parenthood Federation’s website, if science can perfect the contraceptive effect of ultasound on men’s testicles, then we may be in for a new breed of superhero.  Ultrasound Man: able to bear the burden of pregnancy prevention for women everywhere. 

I joke, but for decades women have yearned for gender equality when it comes to bearing the burden of birth control. Could the promise of six months of ultrasound induced, reversible infertility in men be the answer? Well, to date, we only know it works in rats. There is a long way to go before we send the men for a bi-annual ultrasound “zap test”.

This isn’t the first male method touted over the last decade. In 2003, news out of the UK about a birth control pill for men had women nodding their heads with approval. I was immediately dubious and dashed off a commentary for the Calgary Herald that began thus:

Memo to Big Pharma: Save your money. If you think the male birth control pill is going to be a big seller, think again. Memo to women everywhere: Curb your enthusiasm. If you think it’s time men took more responsibility, you’re right — but the Pill for Bill is not going to be it.

Because of the complex hormonal action of the pill for men, I knew it wouldn’t fly. As I noted in my piece:

According to a story from the London Telegraph, because the treatment is invasive, it is likely to be used only by men in long-term relationships. Read it and weep, gals, because this is the wicked truth. It’s OK for women of any age or relationship status to ingest birth control pills or receive the Depo-Provera injection that completely shuts down their reproductive systems, but men would never do the same. It is already postulated that only men in committed relationships are likely to submit to invasive hormonal contraception. That would be supportive husbands and partners of the best kind.

Although a recent  survey by the Family Planning Association found that one third of men would definitely use a birth control pill for men if it became available, I doubt very much, once the mechanism of action were explained (full disclosure), that there would be many takers. I suspect the side effects, and concerns about synthetic testosterone, would result in a pathetic compliance rate.

Certainly the ultrasound method sounds much less invasive. Research leader James Tsuruta of the University of North Carolina said: “We think this could provide men with reliable, low-cost, non-hormonal contraception from a single round of treatment.

Happily, “the team plans to investigate the mechanism that causes temporary infertility.” I think the guys would want to know how and why it works before signing up.  But they can rest assured because Dr. Tsuruta also said: “Establishing safety, efficacy and reversability: these are our top concerns.”

As media stories proliferate documenting the growing trend among young women to eschew the Pill (et. al) in favour of non-hormonal methods, news that there may be a safe, simple method for men on the horizon is both welcome and long overdue.

What I find hard to take, however, is this suggestion expressed by Allan Pacey from the University of Sheffield:

There is certainly a place for an effective non-hormonal contraceptive in men, but whether men would find it acceptable to have their testicles scanned regularly remains to be seen.

Riddle me this: What’s wrong with birth control?

April 20th, 2010 by Laura Wershler

I read The Birth-Control Riddle by Melinda Beck, published today in The Wall Street Journal with interest and frustration.  As a veteran pro-choice sexual and reproductive health advocate, I’ve spent decades contemplating this ”riddle”. I have two specific comments in response to the piece, and a few suggestions for potential follow-up stories.
       birthcontrolmethods                                                                                                                                      
 1) I find it discouraging, but understandable, that the article failed even to mention fertility awareness based methods (FABM) of birth control, which when taught so that women/couples can use the method effectively and confidently have a 99.4% effectiveness rate. Don’t take my word for it. The German study called: The effectiveness of a fertility awareness based methods to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study was published in the prestigious journal Human Reproduction in late 2007. 

In addition to the typical North American dismissiveness (by healthcare providers) of FABM as ineffective, is the dismissive response given to North American women who express an interest in learning FABM.  A quick google search or a week’s hits on a google news alert for “Fertility Awareness” (the secular, pro-choice variation of the religiously contextualized Natural Family Planning) quickly establishes the burgeoning interest and use of these methods by young American women. Why is this so readily ignored by the mainstream sexual and reproductive health community (of which I am a part)? I have been mulling over this question for years. I have arrived at several answers. How I would love to see a journalist, any journalist, start asking this question.

