Blog of the Society for Menstrual Cycle Research

Women’s Reproductive Health journal explores postmenopausal hormone therapy

June 17th, 2015 by Laura Wershler

Free access to Women’s Reproductive Health, the journal launched by the Society for Menstrual Cycle Research in 2014, is available to all SMCR members. To become a member of the society or to obtain a subscription contact info@menstruationresearch.org.  For media, submission, and other inquires about the journal contact editor Joan C. Chrisler at jcchr@conncoll.edu.

 

Guest Post by Joan C. Chrisler

The spring 2015 issue of Women’s Reproductive Health contains our first special section: on postmenopausal hormone therapy. The section contains a thought-provoking anchor article by menopause expert, psychologist Paula Derry. It is followed by short commentaries by a multidisciplinary group of menopause experts–a physician, a sociologist, an anthropologist, and a nurse. This set of papers would make an excellent reading assignment for a women’s health course, and it is sure to generate class discussion. The issue also contains two other research reports: one on women’s experiences with gynecological examinations, and the other on the relative absence of mentions of menstruation in novels aimed at adolescent girls because publishers are worried about challenges by parents and school boards that could hurt sales. The issue is rounded out with three book reviews.

 

Women’s Reproductive Health

Volume 2, Number 1 (Spring 2015)

Special Section on Postmenopausal Hormone Therapy

Article
Evidence-based Medicine, Postmenopausal Hormone Therapy, and the Women’s Health Initiative – Paula Derry

Commentaries
The Science of Marketing: How Pharmaceutical Companies Manipulated Medical Discourse on Menopause – Adriane Fugh-Berman

Medicalization Survived the Women’s Health Initiative…but Has Discourse Opened up? – Heather Dillaway

Animal Models in Menopause Research – Lynette Leidy Sievert

Lost in Translation? – Nancy Fugate Woods

Articles
A Multi-method Approach to Women’s Experiences of Reproductive Health Screening – Arezou Ghane, Kate Sweeny, & William L. Dunlop

The Censoring of Menstruation in Adolescent Literature: A Growing Problem – Carissa Pokorny-Golden

Book Reviews
Investigating the Ubiquitous: The Everyday Use of Hormonal Contraceptives – Marie C. Hansen

Menstruation’s Cultural History – David Linton

WomanCode: Caveat Emptor – Elizabeth Rowe

Joan C. Chrisler is a professor of psychology at Connecticut College and the founding editor of Women’s Reproductive Health. Her special areas of interest include PMS, attitudes toward menstruation and menopause, sociocultural aspects of menstruation, and cognitive and behavioral changes across the menstrual cycle.

Exploring menstrual shame, embodiment, and the parameters of premenstrual distress

May 26th, 2015 by Laura Wershler

Concurrent sessions on Saturday, June 6th explore unique cultural experiences of menstruation and delve into the parameters of premenstrual distress at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston.


Strekkja (stretch, flexible) Original artwork by Magdalena Margrét. Used with permission.

Culture and Embodiment: 

Menstruation and objectification in an Icelandic context
Herdís Sveinsdóttir, University of Iceland

The aim of the study is to describe objectification among Icelandic women and how it relates to menstrual attitudes, women´s body consciousness and health behavior. Participants were 320 women aged 20-40 years drawn from the Register of Iceland in fall 2013. Findings regarding disordered eating and objectification will be discussed.

Shame, secrecy, or celebration: Experiences and constructions of menstruation across cultures
Alexandra Hawkey, Centre for Health Research, University of Western Sydney 

Through qualitative interviews this study aims to reveal culturally specific experiences and constructions of menstruation with migrant women from a range of backgrounds, in Australia and Canada. Analysis of the data highlights a range of themes including, cultural silencing; celebration of the girl to women transition; and menstrual rules.

Black Women, Red Tent: Doing Blood Work and Recovery of Black Girlhood, Spirituality and Ritual Exclamations for Black Girl Periods
Sevonna Brown, Williams College

This project invites black women to explore their relationships to their menstruation and their bodies more holistically through a consideration of blood, spirituality, and monthly ritual. This conversation-making and interactive study anticipates collective issues of shame, survival, birth, infertility, sexuality and disease. The research inquiries desire to find Black women in their own Red Tent in celebration of their own bodies, reproductive mysteries, traumas and triumphs.

