Blog of the Society for Menstrual Cycle Research

Yaz, Yasmin and Ortho Evra patch increase risk of blood clots

December 14th, 2011 by Laura Wershler

Blood clots are a serious, if rare, side-effect of hormonal contraceptives. If left untreated, clots can lead to debilitating, or fatal, strokes. The increased risk of blood clots in users of some hormonal birth control brands has been the subject of several recent news stories.

In early December, Health Canada asked Bayer Inc. to change the labels on Yaz and Yasmin, two of the most popular birth control pills, because use of the drugs is linked to higher rates of blood clots.

According to a November 2011 story at cbc.ca/news, health problems associated with these two drugs include stroke, deep vein thrombosis, pulmonary embolism and heart attack.

The concern surrounds the progestin – drospirenone –  used in Yaz and Yasmin. Although promoted as being associated with less bloating and clearer skin than other progestins, drospirenone is also associated with a “1.5-to-three fold increased risk of experiencing a clot compared to women using other birth control drugs.

What this means in real terms varies from study to study, but one study led by Susan Jick of Boston University found the rate of non-fatal blood clots to be 30.8 per 100,000 among women taking Yaz or Yasmin (the only drugs containing drospirenone) compared to 12.5 per 100,00 among those taking pills containing the older, more common progestin levonorgestrel.

In related news this past week, advisers to the FDA recommended that Johnson and Johnson revise the label on its Ortho Evra birth control patch to better explain the risk of blood clots. Use of the patch has been associated with a higher rate of blood clots for several years. Publicity about the clot risk has no doubt contributed to a 50% decline in sales in the last five years. The formulary problem with the patch is its higher dose of estrogen compared to other pills.

The FDA advisers also recommended more detailed description of blood clot risks for Yaz and Yasmin.

What caught my eye in both stories were the take home messages from those requiring these label changes to women using these drugs.

Health Canada said women should talk with their doctors about the risks and benefits of taking drospirenone-containing oral contraceptives but did not urge women to stop using Yaz and Yasmin.

The FDA’s reproductive health advisers “voted 19-5 that the benefits of the weekly Ortho Evra patch outweigh its risks, including a potentially higher risk of dangerous blood clots that can cause heart attack, stroke and other life-threatening problems.”

I want to know why the five FDA panelists opposed to this decision think the benefits of the patch DO NOT outweigh the risks.

These news stories beg the question:  Should women be concerned enough about the increased blood clot risk associated with Yaz, Yasmin and the Ortho Evra patch to stop using these brands?  If you take these drugs, are you concerned?

If adverse publicity about blood clots resulted in a sharp decline in sales of the Ortho Evra patch, we should expect to see a similar decline in sales of Yaz and Yasmin.

The cbc.ca article reports that the family of a Toronto woman, who died of a large pulmonary embolism after taking Yasmin, has filed the first individual civil suit against Bayer Inc. in Canada. It also states that “more than 10,400 individual lawsuits related to the two pills have been filed in the U.S.”  Not to mention the class action suits related to these drugs currently in progress in both countries.

One thing is certain, the litany of stories about the adverse effects of hormonal contraceptives is not about to end anytime soon. Stay tuned.

Boxing and Bleeding

December 2nd, 2011 by Elizabeth Kissling

Robin getting her hands taped at Heavy Hitters Boxing Club (Photo by trainer Jay Morales, used with permission).

Guest Post by Robin Percyz

In the boxing ring, droplets of blood are often an indication of triumph.  In fact, if you’ve ever had the opportunity to fight, seeing blood on an opponent’s face will often evoke a primal, animalistic pleasure.   Boxing is, arguably, one of very few scenarios where bleeding is encouraged.

