Blog of the Society for Menstrual Cycle Research

Flibanserin is NOT “female Viagra” and here’s why

July 30th, 2015 by Laura Wershler

If you’ve been hearing about the “female Viagra” drug Flibanserin in the media over the past couple of months and wonder what it’s all about, Dr. Aaron Carroll at Healthcare Triage sets the record straight and tells you everything you need to know about Flibanserin in this seven-minute video.

To quote Dr. Carroll, “The two drugs aren’t even close to the same thing.” He asks the media and others to stop calling Flibanserin the “female Viagra.” He says, “It makes pharmacology nerds very, very unhappy when you do that.”

#noboozewithflib

For one, Viagra is taken on an as needed basis and does not work if the man is not already sexually aroused. Flibanserin is intended for daily use by premenopausal women and affects the brain, supposedly, to increase feelings of sexual desire. Side effects include, says Dr Carroll, “marked sedation, somnolence and fatigue,” and are made worse in those who consume alcohol.

The video provides need-to-know information because the U.S. Food and Drug Administration is leaning towards approving Flibanserin this summer. Though twice rejected by the FDA, an aggressive public relations campaign spearheaded by drug owner Sprout Pharmaceuticals has resulted in a recommendation to the FDA to approve the drug with risk management options. A letter to the FDA signed by Leonore Tiefer, PhD, of the New View Campaign and over 100 other concerned health experts, sex researchers and clinicians urging them to reject approval of flibanserin explains the many problems with the drug. Here’s what the letter says about Flibanserin and alcohol:

We will leave the topic of flibanserin’s safety to others, except for mentioning the truly absurd situation of approving a daily drug to boost the sex lives of women in their 30s and 40s that must not be taken with alcohol. As sexologists we can say with confidence that this advice is both preposterous and doomed.

The New View Campaign also wrote a song advocating that women and the FDA Throw That Pink Pill Away:

 

 

 

 

 

 

 

 

 

 

 

 

 

The Society for Menstrual Cycle Research added its voice to those opposing FDA approval of Flibanserin by passing the following resolution in June at its 2015 Biennial conference in Boston, MA:

The Society for Menstrual Cycle Research regrets the recommendation by the Bone, Reproductive, and Urologic Advisory Committee and the Drug Safety and Risk Management Advisory Committee on June 4, 2015 that Flibanserin be approved with risk management options. The discussion after the vote was recorded made it clear that even those in favor had serious reservations about the efficacy and safety of the drug. We believe that women want safe and effective options, not unsafe and ineffective medications. Therefore, we urge the U.S. Food and Drug Administration to override the Advisory Committees’ decision and reject this drug.

NOTE: This post was updated on July 30, 2015 at 12:55 p.m. EST with the addition of the song.

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.

Menstrual suppression, regulation and metaphors

May 8th, 2015 by Laura Wershler

Four takes on Fertility Control 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

Image by Diana Álvarez

Not A “Real” Period: Redefining Menstruation and Reconfiguring Birth Control
Katie Ann Hasson, University of Southern California

Menstruation, as a “natural” bodily process, seems self-evident, despite a great deal of feminist work that has highlighted menstruation as culturally constructed. Yet even in this work, how menstruation is defined or what “counts” as menstruation is rarely questioned. Examining menstruation alongside technologies that alter it highlights these definitional questions.

I examine the case of menstrual suppression birth control as a technology that regulates menstruation, drawing on an analysis of medical journal articles and FDA advisory committee transcripts paired with websites used to market menstrual suppression to consumers. Across these contexts new definitions of menstruation converged on a distinction between bleeding that occurs when women are taking hormonal birth control and when they are not. This distinction was previously known but became newly salient as it helped to normalize menstrual suppression contraception. Redefining menstruation was an important step in reconfiguring birth control pills into menstrual suppression pills, and thus in reconfiguring co-constructed uses and users of birth control pills. This paper seeks to broaden a sociological understanding of gendered embodiment by attending to the co-construction of users, bodies, and technologies through processes of reconfiguration.

