Blog of the Society for Menstrual Cycle Research

Symptoms are Demeaning….and Feminine?

January 31st, 2014 by Heather Dillaway

According to a recent piece in The Times, a reputable English newspaper, symptoms are demeaning AND feminine. More specifically, the article reports on the prostate cancer experiences of Sir Michael Parkinson, or “Parky,” a famous British talkshow host. Parkinson reveals his harrowing experience of getting prostate cancer treatment and its “grueling” side-effects. While the treatments worked, they apparently produced menopause-like symptoms (hot flushes and weight gain) that reminded him of “how women feel when they are going through menopause.” Parkinson is quoted directly as saying, “In a sense you become a woman. I’m getting fitted for a bra next week!” The reporter goes on to say “he’s joking but he’s also deadly serious.” The “menopausal” symptoms that Parkinson had during his prostate cancer treatments are also described as “demeaning” in the same paragraph.

Parkinson is a major public figure in the UK, with significant media influence. I’m certain that this article was read by many as a result, and it makes me wonder about the far-reaching impact of the negative characterizations made about both women and bodily symptoms in this article. When I read this article, I find the equation of symptoms and femininity problematic, for lots of health conditions that produce bodily changes and sensations are not only experienced by women. Experiencing a hot flush or hot flash, while often attributed to menopause, is not menopause-specific all of the time. You can have hot flushes from exercising hard, from the flu, from medications that treat a range of diseases, or when you’re embarrassed. You can have weight gain at midlife (or any time of life for that matter) for a variety of reasons unrelated to menopause. Both the equation of women with symptoms and the definitions of symptoms as negative and “demeaning” show exactly how little progress we have made in eradicating gendered ideologies that harm us. Women are equated with their bodies and seen as lesser than men because of this equation. Men are supposed to be able to rise above their bodily functions, signs, and symptoms and live the life of the mind. Thus, when men experience a symptom they must rid themselves of it because, oh, the horror, they might be “like women” if they have to pay attention to their bodies at all. Research studies show quite often that women are ignored by doctors when they report a long list of symptoms and are not given the treatments they need to ease those symptoms as much as men are, because doctors learn to assume that women are just overreacting. Symptoms are not real if reported by women, studies suggest. Yet, when men experience symptoms and report them they are treated for them more often, especially when they report things such as pain. I interviewed a woman once who told me that “symptoms are always negative” and I wonder if that is partially because of the equation of symptoms with femininity and women’s bodies.

I am certain that it was difficult for Parkinson to undergo treatments for his prostate cancer. I also know that hot flushes and weight gain are never comfortable for people, especially when they seem uncontrollable. BUT, when we go on to support the characterization of symptoms as “what women feel” and then in the next breath say that those symptoms are “demeaning,” we head right into reifying gender ideologies that harm every single one of us. Men should be able to notice changes in their bodies without feeling “feminine.” We should recognize bodily symptoms as part of both health and illness that everyone experiences. And women should not have to be defined only by the fact that they go through certain reproductive transitions that include symptoms. I know Parkinson is perhaps from a generation that might still be holding tightly to gender ideologies that do not make much sense for the contemporary world, but I hold the reporter responsible for some of the characterizations made in this article, too. It is 2014, and aren’t we supposed to be more progressive than this? Because you experience a hot flush you should be fitted for a bra? In the YouTube video that appears along with this post, Parkinson himself admits “men are silly about their health.” I’ll say. But comments reported in the recent Times article go way past being silly.

Etiquette for menstruation

November 19th, 2013 by Holly Grigg-Spall

Photo courtesy of sweeteningthepill.com

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

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

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

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

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

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

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

Is PMS Overblown? That’s What Research Shows

October 24th, 2012 by Elizabeth Kissling

If PMS is a myth, then what on earth can we blame for all the lady-rage?

Photo by Flickr user dearbarbie // CC 2.0

You may have seen the article in The Star or The Globe and Mail or The Atlantic about the recently published research review by a team of medical researchers who assert that “clear evidence for a specific premenstrual phase-related mood occurring in the general population is lacking.” Judging from the headlines and the online comments, this proposition is surprisingly controversial–probably because the headlines were frequently misleading, suggesting the findings are much broader than they are. Some online commenters are especially angry, insulting the intelligence and methods of the researchers, proclaiming that of course hormones affect moods, as does menstrual pain, citing examples of their own or their wives’ experience.

