Blog of the Society for Menstrual Cycle Research

How do YOU define reproductive health?

December 8th, 2011 by Heather Dillaway

By Justine Siegemundin, 1723. Public Domain, via Wikimedia Commons.

Menstruation and menopause are reproductive health experiences, aren’t they? At least that’s what I think. But I’m starting to wonder how many people agree. I’ve been thinking a lot lately about how people define the things they experience and how researchers define the things they research. The last blog entry I wrote was on the confusing and frustrating definitions of the menopause transition. Today I thought I’d zoom out a bit more and think about what “reproduction” and/or “reproductive health” means. I personally think of reproductive health as encompassing a woman’s entire life course and including a whole range of experiences (and the pursuit and achievement of individual wellbeing throughout all of these experiences) but I don’t know if others do. For instance, about two weeks ago I was on the phone with a potential coauthor, and she and I had a misunderstanding because I was talking about “reproductive health” as including prevention of HIV and other STDs and she was thinking of “reproductive health” as just about conception, pregnancy, and birth.  I’ve been studying what I think of as women’s normal reproductive processes and experiences (e.g., menopause, menstruation, pregnancy, childbirth, and breastfeeding) for a long time, so I thought I would use this blog entry to tell readers what I think about “reproductive health” and see if anyone agrees with me.

Adrienne Rich, in her 1986 edition of Of Woman Born, proposes that biological reproduction has been defined narrowly by most people (feminist or otherwise). Thus, for many, “reproduction” is equated with just two female processes: pregnancy and childbirth.  While it may not have been the goal of any one person to define reproduction so narrowly, this seems to be a reality.  At various points throughout history, conception and contraception – at times, even abortion – have been added to the definition of what “reproduction” meant, or what “reproductive rights” women were owed, but “reproduction” and “reproductive health” still refers to a very short list of experiences.

I believe we should acknowledge, however, that women’s “reproductive” experiences include more than just conception, contraception, pregnancy, and birth. Reproduction includes an entire range of reproductive experiences, including: menstruation and menopause, use of and problems with contraceptives, choosing whether to become a mother/father, breastfeeding, HIV and other sexually-transmitted diseases/infections, prostate and breast cancer, awareness of and access to reproductive health care, protection against sterilization abuse, vasectomy and hysterectomy experiences, the rights of single and/or lesbian mothers, the rights of single and/or gay fathers, donor insemination, cloning and other new advancements in reproductive technology, adoption, infertility treatments and experiences, gynecological practices, alternative reproductive health movements, decisions over whether to engage in heterosexual intercourse, and making informed “choices” in any of these instances. This is just a partial list, and I could go on and on. I propose that we think of “reproduction” (and, by default, “reproductive health” experiences) as the collection of (a) biological, physiological and/or embodied processes and (b) emotional, social, economic, and political decisions and/or actions that individuals — along with their families and other social groups — participate in (either voluntarily or sometimes through some sort of coercion), as they transition in and out of certain stages of their life course, decide whether or not to be sexually-active, and/or decide whether or not to become genetic, gestational and/or social “parents” or caregivers of children.  Any one reproductive experience – for example, menstruation or menopause – can also really be a set of processes and decisions and actions that women make/take/experience/pass through over an indefinite period of time – usually not happening in just one moment. Thus, menstruation or menopause are full-fledged and complicated reproductive experiences in and of themselves, as much as pregnancy or childbirth or any other “reproductive” experiences are, that the majority of women pass through, albeit in different ways, throughout their lifetimes. So are all of the other processes and experiences I’ve named above, and more I haven’t named. “Reproductive health” would then refer to a state of physical and mental wellbeing, indeed biopsychosocial wellbeing, while experiencing any of these sets of processes or decisions or actions.

Earlier menopause with ovary-saving hysterectomy

November 22nd, 2011 by Chris Hitchcock

Recently Heather Dillaway blogged about the challenges and frustrations of naming, and this blog continues with that theme, looking at a recent article about increased rates of ”ovarian failure” following ovary-preserving hysterectomy.

