Blog of the Society for Menstrual Cycle Research

Contraceptive Ignorance, Surviving the Zombie Apocalypse, Period Photoshoot, and other Weekend Links

May 19th, 2012 by Elizabeth Kissling

  • TLC is developing a new reality show about “extreme savers” and wants to talk with women who use cloth menstrual pads to save money. If you’re interested, GladRags has the casting call. This could be a great opportunity for menstrual education, or it could be a nightmare. Given that this is the network of Toddlers and Tiaras and Tattoo School, I know where I’m putting my money down.
  • A new study from the Guttmacher Institute finds that a nationally representative group of 1,800 unmarried women and men between the ages of 18 and 29 apparently do not truly understand how proper use of contraception can prevent pregnancy:

    • The quiz asked respondents to choose “true” or “false” answers for basic statements such as “all IUDs are banned from use in the United States” or “condoms have an expiration date.” More than half of the men and a quarter of the women received either a D or F on the quiz.

  • In a guest post at Sexy Period, Suzan Hutchinson, TSS survivor and Director of Connectivity for You ARE Loved, reminds us that while Toxic Shock Syndrome isn’t common, it still happens and the risks and symptoms aren’t well known. (I somehow missed this back in January when it first appeared.)
  • Dr. Jen Gunter’s Gynecology Survival Guide for the Zombie Apocalypse is also useful in an an earthquake, snow storm, flood, or any other natural disaster.
  • Friend of re:Cycling Amy Sedgwick (of Red Tent Sisters) is offering a free teleseminar on May 24 for women who are finding it difficult to conceive.
  • There Will Be Blood. Vice magazine has published a series of fashion photos featuring menstruation. View as a slide show, or click here to see thumbnails of all seven photos, which you can click to enlarge.

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Posted in Internet, Menstruation | No Comments »

Midlife Muddle — Own the Power of Naming

May 17th, 2012 by Elizabeth Kissling

Guest Post by Jerilynn Prior, M.D. — Centre for Menstrual Cycle and Ovulation Research

By “midlife muddle” I don’t mean the trouble concentrating or remembering names that sometimes occurs for all of us (but more frequently if we’ve wakened with night sweats and not gotten back to sleep). I mean the condoned and official confusion about naming of women’s reproductive aging. Let me show you why I am upset.

 

STRAW+10 staging system for reproductive aging in women

Stages of Reproductive Aging Workshop (STRAW) held a 10-year anniversary last summer. (As someone frustrated by not being “heard” at the original conference, I still think that the “W” in STRAW should stand for Women!) Despite that, STRAW+10 has made progress because at least some of the classification is now supported by population-based prospective data rather than based on what experts believe. The names that are now politically correct are summarized in the STRAW+10 Executive Summary1 and the diagram1 at right.

 

We in the Society for Menstrual Cycle Research have also had our say about nomenclature: “Naming Women’s Midlife Reproductive Transition”.  I wrote this (with revision and refinement by collective effort of SMCR members) because women keep getting left out of this naming business. For example:

  • a regularly menstruating woman with night sweats, heavy flow, and increased cramps could learn to call herself perimenopausal2 (not STRAW+10 Late Reproductive Phase -3b?!).
  • a woman who just finished her period can say, I’m in late perimenopause and have at least a year without further flow before I’ll be menopausal. Based on STRAW+10 she could be told that specific menstruation was her final menstrual period (nickname “FMP”) and the next day, according to STRAW+10 be told that she is now “postmenopausal”!!
  • a woman with sore breasts, irregular periods, and heavy flow could say, I’m in perimenopause. However, she may instead be told she is in the “Early Menopausal Transition.” Because she has heavy flow she is also likely to be prescribed the birth control pill (as is currently and commonly recommended). Usually she will not be told that The Pill will make her perimenopausal irregular flow worse—she may well start spotting in the middle of her cycle.3

This new and improved STRAW+10 still centers all of women’s reproduction on that mythical FMP. But to call the FMP “menopause”, as many women’s health experts do, is just unscientific. It takes at least a year without another menstruation in those of us over age 45 before nine out of ten of us will not get another period4. But one (out of ten) of us will get a further, normal period even though we’ve been that whole year without any4. We can tell that new flow is normal (in other words, does not need investigation for endometrial cancer) if we had cramps or bloating or sore breasts or moodiness—or all of these—that told us our period was coming.

