Blog of the Society for Menstrual Cycle Research

The contraceptive doctor–patient disconnect

June 17th, 2014 by Saniya Lee Ghanoui

Guest Post by Jennifer Aldoretta

There seems to be a growing disconnect in recent years between physicians and their patients, and women are especially susceptible to this given our reliance on doctors for information about contraception. When compared to the questions many of us ask our doctors, the information we receive isn’t always up to snuff.

Patient autonomy, as defined by medical dictionaries, is “the right of patients to make decisions about their medical care without their healthcare provider trying to influence the decision.” Based on many conversations with other women, in addition to my own personal experiences, patient autonomy often does not exist for women seeking information about contraception. And this is a huge problem. Deadly (and rare) birth control side effects have become a hot-topic in the news as of late – which is likely contributing to this physician–patient disconnect – but the growing patient interest in control and autonomy means that this cannot simply be dismissed as a side effect of the media.

A recent study, published in the Journal of Contraception, asked both women and healthcare providers to rank the importance of 34 questions relating to contraceptive options. They found that the things that are most important to women are often not as important to their healthcare providers. For example, knowing exactly how a method works to prevent pregnancy was ranked by women as the most important piece of information, whereas how to use a method correctly topped the list for providers. Effectiveness, while still important, was ranked fifth by women, which is a stark inconsistency if you consider just how central a method’s effectiveness is in ads and in the media. The study also found that questions regarding potential side effects ranked in the top three for 26% of women, but only 16% of providers.

These stats may seem inconsequential – after all, physicians should be educating patients about proper use of contraceptive methods. But here’s the problem: the methods suggested by physicians don’t always align with a woman’s stated preferences. I’m certain I’m not the only woman who has been pressured to use a hormonal method (despite my voiced concerns) simply because these methods are considered to be easy and effective. While it seems like a logical solution for physicians to advocate for hormonal methods over methods with higher typical-use failure rates, this approach is ultimately a detriment to women.

A growing number of women seem to be turning to withdrawal, and while this isn’t inherently bad, it becomes bad when a patient isn’t educated on how to properly use it simply because her physician is hesitant to discuss “unreliable” methods. This means that women are turning to potentially unreliable internet sources (or, worse, misinformed friends) for this information. The same can be said for diaphragms, cervical caps, and fertility awareness-based methods. If we want to continue to drive down unintended pregnancy rates, dismissing patient concerns and eliminating patient autonomy isn’t the route we should take. Contraceptive methods aren’t one-size-fits-all, which should be obvious by the huge differences in side effects experienced from person to person. So why do so many contraceptive consultations continue to be carried out in this one-size-fits-all fashion?

Empowering women through family planning is more complex than simply prescribing the most effective methods. It must be coupled with engagement in an open dialogue, including acknowledgement of patient concerns and a respect for patient autonomy. Patients are increasingly demanding autonomy, and if healthcare providers wish to remain a respected part of a woman’s health, it’s time to set aside contraceptive biases and listen.

  

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

  

New material for condoms, birth control controversies, and more weekend links

June 14th, 2014 by Elizabeth Kissling

  

A powerful period poem and more weekend links

June 7th, 2014 by Elizabeth Kissling
  

Ms. June—Menstruation Pin-Up

June 6th, 2014 by Saniya Lee Ghanoui

Guest Post by Jen Lewis

Beauty in Blood Presents
Ms. June: Curves
Cycle: June 2013
Menstrual Designer: Jen Lewis
Photographer: Rob Lewis
  

Congressional Action on Menstrual Hygiene Day

May 28th, 2014 by Saniya Lee Ghanoui

Maloney press release for the Robin Danielson Act of 2014

As I’m sure you’re well aware, today is Menstrual Hygiene Day and there are activities all across the globe to commemorate this day.

The SMCR is excited to announce that it contributed to the day by endorsing the Robin Danielson Act of 2014, a legislation that would require the National Institutes of Health (NIH) to research whether menstrual hygiene products contain synthetic additives that pose health risks (including risk of Toxic Shock Syndrome). What’s more, Congresswoman Carolyn Maloney (D-NY) introduced an updated version of this Act today, on Menstrual Hygiene Day! According to Maloney’s office, she first introduced legislation regarding tampon safety in 1997 with the Tampon Safety and Research Act; subsequent versions of this bill were introduced in 2003, 2005, 2008, and 2011.