Ovary-saving hysterectomy linked to early menopause,” reads the USA Today on-line headline, and the article opens with the statement that:

Younger women who have a hysterectomy that spares the ovaries are almost twice as likely to go through early menopause as women who do not have their uteruses removed, according to a new study. 

It’s an alarming statement, and one likely to alarm an already anxious woman. The study in question was a longitudinal study following 406 women aged 30-47 at the time of their surgery and a control group of 465 similar-aged women who did not have a hysterectomy. The study will be published in the December 2011 issue of the peer-reviewed journal Obstetrics & Gynecology, and the news coverage was drawn from the Duke University press release, entitled “Hysterectomy Increases Risk for Earlier Menopause In Younger Women”.

The first challenge of naming is in the subtle difference between the press release’s earlier menopause, and the USA today article’s early menopause. Early menopause is defined as menopause that occurs before the age of 40; the earlier menopause in the article is a difference of about 2 years — an important difference.

In women who no longer have menstrual flow, how did the authors establish menopausal status, or ”ovarian failure”, as they called it? In women with a uterus, menstrual flow is a convenient landmark, which is roughly aligned with the hormonal changes to decide when menopause (or is it post-menopause?) has begun. We assume that 12 months without menstrual flow likely means that there will be no further flow (although that is not always true), and that it is a good estimate of when ovarian hormonal cycles have stopped. In this article, the authors used an annual blood sample to measure a hormone called FSH (follicular stimulating hormone). FSH is high in menopausal women, and an FSH>40 IU/L was used as a criterion for reaching menopause. However, we have known since 1994 that a high FSH level is not diagnostic of menopause, and, indeed, 6 of the 504 women were excluded because they had a baseline FSH > 40 IU/L, despite having menstruated within the previous three months. Regularly cycling women in their 40′s can have high FSH levels, and later have low FSH levels and ovulatory cycles. In menstruating women, blood samples would also be timed, which is not possible for women who don’t menstruate. It would be interesting to know how the high FSH criterion corresponded to menstrual cycle history in the control group.

Studies like this are hard to do. The authors were careful — they enrolled women prior to surgery and followed control women in the same way. To get 403 women with complete data, they started with over 900 women.  The controls were fairly well matched — similar in age, age at first period, c-section and oral contraceptive history. However, women undergoing surgery were more likely to have had at least one full-term pregnancy (84.5% vs 68.3% in controls), and more likely to have had a previous tubal ligation. In addition, fibroids, endometriosis, ovarian cysts and previous surgery for fibroids were more common in those having a hysterectomy. Both the hysterectomy itself and the history of previous surgery, particularly tubal ligation, may also contribute to a difference between the two groups. Finally, women with hysterectomy were heavier than the control group.

Feeling Uncertainty, Confusion, and Frustration about Menopause

November 10th, 2011 by Heather Dillaway

Last Friday I attended a conference on autoethnography and was privileged enough to listen to Carolyn Ellis give the keynote speech on this new and upcoming qualitative methodology.  Sitting there and listening to Ellis talk about the need for all of us to be reflexive and put ourselves into our research projects, I realized that I probably do need to acknowledge my own feelings of uncertainty and frustration as I study menopause and midlife. Therefore, this blog entry is for you, Carolyn Ellis, as I am inspired by you to be better from now on about acknowledging the connections between me and my work and trying to understand myself as a research instrument as I seek to understand menopause and midlife better.