Premenstrual Distress:

Psychosocial factors associated with Premenstrual Syndrome
Ina Rosvall & Sandra Ekholm, University of Lund

Inspired by critical feminist research the association between PMS and psychosocial factors was studied using 1320 responses to a web survey. 33,9% of the total variance in PMS could be predicted, emphasizing the importance of social norms, family structure and relational factors over hormones in the understanding of premenstrual distress.

Sarafem Redux: PMDD, Antidepressants, and Big Pharma
Shannon M. Peters, Madeline Brodt & Lisa Cosgrove, University of Massachusetts 

Industry-facilitated approval of antidepressants was used to justify inclusion of PMDD in the DSM-5. We provide data on industry funding of clinical trials of antidepressants for the treatment of PMDD, discuss the consequences of these commercial ties, and discuss the role of implicit bias in psychiatric research.

Evaluation of the relative efficacy and mechanisms of a couple-based intervention for Premenstrual Syndrome through a randomised control trial
Janette Perz & Jane Ussher, Centre for Health Research, University of Western Sydney

120 women took part in a randomised controlled trial comparing one-to-one and couple psychological therapy for PMS, in comparison to a wait list control group. Whilst women in all three conditions reported reductions in premenstrual distress and improvements in coping, women in the couple condition reported significantly greater reductions in distress post-intervention.

Measuring the Syndrome: An Introduction to the Measurement of Premenstrual Distress Disorders
Marie Hansen, Long Island University Brooklyn

This presentation will cover the history of the scientific measurement of Premenstrual Disorders and will explore the way in which these disorders are measured by researchers today. Included will be an analysis of two widely used scales: Premenstrual Tension Syndrome Observer Scale/ Self-Rating Scale (PMTS-O/SR) and the Daily Record of Severity of Problems (DRSP).

Media Release and Registration for the SMCR Boston Conference on Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

How do women’s menstrual beliefs impact their contraceptive decision-making?

May 16th, 2015 by Laura Wershler

I’m looking forward to chairing this panel presentation exploring the intersections of contraception and menstrual health beliefs on Friday morning, June 5th, at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston.  The conference theme is Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

Photo courtesy of Jen Lewis

Dueling Medicines: Contraception and Deeply Rooted Beliefs in Menstruation as a Health-giving Process

This panel will address women’s poor use, misuse, and rejection of medical contraception in Africa, the U.S., and other parts of the world. The first panelist will focus on Sub-Saharan women who either reject or stop using contraceptive pharmaceuticals when they become aware of the irregularities in their periods caused by the drugs. Next is an examination of how women in the U.S. who use natural family planning misuse or stop using medical contraception because of their desire for “normal” and “healthy” periods. The last presentation will work to connect Sub-Saharan women’s faith in a pan-African water spirit called Mami Wata to their reluctance to use contraception; the paper will hypothesize that that this popular divinity is ultimately rooted in a sophisticated prehistoric cosmology that analogized menstruation to universal, life-giving patterns of flow in nature and, thus, saw it as the hermeneutic that established and sustained human culture.

Method Mistrust: How women’s mistrust of family planning methods which interfere with their menstrual cycles leads to unmet need, incorrect contraceptive use, and method discontinuation
Ann Moore, Guttmacher Institute, @Guttmacher

Many hormonal contraceptives alter women’s menstrual cycles, making periods last longer, flow heavier or lighter, spot throughout the month, or simply stop. Because women widely mistrust such methods, they often resist, misuse, or stop using them. Based on data from developing and developed countries, this paper shows how wanting “normal” periods adds to their risk of unwanted pregnancy.

I shouldn’t mess around on those days: How women’s’ beliefs about their fertility and their menstrual cycles affect their contraceptive use
Lori Frohwirth, Guttmacher Institute

While modern contraception allows women to think about their cycles only in terms of hygiene and convenience, data show that many women view menstruation as a sign of good physical and reproductive health. This paper explores how the beliefs of American women about menstruation affects their use of the Fertility Awareness Method in combination with hormonal and barrier methods.

The Rainbow Goddess and the Rainbow Snake: Mami Wata Worship as a Source of African Women’s Belief in Menstruation as Medicine
Jacqueline Thomas, PhD, Independent Researcher 

Sub-Saharan women often reject hormonal contraceptives, citing belief in the salutary/reproductive benefits of regular periods. This paper argues that this belief likely reflects faith in the snake-entwined Mami Wata, a popular pan-African wealth/fertility deity. It hypothesizes that Mami Wata (aka the Rainbow Goddess) is a modern-day expression of the Rainbow Snake—a prehistoric menstruation-regulating African/Australian water spirit embodying a sophisticated cosmology that held women’s cycle-based solidarity as responsible for earthly order and human happiness.