 2) My second comment is that this article is a missed opportunity. It is useless merely to list (yet again) the birth control “choices” available to women, as if just knowing about these methods of contraception should make the problem of unintended pregnancy go away. Of one thing we can all be certain: it can’t and it won’t. What this piece lacks is any attempt to explore in depth the writer’s accurate but unexamined statement – Why are the numbers so high? The answer is a complex tangle of cultural, religious, behavioral, educational and economic factors.  Why not make an effort to get to the bottom of the so-called birth control riddle?  

Should Beck be interested in continuing to write about this issue, one angle she might consider exploring is barriers to access to information, support and services for women seeking to use non-hormonal methods of birth control effectively and confidently, including diaphragms, cervical caps and fertility awareness based methods. This is a huge issue of concern to me and the many women who can’t, won’t or don’t want to use hormonal birth control.

I have a theory that a good number of unintended pregnancies happen because women are finding little or no support to access and effectively use non-hormonal methods. Yet this lack of support is not enough to keep them on the pill, patch or ring, or to agree to submit to invasive shots or implants.  Therefore, care providers’ dismissal of young women’s requests for non-hormonal methods may actually be the cause of some of the unintended pregnancies we seem to be so puzzled by. Another issue not being talked about is that some women are getting pregnant while using the pill, patch or ring. These unintended pregnancies, which oddly don’t seem to pull down the “typical use” effectiveness rate of these methods, is partly behind the growing interest in IUDs.  The other reason IUDs are growing in popularity is backlash against traditional hormonal methods.

So the pill won’t kill me; what’s the point?

March 18th, 2010 by Laura Wershler

Women on the pill live longer. So touts a March 12, 2010 Reuters news story out of London, England reporting on a study published March 11 in the British Medical Journal (BMJ). A misleading headline if ever there was one.

The study followed 46, 000 women for up to 40 years, to see if the mortality risk among women sho have used oral contraceptives differs from that of never users. What the study actually found, according to the public release issued by BMJ on March 12 is this: “Women in the UK who have ever used oral contraceptives are less likely to die from any cause, including all cancers and heart disease, compared with never users.”

The study also found a slightly higher risk (of death, I presume) in women under 45 years old who are current or recent users of the pill.  As such, the authors assert:

Many women, especially those who used the first generation of oral contaceptives many years ago, are likely to be reassured by our results.  However, our findings might not reflect the experience of women using oral contraceptives today, if currently available preparations have a different risk than earlier products.

I’m 56 years old. I didn’t take the pill in the UK. But I did take it in Canada in the early to late seventies, back when it was much stronger than it is today. And back when it was NOT common for women to start the pill at 15 and take it for a decade or longer.  Am I reassured by these findings? Sort of. Although years of hard-fought-for healthy, ovulatory menstruation, subsequent to my year long post-pill amenorrhea, are more likely responsible for my good health than having  been an “ever user” of oral contraceptives. And more likely to protect me from heart disease and cancer than whatever benefits I may have derived from my on again, off again pill-taking history.

As for women under 45, it’s not just the “currently available preparations” I’d be concerned about. And there are tons of them: multiple variations of standard pills, continuous use pills like Seasonale and Lybrel, and cycle-stopping contraceptives like Depo-Provera and the Mirena IUD. The other concern is that the contraceptive use of young women today is much different than it was in my youth. They start using oral and other hormonal contraception at younger ages, before their reproductive systems have fully matured and their fertility (regular, ovulatory menstrual cycles) is well established. And they tend to take it for longer. The verdict on the long-term effects of this kind of contraceptive use is yet to be determined.

I’m not going to debate the merits or faults of this study or the unanswered questions it raises. The question I really want to ask is “What’s the point?”

The cynic in me believes that this study, and misleading headlines like Women on the pill live longer, will be used to compel women of all ages to ‘shut up already’ about their growing concerns with hormonal contraception. It will be dragged out as “scientific evidence” that taking the pill saves lives, as is implied in this article published by the Daily Mail:

The contraceptive Pill can extend your life and may even save 1,500 lives a year, a study has suggested.