The reasons I really started studying menopause are the very reasons why I’m still studying it but also frustrated by it. In the mid to late 1990s, my experiences as a birth control counselor at Planned Parenthood in Delaware and Michigan led me to realize that plenty of middle-aged women don’t understand what’s happening to them when they start to have irregular periods in perimenopause. I also watched my mother begin perimenopause in the mid 1990s and be confused and embarrassed to talk about the experience when she had always been the first one who always wanted to talk about pregnancy, childbirth, breastfeeding, and birth control (“What was so confusing about menopause?,” I thought).  I’ve now formally studied and written about women’s thoughts and experiences of menopause since 1999. All along, the terminology and definitions of menopause have been as problematic for me as for the women I’ve studied. I’ve listened to menopausal women who tell me that they are completely confused about biomedical terminology for their life stage and completely baffled about what they’re going through.  I’ve heard them talk about how doctors and other women they talk to are just as confused as they are. What is this thing they’re going through? I’ve talked to other feminist social scientists and humanities scholars who think we should call menopause “reproductive aging” or “the menopause transition” to signify that variation over time is really the only guaranteed experience at this time of life. Endocrinologists and biologists turn around and tell me that the term “reproductive aging” is faulty because all that term signifies is that we are all maturing from birth on – that it is an empty term signifying nothing. I listen to endocrinologists, epidemiologists, public health educators, women’s health advocates, menstrual activist researchers, biologists, and clinical/biomedical researchers who are all ready with their own take on what terminology and definition is “best” for describing this time of life. Some argue that there is a strict three-phase model of perimenopause, menopause, and postmenopause that we should follow. Some argue for a five or even seven stage model for “menopause,” parsing out pre, post, early and late stages of the menstrual life course (such as early and late  premenopause, early and late perimenopause, menopause, early and late postmenopause, etc.). Some argue that perimenopause is really the only “stage” of “menopause” or late reproductive life that women really want to know about because that is when all the (negative) symptoms come. I hear others argue that “menopause” and “postmenopause” are the same thing, or are that these are conflated terms that mean nothing, and that both of these terms should be scrapped. (Yet then I hear individual women I interview tell me that postmenopause is as frustrating as perimenopause.) I hear other researchers say that EVERY term associated with menopause or reproductive aging is faulty. If I listen to individual menopausal women, they tell me the same. Two months ago, I did a presentation on midlife in general, and a feminist humanities scholar (whom I respect quite a bit) told me I shouldn’t be using the term “midlife” at all, because it is a non-term itself, defined by nothing. If I think about all of the terms I associate with menopause – menopause, the climacteric, the change, the change of life, perimenopause, postmenopause, the late reproductive years, the menopause transition, women’s midlife transition, reproductive aging, etc. – I don’t even know what terms I should be using. Over time I have thought that the best case scenario is just to use the term that women themselves use (therefore I used the word “menopause” a lot to describe a whole transition, or adopted the term “reproductive aging” when urged by feminist scholars to do so in order to define a broader transition). But, now, I’ve been critiqued recently for not correcting individual women when they use the “wrong” term to describe what they’re going through.

Menstruation Gets Blamed for Everything!

November 8th, 2011 by David Linton

© Bettman/CORBIS, Creative Commons 2.0

In Gore Vidal’s 2006 memoir, Point to Point Navigation, he name drops his way through more than four decades of a very interesting life with great stories about the famous and notorious folks who crossed his path. One tale is related by his stepmother, Kit, about her former husband and Gore Vidal’s father, Gene Vidal, and his relationship with the pioneering woman pilot, Amelia Earhart, with whom he apparently had a long-running affair. Gene Vidal was also a pilot as well as an innovative businessman involved in many aspects of what was then called air commerce.

According to Kit, her husband had a theory about the accident over the Pacific that killed Earhart. He believed that she had deliberately crashed the plane: “’She was going through a bad time with G.P. [George Palmer Putnam, her publisher husband]; she was also undergoing some sort of premature menopause.’”

Whew! It seems that no matter where you turn, if a woman is having a bad day, the menstrual explanation will be trotted out. But suicide by plane crash as a response to perimenopause?!?! Now, there’s a flight of fancy.