Media Release and Registration for the SMCR Boston Conference on Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

This post was revised and updated on Saturday, May 16, 2015 at 12:35 p.m. MST.


State of Wonder–Part 1: Wondering about missing menstrual mentions in literature

January 22nd, 2015 by Laura Wershler

In her novel State of Wonder Ann Patchett explores, among many broad themes, the question: What if there were a drug women could take to extend menstruation and fertility into their seventies? Not evident on the dust jacket, this storyline grabbed the attention of this menstrual cycle advocate.

Set mainly in the jungle of Brazil, the novel revolves around the decades-long research of Dr. Annick Swenson who has kept the location and progression of her research secret from the drug company funding her work with the fictional Lakashi tribe. When a male scientist sent by the drug company to find Dr. Swenson and deliver a message is reported dead, Dr. Marina Singh, a research pharmacologist, becomes the second emissary charged with finding Dr. Swenson and assessing her progress towards the promised drug.

Finding Dr. Swenson is a formidable task, but when she does Marina eventually learns the complex botanical explanation for the Lakashi’s extended fertility, as well as the justifiable reasons why the research location has been so scrupulously protected.

This literary novel, a satisfying read, powerfully renders the mystique of the Amazon jungle, conveying both the wonder and trauma Marina experiences there. For an insightful review of State of Wonder I’d recommend Lydia Millet’s. This series of posts is not a review, but rather commentary on the niggling details related to the extended fertility storyline. Spoiler Alert: Some plot points will be revealed.

After a few weeks in the jungle—the timeline is fuzzy—Marina is invited by two other female researchers to the grove of Martin trees where she observes Lakashi women of all ages scraping tree bark with their teeth, a practices she is told that begins at menarche and is the key to their lifelong fertility.

Marina learns the women chew the bark every five days except when they are menstruating and when they’re pregnant; the bark repulses them from the moment of conception. She is told also that although the women don’t all come to the grove on the same five-day cycle, they’re menstrual periods are “pretty much” synchronous so the researchers “get a few days off every month.” That is, days off from observing them in the grove while taking pin-prick blood samples and collecting cervical mucus swabs to monitor estrogen levels that Dr. Swenson has taught the Lakashi to do themselves with Q-tips. Dr. Swenson’s research team charts and studies every cycle of every menstruating girl and woman.

The researchers tell Marina they also chew the bark and invite her to try it. Here is where, in a story that speaks intimately about the tribal women’s menstrual cycles, I wondered why Patchett did not include even one sentence to acknowledge when Marina had her last period. (At 42 she has thought about her fertility and her prospect of having a child someday.) Because she scrapes the bark one assumes she isn’t menstruating, and she’s been in Brazil long enough–weeks spent in Manaus before getting to the jungle–to have had at least one period. Where is she in her cycle? This matters because of what happens later in the story. So, since menstruation is integral to the novel, why not mention it? And why don’t the other female researchers mention whether their cycles, too, have synchronized with the Lakashi’s?

In most novels, probably too many, the menstrual cycles of female characters are invisible unless they figure prominently in the plot. It made no sense to me that Patchett chose to make Marina’s cycle invisible. Even if readers can deduce this missing information, surely this is the wrong novel in which to require us to do so. Again, I ask, “Why?”

Continued in State of Wonder—Part 2: Wondering about missing menstrual femcare products and birth control references

 

Male Menopause, Andropause and now “Manopause”?

August 22nd, 2014 by Heather Dillaway

August 18, 2014 cover of TIME magazine

By now, everyone has probably seen this week’s TIME cover story. The magazine’s August 18th cover photo showed a topless, seemingly frumpy, middle-aged man worried about his loss of testosterone and (therefore) manhood under the title, “Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry”. The cover story details the booming testosterone (“Low-T”) industry in the U.S., describing the reasons why middle-aged men might go to the growing number of Low-T clinics for treatment. While the article draws some interesting parallels to the hormone therapy industries that have targeted women and highlights some of the important risks and unknowns about Low-T treatments, there are some interesting gaps and missteps in the article that are worth detailing.

First, if we are going to talk about a male menopause, can we please pick one term? This author of this article refers to male menopause, andropause, and then titles his article “manopause.” So, which is it? Having all of these terms floating around is just confusing. As we know from research on women’s menopause, having more than one term or having vague terms for a health condition just leads to confusion. This article adds to the confusion over terminology.