In this sport, the notion of blood is a funny thing, depending on where it’s coming from.  When I sit in my corner after Round 2 of a fight and stare across the ring at my opponent’s bloodied face, my trainer encourages me with zeal.  He’ll boast, “Look at the blood, mama- you’re hurting her!! GOOD!”  Even my own blood, running down my nose and into my mouth is somewhat appealing, reminding me of the “beast” I am trained to be.

At my boxing club, the carpet lining the ring is stained with visible traces of bloody bouts and sparring.  We can point and laugh at whose blood is whose and remember the victory and triumph that resulted from those stains.  However, that blood-induced pride would quickly dissipate had it resulted from menstruation.

In the gym, menstruation is held to a sort of “don’t ask, don’t tell” policy.  You would be right in assuming that female boxers are the minority in this culture.  As such, my monthly menstruation is never the topic of the day, nor will it ever be discussed.  “Menstrually” speaking, we want our women to have healthy cycles, yet we generally regard menstruation as disruptive, unspoken, and above all, disgusting.  In the boxing community, we encounter a clear and evident divide between that of “good” and “bad” blood.  It’s as clear as this:  Blood from the nose – GOOD!  Blood from between a woman’s legs – BAD and, further, DISMISSED!

As a female boxer, I think about my “blood” on a fairly regular basis.  Bleeding is something that should innately occur to my system every 28 days (more or less).  However, like many female athletes, my menstruation has taken a hiatus for some unknown amount of time.  They call it amenorrhea, symptomatic of the female triad.  This is all fancy jargon that basically communicates one simple fact: I don’t get a period – ever.

Boxing is an interesting sport in that it exercises much more than physicality.  As fighters, we are expected to fight within a certain weight class.  For many competing athletes, this often means excessive physical exertion on top of brief bouts of starvation prior to fighting.  Smart?  Of course not!

After some time without a menstrual period, I certainly began to experience some psychological hypersensitivity.  Am I woman?  Where did my period go?  These were the kinds of thoughts running through my head prior to each bout, when the doctor would ask me, “When was the last date of your menstrual period?”  I don’t know.

As women, we associate our first menstruation as a coming of age that says “I AM NOW A WOMAN!”  The loss of a menstrual cycle would, reasonably, mean that you are now LESS of a woman.  Or, perhaps, am I woman at all?

It’s just blood.  I wondered why blood between my legs would have anything to do with feeling like a woman.  After all, it was annoying to have to worry about it for four to seven days out of the month, not to mention training with it.

what to tell the girl in my life about menstruation?

November 24th, 2011 by Alexandra Jacoby

Ever since I saw this uterus pillow, I have been thinking about what to tell the girl in my life about menstruation. She’s ten years old. This pillow is exactly something I would give her! It’s handmade, using strong colors of the kind I like, and about a subject most people don’t want to talk about. [I like to annoy her!] Also, it’s pretty.

I’ve had it since the summer, and I still haven’t given it to her — because I want to say something with it.

uterus pillow - ovulating

uterus pillow by Wendy Caesar.

But – what?

I have no idea what she knows or thinks or feels about her body in general, or about menstruation in particular.

Where do I start?

[translate that to several months of procrastination]

Telling myself that it was research and preparation for a good talk, I started asking people what they think I should say to a ten-year old girl in my life. Most asked me if it wasn’t too early to start this topic? I mean if she isn’t menstruating yet…

why bring it up?

Her school will know when to start the conversation. Or maybe leave it up to her, to whenever she asks you…

She’ll ask her mother then probably. Or maybe her mother has already started this conversation….

Wait! None of that matters —

I am totally ducking. I am afraid to get it wrong.

How will she know that conversations are not tests, or competitions, if I keep acting like there’s a right way to do this— like I need training, expertise or approval to talk to the girl in my life about something that I have experienced myself for several of her lifetimes?

I want her to know that it’s ok to not-know EVERYTHING about your body and what comes next, and that it’s ok to ask questions from a place of not-knowing.

Right. Decision made. I will not become an expert before talking with her.

I’ll make this about her and about me.