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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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Cardiovascular deaths increase with steady aging, not menopause

September 27th, 2011 by Chris Hitchcock

Earlier this month, researchers published a statistical analysis of mortality data in England, Wales and the United States, disproving the common statement that, after menopause, women face increased rates of mortality from heart disease. There are other studies that have come to similar conclusions, but there are a few things that make this study different. One is that it drew on epidemiological data from three different parts of the world, which reduces the likelihood of a local coincidence. A second is that they took care to create longitudinal data sets, comparing women born in different birth decades with the appropriate mortality over time. In doing so, they avoided the problems of cross-sectional data.

The authors found that there was a steady exponential increase in risk with age, and that there was no sign of accelerated risk at the typical age of menopause (50). They compared different versions of mortality curves, and were able to show that a two-stage model of mortality with a hinge at menopause was not a good fit to the data.

These findings have received national and international coverage, and are a major blow to the argument that menopausal women require premenopausal hormones to retain premenopausal protection from cardiovascular risk. Menopausal women are older than premenopausal women, and that is why they are more likely to die from cardiovascular disease, not because of the hormonal changes of menopause.

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Menopause Isn’t for Dummies

September 23rd, 2011 by Elizabeth Kissling

Roseanne’s Nuts was one of the delights of summer 2011, especially for those of us who have missed the comedic talents of Roseanne Barr. If you don’t watch television (or are outside the US), Roseanne’s Nuts is Roseanne Barr’s return to episodic television, this time in the form of a reality show set on the star’s 40-acre macadamia nut farm in Hawaii. When her eponymous sitcom ended in 1997, she made a couple of attempts at talk show hosting, then left L.A. and the limelight to raise her youngest son and macadamias in Hawaii. He’s now a teenager, and the nuts are ready to harvest.

An ongoing thread of the show is Roseanne’s plan to harvest and distribute her nuts as a low-cost protein source for impoverished people. Each episode also has its own self-contained, seemingly unscripted plotline. Unlike many of today’s popular reality shows, however, there are no manipulated showdowns or drunken feuds. Much of the time, Roseanne and her family seem like everyone else’s family — if only the rest of us could live off sitcom residuals and were followed around by a camera crew. There is laughter and teasing, and some conflict underpinned with genuine affection, but everything isn’t always tidily resolved in 22 minutes.

In the Episode #15 (original air date September 10), 58-year-old Roseanne copes with continuing symptoms of menopause. It’s handled so honestly (for the most part) that I’m going to overlook the fact that the episode was titled “Menopause for Dummies”.* The episode opens with Johnny Argent, Roseanne’s manpanion**, sharing a list of menopause symptoms he has found on the internet. Roseanne acknowledges having them all, except for tingling in her extremities, and decides to visit her friend, Dr. Allen, and to investigate whether she should receive hormone treatments. (The full episode can be watched online at Lifetime.com until Oct. 11; preview a short clip at right.)

-+-+-+- SPOILERS AHEAD -+-+-+-

Roseanne visits Dr. Allen — on camera, of course — this is a reality show — and explains her concerns. He asks about her libido and her sex life, and she replies, “It’s like an old person’s”. She responds forthrightly to his suggestion that dryness may be the cause of her ‘feminine itching’: “that’s all dried up like a sonofabitch”. Dr. Allen wants to measure Roseanne’s hormone levels with a 24-hour urine test, as he believes that will provide more precise information than any blood test. Roseanne is horrified by his description of her contribution to the procedure (“You pee in a bucket for 24 hours”), but even more horrified by his other recommendation: she needs to exercise.

Roseanne tells the camera — the proxy for us, the audience at home — that she doesn’t know if she’ll go on hormones or not. Her women friends recommend red wine, saying it’s bad for menopause (“because it makes you sweat”) but good for the libido. Her eldest son Jake is delighted to hear that his mom is considering hormones, telling the camera, “After eight years of being batshit crazy, I think she’s finally ready. I’m so happy — once she gets hormones, my life’s gonna be a lot easier.”