Second, the article is titled “Manopause” but really has little to do with this supposed testosterone “deficiency” condition. The article is mostly about the growing Low-T industry and men’s search to remain youthful. It is more about potential treatments for testosterone deficiency than anything else. Anyone looking for information on what “manopause” is would be misled by the title and would not find any answers in this article. At most, readers learn that men who are worried about aging might have low testosterone. Readers will not gather comprehensive information about manopause, andropause, male menopause, or male aging.

Third, this article only addresses research on testosterone “deficiency” in a cursory manner. Readers looking for actual evidence of decreasing testosterone in midlife or the need for Low-T treatment should make sure to consult scientific studies of such things. Since this is TIME magazine, this is not a source of any real information on these subjects. As another commenter reports, the author’s reference to “foggy science” is also misplaced; while we do not have complete answers, there are real studies to be found on this subject.

Fourth, there are comparisons made to women’s menopause, hormone therapy for women, and how women handle their midlife transitions in this article. While it makes sense to compare endocrinological changes in women’s and men’s bodies and burgeoning hormone replacement industries for midlife women and men, comparisons about how women and men “handle” their midlife transitions are a bit misplaced and subjective here. The author states that “women handle their [bodily] betrayal more matter-of-factly – a nip, a tuck, a tint, maybe, but not a Vegas condo”. The author argues that, “judging by the demographic profile of sports-car buyers,” men don’t deal well with testosterone deficiency and bodily change. As someone who has studied women’s bodies and women’s menopause for almost 20 years, I think this comparison masks the variation in how women or men might experience these transitions and reifies gender dichotomies that help no one in the long run. Women DO have trouble with bodily change at times. And the majority of men still forgo Low-T treatments. The author would have done better if he had steered away from these gendered generalizations about how individuals “handle” midlife.

A commenter at HealthNewsReview.Org asks, Does Manopause Really Warrant one of TIME’s 52 Covers This Year? This is a great question. The power of pharmaceutical industries in this country means that topics like this get more press than is probably warranted (especially in light of all of the topics that could have had this front page, such as Ebola, Ferguson, Parkinson’s or ALS disease, foreign conflicts, etc.). Some scholars argue that we are experiencing the “pharmaceuticalization” of society, which puts industries like the Low-T industry front and center and makes us think in terms of “deficiency”, “disease”, and “replacement”. Pharmaceuticalization reinforces ideas about the importance of youthfulness and unchanging bodies and makes the onset of midlife problematic in general. We are actively urged to fight bodily change (here termed bodily “betrayal”) despite how normal it is.

Lately I’ve also seen a lot of press on men and masculinity. NPR has been running an “All Things Considered” series on boys and men this summer, detailing the hardships and unique experiences that boys and men have. I also read that a group of middle aged men recently got together to create a play called “Four Play” to combat the hype around Menopause: The Musical – to make sure that men have their stage too. In Detroit this summer we’ve also been tangoing with groups of Men’s Rights Activists who feel that feminists are taking over the world. To me, the “Manopause” cover of TIME magazine falls right in line with other recent attention to “men’s issues”. To me, this is all a backlash against attention given to women’s issues. In some cases I don’t even think it’s a conscious or calculated backlash but it still presents as one.

Overall, I’m indifferent about this TIME story. I don’t think it warrants the cover photo or the cover story but it is interesting to find out about a growing testosterone industry. Nonetheless the hype around the story concerns me because I keep thinking about what’s lurking behind the hype. For instance, we have to think about the gendered dynamics behind these stories and media portrayals, for gender forms an important backdrop here and can hinder the pursuit of real knowledge about these midlife transitions. Gender ideologies are what make testosterone (and estrogen) important in the first place. In addition, I do think we need to settle on one term for male menopause/andropause/manopause and why it might be important for us to think about. Finally, we really need to think about what pharmaceuticalization means for all of us.

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

Depo Provera and menstrual management

April 8th, 2014 by Holly Grigg-Spall

Melinda Gates speaking at the London Summit on Family Planning; Photograph courtesy Wikimedia Commons

A few weeks back I did an interview with Leslie Botha regarding the distribution of Depo Provera to women in developing countries. Recently Leslie shared with me an email she received from someone working in a family planning clinic in Karnataka, India. He described how he was providing the Depo Provera injection to women and finding that, after they stopped using it, they were not experiencing menstruation for up to nine months. He asked for advice – “what is the procedure to give them normal monthly menses….is there any medicine?”

