Blog of the Society for Menstrual Cycle Research

The pill, reduced period pain and the ongoing delusion

January 20th, 2012 by Laura Wershler

Is there a woman over the age of 18 anywhere who doesn’t know that taking the birth control pill can make her periods lighter and less painful? Most women know this, but not many know why. The news stories swirling around a new study about the pill and period pain will not enlighten them.

Photo credit: Ceridwen, Creative Commons 2.0

A 30-year longitudinal Swedish study has finally proved the worth of what is accepted practice in North America and Europe: the prescribing of combined oral contraceptives (COCs), or birth control pills with synthetic estrogen and progestin, to treat painful periods known clinically as dysmenorrhea.

Of course, pharmaceutical companies that manufacture COCs are probably eager for this research, as prescribing the pill for dysmenorrhea is still an off-label use in the U.S. (unlicensed use in the U.K.). Pill manufacturers may be able to use this finding to lobby the FDA (or equivalent agencies in other nations) to approve the pill as treatment for menstrual pain, leading to increased sales and insurance coverage. Perhaps that’s why news media have been treating this discovery as breaking news.

Take this headline: Yes, the Pill CAN ease the agony of period pain: Scientists confirm what millions of women already know, or this one: The pill ‘does ease period pain’, or this one: Combination oral contraception pills cut menstruation pain, or, really, any of these.

You can read the abstract of the study by Swedish researchers Ingela Lindh, Agneta Andersson Ellström and Ian Milsom, published this week in the journal Human Reproduction, here: The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. The conclusions are simple: “COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhea more than increasing age and childbirth.”

Forget the age factor for the purposes of this discussion. The fact that COC use reduces the severity of dysmenorrhea is not astounding. This is old news. So says Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, quoted in a USA Today story:

“The study results are not surprising. It’s gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman’s period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill.”

What is astounding is what Dr. Goldstein, and other OBGYNs, didn’t say in responding to the study. That the reason the pill reduces menstrual pain is because the synthetic hormones in the pill shut down a woman’s own menstrual cycle. The “period” women experience when on the pill is technically known as a “withdrawal bleed,” brought on by seven days of placebo pills. While it feels like a period to menstruators, it is not the same physiologically as the period they experience when NOT on the pill. That’s why it doesn’t hurt as much.

The point is, the pill is too often credited with regulating the menstrual cycle. It does no such thing. The pill does not regulate any woman’s menstrual cycle; it supercedes it. This research, and the many news stories that reported it, once again ascribe power to the pill – this time the power to cut menstrual pain. This is an incomplete truth.

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Posted in Birth Control, Communication, Dysmenorrhea, Health Care, Menstruation, New Research, Pharmaceutical | 6 Comments »

Searching for Menopause Blogs

January 6th, 2012 by Heather Dillaway

Lately re:Cycling has featured several posts on menopause, and I have begun to think about the other menopause blogs that might be out there. Turns out there are plenty – maybe not as many blogs as there are about reproductive experiences like pregnancy or childbirth but still a lot. There are even blogs that compile info on menopause blogs such as Menopause the Blog.

Blog Series 13 by Richard Smith // CC BY-NC 2.0

If you start searching for these blogs it becomes clear that many talk about hot flashes as a major sign or symptom of menopause (or perimenopause), and offer either strictly biomedical or more natural/alternative remedies for signs or symptoms (e.g., Menopause Symptom Report or I Hate Menopause). Other blogs are written primarily for their comedic value (e.g., Menopause Maniac), support value (e.g., Menopause Goddess Blog), or purely informational value (e.g., Menopause the Blog). (Menopause the Blog does a good job of summarizing some of the major blogs out there, just FYI for those who are interested.)

Many of these menopause blogs conflate the menopause transition with midlife in general (you only have to read a few blog entries to know that women talk as much about the bad and good of midlife as a life stage as they talk about menopause) but some are very specific to menopause. I find it very interesting that there can be so many different kinds of menopause blogs. I also find it interesting that so many of these menopause blogs seem to be trying to work out what midlife as a life stage means as well, which resonates with Paula Derry’s earlier post this week about how little we know about women’s midlife in general.