Some of my SMCR colleagues who study menopause may cringe at these scenes, but I think they’re representative of the kind of communication many women experience around menopause; that is, well-meaning, if ill-informed, advice from friends and family. It feels like the kinds of conversations lots of us have in our own living rooms and front porches. It is this feeling of unscripted authenticity that draws viewers to Roseanne’s Nuts. I also note the special irony of menopause; after 20 or 30 years of our hormones being blamed for erratic and irritable behavior, we’re now advised to consume hormones to rein in our erratic and irritable “batshit crazy” behavior.

Breaking News: Pfizer ordered to pay millions in PremPro cases

February 8th, 2011 by Elizabeth Kissling

Pfizer, which now owns Wyeth’s PremPro synthetic progestin-estrogen combination that was widely taken for relief of discomforts that sometimes accompany menopause, has been ordered to pay damages in two separate cases this week. The company must pay more than $10 million in damages to an Arkansas woman after an appeals court reinstated a jury verdict. And yesterday in Pennsylvania, an appeals court overturned a previous ruling that Pfizer’s Wyeth unit deserved a new trial in the case of a Philadelphia woman who had been awarded $1.5 million in compensatory damages and $8.6 million in punitive damages on her claim.


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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.

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Hormone Therapy and the Brain

November 24th, 2010 by Elizabeth Kissling

Medical-Anatomical-Superior-half-of-diseased-brainSo there’s a surge today in news stories about how hormone treatment for menopause (popularly known as ‘hormone replacement therapy’ or HRT) benefits the brain, apparently based on publicity over this study published in Hormones and Behavior. In media interviews, the researchers suggest that HT enhances the communication between left and right sides of the brain, making the older women’s brains more similar to those of younger women. The researchers had the women perform tasks designed to demonstrate fine motor coordination, such as tapping buttons with different fingers. Of the 62 women in the study, the 36 on hormone treatments showed higher levels of motor coordination, leading the researchers to conclude that hormone treatments, especially estrogen, “exert positive effects on the motor system thereby counteracting an age-related reorganization.”

Admittedly, I have not read the entire study, just the abstract and press summaries, but would you consider me too cynical if I suggested that the publicity this research report is receiving is more about promoting the use the hormones among menopausal women than the significance of the research findings?

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“A Non-Hormonal ‘Fix-It’ for Women Suffering From a ‘Broken Internal Thermostat’”: Just Wear Athletic Clothing to Bed!

November 15th, 2010 by Heather Dillaway

sleepless.jpgThe title of this blog entry comes straight from a media release about Goodnighties® Recovery Sleepwear. That’s right, now there is finally sleepwear made out of a fabric similar to the fabric worn by “Olympians, Astronauts and Even Racehorses” to wick away the moisture of hot flashes, night sweats, and chills accompanying some women’s perimenopause, menopause, and postmenopause. Using the “power of negative ions,” Goodnighties® sleepwear purportedly offers that rest, relaxation, recovery (and, ultimately, sleep!) that most midlife women are lacking! Some users are quoted on the website as saying that Goodnighties® sleepwear “changed their lives.”

One one hand, this makes complete sense — why didn’t people think of this before? Athletic clothing would help someone deal with hot flashes and night sweats in the middle of the night, if only making it so that one doesn’t have to get up and change their clothes or sheets. And considering we’re currently in a “menoboom” (Barbre, 1998), with the aging and menopause of the Baby Boomers, what a great idea to market moisture-wicking clothing to menopausal women! Talk about a money-maker.