Here’s what I’ll do:

I’ll ask her what she’s heard so far:

  • What do you know about menstruation?
  • What did your mother tell you?
  • School?
  • Friends?
  • Female relatives?
  • Your father?

I’ll check in with her:

  • What does it feel like? – What people told you —
  • Is it: scary, embarrassing, no big deal, exciting…

I’ll tell her why I brought this up:

The menstrual cycle is not just about bleeding and whether you can get pregnant today — though, those two situations are reason enough to learn as much as you can about your cycle. You want to be prepared for, and satisfied with, both experiences.

uterus pillow - menstruating

the same uterus pillow, by Wendy Caesar.

The menstrual cycle is one of your body’s vital signs.

Its hormones and processes affect and interact with how you feel, how your bones grow, how your skin looks, your body temperature… From the inside out, of your body-your home, your cycle determines your quality of life in many ways.

Most of us know little about how our bodies work. And, unless we feel pain, have difficulty doing something we want to do, or are incapacitated, we don’t necessarily need to know any more than the little we know.

But — and this is why I bring it up — the more you do know about how it works, the more power you have over the quality of your body-life, which in turn feeds your mental-spiritual-emotional life. And back around again.

Literary Menstruphobia, Part I

September 1st, 2011 by David Linton

The taboos against menstrual sex are ancient and deep-seated.  Despite the well established fact that sexual intercourse during the period is not medically counter-indicated nor somehow debilitating to women and, furthermore, that some women find the experience more pleasurable than the non-menstrual variety, the prejudice lingers on.  What’s more intriguing is the ways and places that menstrual sexual phobias are made manifest.

According to several literary and cinematic biographies, two of the most revered figures in the English language critical and literary cannon may have been so traumatized by menstrual encounters on their honeymoons that they swore off sex for evermore.

In 1994 a British biopic named “Tom & Viv” offered up the sad story – we might call it an anti-romance – of the poet T.S. Eliot and his wife, Vivienne Haigh-Wood (played by Willem Dafoe and Miranda Richardson) who eloped in 1915.  According to the IMDB summary, the film depicts how “her longstanding gynecological and emotional problems disrupt their planned honeymoon.”  In fact, what the scene shows is that Eliot is so appalled by his wife’s menstrual condition – the sheets are awash in the results of her heavy flow – that he nearly goes into shock.  His repulsion is so great that he has to leave her for a walk on the beach where he wades fully clothed in the waves to cleanse himself.

The entire film consists of little more that a series of scenes in which Viv causes one embarrassing emotional fracas after another in desperate attempts to gain the affection of her increasingly alienated, cold and aloof husband.  There is little doubt that hormonal imbalances are the cause of her instability as early in the film a close mother-daughter conversation conveys the fact that she is perpetually on the brink of yet another menstrual misstep.

Eventually, Eliot has his wife committed to a mental institution where she spends the rest of her life, even after she enters menopause and, we are told and shown, she has become calm and serene.

The YouTube clip that is posted from the film does not include the crucial honeymoon bloody sheets scene but, at over eleven minutes in length, it does display quite a few of the scenes demonstrating Viv’s hormonal flare ups.  Though the film might deserve a subtitle like “Beware the Menstrual Monster,” it does give Miranda Richardson an opportunity to chew up every piece of available scenery.

We’re back!

July 27th, 2011 by Elizabeth Kissling

Tap, tap.

Is this thing working? Is this thing on?

After some rest, reconnaissance, and re-organization, re:Cycling is back — bigger, bolder, and with more menstruation and women’s health news than ever. Most of our old team is back, along with a few new recruits and some exciting guest bloggers. There’ll be some new features here as well. More about all of that is coming soon. Our posting will be spotty and irregular throughout August, but expect to see a more consistent, regular flow after September 1. (Yeah, see what I did there? )

We’ve missed a lot of action in four months away. We can’t possibly summarize all of it, but here are some of my personal highlights:

 

July 19 – The Institute of Medicine (U.S.)  just released a report on preventive health services for women, and the consensus is that health plans under the Patient Protection and Affordable Care Act (ACA) of 2010 should cover contraception without demanding co-payments. You can read and/or download the full report here.