Perhaps what interests me the most, however, is that all of these menopause blogs seem to be either aligning with or struggling against very negative definitions of menopause. Based on my quick perusal, no blog seems to have moved past or risen above the constant negotiation of biomedical definitions. Even if bloggers are writing about how happy they are at menopause or how much they’ve learned about themselves at this life stage, blog entries still seem to be written in response to negative definitions (or at the very least, in response to the ghosts of negative definitions that still hang around menopause even when it is defined more positively).

To me this means that researchers Antonia Lyons and Christine Griffin are correct in proposing that there is only one “master narrative” of menopause and that women, doctors, women’s partners and children, medical institutions, workplaces, strangers, women’s friends, etc., have no choice but to deal with this master narrative in some way.  This also means that Abbey Hyde and her co-authors are correct in asserting that even when women aren’t using biomedical definitions to describe their menopause transition, these definitions still shape women’s perceptions of their experiences.

So, my question is, have others read these menopause blogs? And if so, does anyone have a different take on these blogs? Perhaps I’m being too harsh and using a very specific lens to look at these varied blogs. But perhaps not. What then? If you agree with me, is this what blogs are ultimately supposed to be in the end – a response (be it direct or indirect, conscious or unconscious) to the master narratives in our lives?

 

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Posted in Communication, Internet, Menopause | 3 Comments »

On Menopause Definitions

December 28th, 2011 by Elizabeth Kissling

Guest Post by Paula S. Derry, Ph.D.

In a recent blog post, Heather Dillaway commented on the uncertainty, confusion, and frustration she felt as a menopause researcher, given the lack of consensus about the most basic aspects of the menopause transition. Researchers don’t agree about their definitions, and can’t even agree on what needs to be defined. She asked for reactions to her entry; I’ve found that my reaction has grown into this separate post.

Fire in the Head by Beate Knappe // CC 2.0

I, unlike Heather, am not a sociologist. I’m a health psychologist. My training and current work include analyzing, critiquing, and making sense of experimental research and theories. I have also developed workshops for community women and for professionals whose aim is to provide health-promoting information and decision-making heuristics. I have given a lot of thought to the issues that Heather raises, and this is as far as I’ve gotten with them.

To me, there are many layers of issues involved. The first is the fact that the science — about the physiology of menopause and the processes leading up to it — is limited and incomplete. Part of the reason that professionals disagree about whether the life course of menstruation has five stages or seven, or why women have hot flashes, or even why women have a menopause, is that we don’t actually know. We simply do not have the scientific facts. We don’t understand what the underlying process is or how it works. Given this uncertainty, professionals must make judgments about how to define terms and what their hypotheses (or best guesses) are about underlying processes. A second fact, along with our limited real knowledge, is the tenacity with which professionals assert their judgments and argue against competing views. People disagree and they hold strongly to their positions—about language and the facts. To me, it makes sense to have definitions of stages of menstrual life that are objective and easily measurable (like the STRAW staging system) for researchers who need to compare results with each other. It doesn’t make sense to assert that this system, based on expert opinion and not on experimental facts, actually defines when a particular stage really “begins.” It makes sense to say that experimental research supports the idea that changes in the thermoregulatory center of the hypothalamus are important processes if you’re trying to understand hot flashes.  It does not make sense to conclude that these brain changes in themselves explain hot flashes; other factors must also be involved.

I think another source of confusion is that menopause is not one thing, but many. It is a circumscribed biological change (lack of periods and what leads up to them physiologically) and also a psychosociocultural matter. We have a term for when girls begin to menstruate (menarche), a separate term for the larger biological changes of which menarche is a part (puberty), and another term for the biopsychosociocultural changes of which puberty is a part (adolescence). I think these kinds of distinctions are confused with regard to understanding menopause in part because there is cultural confusion about midlife (or mature adulthood or whatever term you use) as a life stage.  There is no cultural consensus about this stage of life.  And, indeed, this isn’t surprising.  Some women are planning retirement while others are training for a new job or career.  Some are grandmothers while others are raising a young child.  My opinion, also, is that we as a culture have a paucity of concepts of mature, responsible adulthood and what it means.  Continue reading...

