Blog of the Society for Menstrual Cycle Research
Last week, we reported that new research shows a relationship between irregular menstrual cycles and sleep difficulties. Now we learn that irregular menstrual cycles are associated with a higher risk of both type 2 diabetes and coronary disease. As we’ve said many times, the menstrual cycle doesn’t happen just in the uterus and vagina; it is part of a complex system, affecting nearly every other bodily system, and a window into women’s health.
The headline of a story at ABC news about infertility among female athletes is “Female Athletes Are Too Fit To Get Pregnant“. Many women athletes in their 20s, at peak performance levels and peak physical fitness by most measures, may find themselves unable to conceive. This is attributed to low percentages of body fat, which essentially shut down the hypothalamus, which then fails to trigger the H-P-O (hypothalamus, pituitary, ovary) hormone sequence necessary for regular menstrual cycles. About 12% of infertile women seeking treatment are athletes.
According to the article, even women who are not professional athletes (or training at that level) can experience infertility due to physical fitness:
It noted that recreational jogging — only 12 to 18 miles a week — can result in poor follicular development, decreased estrogen and progesterone secretion and absent ovulation.
Setting aside the seriousness of infertility, I’m intrigued by the tone of the article, and especially the language of the headline. In North America today, there is a strong emphasis socially and in mass media on the importance of exercise and being physically fit, and corresponding demonization of fatness as a personal moral failing. But amenorrhea and infertility as a result of thinness is reported without judgment and body-shaming. There are no quotations from experts about women exercising too much or advice to stop working out; instead, professional athletes are advised to freeze their eggs in their early 20s. When fat* women have trouble conceiving or have difficult pregnancies, it is frequently attributed to their weight, which is presumed to be a behavioral a matter of choice.
*I am following the practice of other advocates of fat acceptance and Health At Every Size (HAES) in using the term fat as a descriptive adjective, not a pejorative.
Some ecards, creators of absolutely genius electronic postcards, have introduced a special series of HPV WTF cards to commemorate National Cervical Health Month. (I’ll bet you didn’t even know it was National Cervical Health Month!)
Send them to people you care about who have a cervix.
[via Feminist Campus]
A couple of months ago, we wrote about Kate Seear’s research findings that menstrual etiquette is a frequent cause of delayed diagnosis of endometriosis. In related news, medical researchers writing in a recent issue of the Journal of Obstetrics and Gynaecology have found that adenomyosis, the presence of endometrial tissue embedded within the muscular wall of the uterus, is under-diagnosed.
S. Basak and A. Saha, the study’s authors, examined the data of more than 1000 hysterectomies performed for pelvic pain or abnormal uterine bleeding (in other words, hysterectomies for cancer and uterine prolapse were excluded from the data set) in the UK in a three-year period. In 26 of those cases, adenomyosis was identified post-surgery via tissue analysis.
The medical histories in these 26 cases were then examined more closely. The majority of the women had sought medical attention for menorraghia (excessive menstrual bleeding) and dysmenorrhea (painful periods). Eleven of the women’s uteruses were enlarged, and 16 underwent pelvic ultrasound exams. But adenomyosis was suspected clinically in only one case; the others were identified as uterine fibroids (five cases) or “dysfunctional uterine bleeding” (20 cases).
Examination of patients’ case histories found that the medical consultations focused on menstrual flow. The researchers found that other symptoms of adenomyosis, such as pelvic pain, pain during intercourse, painful periods, and feelings of pelvic pressure, were not adequately addressed – even when examination or ultrasound findings indicated an enlarged uterus.
Basak and Saha ask,
Does failure of preoperative suspicion of adenomyosis matter? In the absence of an accurate diagnosis, appropriate treatment is unlikely to be offered, or may be delayed. This results in failure of treatment and continued suffering.
To identify adenomyosis earlier, they recommend more careful discussion with patients of pelvic symptoms, MRI, and follow-up care with women who elect for conservative management of their symptoms. Once again, open communication about all aspects of menstruation isn’t about challenging taboos just for the sake of challenge; it’s critical for women’s health and well-being.
The popularity of the birth control pill is an essential element of our cultural attitude towards menstruation, and women’s bodies as a whole. After taking the pill for ten years I recently decided to stop, for good. I have this month had my first real period in a decade. I didn’t decide to come off the pill because I want a baby, it’s because I want to blog, and have been blogging about the pill for several months. My blog ranges from my own personal ramblings about taking the pill, to adventures in the world of women’s studies. I am not religious, pro-abstinence or anything like a hippy, I just came to realise that I was taking a very powerful medication every day and I wasn’t sure exactly why.
I had an understanding that the pill was a wonderful invention that liberated womenkind, but ten years in and on Yasmin I was experiencing panic attacks, constant anxiety, paranoia and depression, as were many of my friends and friends of friends. I began to research how the pill actually works and was amazed to discover the whole body impact and potential side effects of this impact. I didn’t know the pill suppressed my hormone cycle every month and that this suppression had consequences for many functions of my body, most interestingly the system underpinning my mood and sense of well being. I didn’t know this, and soon discovered most women didn’t know this either and were blithely popping a pill they thought safe, easy and effective, and not even just for contraception when contraception was needed – they were taking it at fourteen years old and continuing for a large part of their lives. Aside from internet forums for medications discussion I could find no one intelligently criticising, analysing or considering the potential effect of the pill’s impact. Anyone who did so was considered to have a conservative, anti-women agenda.
Considering the pill’s mythology and legacy it has been hard to get the word out there that some women will experience insidious effects on their mood and emotional state and that women should know more about the pill if they are to truly be making an informed decision about their bodies. Margaret Sanger fought for education, availability and freedom of choice – the dominance of the pill, and the culture of pill pushing has created a situation in which many women do not know what they are taking, what it does to their bodies or what they could use as an alternative that would be just as effective, or even get hold of these alternatives if they do know and want them. There are still many women out there who are unnecessarily suffering as I did with depression and anxiety, doubting themselves and their sanity. I always say – yes women who don’t take the pill feel bad sometimes too – but it’s very important that women taking the pill know that if they do feel bad it could be that medication they take every day, so casually, it seems odd to even call it a medication.