 

July 18 – Remember Summer’s Eve marketing disaster last summer? They still don’t get it. This year’s “Hail to the V” campaign may be saluting vaginas, but it’s still telling everyone vaginas are dirty.

As Maya put it over at Feministing.com,

That chatty hand claims to be my vagina but is clearly an impostor, because my vagina would never refer to herself as a “vertical smile,” knows better than to even mention vajazzaling to me, and is too busy complaining about how long it’s been since she’s gotten laid to give a damn about if my cleansing wash is PH-balanced. My vagina is not a whiny little pussy.

If you’re not offended enough, check out the stereotypes in the Black and Latina vaginas. For a satisfying satirical response, check out Stephen Colbert’s July 25 program.

 

July 13 – Bloggers at Ms. magazine have done yeoman work drawing attention to the sexism in the latest PSA from the milk industry, criticizing the sexism toward both women and men in the Milk Board’s stereotype-rich “Everything I Do Is Wrong” campaign about PMS. Ms. has also promoted Change.org’s petition protesting the campaign. Update: By July 24, the campaign had been pulled in response to protests.

2011 Ad for Always brand maxi padJuly 5 – As copyranter astutely notes, the use of a RED spot in the center of a maxi-pad to represent menstrual blood is an historic moment in advertising history. Are we finally done with the mysterious blue fluid? (By the way, copyranter is THE source for smart, snarky analysis of advertising;  he oughta know — his day job is writing the stuff.)

 

June 20 – Corporate and subsidized donations of disposable menstrual pads may be good for girls, but not so good for the environment.

 

June 2 – British artist Tracey Emin  art student at University of Wisconsin, follows in Judy Chicago’s inspirational footsteps and turns her tampons into art.

 

What else have we missed? Add your links in the comments, and don’t be shy about sending us suggestions!

 

 

How much blood is too much?

January 24th, 2011 by Elizabeth Kissling

The US Food and Drug Administration (FDA) approved tranexamic acid tablets as treatment for heavy menstrual bleeding more than a year ago, but you probably haven’t seen much of this television commercial to promote the drug (brand name Lysteda). Matthew Arnold reports in Medical Marketing and Media that television network executives are put off by the ad’s explicit mention of “periods” and “bleeding” combined with the symbolism of fall red rose petals.

(The article appeared in the December, 2010, print issue of MMM, but online October 20, 2010.)

Maka Pads help girls and women in Uganda

November 12th, 2010 by Elizabeth Kissling

The Kasiisi Project Girls Program is now the first producer of locally manufactured sanitary pads in Uganda. Their M.A.K.A. pads (Menstruation Administration Knowledge Affordability) are made of papyrus. A package of ten sells for 650 shillings — one-third of the cost of imported pads. The availability of MakaPads helps women miss work and girls miss school less frequently.

The Power is in the Vag

November 8th, 2010 by Elizabeth Kissling

In the latest episode of Vag Magazine (a production of the Upright Citizens Brigade), Fennel shares her strategy for managing menstruation.


Vag Magazine Episode 3: “Swamp Ophelia” from Vag Magazine on Vimeo.

“We’ve had some complaints from our cleaning feminists.”

Block that Bloody Metaphor

September 14th, 2010 by David Linton

The challenge that advertisers face when promoting the sale of menstrual products is how to visually demonstrate how the product works or the aspects of the cycle that product addresses without showing actual menstrual blood or a woman’s anatomy. One well established solution is the use of blue liquid to demonstrate absorbency or the ubiquitous white clothing every menstruating woman is thought to prefer.

Creative metaphors and symbols abound.