“Bringing Down My Period” – Metaphors Around Ending an Unwanted Pregnancy
Susan Yanow, MSW

Around the world, including in the United States, women are self-inducing miscarriage/abortion using medicines obtained via the Internet, friends, etc. While some women consider this practice “DIY abortion’” others frame it as “bringing down the period” or “menstrual regulation.”

This presentation will share information on prevalence of this practice in the U.S., legal issues, and the disproportionate impact of these restrictions on low income and rural women will be highlighted. Participants will be invited to consider what the role of clinicians and activists could/should be in supporting women who choose to self-induce to end an unwanted pregnancy.

“I would not recommend it to anyone.” – What can we learn from women who share their bad experiences with Depo-Provera?
Laura Wershler, Women’s Health Critic

In three years my blog post Coming off Depo-Provera can be a women’s worst nightmare, (re:Cycling, April 2012)  gathered 900+ comments, many suggesting that the title was an accurate statement of experience for many women. A later post, Stopping Depo-Provera: Why and What to do About Adverse Effects, a Q&A with endocrinologist Dr. Jerilynn C. Prior, received almost 400 comments.

Analysis of these comments (excerpts to be presented) revealed four recurring themes: 1) Uninformed choice 2) Lack of body literacy 3) Feelings of anger, fear, regret, betrayal and solidarity 4) Frustration with health-care providers. I’ll present arguments as to why this contraceptive method, as currently provided, does not serve reproductive choice or justice and offer suggestions for criteria required to ensure Depo-Provera is a contraceptive method that respects informed choice, body literacy, and women’s well-being.

 “I Won’t Have What She’s Having!” – Menstruation Suppression, Illusion of Choice, and the Lure of Posthumanisms
Diana Álvarez, Student, Texas Woman’s University

This paper explores why women choose to take menstruation cessation birth control pills and how this “choice” influences the way women view themselves. I am interested in understanding how the current cultural rhetoric on menstruation serves as a type of coercion for women to take these drugs. The analysis represents women’s eliminated cycles as a type of (dis)placing of the female body. Women are being convinced that the natural physiological occurrences of their bodies are at best inconvenient but at worst completely unnecessary and in need of elimination. Menstrual suppression will be discussed as a step towards posthumanism which as defined by Richard Twine is the “belief that the human race should be ‘enhanced’ using technological means.” I’ll address how the practice of not menstruating embraces a cyborg feminine identity.

Media Release and Registration for the SMCR Boston Conference.

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

 

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.”

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.

Giving birth in ditches

July 30th, 2013 by Holly Grigg-Spall

The second week of July began with a post at The Daily Beast titled ‘Are Tampons Anti-Feminist’ and ended with my own post for Dame ‘5 Facts About Menstrual Suppression.’ In between there was ‘Not Everything is a Feminist Issue for Chissakes,’ and ‘I Do Not Think Tampons Are Anti-Feminist, for Chrissakes.’ Meanwhile, towards the end of that week, women were having their tampons and pads confiscated by security guards at the Texas Senate as they entered to protest the proposed ban on abortions after 20 weeks. It was a perfect storm for a debate around menstrual shame.

With notable foresight the first article mentioned ends with, “For women who can’t break the silence, there are other ways to protest. Just ask DiFranco. “I didn’t really have much to say/the whole time I was there,” she sings in “Blood in the Boardroom,” “so I just left a big brown bloodstain/on their white chair.”” Later, women at the Texas Senate shared responses that were similar to this statement (“No tampons allowed? Guess we’ll just have to bleed all over the seats” and “Maybe it’s time for a bleed-in”), although there were an equal number remarking on their feelings of humiliation and horror at having their tampons and pads exposed in public.

Somehow, along the way, these threads of discussion were merged – if we’re considering tampons as anti-feminist, or menstrual shame culture as anti-feminist more accurately, then surely what we’re saying is that women should just bleed all over their furniture and clothing, right? Right?

Texas native and high-profile feminist writer Amanda Marcotte weighed in on the debate: “I used to joke that anti-choicers would start considering bans on menstruation,” she wrote.