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Posted in Communication, Language, Menopause, Philosophy | 4 Comments »

I’ll read for the cure, but I won’t drink the pink Kool-Aid

October 19th, 2011 by Laura Wershler

OPINION

Every October it’s the same thing:  Buy pink, think pink, drink the pink Kool-Aid.  All in pursuit of (mostly) the cure for breast cancer.

Forget the cure. I’m much more interested in preventing the disease. As such, I’ve refused for years to walk or run for the cure to breast cancer. Not only am I concerned that too little of the money raised by such events is being spent on prevention research, I also don’t like what can only be called the commodification of breast cancer.  For more on this check out thinkbeforeyoupink, a program of Breast Cancer Action.

In addition to these concerns, I find some of the breast-cancer fundraising and awareness-building activities being promoted this year to be nothing short of cringe-worthy.

I certainly won’t be attending boobyball 10 next month.  This auspicious event is put on by Rethink Breast Cancer, a Canadian non-profit geared to building awareness in the under-40 crowd. Too bad Rethink’s booby fetish seems more appropriate for the under-12 set.

And I won’t be wearing an “I love boobies” bracelet anytime soon.  Nor will students at a middle school in Kelowna, British Columbia, where the bracelets were recently banned because the message was deemed “offensive.” I’d ban the $3.99 over-priced plastic wristbands just for being silly.

The bracelets, along with other silly “I love boobies”  promotional products, are sold by keep-a-breast.org, the mission of which “is to help eradicate breast cancer by exposing young people to methods of prevention, early detection and support.”

Although I’m sure both of these organizations mean well, I want to scream, “Enough already!”  I know I don’t fit either org’s demographic, but still, enough already.

What I will attend, this evening, and with some hesitation, is the inaugural Read for the Cure event in Calgary.  For $90 I’ll enjoy wine and nibbles, hear three Canadian female authors read from their work, and take home three books by these featured writers.

Marina Endicott is one of three featured authors at Read for the Cure in Calgary, Alberta on October 19.

Read for the Cure is a Canadian endeavor launched in Toronto in 2006 by two women from the same book club who had recently completed treatment for cancer.

“Acknowledging the important role of reading in their lives, and the wonderful support they had received from their fellow members during their treatment, they saw an opportunity to harness the energy of enthusiastic book clubs and readers to raise funds for cancer research.”

I love books, I love my own book club, and I’m going to the event with a dear friend whose mother died of breast cancer.

While breaking my self-imposed boycott of cancer-related fundraising events, I plan to ask a few questions of my fellow attendees:

What’s your take on the mammography screening controversy?

Are you aware of the connection between healthy ovulatory menstruation and breast health?

What do you know about vitamin D and cancer prevention?

I’m also hoping to engage representatives from the Alberta Cancer Foundation and the Cancer Research Society — the two recipients of the event’s proceeds — in discussions about the current research projects they’re funding.  Do they know about the Breast Cancer Prevention Study being conducted by Grassroots Health to explore the association between vitamin D levels and breast cancer?

Tonight, my drink of choice will be red wine. Here’s to a fun evening.

 

 

 

 

 

 

 

 

 

 

 

 

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Posted in Activism, books, Communication, Health Care, New Research, ovulation | 2 Comments »

Some Online Articles on Menopause ARE Worth Reading!

October 13th, 2011 by Heather Dillaway

I get Google Alerts on “menopause” every Wednesday because it’s important that I know about the new bits of information popping up about the topic I research most. Most of the time, though, I’m frustrated with the discussion of menopause online and don’t pay attention much to the alerts I get. Yet, amidst the endless biomedical debates about whether soy or other supplements and alternative therapies reduce hot flashes, whether hormone therapies (HT) are risky, and whether or not a male menopause exists, there ARE a few important things to notice in the online menopause world. For instance, a short article called “True or False: Test your menopause smarts” at SunHerald.com (a news sources for the “Biloxi-Gulfport and South Mississippi” region) represents what I see as a fairly positive contribution to the online readings on women’s health and, more specifically, menopause. For instance, in reviewing menopause the author proposes that:

1.       There ARE variations in women’s experiences, and that these variations are normal!

2.      Too often we see menopause as primarily negative, when there are positive things about menopause. Or, at the very least, women might be likely to feel indifferent about menopause.