Recently, a TV ad and associated web site have appeared marketing a product to treat what is called (in Capital Letters) “Heavy Menstrual Bleeding (HMB).” The web site states, “Heavy Menstrual Bleeding (HMB) is a medical condition also known as Menorrhagia.” Perhaps it would be more accurate to say, “Menorrhagia is a medical condition also known as heavy medical bleeding,” but maybe that’s just being picky.

The home page of the site claims that “Millions of women don’t have normal periods. Their periods are too heavy. But how much is too much?” The last sentence is printed in large type in a bright menstrual red color. Later, citing the US census, the site claims that there may be as many as 22 million women in the US who “suffer” from HMB, leaving unanswered how they define “normal,” a statistical term, if such a large number of women have the condition.

Since the ads and the site are the creation of a drug company, Ferring Pharmaceuticals, and the advice given is the usual “speak to your doctor” if you have these conditions, obviously there is a financial interest involved. Nothing new there. But it is fascinating to see how women’s bodies and their menstrual flow are visually constructed.

In this case, women are likened to a variety of drinking glasses containing some clear water. There are tall, slender glasses, short, round glasses, wine glasses with stems, glasses that bulge in the middle, glasses that flare out at the top. Each glass (there are nine different ones on the home page) has a different level of water in it, one only a quarter full, another three quarters, another half full, etc. We are to understand that this represents the wide variety in women’s bodies as well as the variations in the amount of menstrual blood each one produces each month.

I suppose that still water at a high level in a clear glass is an effective metaphor for a menstruating body, but when they did the video version of the promotion, they got carried away. The first image is of at lest three dozen different glasses with the suggestion of many more off to both sides of the frame. Then, as gentle music plays and a soft woman’s voice tells about HMB and that it can be treated, we see a number of glasses with low water levels. The narrator tells us that, “Every month millions of women have perfectly normal periods,” as the camera pans glasses with small amounts of water, but then, as we learn that “millions of other women don’t have normal periods,” we see a variety of glasses sinking into water or running over with water dripping down the lip or whirling through the air in slow motion as their contents spew across the frame in large and small blobs and droplets. The women represented by these glasses are in trouble and while a large glass tumbles out of control, its contents spewing every which way, the phone number and web site info settle on the screen.

I suppose it’s a good thing they used clear water. Had it been red it would have resembled a horror movie. But maybe that’s what was actually intended.

New “Brilliant” tampons

August 20th, 2010 by Elizabeth Kissling

Ladies, are your tampons doing enough? Apparently absorbing menstrual fluid without leaking is no longer sufficient: new, Brilliant pH tampons “are clinically shown to reduce the usual feminine pH increase that occurs during your period.”

But let Dr. Streicher explain in this commercial for Brilliant pH tampons.

Screen cap of Dr. Lauren Streicher ad

Video should open in new window.

Of course, Brilliant also includes a “comfortable, soft plastic applicator” with “smooth rounded tip” and raised ridge for “easy grip”.

Blood on Screen: Red Moon

August 2nd, 2010 by Giovanna Chesler



Red Moon: Menstruation, Culture and the Politics of Gender may have crossed your path as The Moon Inside You (its original title prior to 2010 its current distribution through Media Education Foundation). It is a film that has enjoyed wide release, with exhibition on French television and inclusion in an EU showcase of films that circulated last year. The broad exhibition strategy of Red Moon is fitting; it has a casual, heartfelt and humorous style that should appeal to many.

The purpose of Red Moon, as articulated by the filmmaker Diana Fabianova in voice over, is to answer this question: “At any given time, 25% of the female population is menstruating. Invisible. Discreet. Why is this normal, biological function taboo? There must be some deeper meaning.” There are problems with this statistical framing device – 25% is an over inflated number that eliminates girls and post-menopausal women as “females”. It also glosses over females that do not menstruate because of gender transformations and amenorrhea. Outside of this statistical malfunction, there are a few other facts provided through voice over which are not supported by specific research or attributed directly to any menstrual researchers. However, beyond these slights, Red Moon has great potential to make a taboo subject approachable.