I would argue that between menstrual shame culture and the pharmaceutical industry we have a “ban on menstruation” of a kind already.

When asked why it was necessary to keep tampons and pads “private” anyway and why it was that confiscating them in public was being discussed as a power move on the part of the Senate employees, she responded with:

“I’m not afraid to be a urinating human being, but I also don’t just go pee on the street corner. One can want to go about without blood on their clothes and not be ashamed of being female. I promise.”

And then, after some attempts at reasoning, “Convinced. I am going to pee freely now, and anyone who says no is just down on me for having a urethra.”

Never mind that they weren’t confiscating toilet paper, available and publicly displayed in the Senate bathrooms.

Elsewhere she suggested that those who were questioning our acceptance of the menstrual hygiene industry’s messages were just “weirdos.”

Marcotte: “I just want once to make a tampon joke without the weirdos who think women should bleed freely for “feminism” coming at me.”

Response: “Do these people have jobs? Or couches?”

Marcotte: “I have no idea. I just assume it’s part of that crunchy fake feminism that thinks women should give birth in ditches, too.”

I don’t think many women are going to argue that we bleed on our couches and clothes because, considering the statistics on division of housework, it’s definitely women who are going to have to clean that up. And if doing laundry isn’t anti-feminist, well, I don’t know what is.

Elsewhere the writer of ‘Not Everything is a Feminist Issue…’ Erin Gloria Ryan, another high-profile feminist writer, when directed to re:Cycling as a source of knowledge on the issue responded with “Ill read it (the blog) aloud at my next fun social gathering filled with normal people.”

Whether it’s from lack of awareness of the history of oppression of women via their bodies or whether it’s just another symptom of the corporate/capitalist feminism that dominates the mainstream, these are the women considered to be representative of the whole.

I relay the details of this interesting week not to depress, but to galvanize.

I, for one, am proud to be a weirdo, an abnormal person, a crunchy feminist, a fake feminist, oh and a miserable enemy of uteri everywhere, a bitch, and a…err…fish.

Yaz and Yasmin: An Unacceptable Level of Risk?

June 25th, 2013 by Elizabeth Kissling

Photo by Flickr user Beautiful Lily // Creative Commons 2.0

Don’t feel bad if you missed last week’s headline news about the deaths of 23 young women from their birth control. It was a top story for CBC news and a few other Canadian sources, but it was barely a blip on the radar of most U.S. news outlets. Yaz and Yasmin, two similar new-generation birth control pills from Bayer, are suspected in the recent deaths of these young Canadian women.

These are among the best selling oral contraceptives in the world, but this is not the first time Yaz and Yasmin have been suspected of causing death or adverse effects. Earlier this year, Bayer agreed to pay up to $24 million to settle claims from plaintiffs with gall bladder injuries caused by the drugs, and the company set aside $1 billion to settle claims from approximately 4,800 women who have suffered blood clots due to Yaz or Yasmin. As of February, 2013, approximately 10,000 lawsuits against Bayer are still pending in the U.S., and an additional 1,200 unfiled claims are pending. The company anticipates additional lawsuits—and additional settlements—regarding blood clot injuries, such as pulmonary embolisms or deep-vein thrombosis.

The history of the birth control pill and its social impact is well documented. First approved by the U.S. Food and Drug Administration in 1960, it quickly became the world’s first “lifestyle drug,” and it has become the one of the most studied drugs in history. It is considered to be so safe that the American Congress of Obstetricians and Gynecologists (ACOG) recently recommended that oral contraceptives be sold without a prescription.

But all hormonal contraceptives–the pill, the patch, the shot and the vaginal ring–carry a risk of blood clots. For most users, this is a minor concern, affecting approximately six of every 10,000 pill users. For users of new-generation pills—that is, pills containing drospirenone, the fourth-generation synthetic progesterone found in Yaz, Yasmin, Ocella and several other brands—the risk jumps to ten of every 10,000 users, although Bayer maintains that their own clinical studies find the risk comparable to older pills. Note, however, that the risk in most of these studies is compared either to other hormonal contraceptives or to pregnancy, not to using effective non-hormonal contraception. As if women’s only choices were to be pregnant or be on the pill.