But Sarah Romans, MB, M.D.; Rose Clarkson, M.D.; Gillian Einstein, Ph.D.; Michele Petrovic, BSc and Donna Stewart, M.D., DPsych–the five medical scholars who reviewed all the extant studies of PMS based on prospective data–did not claim in the now-infamous Gender Medicine review study that PMS does not exist, or that hormones do not affect emotion or mood. The variety of research methods used in other studies prevented them from conducting a meta-analysis–a statistical technique that allows researchers to pool results of several studies, thus suggesting greater impact–so the authors instead looked at such study characteristics as sample size, whether the data was collected prospectively or retrospectively (that is, at the time of occurrence or recalled from memory), whether participants knew menstruation was the focus of the study and whether the study looked at only negative aspects of the menstrual cycle. Although their initial database searches yielded 646 research articles dealing with the menstrual cycle, PMS, emotions, mood and related keywords, only 47 studies met their criteria of daily prospective data collection for at least one full cycle.

When the authors scrutinized these studies, they found that, taken together, there is no basis for the widespread assumption in the U.S. that all (or even most) menstruating women experience PMS. In fact, only seven studies found “the classic premenstrual pattern” with negative mood symptoms experienced in the premenstrual phase only. Eighteen studies found no negative mood associations with any phase of the menstrual cycle at all, while another 18 found negative moods premenstrually and during another phase of the menstrual cycle. In other words, the symptoms these women experienced were not exclusively premenstrual, making the label inaccurate. Four other studies found negative moods only in the non-premenstrual phase of the cycle.

So let’s be fair, angry online commenters (and careless journalists): The researchers aren’t telling you menstrual pain is all in your head, or that your very real period pain won’t affect your mood. Sarah Romans did tell James Hamblin of The Atlantic,

The idea that any emotionality in women can be firstly attributed to their reproductive function—we’re skeptical about that.

Rightly so–feminists have been saying this for decades. Feminist critiques of PMS as a construct point to both the ever-increasing medicalization of women’s lives and the dismissal of women’s emotions, especially anger, by attributing them to biology.

Part of what makes PMS difficult to study, and difficult to talk about, is the multiple meanings of the term. In the research literature, there are more than 150 symptoms–ranging from psychological, cognitive and neurological to physical and behavioral–attributed to PMS. There is no medical or scientific consensus on its definition or its etiology, which also means there is no consensus on its treatment.

In everyday language, its meaning is even more amorphous. Some women and girls use PMS to mean any kind of menstrual pain or discomfort, as well as premenstrual moodiness. Some men and boys, as well as some girls and women, use it to diminish a woman’s or girl’s emotions when they disagree with her, or want to dismiss her opinions, or are embarrassed by her feelings.

Even researchers are influenced by entrenched cultural meanings. Romans and her colleagues observed that none of the 47 studies analyzed variability in positive mood changes, which they attribute to biases of the researchers. Many women have reported anecdotally that they feel more energetic, more inspired or other positive feelings during their premenstrual phase, but this is seldom studied or regarded as a “syndrome.” Romans and colleagues note that most measures of menstrual mood changes only assess negative changes, so even if positive changes are occurring, researchers are missing them. They also cite research indicating that both women and men tend to attribute negative experiences to the menstrual cycle, especially the premenstrual phase, and positive experiences during the premenstrual phase to external sources.

Romans and her colleagues do not deny the existence of menstrual pain, or even the existence of PMS. What their study shows is that very few women experience cyclic negative mood changes associated with the premenstrual phase of their ovulatory cycle. PMS is not widespread, and the authors are careful to distinguish it from premenstrual dysphoric disorder (PMDD), which is rarer still. As Gillian Einstein, one of the researchers, told the Toronto Star, “We have a menstrual cycle and we have moods, but they don’t necessarily correlate.” She did not add, but I will, that it it is unfair and unreasonable to assume that every woman’s moods should be attributed to her menstrual cycle and to refuse to take her feelings seriously.

Cross-posted at Ms. blog.

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?  :-)

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.

