The taboos against menstrual sex are ancient and deep-seated. Despite the well established fact that sexual intercourse during the period is not medically counter-indicated nor somehow debilitating to women and, furthermore, that some women find the experience more pleasurable than the non-menstrual variety, the prejudice lingers on. What’s more intriguing is the ways and places that menstrual sexual phobias are made manifest.
According to several literary and cinematic biographies, two of the most revered figures in the English language critical and literary cannon may have been so traumatized by menstrual encounters on their honeymoons that they swore off sex for evermore.
In 1994 a British biopic named “Tom & Viv” offered up the sad story – we might call it an anti-romance – of the poet T.S. Eliot and his wife, Vivienne Haigh-Wood (played by Willem Dafoe and Miranda Richardson) who eloped in 1915. According to the IMDB summary, the film depicts how “her longstanding gynecological and emotional problems disrupt their planned honeymoon.” In fact, what the scene shows is that Eliot is so appalled by his wife’s menstrual condition – the sheets are awash in the results of her heavy flow – that he nearly goes into shock. His repulsion is so great that he has to leave her for a walk on the beach where he wades fully clothed in the waves to cleanse himself.
The entire film consists of little more that a series of scenes in which Viv causes one embarrassing emotional fracas after another in desperate attempts to gain the affection of her increasingly alienated, cold and aloof husband. There is little doubt that hormonal imbalances are the cause of her instability as early in the film a close mother-daughter conversation conveys the fact that she is perpetually on the brink of yet another menstrual misstep.
Eventually, Eliot has his wife committed to a mental institution where she spends the rest of her life, even after she enters menopause and, we are told and shown, she has become calm and serene.
The YouTube clip that is posted from the film does not include the crucial honeymoon bloody sheets scene but, at over eleven minutes in length, it does display quite a few of the scenes demonstrating Viv’s hormonal flare ups. Though the film might deserve a subtitle like “Beware the Menstrual Monster,” it does give Miranda Richardson an opportunity to chew up every piece of available scenery.
A new study published in the Journal of Obstetrics and Gynecology has found that adolescents are usually able to tolerate the Mirena® IUD rather well. The mean age of girls in this British study was 15.3 years, and they were prescribed the Mirena® for painful and/or heavy periods that did not respond to oral medications. 93.4% of girls in the study (45 young women) reported “significant improvement” within four months. The researchers conclude “that Mirena is a well tolerated and effective alternative for heavy periods±dysmenorrhoea in adolescents who do not respond to oral therapy.”
So will this finding make it easier for young women to obtain an IUD if they’d like it for birth control, now that there is evidence that it is well tolerated?
Guest Post by David Linton, Marymount Manhattan College
Debates about Christianity’s attitudes toward women sometimes focus on Jesus’ relationship with Mary Magdalene and isolated engagements with other unnamed women encountered during his travels. Little is made of a healing scene in the book of Luke(8:43-48) where Jesus had momentary contact with a woman who, in all likelihood, had a severe case of menorrhagia. Here’s how the translation is described in the Revised Standard Version”
“As he went, the people pressed round him. And a woman who had a flow of blood for twelve years and could not be healed by any one came up behind him, and touched the fringe of his garment; and immediately her flow of blood ceased. And Jesus said, “Who was it that touched me?” When all denied it, Peter said, “Master, the multitudes surround you and press upon you!” But Jesus said, “Some one touched me; for I perceive that power has gone forth from me.” And when the woman saw that she was not hidden, she came trembling, and falling down before him declared in the presence of all the people why she had touched him and how she had been immediately healed. And he said to her, “Daughter, your faith has made you well; go in peace.”
The story is rendered with remarkable efficiency. The stealth of the woman was motivated by her clear understanding that she was a pariah in her community,that she was forbidden by the rigid rules of Leviticus from having contact with others lest she contaminate them. Peter’s response is particularly interesting. Rather than acknowledging the severe violation of the rules and dealing with its consequences (Jesus would have had to go away from everyone to be cleansed), Peter denied that any contact had even occurred. (Does this foreshadow his later denial of even knowing Jesus?)
But Jesus seems utterly indifferent to the rules as he places the well being of a suffering woman above the demands of his cultural prohibitions.
The fact that Jesus’ heroic menstrual encounter has been expunged from the narrative of his life reveals, yet again, just how pernicious the taboos and prejudices are. Wouldn’t it be wonderful if Sunday School classes set the menstrual record straight?
To make matters worse, the wonderful gospel song that extols the woman’s faith, first recorded by Sam Cooke and the Soul Stirrers, “The Hem of His Garment” has been similarly sanitized so that she is simply “sick.” The YouTube link that contains the song takes on extra layers of meaning when you listen to it with the thought in mind that it is an unacknowledged story of reactons to the menstrual taboo. The YouTube link also contains an additional Soul Stirrers recording, “Jesus Wash Away My Troubles” – a bonus!
Fibroids are benign growths in the uterus that are estimated to occur in as many as 70% of women. Fibroids are often asymptomatic; many women don’t even know they have them. But fibroids can become large and painful, and can cause heavy menstrual bleeding. Sometimes they can grow large enough to interfere with other organs.