On the other hand, while I think on the whole this is probably a good product for many, I do take issue with some of the language on the site, because of the negative connotations about menopause in particular (e.g., the emphasis on “fixing” “broken thermostats,” “suffering,” and quotes about how 85 percent of women are “known to suffer”). But, this line of clothing is also marketed towards others — those undergoing infertility treatments, “athletes, regular exercisers and weekend warriors with sore muscles,” “people with aches and pains due to injury, surgery, chemotherapy, etc.,” and “[t]hose suffering from painful health issues like fibromyalgia, arthritis and diabetes” — so, it’s not exclusively marketed to menopausal women and not exclusively designed to define menopause as a bad thing.

On another issue, though, the emphasis on relief, recovery, and fixing does make me think that this product is being marketed as something that resolves (negative) symptoms, but I’m not sure how that could be the case? Does anyone have any experience with Goodnighties® sleepwear? Is it actually capable of alleviating the symptoms, or is it just making the public manifestation of the symptom disappear?

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Waiting

October 28th, 2010 by Heather Dillaway

I’ve been thinking a lot lately about the words we use when we’re talking about menstruation or reproductive experiences more generally. I’ve been noticing lately that we use the word “waiting” quite a bit. I have a friend who is “still waiting” for her menstrual cycle to be “normal” again after her second child, and several other friends who are either “waiting” to figure out whether they will get pregnant, “waiting” to be done with their pregnancies, or “waiting” before they can have their last and final kid. I just had my basement waterproofed and one of the basement repairmen told me that his wife had been “waiting” ten months to get a menstrual period and that they were worried about her (this is information he volunteered after I told him I studied women’s health). I started thinking more about how the menopausal women I interview always talk about “waiting” to figure out whether they are really “at menopause,” or “waiting” to figure out if this is really their last menstrual period. Or how so many girls/young women who are sexually active are “waiting” to get their periods so that they can be relieved to know they are not pregnant. Or how women with painful periods, endometriosis, or migraines are waiting until those days are over each month. What does all of this reproductive waiting (waiting for menstruation, waiting for menstruation to be over, waiting for pregnancy, waiting for birth, waiting for menopause) mean?

 

In all of these instances of reproductive waiting, waiting seems a negative connotation and that seems to stem from the fact that we do not feel in control or in charge of this reproductive time. When I think of the other situations in which I might use the word “waiting”, the same holds true. I tell my kids to “wait their turn” and they don’t like it. And none of us really like waiting in line. Fast food restaurants, frozen dinners, and ATM machines are all in existence because we don’t have time or don’t like to wait. Phrases that we use like “worth the wait” also connote negativity about waiting. So, I finally looked up the actual definition of waiting. Depending on which online dictionary you visit, definitions of “waiting” include: “pause, interval, or delay,” “the act of remaining inactive or stationary,” or “the act of remaining inactive in one place while expecting something.” While some of these definitions do not automatically lend themselves to negativity, waiting is defined mostly as a passive activity that we are forced to participate in, perhaps against our will.


All of this makes me think further about whether women really dislike the waiting or the time that comes with menstruation or other reproductive experiences, and whether women really feel out of control as they engage in their experiences. Is this just a word we use or are we really impatient about menstruation and reproduction? When I think about alternative words that are sometimes used, like “tracking,” other words seem much more agentic in that they put women back in control of their cycles and other reproductive experiences. So, is it just the word “waiting” that has the negative connotation or is that word signifying some larger impatience that we have about reproduction these days? I have a colleague who writes about the “inconveniences” of reproduction and how, in so many ways, we try to avoid the reproductive waiting or reproductive uncertainties we face. For instance, instead of waiting to see when a baby is born, we might plan a c-section so that we can know when we’ll get that baby. Or, now we’re told that if we’re “waiting” more than 6 months to get pregnant that we should probably start taking fertility drugs to shorten our wait or get rid of some of that uncertainty. Or now we can find out that we’re pregnant a couple weeks after conception instead of waiting to see whether we menstruate a few weeks later. We attempt to cut out some of those reproductive waits these days. Menstrual suppression is at least partially popular because then women won’t have to be surprised by their periods or wait to know what bad day their period might fall on.

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.