3.      The menopause transition (perimenopause) can be a long-term process, and the author acknowledges that it could last as long as a decade or more. Women probably need to know this from the start!

4.      Hot flashes are normal despite being frustrating, and that it is likely that you might experience them.

5.      Women might not feel one particular way about sex during menopause – and no matter whether you feel good or bad about sex during menopause it’s probably okay (unless you personally would like it to be different, in which case there are probably things you can do to change your situation).

6.      The U.S. does not represent the best model for how to go through menopause (at least this is what the author infers). In fact, women in other countries may fair much better as they go through menopause, for a variety of reasons that the author does not get into.

7.      Recent breakthroughs in medical science might make women who are worried about having children get a blood test to see how long they have until perimenopause sets in (see my earlier blog post about this blood test last year!). The way in which the author wrote up this part of their article suggests to me that they can see the pros and cons of this blood test, which I like.

Many of my blog posts represent a critique of information out there for menopausal women, but I thought it might be nice to highlight a positive contribution to the online literature on women’s health. Despite my minor critiques of this article (e.g., the word “suffer” appears frequently, and there is a huge focus on sex over other topics, etc.), I think women should read this article. Which leads me to my main point in writing this blog post: there ARE some good things out there about menopause. Anyone else find a good example of positive health information lately?  :-)

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Posted in Communication, Internet, Media, Menopause, Newspapers | 2 Comments »

You’re Taking WHAT Class???

October 7th, 2011 by Elizabeth Kissling

Guest Post by Alexandra Epstein – Marymount Manhattan College.

how school helped me come out of the menstrual closet

Finally, the time had come where I was choosing my classes for my senior year of college. I had finished my required courses to complete my social work minor, and with only a few required courses left until I complete my psychology major, I had lots of room to choose electives! What to take though? Maybe an art class? Or what about a science class? As I scrolled though my options online, something caught my eye. “The Social Construction and Images of Menstruation”. Honestly, anything to do with the social construction of anything is good in my book, so without even thinking much about it, I registered.

Day one in class, it hit me; I was in a class completely focused on the idea of how menstruation is viewed by society. I was a bit taken aback. As a woman, I had grown up “dealing” with my period, but I had never actually thought about it, or what it meant to me as a woman. Now, I can’t stop. I can’t stop thinking about it, I can’t stop talking about it, I can’t stop reading about it. The idea of the social construction behind menstruation has not left my head since I entered that classroom on the first day of the semester.

Not only has this class opened my mind to a whole new concept, but it has made me more comfortable to openly talk about menstruation and everything that goes along with it. It wasn’t even two months ago that I was so uncomfortable with the concept of the period. I wouldn’t talk about it often with my friends, I would hide my tampons in bags within bags so no one would know that I was on my period, and I thought of my period as a burden and huge inconvenience. Within the past month I have grown to love my period. It is something I am proud to be able to experience. I have become very open with conversation regarding menstruation. I have asked all of my female friends about their first experience with their periods, and all of my male friends if they know how to use a tampon. I love the responses I get. Some people embrace the chance to talk about something we as humans don’t normally talk about. However, most people I talk to become so uncomfortable with the fact that I’m talking about such a taboo topic. They ask me why I choose this class, or why my school even offers such a rare subject to study. What they are most shocked by is the fact that my professor is a male. “A guy teaches that class? Isn’t that awkward?” “No!” I reply, “Its brilliant and insightful and I am in love with it.” Too many people are uncomfortable with this topic. I am making it my mission to take the awkwardness out of menstrual conversations.

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Posted in Activism, Communication, Menstruation | 2 Comments »

The Pussy is Stronger

October 3rd, 2011 by Chris Bobel

A friend shared this clip from stand-up comedian and actor Hal Sparks.

He leads with  this “I disagree—vehemently—with the use of the word “pussy” to describe a weak person. Because the vagina is the tougher of the two genitals…. by a long shot!”