Menstruation, Prince Charles and The Biggest Hacking Scandal

August 29th, 2011 by David Linton

In light of the recent scandals over the phone and email hacking practices of Rupert Murdoch’s newspaper editors and reporters it is surprising that there has been so little mention of the fact that the most scandalous, damaging and far reaching hacking story associated with Murdoch centered on menstruation.  The only thorough review of the links between the current story and the earlier one appears in a detailed piece in The Sun-Herald from Sydney, Australia, July 31, 2011.

I have previously written about the incident here and elsewhere, but in light of the current coverage it deserves a fresh look.

In brief: in 1989, a time before either cell phones or email were commonly available (hard to believe there was such a time!), a phone hacker recorded a phone sex exchange between Prince Charles and his then-lover, Camilla Parker-Bowles in which erotic mention was made of tampons.  Three years later the full transcript of the conversation was published in an Australian women’s magazine, New Idea, and a world-wide scandal ensued.

Now, nearly 20 years after the story broke, it is about to come back into play as further investigations proceed into the illegal hacking activities of the Murdoch media empire.  Perhaps we will finally learn how much was paid for a menstrual story that humiliated the Royal Family, who the hackers were, and who authorized its purchase and publication.

And, from a Menstrual Studies point of view, its longevity reflects the deep fascination that the menstrual cycle continues to hold for the general public.

Menopause in the funny pages

January 6th, 2011 by Elizabeth Kissling

Widely distributed U.S. comic strip “Zits” — the ongoing story of the life and times of 16-year-old Jeremy Duncan — began a storyline about menopause this week. Apparently, Jeremy’s mom has begun experiencing signs of perimenopause. So far, it’s not awful. The humor is based on the unpredictability of hot flashes and Jeremy’s apparent embarrassment at seeing his mother spontaneously remove her blouse.

© 2011 ZITS Partnership

© 2011 ZITS Partnership

It’s open to interpretation, of course, but so far (see yesterday’s strip), it seems to me that we’re invited to laugh at how easily the teenage boy is embarrassed, and to sympathize with the menopausal woman.

And the Bad News about Hormone Therapies Continues to Accumulate…

October 21st, 2010 by Heather Dillaway

Yes, the hormone therapies prescribed for women in perimenopause and beyond have already been suspect. Especially after the initial Women’s Health Initiative (WHI) trial results in 2002 (but even before that), researchers documented the health risks associated with the use of hormones during menopause, especially combination hormone therapies (therapies including estrogen plus progesterone, such as Prempro). SMCR’s Jerilynn Prior has done plenty of work on this as has SMCR’s Paula Derry, and WHI researchers and spokespeople have had to come out about many of the health risks as well. Now, this week, we find out that not only is there an increased risk of breast cancer for women who use these hormone therapies but that, according to a New York Times article published on Tuesday, “Women who took hormones and developed breast cancer were more likely to have cancerous lymph nodes, a sign of more advanced disease, and were more likely to die from the disease than were breast cancer patients who had never taken hormones.” According to this New York Times article, this report is the first to reveal WHI death rates.

After the dust settled from the original WHI reports about the risks of hormone therapies, researchers and doctors often made claims that it was still okay for women to be on hormone therapies for an extended period of time. Instances of death (instead of just disease/illness) are now causing some researchers and doctors to come forward and say that it is no longer safe for women to be on hormone therapies for this amount of time. Dr. Chleblowski, an author of the latest study about women’s mortality, is quoted in the New York Times article as saying that women should not stay on Prempro for more than a year or two.

Bottom line, these drugs are dangerous for women. The older we get, the more we realize that illness, disease, and death are a normal part of life. I find myself realizing this more and more each day as I watch people around me get sick, die, or have to deal with the loss of loved ones. But illness, disease, and death caused by prescriptions and indirectly by doctor’s care (what is often termed iatrogenic illness or death) is just not okay – especially when more caution could be used. Sure, it’s happened all throughout history. Plenty of people died so we could have Aspirin, Viagra, epidurals, Coumadin, birth control pills, safe abortions, hysterectomies, and pacemakers, just to name a few.  But, as a doctor quoted in the New York Times article says, “The fallback is that doctors and patients should be deciding this on a one-to-one basis, weighing risks and benefits,” [but] “How do you do that when you don’t know what the risks are?”