The new technique under investigation is called radiofrequency ablation. The procedure involves three small incisions: one for the laproscopic camera so the surgeon can see inside the abdomen, a second for an intra-abdominal utrasound probe to determine the size and location of fibroids, and a third for the Halt device, a needle electrode that penetrates the fibroid and burns the cells, which are eventually reabsorbed by the body. The device also cauterizes the incision to minimize bleeding.
In early tests outside the U.S. with 70 women, 90% were satisfied with the results. It is unknown whether fibroids destroyed with this technique will grow back.
Fortunately, most men, even if they don’t really like it [menstruation], know enough to pretend not to mind, because, after all, most women do it, and there’s not much men can do about it. And for your purposes, for now, pretending is enough. There’s still the occasional guy who can’t handle blood, but the bell curve compensates by giving us the occasional fetishist or enthusiast to make up for it.
A recent press release from the American College of Obstetricians and Gynecologists announces that Hormonal Contraceptives Offer Benefits Beyond Pregnancy Prevention. This is in the same vein as similar articles published over the years about “non-contraceptive benefits of the pill” – a laundry list of the many benefits women may obtain by using hormonal contraception. It’s not clear how they should be used by practicing obgyn’s. One use is certainly as additional talking points to convince women who are cautious or reluctant to replace their body’s own menstrual physiology with a pharmaceutical product.
I haven’t been able to read the full document (for some reason my university access seems to only find the first page of the full document), but it appears that, like previous reviews I have read, it is a biased list, including benefits but not risks. Perhaps what is most in common is the sense that a spontaneous menstrual cycle is somehow suspect, that fluctuations over time are unnatural, and that pharmaceutical control is a good solution.
I can understand why the pharmaceutical industry might want to publish a long list of off-label uses (although they would be quickly stopped by the US’s FDA and regulatory bodies in other countries). But it is a curious thing to find a professional group extolling the many off-label benefits of a class of pharmaceutical drugs. Do cardiologists publish practice bulletins about the non-cardiovascular benefits of statins?
There are other perspectives about how one might treat painful periods or heavy menstrual flow. The published Cochrane Reviews (well-respected summaries of published studies) about cramps suggest that the evidence for non-steroidal anti-inflammatories (NSAIDS, such as ibuprofen) is more solid and clear than that for combined oral contraceptives, and that, to date, no studies have compared them head-to-head. Moreover, NSAIDs also have been shown to reduce menstrual flow.
The press release notes the protective effects against endometrial, ovarian and colorectal cancer, but fails to note the increased risk of sexually transmitted infections. Being on the pill is the most important risk factor for not using condoms.
And when absent or long periods occur, inducing regular and predictable flow will reduce the risk of endometrial cancer, but otherwise primarily serves to mask the underlying issue. In that case, going on the pill can be like hitting snooze on your smoke alarm.
S. Basak and A. Saha, the study’s authors, examined the data of more than 1000 hysterectomies performed for pelvic pain or abnormal uterine bleeding (in other words, hysterectomies for cancer and uterine prolapse were excluded from the data set) in the UK in a three-year period. In 26 of those cases, adenomyosis was identified post-surgery via tissue analysis.
The medical histories in these 26 cases were then examined more closely. The majority of the women had sought medical attention for menorraghia (excessive menstrual bleeding) and dysmenorrhea (painful periods). Eleven of the women’s uteruses were enlarged, and 16 underwent pelvic ultrasound exams. But adenomyosis was suspected clinically in only one case; the others were identified as uterine fibroids (five cases) or “dysfunctional uterine bleeding” (20 cases).
Examination of patients’ case histories found that the medical consultations focused on menstrual flow. The researchers found that other symptoms of adenomyosis, such as pelvic pain, pain during intercourse, painful periods, and feelings of pelvic pressure, were not adequately addressed – even when examination or ultrasound findings indicated an enlarged uterus.
Basak and Saha ask,
Does failure of preoperative suspicion of adenomyosis matter? In the absence of an accurate diagnosis, appropriate treatment is unlikely to be offered, or may be delayed. This results in failure of treatment and continued suffering.
To identify adenomyosis earlier, they recommend more careful discussion with patients of pelvic symptoms, MRI, and follow-up care with women who elect for conservative management of their symptoms. Once again, open communication about all aspects of menstruation isn’t about challenging taboos just for the sake of challenge; it’s critical for women’s health and well-being.
As is the case with many newly approved drugs, tranexamic acid is not a new drug but an approval for a new usage: tranexamic acid has been used in injection form more than 20 years to reduce bleeding during tooth extraction in people with hemophilia (a blood disorder in which blood lacks a clotting factor).
Although it’s unlikely that anyone using hormonal contraceptives would also have heavy menstrual bleeding (remember, hormonal contraceptives suppress menstruation), the new drug comes with a big warning: taking Lysteda along with hormonal contraceptives increases one’s risk of blood clots, stroke, or heart attack.
I’m not a biochemist or a physician, but it sounds like Lysteda is a viable alternative for women who are currently taking (or recommended to take) hormonal contraceptives for the management of menstrual bleeding.
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.