And it is this matter of women’s choices that brings me to my main point: Why we have we seen so little media attention to the safety profile of Yaz/Yasmin (and hormonal contraceptives more generally)? This isn’t about just a few unlucky Canadian women: Four women in Finland have died, more than 50 U.S. users of Yaz and Yasmin died in just a few years and France reports 20 deaths per year due to birth control pills between 2001 and 2011, with 14 attributed to the new-generation contraceptives. This is a major consumer safety concern, and a women’s health issue.

In an earlier time, this might have led to Congressional investigations, such as the Nelson Pill Hearings, which resulted in FDA-mandated Patient Package Inserts (PPIs)—the printed information about risks, ingredients and side effects included in pill packets, first required for oral contraceptives and then for all prescription drugs. It is hard to imagine today’s Congress calling for such an investigation. Among many other social changes since 1970, drug manufacturers in the U.S. hold more influence over both legislators and consumers, now spending nearly twice as much on promotion as they do on research and development.

A parallel can be found in the health crisis triggered by an outbreak of Toxic Shock Syndrome (TSS) linked to tampon use in 1980. TSS is a potentially fatal infection caused by bacterial toxin Staphylococcus Aureus. A new brand of superabsorbent tampon was linked with 813 cases of TSS, including 38 deaths, that year. By 1983, the number of menstrual-related cases reported to the CDC climbed past 2,200, and manufacturer Proctor & Gamble had “voluntarily” pulled the product from the market before the FDA forced them to do so. The intense media coverage, public concern and outcry from feminist activists pushed the FDA to reclassify tampons as a Class II medical device, an upgrade which meant tampons would require more specific regulation and possibly after-market surveillance. They were much slower to mandate absorbency standards, but eventually did so under court order. These actions resulted in a documented decrease in menstrual-related TSS, although it is important to note that it has not disappeared.

Today, more than 30 years later, young women are again dying from something purported to help them, something that affects mostly women. Thousands more are experiencing life-threatening, health-destroying side-effects, such as blindness, depression and pulmonary embolism. Canada’s professional association of OB-GYNs defended the drug, suggesting that perhaps the recent deaths could be attributed to non-contraceptive reasons for which it was prescribed, such as PCOS or diabetes, both of which are associated with higher risks of blood clots. But there is little evidence of public concern, outside of Yaz/Yasmin user message boards. Even feminist outlets aren’t always covering these issues as vigorously as we might hope.

Yet the birth control pill in general has never been more politicized in the U.S.: In the last year or so, we’ve seen headlines and public debates about insurance coverage of the pill, access to emergency contraception and so-called personhood bills which have been introduced in legislatures in at least eight states. Feminist activists and health care advocates have been working tirelessly to protect access to the pill along with other forms of birth control, as well as the right to end an unintended pregnancy—and feminist journalists have been writing about these activities.

In the urgency of responding defensively to these political attacks—and we must respond—feminists cannot ignore corporate threats. Just as preserving contraceptive and abortion access is critical to women’s health and well-being, so is protecting contraceptive safety.

Cross-posted from Ms. magazine blog.

Yaz and Yasmin Back in the Spotlight

May 9th, 2013 by Elizabeth Kissling

Guest Post by Holly Grigg-Spall, Sweetening the Pill

Last year the FDA made the decision to keep the birth control pills Yaz, Yasmin, and Beyaz on the market despite controversy over corporate corruption of the review process.These drugs are back in the spotlight.

The French health minister has called for doctors to stop writing prescriptions, 2,000 lawsuits against Bayer launched in Canada last month, and Marie Claire Australia dedicated five pages to an in-depth feature about the side effects, instigating an investigation by the country’s top current affairs show Today Tonight.