We know that doctors are left in a precarious position, as are female patients, as they contemplate the use of hormone therapies….but what these articles and reports aren’t saying outright is that it is probably better NOT to use these drugs unless we absolutely have to. I was listening to Detroit’s NPR station driving home from work yesterday and heard even Dr. Susan Hendrix, a Detroit-based WHI researcher and doctor say, “maybe we can now just laugh at hot flashes,” instead of rely on combination hormone therapies to help us. At least that’s what she was inferring. We don’t completely understand all of the risks of combination hormone therapies but we know they include possible cancer and death, and delayed diagnosis of cancer as well (which means further death).  Since yesterday was “Love Your Body Day,” I think perhaps we need to love our bodies more by remembering that some of the signs and symptoms we experience (such as hot flashes and irregular bleeding in menopause, no matter how hard to deal with) are not life-threatening, are completely normal, and can be dealt with without drugs — because the alternative is not so benign. Why should women continue to worry about whether they’ll die by Prempro? It seems WHI results are beginning to get even clearer, and I’ll be interested to see whether rates of prescription decrease after this last report. I also wonder what the makers of Hot Flash Havoc might think of this.

Sex, the Brain, and the Pill

August 18th, 2010 by Elizabeth Kissling
Positron emission tomography image of a human brain

Positron emission tomography image of a human brain

Does taking the Pill increase the size of your brain? According to this story in The Daily Mail, you betcha. And it makes women more talkative, too. That’s right – brain scans of 28 women PROVE it.

I know not to take too seriously such headlines in The Daily Mail (there’s a reason my British friends like to call it The Daily Fail), but if that story has you gnashing your teeth, consider this piece from The Guardian to be the antidote:

In fact, there are no major neurological differences between the sexes, says Cordelia Fine in her book Delusions of Gender, which will be published by Icon next month. There may be slight variations in the brains of women and men, added Fine, a researcher at Melbourne University, but the wiring is soft, not hard. “It is flexible, malleable and changeable,” she said.

In short, our intellects are not prisoners of our genders or our genes and those who claim otherwise are merely coating old-fashioned stereotypes with a veneer of scientific credibility. It is a case backed by Lise Eliot, an associate professor based at the Chicago Medical School. “All the mounting evidence indicates these ideas about hard-wired differences between male and female brains are wrong,” she told the Observer.

“Yes, there are basic behavioural differences between the sexes, but we should note that these differences increase with age because our children’s intellectual biases are being exaggerated and intensified by our gendered culture. Children don’t inherit intellectual differences. They learn them. They are a result of what we expect a boy or a girl to be.”

Now adding Delusions of Gender to my reading list; I’ve already read Lise Eliot’s Pink Brain, Blue Brain. (I also heard her present this work at a conference; it’s a very compelling presentation.)


The Leap from Younger Puberty to Fat-Shaming

August 12th, 2010 by Elizabeth Kissling
'Puberty' by Edvard Munch. Photo courtesy of Flickr user independentman // CC 2.0

'Puberty' by Edvard Munch. Photo courtesy of Flickr user independentman // CC 2.0

When the story that girls are reaching puberty earlier than ever began popping up everywhere this week, I did not doubt its veracity. It was no coincidence that I received an email from a friend yesterday, observing with mixed feelings that she had just purchased a first bra for her oldest daughter. Her daughter is 9.

News about girls reaching puberty earlier and earlier isn’t exactly new. We saw a flurry of stories in late 2009, when studies found an association between early menarche, late menopause and breast cancer. Additionally, the finding that African American girls often show signs of pubertal development earlier than other girls is well-established.

The study that triggered this new explosion of publicity, published this week in Pediatrics, assessed girls’ development by evaluating the size of breast buds (as breasts are called in early stages of development). The researchers evaluated an ethnically diverse population of 1,239 girls ages 6 to 8 across three research sites. They found that 10.4 percent of white, 23.4 percent of black and 14.9 percent of Hispanic 7-year-olds had reached “Sexual Maturation Stage 2.” Stage 2 is more typically reached at age 10, but may occur any time from age 8 to age 13. Menarche, the first menstrual period, occurs on average at age 12, in Stage 4, but it, too, varies, occurring as early as age 9 and as late as age 17.