And later…”It bleeds every month and it won’t die.”

That puzzled reaction to menstruation is as old as time, say the cultural historians of menstruation. We know now, of course, that the monthly shedding of the uterine lining is no mystery. Nor does this regular occurrence suggest that women are necessarily witches or demons or otherwise intrinsically cursed or even blessed.

But his point is a good one.

It IS important to reframe the female body as POWERFUL.  As RESILIENT.

And demonstrate how our language—especially the words we use to slur and to exalt—obscures this reality.

Thanks, Hal, for a good laugh and a better think.  You are a REAL pussy.

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Posted in Communication, Humor, Language, Media, Menstruation | 2 Comments »

TMI – Too Much (Menstrual) Information

September 30th, 2011 by Elizabeth Kissling

Guest Post by Michael Yazujian, Marymount Manhattan College

I found this sketch the other day when I was on www.ucbcomedy.com. It is by a sketch duo called Klepper and Grey, who are originally from Chicago, but now live in NYC. It is very similar to the “Her First Period” sketch by the Frantics (posted at re:Cycling August 5, 2011), in that things that are considered socially unacceptable to be shared are being shared in such a friendly tone; the main difference is that in this sketch the information is being shared knowingly. Both sketches make you wonder how do subjects get to a point when they are considered rude or unacceptable to discuss, even though they are so common among so many people. Things like menstruation, sex, and bowel movements are all normal bodily experiences, but they certainly don’t make appropriate dinner party conversation, or topics to share casually with an acquaintance on the street.

I’d be interested to hear comments from others about what they think the increased public display of formerly private matters means, especially when it comes to the conventional menstrual taboos.

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Posted in Communication, Humor, Independent Film | 1 Comment »

Dads, Daughters, and Menarche

September 29th, 2011 by Elizabeth Kissling

Oh, Mr. Dad! Is that the best you can do?

Mr. Dad is a syndicated parenting advice column in my local paper, and the September 26 edition featured a query from a dad worried that his 11-year-old daughter may begin menstruating while her mom is deployed overseas (she just left, and she’ll be gone for a year).

Mr. Dad’s first bit of advice is for the squeamish father to find an adult woman to talk to his daughter about puberty:

Your first assignment is to find an adult woman to run point. This could be a relative, friend, or even one of the female spouses whose husband is deployed with your wife’s unit. She’ll be able to walk your daughter through the basics and give you a list of supplies you’ll want to have on hand.

To his credit, Mr. Dad doesn’t let Nervous Dad off the hook, and does advise that he learn about female puberty “just in case things don’t go exactly according to plan”. But I’d rather see more dads embrace the possibility that they may well be the one their daughter turns to at menarche, like this dad.

Heck, they could even up being the helpful, available next-door neighbor in a time of need, like ol’ Hank Hill, in this video clip.

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Posted in Communication, Menarche, Newspapers | 2 Comments »

The Shame Game

August 22nd, 2011 by David Linton

Long before the current fad in Reality TV shows that trade in humiliation and embarrassment, the prevailing menstrual culture inculcated in women a feeling that exposure of the fact that a period was in progress was a social catastrophe.  However, just as “The Biggest Loser” invites participants to parade their socially unacceptable bodies before the cameras for fame and fortune, there are times when women are invited to share their stories of menstrual humiliation in exchange for a moment of media recognition and even a cute photo spread.

Consider the October 1, 2007, issue of FIRST: for women on the go, a supermarket checkout publication.  A regular column titled “First Blush” that specialized in sharing readers’ “mortifying moments” in this issue was titled “My most mortifying tampon moment!”  It consists of four letters from women aged 35 to 50 relating stories of an exposed string, a blood stain on a car seat, dog mischief, and a child’s blurted remark about her mothers’ “bagina.”

The piece is illustrated by the smiling author of one of the letters, “Meg Fitzpatrick, 42, Yardly, PA” whose story about the adorable daughter’s outburst earns her a prized photo in the magazine.

