Blog of the Society for Menstrual Cycle Research

Should the pill be available over-the-counter?

June 25th, 2010 by Elizabeth Kissling

The New York Times published an op-ed piece a few days ago about making the birth control pill available without a prescription. Kelly Blanchard, president of Ibis Reproductive Health, offers the following rationale:

Women don’t need a doctor to tell them whether they need the pill — they know when they are sexually active and want to avoid pregnancy. Pill instructions are easy to follow: Take one each day. There’s no chance of becoming addicted. Taking too many will make you nauseated, but won’t endanger your life, in contrast to some over-the-counter drugs, like analgesics.

I have mixed feelings, myself. I’m in favor of just about anything that makes contraceptives more accessible to the people who need them, but I fear that the likely increase in cost of OTC pills means the availability won’t benefit those who most the need them – the young and the poor. Also, there are some contraindications for pill use, such as high blood pressure, history of migraine, and use of certain anti-seizure drugs for epilepsy. And despite the happy, shiny images of Yaz and Seasonique commercials, some women just can’t tolerate the side effects, for any number of reasons.

What do you think, re:Cycling readers?

Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Advanced Technology Isn’t Always Advanced Medicine

June 17th, 2010 by Elizabeth Kissling

Panel from Sally Forth cartoon, "About my idea for robot monkeys...."A new report indicates that surgery for endometriosis performed by a robot is less effective than the same procedure performed by a surgeon. The mechanically assisted procedure also took longer to complete. Performing this surgery the traditional way can also help keep hospital costs down.

Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

For Now, Your Genes Belong to You

April 6th, 2010 by Elizabeth Kissling

Guest Post by Barbara A. Brenner Executive Director, Breast Cancer Action

One of the saddest aspects of capitalism is that companies think they can and should own anything they get their hands on. Some time ago, they started obtaining patents on human genes, including two genes implicated in breast cancer: BRCA1 and BRCA2.

The company that obtained the patents on these genes is called Myriad Genetics. With the patents, Myriad controls both the tests given to women to see if they carry mutations on these genes that may predisposed them to breast and ovarian cancer, as well as all the research related to the genes.

How can anyone own our genes? Up until now, no court has been asked that question. But last week, in a ground breaking decision, a federal judge in New York declared that Myriad’s patents on the breast cancer genes are invalid because they patent a part of nature.

That may seem like an obvious thing to most of us, but the research community is up in arms about how their inability to patent genes will inhibit their ability to innovate new treatments. Sounds plausible, but don’t be fooled. These patents are more about making money than they are about taking care of people who are sick.

Menstruation, Menopause, and HIV

March 1st, 2010 by Elizabeth Kissling

Menopausal women seeking relief from hot flash in front of electric fan.

POZ magazine and poz.com claim to be the leading publication and website in the U.S. about HIV/AIDS. The March 2010 issue has a great article by Suzanne Bopp about menstruation, menopause, and HIV. As with medical and cultural knowledge about HIV itself, understanding of how HIV affects menstruation continues to evolve. Irregular menstruation is a common complaint of women with HIV, but

“[Today] we have a better grasp of factors associated with abnormal menstrual cycles: substance abuse, AIDS, wasting disease—it relates more to overall nutritional status,” says Kristine Patterson, MD, clinical assistant professor at the University of North Carolina School of Medicine in Chapel Hill. “If the body doesn’t have enough fat, production of estrogen and progesterone shuts down,” Patterson says. This can happen anytime a woman loses too much weight, and it is exacerbated by advanced HIV disease, which causes the body to burn calories more rapidly.

. . . .

Researchers do know, however, that female hormones affect the virus—and that sex hormones generally have an impact on immunity. “We know that where a premenopausal woman is in her menstrual cycle affects her infectiousness,” Patterson says. “Estrogen plays a role—not only in HIV and the interplay of HIV and meds, but also in [the likelihood of] women transmitting and acquiring HIV.” Estrogen’s role may explain why women progress to AIDS at lower viral loads than men.

Highly recommended. Read the whole thing.


Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Menstruation and Music Don’t Mix

January 29th, 2010 by Elizabeth Kissling

Cartoon illustration of opera singerThat’s the report from this arts blogger at the New York Times. Yesterday, doctors from the Methodist Center for Performing Arts Medicine of the Methodist Hospital in Houston held a daylong symposium on the management of medical problems among musicians specifically and performing artists more generally. Performing-arts medicine is a relatively new specialty, and frankly, I’m not surprised by the need for it. (I know a drummer who has ongoing neck and back problems caused – or at least aggravated – by his art.)