 

So our new Naming position statement says don’t call it “menopause” until you’ve not had a period for a year. And do call it “perimenopause” if things are variable and changing even if you are still having regular flow2.  Three of nine changes can confirm for you that you are perimenopausal even if your flow is still regular:2

  1. Shorter cycles (25 days or less);
  2. Increased cramps;
  3. Heavier flow;
  4. Increased trouble sleeping—especially waking up in the middle of sleep;
  5. New or increased migraine headaches;
  6. Night sweats—especially if they tend to occur before or during flow;
  7. An increase in or new premenstrual mood swings;
  8. New sore, enlarging or nodular breasts; and
  9. Weight gain without changes in what you eat or the exercise you do.

If women can learn to call themselves perimenopausal, they will be saying they know that perimenopause is not the same as menopause—perimenopause is a midlife transition with higher and erratic estrogen levels. Menopause is a fairly stable life phase with normally low estrogen and progesterone levels that begins one year after their last menstrual flow.

 

Furthermore, by naming themselves accurately they will be able to tell whether a medication that is proposed for them has been tested and proven effective in perimenopausal women. Usually symptomatic women are treated with oral contraceptives (that are proven reasonably safe and useful for premenopausal contraception), or offered hormone therapy that has only been tested and shown effective for hot flushes/flashes in menopausal women.

 

So. . . I like the word, perimenopause and think if women understand and own it they will be on their way out of a midlife muddle.

 

References

  1. Harlow, S. Executive Summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging [pdf]. Fertility Sterility, 2012   doi: 10.1016/j.fertnstert.20012.01.128
  2. Prior JC. Clearing confusion about perimenopause. BC Med J 2005; 47(10):534-538.
  3. Casper RF, Dodin S, Reid RL, Study Investigators. The effect of 20 ug ethinyl estradiol/1 mg norethindrone acetate (MinestrinTM), a low-dose oral contraceptive, on vaginal bleeding patterns, hot flashes, and quality of life in symptomatic perimenopausal women. Menopause 1997; 4:139-147.
  4. Wallace RB, Sherman BM, Bean JA, Treloar AE, Schlabaugh L. Probability of menopause with increasing duration of amenorrhea in middle-aged women. Am J Obstet Gynecol 1979; 135(8):1021-1024.

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Posted in Hormones, Language, Menopause, Menstruation, New Research | 4 Comments »

It’s National Women’s Health Week — Celebrate and Reminisce with the FDA

May 15th, 2012 by Elizabeth Kissling

I admit, I didn’t know that this is National Women’s Health Week until I received a reminder in my inbox from a U.S. FDA mailing list, letting me know about the Food & Drug Administration’s role in promoting Women’s Health. They’ve published a brochure (available in both HTML and PDF versions) commemorating 100 Years of Protecting and Promoting Women’s Health.

Image Source: Public Domain

Society for Menstrual Cycle Research members and other women’s health advocates and activists will want to look through the list of the accomplishments the FDA claims responsibility for and lists as unequivocal improvements in women’s health.

For instance, we’ve had many discussions at re:Cycling about the FDA approval of the pill in 1960 as one holding mixed benefits for women, and not always the best choice for women’s health. The brochure also asserts that in 1970, “FDA initiated the first package insert written for consumers to explain to women the benefits and potential risks of oral contraceptives.” That happened in 1970, but Barbara Seaman, Alice Wolfson, and the other founding mothers of the National Women’s Health Network had more to do with its initiation than the FDA.

And here’s another inspiring quote from the FDA brochure:

1980: Making Tampon Use Safer

Problem: In 1980, there were 814 confirmed cases of menstrual related Toxic Shock Syndrome (TSS) and 38 deaths from the disease.
Response: FDA began requiring all tampon packages to include package inserts educating women about the risk of TSS and how to prevent it. In 1997, there were only five confirmed menstrually-related TSS cases and no deaths. The tampon package inserts with TSS information continue to be used today.