Accompanying the article is some promotional copy for a product called “The Combpanion Tampon and Pantiliner Case” that is described as “a hair comb with a hidden compartment in its hollow handle” so that the reader can “carry a tampon . . . without fear of being spotted holding your feminine product.”

I’m prompted to wonder what an equivalent column in a men’s magazine would look like.  Do men ever have “mortifying moments?”

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Posted in Communication, magazines, Media, Menstruation | 2 Comments »

Summer’s Eve Campaign Targets Wrong Body Part

August 2nd, 2011 by Laura Wershler

The print ad for the Summer's Eve campaign refers to the "V" but not the vagina.

If a product manufacturer or its advertising company, or both, cannot figure out which part of the female body their new line of feminine hygiene products can be used for, then both are in big trouble.

There has been much hoopla over the recently launched Summer’s Eve campaign. Links to stories about and response to the campaign can be found in my fellow blogger Elizabeth Kissling’s July 27th post. The most serious backlash to the campaign resulted in three videos perceived as “racially insensitive” being pulled from the campaign website late last week.

What rankles me about the campaign – beyond its patronizing, unsophisticated and euphemistically silly approach to the female genital area - is that it appears to target the vagina when it is clear that none of these products are actually intended for use in the vagina.

Regardless of what one might think about the value of or necessity for these femcare products, an advertising campaign for such products must convey accurate information. Like where to use them.

The product line includes: cleansing wash, cleansing cloths, deodorant spray, body powder, and bath and shower gel. Click on the OUR PRODUCTS box on the website home page and you’ll see this: Meet the products that love your vagina. Oh, really?

These products are not intended, I repeat, not intended for use in the vagina. One would think that the product manufacturer knows this. Why then did they choose a talking vagina, and across-the-board references to the vagina, to convey their product message on the website?

Interestingly, the print and TV ads hold no direct reference to the vagina. The website coyly advises viewers that they can call it “V” for short. It is this moniker and the tagline ” Hail to the V” that crosses over to print and television.

Maybe this was intended as a subtle reference to the other “V” word – vulva . It’s pretty clear this is the body part for which the Summer’s Eve products are intended.

I wanted to know why the creative team at The Richards Group, the ad company responsible for the campaign, chose to use the word vagina instead of vulva. My request for an interview to ask this question was turned down, so instead I asked two colleagues what they thought the reason might be.

Valerie Barr, veteran sexual health educator and training centre manager at Calgary Sexual Health Centre, suspects it’s because vagina is assumed to mean what is actually the vulva. She says, “I believe this assumption, or taken-for-granted use of the term, serves to avoid discussion of the clitoris and therefore, female sexual response.”  Barr says she thinks it demonstrates that in our culture we continue to be unconsciously uncomfortable with women being sexual beings.

Rebecca Chalker, female anatomy expert and author of The Clitoral Truth, also believes that fear of the word clitoris has much to do with it. ”Clitoris is the most toxic word in the English language, and to this day is considered obscene and too offensive to be used in the media. Just try it on people,” she says.

“Eve Ensler (author of The Vagina Monologues) made the vagina safe for the general public – even she did not use the C–word. Vagina has now become the default reference for everything ‘down there.’ Those ad guys are no different. Perhaps they’re just using the default because that’s what they think people can relate to most readily,” Chalker says.

Although vulva is the accurate word to describe the female body part intended to benefit from the Summer’s Eve product line, Chalker says, “It would be a tragedy if vulva becomes the new default. In anatomical parlance vulva just means covering.”  Continue reading...

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Posted in Activism, Advertising, anatomy, Communication, FemCare, Language, Media | 1 Comment »

Marked for Life

February 9th, 2011 by Elizabeth Kissling

CarewNorwegian athlete John Carew just revealed his new tattoo, which features wings and the phrase ‘Ma Vie, Mes Régles’. Apparently Mr. Carew believed that reads “My Life, My Rules”, but with an acute accent (é) instead of a grave accent (è), the actual translation is either ‘My Life, My Period’ or ‘My Life, My Menstruation’.

That’s frankly awesome.


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Posted in anatomy, Art, Celebrities, Communication, Humor, Language, Menstruation | 5 Comments »

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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.