Now it’s time to take more action: turning this introduced legislation into law. Stay tuned for more information regarding petitions of support and other forms of activism and assistance. In the meantime, step one is to write your local congressperson and voice your support for the Robin Danielson Act of 2014. You may find a list of Representatives (and search for your local Rep.) on the House of Representatives website and you may read more about Maloney’s bill (in which SMCR member and President-elect Chris Bobel is eloquently quoted)  on her site.

Happy Menstrual Hygiene Day!

  

Menstrual Hygiene Day!

May 28th, 2014 by Saniya Lee Ghanoui

Happy Menstrual Hygiene Day!

As has been documented this week, today is Menstrual Hygiene Day. Please see the official Menstrual Hygiene Day website for more information and to check out the global activities going on to celebrate this day.

SMCR contributed to Menstrual Hygiene Day by supporting the Robin Danielson Act sponsored by Rep. Carolyn Maloney (D-New York). This Act is an important piece of legislation that calls for more research on Toxic Shock Syndrome (TSS) and the risks associated with additives in menstrual management products.

Tell us how you are celebrating today and we wish everyone a happy Menstrual Hygiene Day!

  

Menstrual Hygiene Day: What’s in a name? Why Menstrual Hygiene Day is called Menstrual Hygiene Day

May 27th, 2014 by Saniya Lee Ghanoui

Guest post by Danielle Keiser

Summary: Menstrual Hygiene Day is not only about the biological process of growing up into a woman, but also about addressing the challenges that exist in many developing countries with regards to managing menstruation safely and hygienically. Such challenges include potential vaginal infections caused by poor access to soap and water and toilets, inadequate or unhygienic sanitary protection materials, or infrequent cleaning or changing of these materials. In many cases, this results in adolescent girls missing school and women missing work. Moreover, the continued silence around menstruation paired with limited access to factual guidance at home and in schools results in millions of women and girls having very little knowledge about what is happening to their bodies when they menstruate and how to deal with it.

Is ‘hygiene’ a negative word?

Menstrual Hygiene Day, oh, be some other name! As Juliet famously said about a rose with regards to Romeo being a Montague, what is in a name? That which we call hygiene by any other name would still be (according to the Oxford Dictionary) “the conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness”, would it not?

Since we launched the initiative to make the 28th of May Menstrual Hygiene Day, we at WASH United have undoubtedly started the conversation about menstruation, with social media buzzing as to why #MenstruationMattersand worldwide events and activities set to take place by many of our 135 partner organizations. One recurring conversation has revolved around disagreement with the term ‘hygiene’, a term that has been criticized for not being ‘period positive’ and doing little to ‘honor the menstrual process’.

I’d like to take the time to explain why we chose the word hygiene, focusing on how optimal Water, Sanitation & Hygiene (WASH) conditions, or more specifically, access to clean water and soap, toilets, sanitary protection materials and factual guidance are prerequisites to enabling women and girls to embrace their periods and feel positive about the whole experience. When menstruation is managed in privacy, with safety and dignity, women and girls are much more likely to develop the comfort and confidence needed to participate in daily activities. And since all human rights stem from the fundamental right to human dignity, when women and girls are forced into seclusion, taunted and teased, or fear leaking due to inadequate menstrual hygiene management (MHM), dignity is difficult to maintain.

 

4 reinforcing thoughts: It’s about hygiene.

1. Imagine that while menstruating, you are either not allowed to bathe or you simply don’t have a shower to rinse your body.

In parts of Kashmir, India, some menstruating women are prohibited from using water sources and advised to stay away from flowing water in general. Also, they are not allowed to look at their reflections in the water.

2. Imagine unexpectedly starting your period in the middle of an important math lesson. Is your first thought, I need to go to the toilet? Do you go to the one dirty latrine that is shared with 65 other boys and girls, without a lock? And what will you do with your stained panties? There’s no hand-washing facility and not even a wastebasket to throw them away in.

There are still 2.5 billion people who do not have access to adequate sanitation. If roughly half of the world’s population is female, that’s 1.25 billion girls and women who cannot simply ‘go to the ladies’ room’ to check on themselves and change their pad, tampon or cup in privacy.