Bayer has gone about settling the 13,000 lawsuits in the US out of court, likely with the hope of keeping the details of confidential files regarding marketing techniques and research out of the public eye. Unperturbed by mounting reports from women of the myriad health issues caused by their products, the company launched Yaz Flex in Australia at the end of 2012. The first oral contraceptive on the Australian market presented as being for the purpose of preventing periods, Yaz Flex comes in a digital dispenser that records how many pills have been taken and alerts the user when she’s missed a dose. There are enough tablets to allow for just three breaks a year. In the US in April the FDA, equally unperturbed, ruled that pharmaceutical company Activis can start selling generic versions of Yaz, providing a low-cost version of what has been the most expensive oral contraceptive of recent years.

The feature in Marie Claire Australia generated 300+ comments on the magazine and television show’s Facebook pages. Many of the commenters were women who had developed blood clots when taking these brands. Some had made the connection at the time and others made the link only as a result of the coverage after months or years of not knowing why they had endured the injuries. Some of the women were presently experiencing the symptoms of a blood clot mentioned in the show and made the decision to stop taking the pill as they typed.

The piece was written by a long-time member of the Yaz and Yasmin Survivors forum and balances interviews with women who suffered the serious physical side effects with those who have been victim to the serious psychological side effects. I’m among those who experienced a long list of negative physical and psychological effects when taking Yasmin for more than two years and it was this forum that prompted me to stop taking it.

Monash University in Australia is one of the few facilities to have undertaken research into the correlation between birth control pills and depression. Professor Jayashri Kulkarni found that women on the pill were twice as likely to experience depression, anxiety, and mental numbness (known as anhedonia). The Yale Daily News reports that in the wake of her research receiving a little media attention Dr Kulkarni received more than 300 emails from women “clearly describing when they went off the pill that they felt subjectively more happy. The anhedonia, for example, disappeared, the irritability disappeared, the sense of poor self esteem disappeared”.

She is now focusing her attention on researching what she believes to be the particular psychological impact of the Yaz brands, those pills containing the synthetic progesterone drospirenone and low-dose synthetic estrogen.

Although there is no direct-to-consumer advertising in Australia these brands of pill gained popularity there just as they did in Europe and Canada. It is interesting to note that Marie Claire US ran an article in 2011 titled ‘The New Super Pill’ that named Yaz and Yasmin as the latest, greatest “no-acne, no-bloat and pms-be-gone” pills that also allow you to “shorten your period”. The pages of magazines such as Marie Claire in the US are usually scattered with adverts for Yaz and Yasmin, the NuvaRing, Nexplanon impant, and Mirena IUD. The print and television commercials often play on the same insecurities reflected and bolstered by the majority of the women’s magazine articles.

Articles with headlines like that of the Marie Claire Australia piece, “Bitter Pills: The Birth Control With Deadly Side Effects”, are usually accused of scare-mongering women off the pill unnecessarily despite the fact that reactions suggest they might well be saving lives. Generally women who decide they don’t want to take one brand are presented with another — and how many women know Yaz Flex, Yaz, Yasmin and Beyaz are 99% similar in composition and won’t just be shifted among the four? Judging from the comments responding to the piece, women who decide they are done with birth control pills are likely to be offered a Mirena IUD, implant, or Depo shot, all of which hold their own set of deadly and life-shattering side effects.

Little Girls! Just Say Yes to Your Dreams!

March 18th, 2013 by Chris Bobel

Seen this one yet? (or the (eerily) related “Birth Control on the Bottom“?)

We posted “Sassy Girlz Candy Birth Control Pills” (written by Carissa Leone in 2011) in our regular installment Weekend Links on Feb 2. I had a mixed reaction. And when a couple re:Cycling readers described the video as “nasty,” I knew we needed to dig in a bit.

Let’s discuss.

There’s something very absurdly funny about eating birth control, even if the women are still tweens and the birth control is merely mulit- colored jelly beans intended to get young girls in the pill-popping groove before they are saddled with a baby and an half-finished high school education.

First of all, women CAN eat their birth control, donchaknow… Warner Chilcott brought to market their chewable, spearmint flavor oral contraceptive, Femcon Fe, for women who have difficulty swallowing pills and apparently, find stopping for 30 seconds to swallow water.