Women who have taken the Pill at any stage in their life are less likely to die from any cause – including heart disease and all types of cancer – than those who have never taken the oral contraceptive.

But wait, here’s the next paragraph:

However, the positive effects may only be enjoyed by women who have taken older-style pills rather than those on newer drugs.

The Queen Mother of Awkward Ad Briefs: Marketing Feminine Hygiene Products

January 7th, 2010 by Laura Wershler

I love Terry O’Reilly’s take on advertising and enjoy listening to his program The Age of Persusion on CBC radio whenever I get the opportunity, usually catching it by chance as I did this past Monday morning. This episode, Marketing the Unpleasant, tackles the subject of advertising feminine hygiene and other “delicate” products. 

Here’s how the episode is described on the show’s website:

They are the ads that make everyone squirm- consumers, media, and especially ad copywriters; ads for the funeral industry, laxatives, incontinence pads, and the queen mother of unpleasant ad briefs- feminine hygiene products. Terry O’Reilly kicks off the 4th season of The Age of Persuasion with an insider’s look at marketing the unpleasant, from the strange-but-true history of marketing menstruation products, to Wal-Mart’s recent decision to sell caskets and urns online.

Now I don’t appreciate the marketing the unpleasant description as regards advertising menstruation products, (he actually calls the assignment  ”the Queen Mother of awkward (ad) briefs”) but the show provides some interesting insight into the history of menstrual product advertising.  I learned that it was ad legend Arthur Lasker who came up with the idea to bring menstruation education to high schools, which subsequently “led generations of young ladies” to his client’s product – Kotex.  Men setting the agenda for what young women learned and thought about menstruation? Just to sell a product?  Hey, it’s still happening today. Now we’ve got male doctors setting us up to buy cycle-stopping and other hormonal contraceptives for everything that ails us. If you listen to the show you’ll hear some clips from a 1950′s Disney produced film called Molly Grows Up. The film was written, directed, produced and consulted by men.  It will make you either laugh or gag.

I’m not sure how I feel about the coy approach O’Reilly takes to the subject of menstrual product advertising. It is annoying to hear perpetuated the same old themes of embarrassment and discomfort. He also suggests that women are more uncomfortable with these ads than men. If true, maybe it is because menstrual product ad campaigns never quite seem to hit the mark.  (Thanks to Society for Menstrual Cycle Research member and re: cycling guest poster David Linton, many of us have seen the broad range of feminine hygiene advertisements developed over the last 100 years.  There is much to critique.) One thing that surprised me is that O’Reilly ignored one of the more groundbreaking campaigns he has written about in the past - the Kotex ads with the red dot and the word “period”.

Marketing the Unpleasant is available as streaming audio.  My suggestion: listen to the intro, the next bit about an Israeli HIV awareness campaign, then skip forward to the 11:00 minute mark where the feminine hygiene section takes over.  See what you think of the piece.  Oddly, of the 13 comments posted about this program, only one – from a woman - references the actual show content. (To be truthful, the comments were mostly from people looking for the streaming audio because they missed the first episode.) I hope if you find the time to listen, you’ll add a comment of your own.

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The “standard of care” for being a girl?

December 22nd, 2009 by Laura Wershler

In a December 21, 2009 news release the American College of Obstetricians and Gynecologists (ACOG) proclaimed that “hormonal contraceptives offer benefits beyond pregnancy prevention“.

You’d have to be an ostrich with her head in the sand not to have heard this message before.  Just open any woman’s magazine to any ad for the pill, or any of the myriad varieties of drug-based birth control, and you’ll find the litany (a prolonged and tedious account) of non-contraceptive benefits used as marketing messages to “sell” birth control to girls and women.  So the news release begs the question: why now?

Maybe the pharmaceutical companies are putting pressure on the gynies to protect their funding and the drug companies profits.  Maybe this news release is damage control.  A recent article in Maclean’s magazine proclaimed a trend towards ”ditching the pill for good“.