Sure, the FDA is proud of those safety rules now, but in 1982 the agency asked the industry to come up with their own voluntary standards because they did NOT want to regulate tampon safety. After years of pressure and organizing from Boston Women’s Health Collective members Esther Rome and Judy Norsigian, activist Jill Wolhander, researcher Nancy Reame, and others to standardize tampon absorbency ratings, the FDA finally enacted regulations in 1989, by court order. Nine years after 38 women died from a tampon-related illness.

Just last year, the FDA could have made another decision that would almost certainly save women’s lives, by removing birth control pills containing the synthetic progesterone drospirenone from the market, but instead the advisory panel voted by a four-person margin that the drugs’ benefit outweighed the risks.

You know what else isn’t on the list? Emergency contraception, a.k.a. the Morning After Pill and Plan B. The agency hemmed and hawed and delayed unconscionably for years, until finally approving it for limited over-the-counter availability in 2006 — a year after Susan Wood walked out of the FDA Office of Women’s Health for good over what she believed to be “willful disregard of scientific evidence showing Plan B to be safe.”

Celebrating organizational achievements that advance and protect women’s health is a fine thing. I’m glad Frances Kelsey withheld approval of Thalidomide in 1960, and for the most part, I’m glad the FDA is on the job. But while we’re celebrating women’s health and reminding everyone to be active, eat healthy, and get preventive health care (if they are so fortunate to have access to health care), let’s also celebrate the activists and advocates that keep agencies like the FDA in line.

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Posted in Activism, Birth Control, Health Care, Law/Legal, politics | 3 Comments »

Are We Stalled?

May 14th, 2012 by Chris Bobel

What is worse? A problem unnamed or a problem named and denied as our own?

In a recent class discussion, a (white) student shared that she while she was in high school (a racially diverse high school, she explained), “everybody got along and racism was not a problem.” But now, since taking my class, she sees there IS racism around her.

The denial of racism in our own lives. This denial, like so many others, is certainly not uncommon, especially among those protected by some measure of privilege. Sometimes our denial is less passive (I didn’t know better); sometimes it is more active (I sure do know, but the knowing is painful and expects me to DO SOMETHING and I rather not, thank you very much).

This reminds me of the responses I typically hear from my students when we discuss menstrual shame. When I show commercials like the one below, they tell me they are NOT ashamed of their periods. They talk openly about their cycles. This menstrual taboo I speak of—old school. When I probe and ask if they carry their menstrual products around in the open, then, they tell me, “No…that’s just not something you do.”

 

A student denies racism in her high school, but sees it OUT THERE. Young women deny menstrual shame while concealing their tampons. These contradictions vex me. What gives?

I think we are in the midst of what sociologist Arlie Hochshild calls a ‘stalled revolution.’

Hochschild uses this concept to explain how the feminist movement helped women pursue careers but stalled before it (and by it, I mean WE) succeeded in dramatically altering the gendered division of household labor. I think the concept applies here, too.

We see racism but NOT HERE, not involving ME.  We follow the rules of concealment even while we deny that we are embarrassed. I am not ashamed; other people are. We can name the problem, but we cannot, will not, claim it for ourselves. That’s where the engine cuts out. That’s where we are stalled.

We live in a culture where racism is DISCUSSED, at least. Look at the tremendous response to the murder of Travyon Martin for a recent example. And we ARE  talking more about periods and about our bodies; the very fact that Kotex launched its ’break the cycle’ campaign in 2010 is fair evidence that the menstrual discourse IS enlarging. But forgive me if I am not jumping up and down with glee. After all, there’s more talk about EVERYTHING now. We have more ways, more means, more access to express and connect, instantaneously.  Some might argue we talk too much; we tweet and post and text before we think. Sometimes talk is just…talk.

Are talking toward change? Or we just talking, talking, talking about other people’s racism, other people’s shame.

What will it take to re-start our engines and both name and CLAIM the problems for ourselves?