But I digress (I guess I just want to be clear that we are ALREADY munching our pills).

It is hard not to love how this sketch takes down the pandering to the girl tween market. Oh lordy. There’s so much potential there! (one estimate figures that kids aged 8-12 years are spending $30 billion OF THEIR OWN MONEY and nagging their parents to spend another $150 billion annually!) Little girls quickly move from Disney to diets, from fingerpaint to fake eyelashes, from tutus to belly shirts…..I have seen it with my own girls and it feels, frankly, like an inexorable force.

Viral sketch writer Carissa Leone graciously replied to my questions regarding the piece. When I asked her what inspired her, she channeled her Women’s Studies training (go team!) and supplied her two main reasons:

(1) “I saw a little girl on the subway,holding a baby doll in one of those pretend baby slings…and I thought, “If only she really knew what motherhood was like. I wonder if anyone has explained the authentic experience. I wish she were carrying a briefcase and reading a teeny issue of Ms. magazine instead… “

AND

(2) “The idea that women can/should have it all, in terms of relationships and families and career still seems to be put forth as a tangible (and”correct”) goal in Western culture. It’s a pressure I and many other peers feel, and one that I don’t think is truly possible, or necessarily awesome.”

And Big Pharma takes a hit, too, per the spot’s director, Brian Goetz, who offered this when I asked him about what led to the sketch:

“I wanted to do the video because the script spoke so well to the branding of pharmaceutical commercials, where no matter what the product, as long as you say there’s a problem and that you have the solution, throw some happy people and fun b-roll in it, you’ve got a successful campaign. On top of that, it’s always fun to legitimize terrible ideas in sketch comedy. And if that means having multi-colored jelly bean birth control pills, all the better.”

But I think there’s more to it that that.

Why do I find myself laughing and crying at the same time? Well, I just finished my advance copy of Holly Grigg-Spall’s forthcoming Sweetening the Pill  or How We Became Hooked on Hormonal Birth Control (out this Spring with Zero Books). In it (and here as well, on this blog), Grigg-Spall makes the case the hormonal contraceptives have become so normative that we, as consumers, permit an imperfect (at best) product to flourish even while other options may be more appropriate. The one-pill-fits-all mindset is so pervasive and bores in so deep, so young, Grigg-Spall argues, that when someone says, ‘hey! I don’t want to be on the pill,’ these—what she calls “pill refugees” — are hastily branded as irresponsible, antifeminist, or just plain dumb. That is, the pill gets constructed as our savior, our liberator, our saving grace, even when its not.

And that’s where this spoof enters….since the pill IS all these things, let’s get those girlies on board NOW! Why wait? Good habits start young, after all. And product loyalty is not just for toothpaste and laundry detergent….

And so, “Sassy Girlz Candy Birth Control Pills” is super smart feminist critique. It calls out the enduring wrongheadnessness of romanticizing motherhood and co-opting what I would call a tragically hollowed-out pseudo feminism harnessed to push product:

  • Little girls playing Mommy is cute, and kinda bullshit!
  • Its never too early to teach little girls about options!
  • She’ll know that birth control means winning a college scholarship

Yup. There’s lots of problems with that. Thanks to the feminist satirists to help us see.

But I have to say one more thing.

Leone and I discussed (what I consider) the unfortunate below-the-belt invocation of gender dysphoria to as she put it, “most absurd, heightening beat” in the sketch (here’s another, more recent example of same, on SNL). I don’t think trans or gender queer or otherwise gender variant people should ever serve as punchlines, as I told Leone so in our email exchange. When I inquired about this moment in an otherwise spot-on sketch, she said that is was never intended it as a negative perception of transgendered kids. But still  it is, and I think it points with a big fat finger at how much work we still need to do to move trans issues from margin to center.

Let’s push forward without leaving anyone behind. Let’s laugh at feminist satire that avoids (even unintended) transphobia. Let’s keep our targets clear and our allies clearer. Let’s say YES to that dream, for real.

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.