But I was surprised to see a blanket recommendation that female vocalists use oral contraceptives to suppress menstruation. According to Keith O. Reeves, the deputy chief of Gynecology at the Methodist Hospital and a professor at Weill Cornell, premenstrual syndrome “brings vocal fatigue, decreased range, loss of power and loss of some harmonics.” Continuous use of synthetic hormones is quite an extreme remedy for an illness without a clear definition or etiology.

But apparently menopause is much harder on the vocal folds – our intrepid blogger can’t even tell us:

As for menopause, you don’t want to know. As Dr. Reeves quotes the great mezzo-soprano Christa Ludwig, “It was a hell of some years.”


Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Will HPV Screening Replace Pap Tests?

January 26th, 2010 by Elizabeth Kissling

Photo of two women in medical consult.Researchers in Italy have recently completed a study comparing the effectiveness of DNA testing for HPV (human papillomavirus) to the commonly used Pap smear for detecting cervical cancer. Their findings suggest that more cases of cervical cancer can be prevented with HPV testing than with the conventional Pap smear, especially for women over 35.

There are, however, some disadvantages to using DNA tests to detect HPV. For example, the test is less specific, which means that there are more false positives in the results. This means more women have to return for further testing. In practice, HPV screening has a callback rate of about 25-30%, compared to a callback rate of about 5-7% for Pap smears, according to Dr. Mark Einstein, a gynecologic oncologist and director of clinical research at Montefiore Medical Center in New York City.

Health News Review points out that although the HPV test is more effective in the sense that it prevents invasive cervical cancer by detecting persistent high-grade lesions earlier and providing a longer low-risk period for older women, replacing Pap smears with it is not necessarily more cost-effective for patients, given the costs of the additional colposcopies that result from the higher callback rate from HPV testing.



Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Don’t Douche!

January 25th, 2010 by Elizabeth Kissling

Unassembled douchebag and accessories.Remember my rant about “vagina wash” back in November? No? I’ll wait while you read it.

Anyway, it’s not just a political rant: there are new data that indicate that douching probably causes bacterial vaginosis. A research team studying the association between douching and bacterial vaginosis published their findings in the February 2010 issue of Sexually Transmitted Diseases. The researchers were interested in determining whether the association between douching and BV is causal, or if the association exists because women douche when they experience symptoms of BV. They compared numerous personal hygiene practices with douching.

A longitudinal study of the vaginal flora of 3620 women – involving a whopping total of 13,517 gynecological visits – found that that only one personal hygiene behavior correlates strongly with bacterial vaginosis: douching. The researchers found no statistically significant correlation between BV and type of underwear (nylon vs. cotton); menstrual product (tampons vs. pads; pads and tampons vs. pads); use of pads or panty liners when not menstruating; weekly or greater use of hygiene spray, powder, or towlettes; or daily versus less than daily bathing and showering.

The researchers concluded that “[d]ouching, but not other feminine hygiene behaviors, is significantly associated with BV, providing additional evidence that douching may be causally associated with BV and is not simply a response to BV symptoms.”

So let’s reserve douche and douchebag to describe anti-feminist people and actions: douches are unnecessary, harmful to women, and sold to women in insulting ways.

Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

“Abortion is a matter of survival for women”

January 22nd, 2010 by Elizabeth Kissling

It was 37 years ago today that the U.S. Supreme Court decided Roe v. Wade, in which the Court held that a woman’s right to an abortion fell within the right to privacy protected by the Fourteenth Amendment.

In commemoration of that decision and women’s right to autonomy over personal reproductive decisions, I’m posting some of the newly released video of the late Dr. George Tiller talking about why he performed abortions.


Thank you, Dr. Tiller, for trusting women.


Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

New Treatment for Uterine Fibroids

January 18th, 2010 by Elizabeth Kissling

Illustration of radiofrequency ablation technique to remove fibroids.Tuesday’s Wall Street Journal reports a new surgical technique for relief of uterine fibroids is currently being tested at six medical centers in the U.S., along with two in Mexico and one in Guatemala. Presently, the only sure cure is hysterectomy, because fibroids sometimes grow back when suppressed with drugs or removed individually.

Fibroids are benign growths in the uterus that are estimated to occur in as many as 70% of women. Fibroids are often asymptomatic; many women don’t even know they have them. But fibroids can become large and painful, and can cause heavy menstrual bleeding. Sometimes they can grow large enough to interfere with other organs.