The Pediatrics study does not, however, reveal what has caused the age of puberty to fall. Many are quick to blame the alleged obesity epidemic, as the study found that heavier girls were more likely to have more breast development. But Dr. Frank M. Biro, the first author of the study and the director of adolescent medicine at Cincinnati Children’s Hospital Medical Center, told the New York Times that it is unlikely that weight alone explains the findings. Instead, he speculates that environmental chemicals may influence early breast development, and he and his colleagues are presently running lab tests to assess the girls’ hormone levels and chemical exposure.

Fat is one of many factors affecting pubertal development. Others include:

  • environmental toxins, including phthalates and Bisphenol A, commonly known as BPA, which can be found in nearly anything made of plastic: baby bottles, toys, plastic serving utensils, and more
  • premature birth and low birth weight, which affect endocrine function
  • psychosocial stressors, such as family dysfunction or abuse
  • formula feeding, especially without breast feeding
  • in-utero chemical exposure
  • and, often neglected in these discussions, endocrine disruptors–the hormones used in raising beef and dairy cattle as well as chicken in this country. Almost all foods in a modern North American diet contains endocrine disruptors.

(For a more thorough analysis of causes of early puberty, see Sandra Steingraber’s report, The Falling Age of Puberty in U.S. Girls: What We Know, What We Need to Know, published in 2007 by the Breast Cancer Fund. Among other findings, Steingraber reports that new research has revealed that the amount of natural hormones a child’s body produces on its own is much lower than previously estimated; this means “safe levels” of exposure to synthetic hormones and endocrine disruptors must be recalibrated, and policy modified accordingly.)

Sadly, much of the public discussion of this research seems to be centering on the possible role of the alleged obesity crisis (or in fat activist Kate Harding’s preferred terminology, “the obesity crisis OOGA-BOOGA!”), despite a lack of concrete evidence. I’d hate to see this research lead to increased fat-shaming and body image issues for young girls, as there are far more serious consequences of a dramatic decline in age of puberty.

Why isn’t the focus on what can be done to help girls? Research published ten years ago by Girl Scouts, Inc., reported that 8- to 12-year-old girls are growing up in an increasingly stressful environment, as their cognitive and physical development occur at an accelerated pace, while emotional development does not. In other words, despite the budding breasts, a 10-year-old is still a 10-year-old psychologically. The resulting tension leads to young girls dealing with teen issues, such as sexuality and relationships, before they are ready.

Hot Flashes: Now Especially for Fat Ladies

July 14th, 2010 by Elizabeth Kissling
Photo of art by Czarnobyl by Flickr user urbanartcore.eu || CC 2.0

Photo of art by Czarnobyl by Flickr user urbanartcore.eu || CC 2.0

Since yesterday, although it seems longer, my RSS reader has been clogged with links to news reports about a UCSF study in which some women who lost weight found that their hot flashes diminished. Of course, that’s not what the headlines say. Here’s a sample of some of the titles of current stories about this study on Google news:

  • Hot Flash Relief: Weight Loss Works, What Doesn’t? (US News & World Report)
  • Bad hot flashes? Try dropping a few pounds (MSNBC.com)
  • Losing weight may ease menopause symptoms (NBC13.com)
  • Symptoms of Menopause Can Be Relieved by Weight Loss (Health News)
  • Weight Loss Helped Overweight And Obese Women Reduce Hot Flushes (Medical News Today)

OK, that’s enough – see the trend? Suddenly weight loss is the cure for hot flashes. But in the actual study – which was about urinary incontinence, not menopause -141 women provided researchers with data about their hot flash symptoms six months after the study began. Sixty-five of the 141 women said they were less bothered by their hot flashes six months after participating in the weight loss program, 53 reported no change, and 23 women reported a worsening of symptoms.

Look at those numbers again, more slowly this time: 65 of 141 women who participated in a weight loss program were less bothered by hot flashes after six months. That’s 46% of the women – less than half – who found relief. Almost as many reported no change in symptoms, so why is this being touted as a successful intervention?