[O]ral contraceptive prescriptions in Canada levelled off in 2008, reports pharmaceutical industry analyst IMS Health Canada. Health care workers are seeing a growing demand for non-hormonal methods. Spurred by concerns about their health, the environment, or even frustration with family doctors, who sometimes seem to push the pill as a modern-day cure-all, Canadian women are looking for other options.

Are declining prescriptions for hormonal contraceptives a growing trend in North America?  Is there a backlash brewing against the pill, the patch and the ring?  One can only hope that the days when your gynecologist could convince you that taking the pill is a panacea for everything that, supposedly, is “wrong” with women’s bodies are coming to an end.

Hormonal contraceptives are drugs that disrupt a woman’s normally functioning endocrine system with synthetic versions of estrogen (ethinyl estradiol) and progesterone (progestin) to induce infertility.  [Do not be fooled by the language used in the press release.]  These drugs have a time and place.  But precribing the pill must never become the “standard of care” for being a girl.  Mothers everywhere, take note.




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Early menarche, late menopause and breast cancer – what’s the whole story?

December 10th, 2009 by Laura Wershler
Mammograms showing healthy (left) and (right) cancerous breast. Courtesy of the National Cancer Institute.

Mammograms showing healthy (left) and (right) cancerous breast. Courtesy of the National Cancer Institute.

Can having too many menstrual cycles give you breast cancer?  That’s what one might conclude from two unrelated articles that appeared in national newspapers this week.

First was Nicholas D. Kristof’s Op-Ed in the New York Times. Kristof had recently attended a symposium exploring whether certain common chemicals are linked to breast cancer and other ailments. The role of estrogen – both the real thing our bodies produce and the pseudo-estrogens – in breast cancer was his major example.

The real thing:

One theory starts with the well-known fact that women with more lifetime menstrual cycles are at greater risk for breast cancer, because they’re exposed to more estrogen. For example, a woman who began menstruating before 12 has a 30 percent greater risk of breast cancer than one who began at 15 or later.

The pseudo-estrogens:

One class of chemicals that creates concern — although the evidence is not definitive — is endocrine disruptors, which are often similar to estrogen and may fool the body into setting off hormonal changes. This used to be a fringe theory, but it is now being treated with great seriousness by the Endocrine Society the professional association of hormone specialists in the United States. …These endocrine disruptors are found in everything from certain plastics to various cosmetics.

(Do you ever wonder, like I do, why the birth control pill is not considered an ‘endocrine disruptor’ when that is exactly what it is?)

The second mention of the connection between too many periods and breast cancer came in dietician Leslie Beck’s Food For Thought column in Canada’s Globe and Mail. She was reporting on a new study showing that women with breast cancer need not shun soy:

By acting like weak forms of the body’s own estrogen, some experts have worried that soy isoflavones could possibly promote cancer growth.  That’s because certain risk factors for breast cancer, such as beginning your menstrual period before age 12 or starting menopause after 55, are related to the length of time breast cells are exposed to the body’s own circulating estrogen. It’s thought that estrogen can promote the growth of breast cancer cells.

It’s reasonable to think that the both the writers and readers of these articles (and the many more that have surely mentioned this connection) might assume from this information that too many menstrual cycles means too much estrogen, therefore too many menstrual cycles must be a bad thing.  What they don’t know is that not all menstrual cycles are created equal. It’s not necessarily about quantity, it’s about quality.

Common belief is that all menstrual cycles are ovulatory. (Unless, of course, you are using a hormonal birth control method that suppress ovulation like the pill, patch or ring.) In other words, the assumption is that if get your period you must have ovulated. This assumption is challenged by UBC endocrinolgist Jerilynn Prior, MD, and Scientific Director of the Centre for Menstual Cycle and Ovulation Research (CeMCOR). In her article Is Ovulation (and are normal Progesterone levels) Important for the Health of Women?, Dr. Prior has this to say about the connection between ovulation, menstruation and breast cancer:

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.