The new technique under investigation is called radiofrequency ablation. The procedure involves three small incisions: one for the laproscopic camera so the surgeon can see inside the abdomen, a second for an intra-abdominal utrasound probe to determine the size and location of fibroids, and a third for the Halt device, a needle electrode that penetrates the fibroid and burns the cells, which are eventually reabsorbed by the body. The device also cauterizes the incision to minimize bleeding.

In early tests outside the U.S. with 70 women, 90% were satisfied with the results. It is unknown whether fibroids destroyed with this technique will grow back.


Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Open Call: Medical Screening Procedures Unique to Women

December 27th, 2009 by Elizabeth Kissling

One of the reviewers for the forthcoming edition of Our Bodies, Ourselves, who blogs anonymously at Mom’s Tinfoil Hat, is seeking contributions for the chapter she is reviewing.

I am busy reviewing and contributing to the second chapter of Our Bodies, Ourselves that was assigned to me. It is called “Unique to Women” and is about screening tests and medical procedures. I am trying to get through the technical side of writing this: checking on new screening guidelines, new screening tools, and such scientific type things. But, I really want to take into account the needs and points of view of many women, including disabled women, women of color, women from different cultural and religious backgrounds, women who are trans, men who are trans, women who are survivors of sexual abuse and/or assault, women who work in the sex industry, women who are polyamorous, women who are gay, women with piercings and tattoos, women of size, etc.

Her deadline is New Year’s Eve, so please contact her ASAP if you can contribute.

Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

The “standard of care” for being a girl?

December 22nd, 2009 by Laura Wershler

In a December 21, 2009 news release the American College of Obstetricians and Gynecologists (ACOG) proclaimed that “hormonal contraceptives offer benefits beyond pregnancy prevention“.

You’d have to be an ostrich with her head in the sand not to have heard this message before.  Just open any woman’s magazine to any ad for the pill, or any of the myriad varieties of drug-based birth control, and you’ll find the litany (a prolonged and tedious account) of non-contraceptive benefits used as marketing messages to “sell” birth control to girls and women.  So the news release begs the question: why now?

Maybe the pharmaceutical companies are putting pressure on the gynies to protect their funding and the drug companies profits.  Maybe this news release is damage control.  A recent article in Maclean’s magazine proclaimed a trend towards ”ditching the pill for good“.

[O]ral contraceptive prescriptions in Canada levelled off in 2008, reports pharmaceutical industry analyst IMS Health Canada. Health care workers are seeing a growing demand for non-hormonal methods. Spurred by concerns about their health, the environment, or even frustration with family doctors, who sometimes seem to push the pill as a modern-day cure-all, Canadian women are looking for other options.

Are declining prescriptions for hormonal contraceptives a growing trend in North America?  Is there a backlash brewing against the pill, the patch and the ring?  One can only hope that the days when your gynecologist could convince you that taking the pill is a panacea for everything that, supposedly, is “wrong” with women’s bodies are coming to an end.

Hormonal contraceptives are drugs that disrupt a woman’s normally functioning endocrine system with synthetic versions of estrogen (ethinyl estradiol) and progesterone (progestin) to induce infertility.  [Do not be fooled by the language used in the press release.]  These drugs have a time and place.  But precribing the pill must never become the “standard of care” for being a girl.  Mothers everywhere, take note.




Post to Twitter Post to Plurk Post to Yahoo Buzz Post to Delicious Post to Digg Post to Facebook Post to MySpace Post to Reddit Post to StumbleUpon

Who Lacks Health Literacy?

December 18th, 2009 by Elizabeth Kissling

You may have heard the news that 23 hormone replacement therapy lawsuits filed by women diagnosed with breast cancer were dismissed by a New York judge this week. Judge Martin Shulman granted Pfizer’s motion to dismiss for two reasons: the plaintiff’s delayed filing exceeded the the three-year statute of limitations in New York, and that “the potential risk of contracting breast cancer from taking HRT medication was well known at all times out there in the stream of public information.” Oddly, Judge Shulman simultaneously asserted “that the debate over HRT health problems has not yet been settled.”

I can’t argue about exceeding the statute of limitations, but it’s difficult for a judge to assert that breast cancer risk of hormone therapy is well known public information. The Lancet reported today that up to half of US adults have trouble interpreting medical information, displaying low levels of health literacy. Health literacy, according to The Lancet, is the ability to comprehend and use medical information that can affect access to and use of the health-care system. Health literacy is more than reading and comprehending news reports of medical issues (which are often of poor quality – see Health News Review for sharp analysis of health news); one must also know how to navigate the complexities of the health care system, including knowing how and when to question one’s physicians and pharmacists.

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.