Because the women lost weight. Most of the news reports of this research stop just short of fat-shaming, but I submit that is exactly why this study is getting so much media attention. Even though it is well-established that diets do not work, even if you call them a “lifestyle change” or “a whole new way of eating”, and that the BMI (Body Mass Index) is useless as a gauge of health. In fact, fat is not a measure of health. But why pass up an opportunity to shame women about their bodies?

A New Blood Test to “Predict” “Menopause”? Is this What Women Really Want?

June 28th, 2010 by Elizabeth Kissling
Collage by Merlinprincesse | Creative Commons 2.0

Collage by Merlinprincesse | Creative Commons 2.0

Guest Post by Heather Dillaway, Wayne State University

I keep seeing news articles about a “new Iranian study” that hopes to better predict “age at menopause” for women, and the authors of this study supposedly discovered a “blood test” that will be able to “predict menopause” within the next few years. It is touted as a way to judge when women will be “done” or be at the “end” of “menopause” and also to predict by default when they will be at the “end” of their “fertile” years (so that maybe they can know when they have to pop out that first or last baby). After seeing so many references to this study over the last week and having studied how women feel about the “beginning” and “end” of menopause for the last ten years myself, I can’t just sit back and not critique the underlying assumptions that are part of this study and air some of the concerns that I have about this impending blood test.

First, there is an assumption that the cessation of menstruation (as biomedical researchers define it) is the defining moment of “menopause.” Thus, what these scientists are trying to predict is the age when women might reach “menopause” (or 12 months past their last menstrual period). Yet, not all women judge the “end” of menstruation as the most important aspect of their menopause experience, in fact many women are much more concerned about when other signs and symptoms of “menopause” will begin and/or how long they will last, for instance, irregular bleeding or heavy bleeding in “perimenopause” or hot flashes, night sweats, etc. Can a test predict when irregular bleeding might start and how long it might last? And if a test predicts that a woman might reach her “age at menopause” right after her 54th birthday, will that make a 45-year-old woman with irregular bleeding feel assured that she has only 9 years left? In addition, can a test predict how soon a woman might start experiencing hot flashes and how long they might last, if that is instead to be her most worrisome sign or symptom?  If a test predicts that a woman’s age at menopause will be around age 49, will that woman feel assured about her hot flashes at age 48, having no idea how long those hot flashes will last but maybe hoping that they’ll end right alongside her last menstrual period? While the authors of this study (like most other biomedical studies) want to continue to uphold the definition of “menopause” as the official “end” of menstruation and ultimately the “end” of fertility, and hold this up as the most important part of menopause that we should know about, I beg to differ. Women want to know more than just their “age at menopause” or the final end to their fertility.

Second, continuing to define menopause primarily through the cessation of menstruation as this study does means that those women who do not menstruate regularly before menopause (e.g., pregnant women, breastfeeding women, women with amenorrhea before menopause, serious athletes, women with eating disorders and other health conditions, intersexed women, women on Depo-Provera or Seasonale, women with partial hysterectomies, women on hormone therapies, etc.) continue to be defined as abnormal and even infertile, if we follow through with the mindset of the authors of this study. In my mind, this study seems not to be written for those groups who haven’t been menstruating regularly before their “age at menopause” or who might even have been defined as “infertile” before menopause. The assumption is that all women menstruate regularly and are fertile before menopause and, therefore, menopause can mean the end of menstruation and fertility, but so many women’s experiences negate this assumption and reality. Even women who have simply been on the birth control pill for ten years or women who had a tubal ligation negate the idea that “menopause” is the end of fertility. There are so many factors that interrupt “normal” “menopause” or “normal” “fertility,” and this study does not explain any of that. If women have not been faced with a regular menstrual cycle earlier in their lives and have not been “fertile” before menopause, how are they supposed to interpret this study’s definition of “age at menopause” or fertility? Does this calculation still work for them? Presuming it does, what should they assume when they reach that predicted age at menopause? Should they just assume they’re done, and take the authority of the blood test as fact, that they are indeed “menopausal”? And should women who have experienced troubles with fertility before menopause wait to think that they are infertile until after the predicted age of menopause? This blood test leaves me with many questions and few answers, especially when I start to think about all of the supposed causes of age at menopause and infertility, and all of the women who are left with unexplained experiences if we rely on this blood test to give us the answers.

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