 

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Posted in Advertising, Communication, FemCare, Menstruation | 17 Comments »

Man boobs, Teen Sexuality, a Drug to Prevent HIV, and More Weekend Links

May 12th, 2012 by Elizabeth Kissling

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How come we even have a Society for Menstrual Cycle Research?

May 11th, 2012 by Alexandra Jacoby

“How come we even have a Society for Menstrual Cycle Research?

Don’t we already know how it all works?”

That’s what my friend said to me when I was telling him something about something that came up related to the Society.

Well, do we?

—Already know how it all works.

I’ll go first.

I totally don’t.

For example, I didn’t grasp that taking birth control pills meant not having a period—even though I had been taking them for over 20 years.

And, when I mentioned that to someone recently, she said, “What do you mean? I thought the pill regulated your period…” The woman who overheard us, leaned in, “What? I don’t understand. I thought it controlled when…”

This isn’t the only time I’ve been in a conversation, where most of us didn’t know much about how our bodies work when it comes to the menstrual cycle. We just hadn’t given much consideration to the internal processes, nor to the effects of the things we do to manage our cycle experiences (personal and social) as they relate to our day-to-day well-being, sexuality, fertility, relationship with the environment…

It’s not unusual to be involved in things we don’t fully understand. What all the parts do, and how they interact, and why the whole thing is organized the way it is—none of that is self-evident. So if nothing prompted you to ask, or to go deeper, wider than the first level of understanding (I took birth control pills to avoid getting pregnant, didn’t think it any further), then you stopped where you stopped.

In addition to what we individual women don’t know we don’t know, collectively, we do not know all about how the menstrual cycle works.

New discoveries are being made all the time, and not everyone agrees about what they mean, and sometimes they undo what we thought we understood.

I don’t see how we could ever be done understanding how our bodies work in general. Our bodies are continually evolving, as are our lifestyles and our environment. And, specifically, when it comes to the menstrual cycle, I think my friend’s point of view is a typical one, maybe informed by the femcare aisle in the drug store, the condom rack nearby, and that the pill is (probably) available behind the pharmacist’s counter. That about covers it, right?

Must admit: I used to think so.

The mission of the Society is here: http://menstruationresearch.org/about-the-society/. Read it.

What do you think?

Do you feel sufficiently informed, equipped, able and healthy when it comes to every aspect of your life impacted by the workings of your menstrual cycle?

Are new research developments clear to you?

Do you know what to expect throughout your menstrual life stages? What’s deemed typical, within a range of normal, and what’s a sign of a health issue?

How much variation is there among us?

What tells you when to look further, and when to accept the current perspective—and where do you go to get that information and guidance?

Do you feel supported by what is available to you?

 

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Posted in Menstruation, Philosophy | 3 Comments »

Redbook Gets It Right

May 8th, 2012 by David Linton

Our recent Weekend Links post referred to a cheesy piece in Cosmopolitan magazine about stupid and offensive remarks that have been said to women by their ob/gyn.  At about the same time, Redbook‘s May 2012, issue had an article by another ob/gyn, Dr. Hilda Hutcherson, titled, “Have a healthy, happy vagina,” which used a q & a format to address “the five issues women stress about most” concerning their “lady parts.”

Image from Redbook, May 2012, p. 183

  1. Will childbearing “ruin” my vagina?
  2. Is the smell okay?
  3. Do I look weird down there compared to other women?
  4. Why don’t I have vaginal orgasms?  Can I change that?
  5. Why does my vagina sometimes hurt when I have sex?

The responses to the questions were basically thoughtful and supportive, though a bit coy sometimes, with the talk about “lady parts.” In other words, they gave the kinds of information that’s found all the time in the posts on re:Cycling.

It also included four dumb/insensitive things doctors have said while their patient was “in the stirrups.”  The heading was, “Your OB/GYN said WHAT!?”