As it begins with man-on-the-street interviews, the film seems to have interest in addressing men as equally as women. Through interviews with researchers who have written about menstruation in the 80’s and 90’s, the film attends to menstrual taboo historically and highlights menstrual suppression as an issue to address within patriarchy. There is a fantastically creepy interview with Elsimar Couthino, famous for inventing Depo Provera, Norplant and for writing Is Menstruation Obsolete (the book that launched millions of suppressed periods.) In his interview Couthino believes that women should have no more than one period in her lifetime and he likens menstruation to pending death: “First of all, menstruation is incompatible with life and nature, because an animal cannot survive bleeding longer than a few minutes in the forest. Blood, the smell of blood (he sniffs) attracts the predators. This one is bleeding. She is going to die.” Fabianova comically cuts to a hooting owl, waiting for your blood.

Fabianova is critical of pill-popping mentality and finds it better to challenge the negative view of menstruation, and silence around it, rather than do away with the period altogether. While she provides some examples of solutions to painful PMS (a belly dancing class delights, for example) the film does not directly address dysmenorrhea and severe menstrual challenges which have become justification for suppression in the first place. It does however, remind menstruators on hormonal birth control that the blood you see is a fake-period.

In fellow Re:Cycling blogger Chris Bobel’s recently released book New Blood: Third Wave Feminism and the Politics of Menstruation, she focuses on the type of menstrual activist stylings akin to Red Moon. In short, feminist spiritualism, according to Bobel, is a narrowly focused mode of menstrual positivism that essentializes the idea of womanhood through menstruation. The movement typically appeals to middle class white women and identifies menstrual change through the self. In feminist spiritualism, political action is limited to the individual menstruator or to the girls the menstruator is encouraged to educate. Red Moon treads in this territory throughout as interviewees speak to menstrual energy, the preciousness of menstruation, and the spiritualism in bleeding. The film ends with this logic as a nude woman walks through city streets, dropping red blobs that spring new trees to life through CGI effects. In voice over we hear about the filmmaker’s changed subject position: “I no longer fight with my hormonal clock, because it is she that reminds me once a month that I have a personal, intimate connection to nature and the universe.” It’s too bad the film narrows its final message to the individual, rather than reflecting on some of the broader work done throughout, like connecting negative menstrual associations to patriarchy, and demonstrating how certain menstrual practices harm the environment and our wallets. Overall, Red Moon is a conversation starter that requires additional reading to supplement its message.

More on life-giving female fluids

April 23rd, 2010 by Chris Hitchcock

When I was pregnant and then learning to breast-feed my daughter, my doula told me that breast milk had great anti-biotic properties, and that it was good to use on eye-infections and cuts. Turns out that there is science behind that. Not only that, but now scientists have shown that breast milk contains substances that may kill cancerous cells. They’re calling the extracted substance HAMLET – not sure why a substance extracted from lactating women would be named after a grieving, tortured young man struggling with suicidal and homicidal thoughts, but I’ll leave more thoughts on that to those who are better at post-modern analysis.

It reminds me of the idea of harvesting stem-cells from menstrual blood. And also some questions about that. Like, is this one of the cases where it matters what produced the menstrual blood? Not all episodes of menstrual bleeding are the same. So how does stem cell quality differ among these different sources of uterine blood?

  • a normal ovulatory cycle
  • normal-length but anovulatory cycle
  • very long or irregular cycles, which tend to be anovulatory
  • withdrawal bleed when you are on the pill
  • or even a post-menopausal vaginal bleed from taking sequential hormone therapy

I don’t even know if anyone is asking these questions, because there is relatively little interest or appreciation in the varieties of sources of menstrual blood and how it might change its quality.

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.