I have written previously about one potential problem of providing women with Depo Provera – the possibility of continuous spotting and bleeding that would not only be distressing with no warning that this might happen and no medical support, but could also be difficult to navigate in a place with poor sanitation or with strong menstrual taboos. As women in developed countries are so very rarely counseled on side effects of hormonal methods of contraception, it seems unlikely women in developing countries receive such information. As we know, some women will instead experience their periods stopping entirely during use of the shot and, as we see from this email and from the comments on other posts written for this blog, long after use.

In this context I find it interesting that the Gates Foundation’s programs for contraception access have a very public focus on Depo Provera. The method was mentioned again by Melinda Gates in a recent TED interview and when she was interviewed as ‘Glamor magazine Woman of the Year’ the shot was front-and-center of the discussion of her work. Yet the Foundation also funds programs that provide support for menstrual management and sanitation.  Continuous bleeding from the shot, or cessation of bleeding altogether, would seem to be an important connecting factor between these two campaigns.

Much has been written on the menstrual taboo in India and how this holds women back. In the US we have come to embrace menstrual suppression as great for our health and our progress as women. We see menstruation as holding women back in a variety of ways. However, in India could lack of menstruation also be seen as a positive outcome? Instead of dealing with the menstrual taboo with expensive programs that provide sanitary products and education, might suppressing menstruation entirely be seen as a far more cost-effective solution? It may seem like a stretch, but I am surprised this has not been brought up during debates about the need for contraceptive access in developing countries. Yet of course, the menstrual taboo may well extend to absence of menstruation – a woman who does not experience her period might also be treated suspiciously or poorly.

When Melinda Gates says women “prefer” and “request” Depo Provera I always wonder whether that’s after they’ve been told how it works (perhaps described as a six-month invisible contraception) or after they’ve had their first shot or after they’ve been on it for two years and then, via FDA guidelines, must find an alternative? How much follow up is there? As the self-injectable version is released widely how will women be counseled? Gates argues that the invisibility of the method is part of the draw as women do not have to tell their partners they are using contraception, but what happens when they bleed continuously or stop entirely?

It seems to me like there might be a real lack of communication – both between medical practitioners and their patients, drug providers and the practitioners, and those who fund these programs with everyone involved. It is often argued that the risks of pregnancy and childbirth in developing countries justify almost any means to prevent pregnancy – including the use of birth control methods that cause health issues. How much feedback are groups like the Gates Foundation getting on women’s preferences if they seem to be so unaware of the potential problems, even those that would greatly impact their wider work?

Is the birth control pill a cancer vaccine?

March 11th, 2014 by Holly Grigg-Spall

I’d given up reading the comments on online articles for the good of my mental health when a small slip last week steeled my resolve. In response to an article exploring the arguments made by “birth control truthers” a concerned father decided to have his say, taking the defensive arguments put forward by those in opposition to these “truthers” to their only logical conclusion:

“Perhaps we should market contraceptive pills as hormonal supplements to reduce cancer risk instead of as “contraception”? After all, it is only in modern times that women have hundreds of menstrual cycles throughout their lives. Even up until 1800 it was common for women to be either pregnant or lactating throughout much of their short lives.

The body simply wasn’t built to handle so many menstrual cycles, which raises the risk for cancer.

Who could argue with taking supplements to prevent cancer?

This may sound strange, but I am seriously considering putting my 11 year-old daughter on the pill (with no placebo) just for the health benefits. I just have to convince my wife first who is a little shocked by the idea…”

I cannot count how many times I have heard that the birth control pill “prevents cancer” – specifically “preventing” ovarian and endometrial cancer.  In the last few months I have seen references to this benefit explained less and less so as a “lowered risk” and more and more so as a “preventative” action.  I think this is significant as the word “prevent” suggests that the pill guarantees you will not get these forms of cancer. And yet, to remark that the pill is counted as a carcinogenic substance by WHO – due on the increased the risk of breast and cervical cancers – will get you tagged as a “truther.”

What is interesting, of course, is that despite the “cancer protecting” benefits of pregnancy, and early pregnancy at that, we do not see women encouraged to get pregnant in order to lower their risk of ovarian cancer.  Criticism of child-free women does not generally include comments about their lax attitude towards their own health. The risk goes down further with every pregnancy and further still with breast feeding, especially breast feeding for a long period of time after birth. Women who have children young, and multiple children, have a lower risk of breast cancer than women who have no children or children after 30. Yet we see more talk of women having “too many” children at an age that is “too young” – in fact I was contacted via Twitter by someone who read this piece and who saw, in the comments, that one woman who uses natural family planning admitted to both liking the method and having 14 children. This admission disgusted the person who contacted me, even when I pointed out that it seemed the woman had very much chosen to have those 14 children.