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Posted in Communication, magazines, Media, Menstruation | 1 Comment »

The Eternal Feminine: Focused, Goal-Oriented, Practical, and Loving

April 30th, 2012 by Paula Derry

Visiting colleges became part of our repertoire of family trips back when my daughter was a senior in high school.   We visited many schools to get a sense of the range of possibilities that existed.   As was typical, Vassar offered a tour of the campus for groups of prospective students and their parents, led by tour-guides who were undergraduate students.  Vassar’s tour had one unique feature.  An original campus building, which dated to the post-civil war era, had an exceptionally wide hallway.  This, we were told, was because the all-woman student body needed to be able to walk back and forth repeatedly in the halls in their wide skirts, as part of a college program in physical fitness. Vassar, founded on the idea that the education of women should equal that of men, had a program of physical culture to offset criticisms that the school was endangering women’s health by educating them.

Sheila Rothman describes Vassar’s history in her book “Woman’s Proper Place,” published by Basic Books in 1978.  The common wisdom in the second half of the 19th century was that people have a limited amount of biological “vital energy.”  Rothman (p.24) quotes a contemporary physician:  ”Woman has a sum total of nervous force equivalent to a man’s” but the force is “distributed over a greater multiplicity of organs…The nervous force is therefore weakened in each organ…it is more sensitive, more liable to derangement.”  Menstruation and pregnancy were times of special danger, when the demands on her system were greater and the possibility of physical and mental disorder increased.  Menstruation was a time when women were irrational, even insane.  Caution, however, was always called for, as when intellectual activity or other exertion used up nervous energy.  Thus, when Vassar was founded, a program was put in place to overcome women’s predisposition to illness through a structured environment and programs of physical exercise.  Later, the Association of Collegiate Alumnae conducted a survey to provide research evidence as to whether female college graduates were normal.

Image by Thiophene_Guy // CC 2.0

Back in the Vassar of the present, our student tour guide wondered:  “How could anyone believe anything so silly?” It’s true that we no longer talk about a “vital force.”  Yet, broad generalizations about the nature of women and reproductive physiology continue to exist that have an air of plausibility, based today on a different scientific language, one of hormones, neurotransmitters, and other players.   Not very long ago, menopause was defined as an “estrogen deficiency disease” that had a uniquely powerful effect on health.  Heart disease was a disease of civilization for men and a disease of the ovaries for women.   The idea that the menstrual cycle destabilizes women’s minds, creating mood and intellectual changes, continues to exist.

One of my favorites is the idea that women are somehow receptive, loving, and self-denying because of their maternal role, which is somehow mediated by estrogen.  Thus menopause may be said to be a time that women regain the ability to focus more on themselves, liberated from a physiological preparedness for reproduction and its needs.   Pregnancy is a dreamy time when women are moody and unable to think clearly.

Sure, mothers are receptive, loving, self-denying, but they are also many other things.  I love being a mother.  My relationship with my daughter has been powerful, unique, and wonderful.  However, I know that a mother who is lost in a dreamy connectedness to her child or reflexively puts her child before herself can’t do everything she needs to do.   A mother is emotionally connected to her child but also must be an individual who perceives the child accurately, as a separate person, in terms of the child’s motivation and perspective, in order to provide both a sense of connection and the mirroring needed for a child’s emotional development.   Further, children misbehave, make mistakes, and must be taught all kinds of things; mothers must have clear-headed, pragmatic, problem-solving skills.  Continue reading...

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Posted in Hormones, Menstruation, Pregnancy, Reproduction | Comments Off

The Medically Unnecessary Transvaginal Ultrasound and other Weekend Links

April 28th, 2012 by Elizabeth Kissling

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KOTEX IS IN THE HOUSE! (or, Is the House?)

April 27th, 2012 by David Linton

Despite occasional efforts by manufacturers of menstrual pads and tampons (the giants of the menstrual-industrial complex – thanks, President Eisenhower) to present period-positive images, they still seem unable to resist representing menstruation as an undesirable, embarrassing phenomenon. Women, particularly teens, are expected to grin and bear it as best they can while enduring their monthly misery.  Consider a recent example.