3. Imagine having no idea, or a very faint one, about what a period is, why it happens, or how to take care of it when it happens.

Worldwide, many girls feel a ‘culture of silence’ around menstruation, including in their families. Often, male family members are clueless about menstruation, treating it as something negative or a curse. Girls do not feel comfortable even talking to their mothers about the subject, and many teachers only skim the surface on lessons about puberty and reproduction because it makes them uncomfortable.

May 28th is Menstrual Hygiene Day!

May 26th, 2014 by Chris Bobel

MHD fullcolor


Breaking the Bloody Taboo: The 28th of May is Menstrual Hygiene Day 
Let´s Start the Conversation About Menstruation!

On May 28th – the first global Menstrual Hygiene Day – more than 90 international and local organizations are coming together to break the silence around menstruation and raise awareness about the fundamental role that menstrual hygiene management (MHM) plays in enabling women and girls to reach their full potential. Bringing to light the ways menstrual hygiene impacts education, health, the economy, the environment and human rights, Menstrual Hygiene Day advocates for a world in which every woman and girl can manage her menstruation hygienically, in privacy, in safety and with dignity – where ever she is. Those present at SMCR’s biennial conference in NYC last June will remember the early buzz about this one of a kind event. And now…ta da!

Our very own SMCR is one of these 90 organizations and our contribution to Menstrual HeMenstrual Hygiene Day is supporting the Robin Danielson Act–an essential piece of national legislation calling for research on toxic shock syndrome and the risks attached to synthetic fibers and other additives in menstrual management products. See David Linton’ re:Cycling blog post for more information about this initiative!

Initiated by WASH United, Menstrual Hygiene Day will be celebrated in Berlin, Nairobi, Delhi, Kathmandu and many other locations around the world with exhibitions, film screenings, workshops and gatherings, all aimed at breaking the deafening silence around menstruation. Visit here to learn more about local events. Check out all there is to know about MH Day here including this Rockin’ infographic. 

What are YOU doing to celebrate Menstrual Hygiene Day? 

  

Birth control trends, menstrual leave, and more weekend links

May 24th, 2014 by Elizabeth Kissling
  

We Bring Our Bodies to Work

May 23rd, 2014 by Heather Dillaway

“Woman Working,” courtesy of Open Clip Art

A recent study by researchers at La Trobe University and Monash University in Melbourne, Australia, suggests that working women “need more managerial support [while] going through menopause.” This “Women at Work” study explored the health and wellbeing of working women and women’s satisfaction at work, yet focused on working experiences in or around menopause. The lead researcher, Professor Gavin Jack, reports that “menstrual status did not affect work outcomes” but that “if a woman had one of the major symptoms associated with the menopause — for example weakness or fatigue, disturbed sleep or anxiety, then this did influence how they regarded work.” Jack is further quoted as saying: “What is really important is not the fact of going through the menopause in itself, but the frequency and severity of symptoms which women experience, and how these factors affect their work.”

This study has been described in several news sources over the past few weeks, such as the International Menopause Society, Science Daily, and IrishHealth.com. I have many reactions to this research, both positive and negative.

I’ll present my positive feelings first: I appreciate the fact that researchers are talking about the fact that menopausal women are a large part of the workforce and that menopausal experiences matter for individual women. I also applaud the attention given to the fact that workers are human beings with bodies, and that bodies matter. The idea that employers should recognize that paid workers have bodies and that paid workers may be affected by their bodies is an excellent one. I agree that employers should be educated to be more sensitive to menopause and other bodily experiences that their paid workers might have, and simple adjustments in work policies and work environments can go a long way in making employees happier and more productive (plenty of research has already shown this). Finally, and maybe most importantly, as one article in Science Daily notes, “Not enough attention is paid to the experiences which people go through at different stages of life — the workplace treats this very unevenly.” I couldn’t agree more. Especially when it comes to midlife and aging, we forget that paid workers are still dealing with bodily transitions. We forget the range of chronic illnesses that paid workers might have at midlife and beyond, as well as the many normal health transitions that any midlife or aging individual deals with. Anything from the acquisition of bifocals (and learning to see differently through bifocal lenses) to the hassles of dealing with back pain, neck pain, arthritis, hearing impairments, insomnia, etc., can affect one’s work. Not to mention menopause, prostate conditions, and other aging health concerns that can involve a range of different signs, symptoms, and stages. Starting at midlife, it is also much more common to deal with caregiving for elderly parents, divorces and remarriages, putting kids through college (or putting up with adult kids living at home), deaths of parents and spouses/partners,  and other social transitions, and all of these things will impact how a paid worker feels and acts on the job. There is much to pay attention to about paid workers in their 40s, 50s, 60s, and beyond, and I believe that this research is a good start on that. Middle-aged paid workers may be reaching the peaks of their careers and may be excellent at their jobs, but they’re still dealing with a multitude of other life circumstances at the same time. And if they’re not performing well on the job, it may well be because of these very same issues. Paid workers are people, with full lives and physical bodies that they can’t leave at home (no matter how much they try).