It seems the people who are advocating prescription of the pill for cancer prevention purposes are not advocating women have children earlier, more children, or consider breast feeding for the good of their own health – in fact two of the loudest critics of my “birth control truther” book are vehemently against pregnancy and breast feeding being part of women’s lives (Amanda Marcotte and Lindsay Beyerstein). The risks of the pill are frequently compared to the health risks associated with pregnancy and child birth,  but we don’t often hear women say they are choosing to not have children to avoid putting their health at risk for nine or so months.

Which leads me to this article in the LA Times that suggested nuns should also be on the birth control pill for its cancer-protecting abilities:

“And are the pills really unnatural? Our hunter-gatherer ancestors had their babies four or five years apart, because of long intervals of breastfeeding. As a result of that and their shorter life spans, they had as few as 40 menstrual cycles in a lifetime, while a modern woman can have 400. Though we can’t claim that today’s pills are perfect, their use is certainly less unnatural than enduring the hormone turmoil of hundreds of menstrual cycles.

This brings us back to the Colorado nuns, the Little Sisters of the Poor. Nuns have a substantially higher risk of reproductive cancers than women who have children, in part because of their celibacy, which means a lifetime of uninterrupted menstrual cycles. In 2011, my wife and I attended an obstetric conference in the Pontifical University of the Holy Cross in Rome. The keynote lecture there recommended that nuns use oral contraceptives for two or three years after taking their vows, in order to benefit from a long-term reduction in reproductive cancers to which nuns are otherwise exposed by their celibate life.”

In Honor of (a Sampling of) our Brave Menstrual Champions!

November 26th, 2013 by Chris Bobel

The recent death of writer Doris Lessing led me to revisit her work a bit. *

Author of more than 50 books as well as an opera, Lessing was brave. She spanned genres, refused to tow a singular ideological line and used her Nobel Prize moment to remind us that privilege shapes greatness as much, even more perhaps, than talent.  And Lessing wrote about menstruation when few others dared.

In her 1962 novel The Golden Notebook, protagonist Anna Wulf journals on the first day of her period—chronicling every thought and feeling her menses produced for her. In the passage below, Wulf’s disgust with her body is hardly a menstrual-positive standpoint (and isn’t something off with her cycle if she detects such an offensive smell?). But there is an honesty, here. A broken silence. Lessing brought to the fore the reality of the fraught and conflicted menstruating body in the early 1960s, and that was a bold move.

I stuff my vagina with the tampon of cotton wool … I roll tampons into my handbag, concealing them under a handkerchief … The fact that I am having my period is no more than an entrance into an emotional state, recurring regularly, that is of no particular importance … A man said he would be revolted by the description of a woman defecating. I resented this … but he right … For instance, when Molly said to me … I‘ve got the curse; I have instantly to suppress distaste, even though we are both women; and I begin to be conscious of the possibility of bad smells … and I begin to worry: Am I smelling? It is the only smell that I know of that I dislike. … But the faintly dubious, essentially stale smell of menstrual blood, I hate. And resent. It is a smell that I feel as strange even to me, an imposition from outside. Not from me. Yet for two days I have to deal with this thing from outside—a bad smell, emanating from me. … So I shut the thoughts of my period out of my mind; making, however, a mental note that as soon as I get to the office I must go to the washroom to make sure there is no smell (pp. 339-340).

Lessing is not alone among the brave who dare to Speak a Menstrual Language. In honor of Thanksgiving in the US, I offer this shout out to a short list of  the courageous who inspire. Thank you menstrual champions.

Rachel Horn, of Sustainable Cycles, who cycled coast to coast this summer, promoting menstrual literacy and menstrual cup awareness.

Holly Grigg-Spall, who has put herself on the line with her new book Sweetening the Pill: Or How We Got Hooked on Hormonal Birth Control. Grigg-Spall has been challenged, sometimes pretty nastily, for suggesting that one can use a feminist reproductive justice lens to be critical of the pill.

And how about radical feminist pioneer of queer cinema, Barbara Hammer. Her 1974 expeimental film Menses playfully interprets, though a group of women enacting their own individual fantasies, what menstruation means to them. 1974!