A few weeks ago, the small college where I work received 12 large cartons from a firm called Brand Connections, which apparently specializes in managing promotional campaigns that involve providing free samples of products.  Each carton contained 72 box-like items made up to look like thick text books but with a cover that closely resembled a copy of Teen or Seventeen magazine.  In large letters on the spine and front are the words, “GET REAL.”  The instruction sheet in each carton included warnings that the contents “may not be suitable for children” and that selling the items rather than giving them away “may result in civil and/or criminal prosecution.”  And, in bold type, the page states, “This box contains FREE House of Kotex samples!”  The college authorities were directed to, “Please hand out the House of Kotex samples to your Universities [sic] female students for their enjoyment.”

 

However, the contents of the package itself were a bit more ambivalent about any connection between menstrual products and enjoyment.

The box opens to disclose, on the right side, two plastic pouches, one white containing a pad and a panty liner, and one black containing a pad, a wipe and a tampon.  On the left, emulating a feature popular in teen girl magazines, is a six item quiz in which girls are asked to choose favorite shoes, lip gloss colors, eye shade, date wear and weekend entertainment.  The sixth item, “Being on your period is. . .” provides the following choices:

  1. the worst
  2. not so bad
  3. part of life
  4. super annoying

If one picks 1. or 4., one is directed to the black pouch; if one chooses 2. or 3., the white pouch is for you.

The cartons were placed around the campus at strategic locations for young women (or curious young men) to pick up the packets.  One enterprising student rifled a few dozen of the tampon packs to store up a stash of her preferred product for the next few months.

Though the cover photo of two smiling young women and the slangy headline references to bonding, fun, and sharing, as well as the playful references to popular items inside created a sense of happy girlhood, the non-so-subtle way the period was described unfortunately reinforced the nuisance trope that is so deeply engraved in young women already.

Readers are invited to propose alternative options to the last question in the menstrual quiz.

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Posted in Communication, Disposable menstrual products, FemCare, Girls, Menstruation | 2 Comments »

Searching for Good News about Menopause

April 26th, 2012 by Heather Dillaway

Lately I’m fed up with the kinds of articles and news items that cross my desk (or computer screen) about perimenopause and menopause. So much of the news on this midlife transition seems negative. I hear about the new treatments for (unbearable) hot flashes or a new movie saying how terrible menopause is (remember my blog entry on Hot Flash Havoc? That movie is still getting a ton of press for better or worse). The most neutral reports seem to be about lifestyle changes (exercise, diet, quitting smoking, etc.) women can make to lessen “problematic” symptoms.

So, I’m starting to wonder: Is there any purely good news about menopause? Any news that will make women feel good about their midlife transitions?

To answer my own question, I typed “good news about menopause” into google, bing, and yahoo search engines. Readers of this blog should try it themselves. Type it in and see what you get.

When I typed this phrase into different search engines, right away the same sorts of news articles described above popped up. There is “good news” for menopause “sufferers” who want to try out new medical treatments for menopausal symptoms (you too can lessen your hot flashes!), “good news” that menopausal women can reverse aging (read: aging is bad!), “good news” that perimenopausal women can change their diet, “good news” that women can take supplements that will make sex better after menopause, etc. In my opinion, most of these articles have a negative undertone – that menopause is something to be suffered and endured and disliked overall. While these articles might be offering solutions to make life better, the underlying message is still that this life stage sucks for women. There were few exceptions to this, but the exceptions are worth mentioning. For instance a blog about the wisdom and freedom that women can find at menopause did pop up, as did another “menopause goddess” blog that gave a much more positive spin to this midlife transition. I personally wish I had seen more items like the latter two. For me, most of the “good news” that popped up is not so good.

I think about the perimenopausal or menopausal women who might be looking for “good news” about their life stage and I wonder what they might be looking for. If you are perimenopausal or menopausal and you’re reading this, what “good news” are you looking for? And how do you feel about the “good news” you’re getting?

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Posted in Communication, Internet, Media, Menopause | 6 Comments »

Marilyn Monroe’s Ovaries, Crazy Things Gynecologists Say, and other Weekend Links

April 21st, 2012 by Elizabeth Kissling

 

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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.