The M Word—In Multiplex

May 21st, 2014 by Saniya Lee Ghanoui

Saniya Lee Ghanoui and David Linton

Cross-posted from Public Books

Tanna Frederick, Eliza Roberts, and Frances Fisher in The M Word.

We don’t know where the coy linguistic practice of using-while-not-using so-called offensive words by appending the term “word” after its initial letter and preceded by “the”—as in “the N-word”; “the C-word”; “the F-word”; “the R-word”—came from. The practice functions in spoken and written speech the way the “bleep” does on television. Everyone presumably knows what the word in question is and says it silently to themselves whenever they hear or read the euphemism, but a quaint regard for a Victorian notion of what can be said in “polite company” allows the meaning of the expression to be put into play while not offending anyone. Furthermore, the construction is usually reserved for talking about the word rather than using it in its actual grammatical form. As such, it functions as a meta-phrasing, raising consciousness about the need to be sensitive to the potential that words have to hurt or defame their referents.

This year, Henry Jaglom, the Woody Allen of the West Coast, has cleverly appropriated the practice by applying it to another value-laden, emotionally charged topic: menopause. And while the word “menopause” itself is not as socially verboten as the four words alluded to above, the taboo phenomenon itself is, in some ways, just as culturally vexed and discomforting as the subjects of the other coded expressions.

Jaglom’s decision to name his new film (his 19th feature) The M Word cleverly appropriates the semantic maneuver to several ends. He invites the audience to think about the function of the hyphenation gambit in all its manifestations while at the same time bringing menopause out of its closet for some close scrutiny.

The plot device Jaglom utilizes for this purpose is the “film-within-a-film” construction employed in The Truman ShowThe Artist, and Boogie Nights. Here, as in those films, the nature of the medium itself and the way it shapes the behavior of individuals becomes both metaphor and content. In The M Word, a character named Moxie (Tanna Frederick) sets out to make a documentary television series—inspired by her menopausal mother and two aunts—that involves interviewing a variety of women (and one man) about their experiences and views on menopause for a TV documentary called “The M Word,” which is also the title of the (non-documentary) film we, in turn, are watching in the theater. (The film is actually about perimenopause but, as is common in every-day speech, uses the word “menopause” instead. To avoid further confusion and at the risk of perpetuating this mislabeling, we will use the term of the filmmaker’s choice as well.)

Moxie is an actor on a children’s television show at the fictional KZAM network in Los Angeles, where the staff seem to have one thing in common: most of them are menopausal women. The appropriately named Moxie pitches her idea for “The M Word” at a crucial time—her station is bleeding money and a New York–based “suit,” Charlie Moon (Michael Imperioli), is flown in to assess the situation (someone is embezzling funds from the station) and make any necessary employee cuts. And this is where the title’s second meaning comes into play: money. The parallel between the menopausal women and the “menopausal” television station is obvious: both are on their last legs and losing to younger and fresher women/programming. The discussions about money are handled in the same delicate way as menopause; it is something no one wants to talk about but everyone knows what is happening. Moxie, however, brings both M-words out of the closet.

The documentary includes many zany exchanges, as when Moxie asks her mother “What are you feeling right now?” and her mother (Frances Fisher), experiencing a hot flash, fans herself with a head of romaine lettuce and responds, “I’m feeling quite wet.” But it is this type of pep that serves Moxie well when she organizes an impromptu sit-in to save her colleagues’ jobs immediately after Charlie fires a good portion of the staff.

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.