Menarchists Jaqueline J. Gonzalez and Stephanie Robinson, who founded the Menstrual Activist Research Collective (M.A.R.C) in 2011, and just released their line of menstrual gear (http://www.etsy.com/shop/menarchists) at cost so you can help them spread the good word, or as they put, leave your MARC! We bleed. It is okay. We bleed. 

Then there’s Arunachalam Muruganantham, the self described “school dropout” (and now the subject of a new documentary) who developed a table top machine that rural Indian women can use to produce and sell low cost single use menstrual pads. He wants to make life easier for Indian women (and he is not interested in getting rich). Yes, there are sustainability issues, here, but there’s also a widening of options for women.

Used with Permission

Every teenager who, on the way to the school toilet, ever dared to walk down the hall with femcare-product-of-choice in open view. 

Every menstruator who hangs cloth pads on the clothesline with the rest of the laundry.

YOU, for reading this blog and demonstrating that menstrual issues are important, and deeply connected to how we ALL experience our embodiment, whether we shed or not. Can you imagine living in a world in which menstrual talk was NOT taboo? Pause for a moment and ponder that. Wow. Where’s the shame?  I see people talking freely about their experiences. Questions answered. Needs met. Isolation broken. As Liz Lemon of 30 Rock fame was known to say “I want to go to there.” I really do.

These menstrual champions are just a fraction of those who are actively creating that world so we can.

 

 

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.

“Prescribing the pill has become ‘standard-of-care’ for being a girl”

October 16th, 2013 by Laura Wershler

I had the privilege of writing the foreword for Holly Grigg-Spall’s recently published book Sweetening the Pill: Or How We Got Hooked on Hormonal Birth Control. It’s astounding to me that more than 30 years ago, before Holly was born, I was asking some of the same questions she explores in her book. I thought we’d have more answers by now, but one thing is certain: Holly’s book has prompted long-overdue discussion and debate about issues related to hormonal birth control. Below is my foreword to Sweetening the Pill.

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In a letter dated March 22, 1980, I proposed to the editor of an American woman’s magazine that they consider my enclosed article: The Contraceptive Dilemma – A Subjective Appraisal of the Status of Birth Control.

I wrote:

“Recent articles (about birth control) deal almost exclusively with the basic pros, cons, and how-tos of the various contraceptives available – matter-of-fact discussions that reduce birth control to a mere pragmatic decision. If only that were the case. 

Contraception, like the sexual interaction that necessitates it, involves our emotions as much as it does the facts. Yet the subjective, personal aspect of contraception is so often ignored. In this age of scientific research we are expected to (subjugate) our emotional reactions to significant probabilities, our anger to logic. Very real fears and earnest questions are dismissed as irrelevant….”

Although today I wouldn’t use the phrase “emotional reactions,” it’s hard to believe that three decades later, the status of birth control and women’s relationship to it has not much changed. Websites, not magazines, now host information about the basic pros, cons and how-tos of available birth control methods. And it is writers like Holly, half my age, who honour women’s real fears and ask earnest questions that are still being dismissed as mostly irrelevant.

Just as my personal story with the pill – including over a year of distressing post-pill amenorrhea – set me on a course of research and advocacy, so too has Holly’s personal experience. Sweetening the Pill explores and challenges the ways in which the pill and other drug-based contraceptives damage women’s health, threaten our autonomy and thwart body literacy. What we don’t know about our bodies helps pharmaceutical companies “sell” their contraceptive drugs, and keeps us “addicted” to them.

At some point between my first attempt at non-hormonal contraceptive advocacy and Holly’s exploration of how we’ve become hooked on hormonal birth control, something disturbing transpired. Prescribing the pill, or other forms of hormonal contraception, has become, in the minds of most health-care providers, the “standard of care” for being a girl. It is all too common to subjugate a girl’s menstrual cycle to synthetic hormones that superficially “regulate,” but actually suspend the maturation of her reproductive system. And for many girls, the use of hormonal contraception continues well into their 20s, without awareness of what might be or has been sacrificed.

There are many women like Holly who are fed up with hormonal birth control. I’ve met scores of them during my 30 years involvement within the mainstream pro-choice sexual and reproductive health community, the one that prides itself on inclusion and diversity. Yet I’ve been unsuccessful in my constant advocacy for this community to accommodate a more inclusive, diverse approach to contraception, to provide acknowledgement, support and services to women who cannot or do not want to use drug- or devised-based methods. We pay lip service to the idea, but the message we convey is: “You’re on your own.”

I’ve found enthusiasm in other realms for my menstrual cycle advocacy and my belief that many women want to, and can, learn to use non-hormonal methods effectively and confidently. I’ve found scientific evidence of the value of ovulation to women’s health and well-being.

I’ve read, met or worked with several of the sources included in this book. Many have devoted their careers to understanding women’s bodies and our relationships with our bodies in ways the medical mainstream typically ignores and barely comprehends. They have made contributions that help us imagine a different way of thinking about fertility, contraception and our menstrual cycles in relation to our sexual, reproductive and overall health.

I like to think that all of our work provides the framework, reason and evidence to support the decision Holly made personally and that hundreds of thousands of women have made or are considering making – saying no to hormonal birth control.

Sweetening the Pill is an important book because it speaks to young women who intuitively, subconsciously, or actively are leaning in this direction. It offers a contemporary perspective on the pill and its influence on our bodies and our lives, as well as evidence that affirms and confirms we make sacrifices – large and small – to live under its influence. It remains for readers to decide what to do about it.

Essentialism and experience

August 26th, 2013 by Holly Grigg-Spall

My forthcoming book ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control’ began to take shape on the pages of this blog and much of the process of its development was spurred on by the work of members of SMCR. As such, it seems only fitting, with the release date of September 7th soon here, to share for my post this month an excerpt and to say thank you for the support of this community. I hope to have added something of interest and value to this on-going conversation.

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Women often discuss menstruation and birth as happening to them, rather than as part of them and their experience. Emily Martin remarks in ‘The Woman in the Body’ that women often see their self as separate to their body. Women’s central image is that “your body is something your self has to adjust to or cope with” and therefore, Martin concludes,“your body needs to be controlled by your self.”

Martin explores the idea that women did not fit into the structure of the jobs that were open to them in industrialized society. These jobs most often required monotony, routine and repetition. Although in reality no more suited to men than they were women, it was women that were judged as innately unable to succeed in such positions due on the constantly changing and supposedly unpredictable nature of their physical state.

As Martin states, “Women were perceived as malfunctioning and their hormones out of balance,” especially when experiencing PMS and menstruation, “rather than the organization of society and work perceived as in need of transformation to demand less constant discipline and productivity.”

The rigidity of society was forcefully imposed on women as it was on men. For all, both men and women, it is inhumane but it was women that were required to adapt in a more dramatic and overt way. Men are viewed as naturally given to the industrious and disciplined way of life demanded of them and the structure of society is built on these assumed capabilities.

If we admit that women do change through the month, that we do menstruate, experience PMS, have differing moods week to week, we fear that this admission will be used as justification for negative judgment.

Martin counters the feminist refrain of “biology is not destiny”; “I think the way out of this bind is to focus on women’s experiential statements – that they function differently during certain days. We could then perhaps hear these statements not as warnings of the flaws inside women that need to be fixed, but as insights into flaws in society that need to be addressed.”

The idea that men are otherwise unchanging is falsified. Men also experience hormonal changes with studies suggesting they experience a cycle daily that is equivalent to the monthly cycle of women as well as changes in hormone levels across their lifetimes.

Women’s “experiential statements” as Martin describes them are often silenced in the discourse surrounding hormonal contraceptives. It is a betrayal of the feminist cause to speak out with openness about the side effects of the pill.

When Yaz and Yasmin were released the marketing strategy co-opted the idea of word of mouth. In a commercial women were seen passing along the “secret” of these new drugs with their host of beneficial yet superficial side effects. Receiving messages of increased physical attractiveness as the result of a drug that many women were using anyway, only a different brand, increased the transference of this experience from one woman to the next.

In the face of such powerful manipulation, what place does a skillfully worded informational insert have in women’s decision making process? The time of the Nelson Pill Hearings was a very different to today.

Naomi Wolf mentions the pill briefly in ‘The Beauty Myth.’ She remarks that it was originally marketed as a drug to keep women “young, beautiful and sexy,” concepts parallel to those promoted by Bayer through its contemporary advertising. Wolf quotes, in the context of the beauty industry, John Galbraith, “Behavior that is essential for economic reasons is transformed into social virtue.”

Women who do not want to take the pill are treated as difficult and irresponsible. If they do not accept the pill they are ungrateful of the work of women in history and of the privilege afforded them.

Today the initial decision to take the pill is often made for teenage girls. Many of them do not reassess the decision independently until they are well into their twenties by which time their relationship to the drug and to their bodies is so complex as to potentially prevent them successfully coming off the pill. The choice to take the pill is fiercely protected and yet that choice is rarely autonomous and informed.

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.