Blog of the Society for Menstrual Cycle Research

The Eternal Feminine: Focused, Goal-Oriented, Practical, and Loving

April 30th, 2012 by Paula Derry

Visiting colleges became part of our repertoire of family trips back when my daughter was a senior in high school.   We visited many schools to get a sense of the range of possibilities that existed.   As was typical, Vassar offered a tour of the campus for groups of prospective students and their parents, led by tour-guides who were undergraduate students.  Vassar’s tour had one unique feature.  An original campus building, which dated to the post-civil war era, had an exceptionally wide hallway.  This, we were told, was because the all-woman student body needed to be able to walk back and forth repeatedly in the halls in their wide skirts, as part of a college program in physical fitness. Vassar, founded on the idea that the education of women should equal that of men, had a program of physical culture to offset criticisms that the school was endangering women’s health by educating them.

Sheila Rothman describes Vassar’s history in her book “Woman’s Proper Place,” published by Basic Books in 1978.  The common wisdom in the second half of the 19th century was that people have a limited amount of biological “vital energy.”  Rothman (p.24) quotes a contemporary physician:  ”Woman has a sum total of nervous force equivalent to a man’s” but the force is “distributed over a greater multiplicity of organs…The nervous force is therefore weakened in each organ…it is more sensitive, more liable to derangement.”  Menstruation and pregnancy were times of special danger, when the demands on her system were greater and the possibility of physical and mental disorder increased.  Menstruation was a time when women were irrational, even insane.  Caution, however, was always called for, as when intellectual activity or other exertion used up nervous energy.  Thus, when Vassar was founded, a program was put in place to overcome women’s predisposition to illness through a structured environment and programs of physical exercise.  Later, the Association of Collegiate Alumnae conducted a survey to provide research evidence as to whether female college graduates were normal.

Image by Thiophene_Guy // CC 2.0

Back in the Vassar of the present, our student tour guide wondered:  “How could anyone believe anything so silly?” It’s true that we no longer talk about a “vital force.”  Yet, broad generalizations about the nature of women and reproductive physiology continue to exist that have an air of plausibility, based today on a different scientific language, one of hormones, neurotransmitters, and other players.   Not very long ago, menopause was defined as an “estrogen deficiency disease” that had a uniquely powerful effect on health.  Heart disease was a disease of civilization for men and a disease of the ovaries for women.   The idea that the menstrual cycle destabilizes women’s minds, creating mood and intellectual changes, continues to exist.

One of my favorites is the idea that women are somehow receptive, loving, and self-denying because of their maternal role, which is somehow mediated by estrogen.  Thus menopause may be said to be a time that women regain the ability to focus more on themselves, liberated from a physiological preparedness for reproduction and its needs.   Pregnancy is a dreamy time when women are moody and unable to think clearly.

Sure, mothers are receptive, loving, self-denying, but they are also many other things.  I love being a mother.  My relationship with my daughter has been powerful, unique, and wonderful.  However, I know that a mother who is lost in a dreamy connectedness to her child or reflexively puts her child before herself can’t do everything she needs to do.   A mother is emotionally connected to her child but also must be an individual who perceives the child accurately, as a separate person, in terms of the child’s motivation and perspective, in order to provide both a sense of connection and the mirroring needed for a child’s emotional development.   Further, children misbehave, make mistakes, and must be taught all kinds of things; mothers must have clear-headed, pragmatic, problem-solving skills.

Coming off Depo-Provera can be a woman’s worst nightmare

April 4th, 2012 by Laura Wershler

Need proof that women are sometimes desperate for information and support when it comes to quitting hormonal contraception? You need look no further than the 100 plus comments in reply to an old blog posting at Our Bodies OurselvesQuestions About Side Effects of Stopping Contraceptive Injections.  The comment stream – a litany of woes concerning women’s discontinuation of Depo-Provera – has been active since Nov. 2, 2009.

On March 29, 2012, Rachel, author of the post, wrote a follow-up piece in which she laments: “Although a quick internet search finds many women complaining of or asking about post-Depo symptoms, there isn’t much published scientific evidence on the topic.” Beyond research about bone density and length of time to return to fertility, little is known about the withdrawal symptoms women have been commenting about.

Depo-Provera is the 4-times-a-year birth control injection that carries an FDA “black box” warning that long-term use is associated with significant bone mineral density loss.  Never a fan, I made a case against this contraceptive in a paper for Canadian Woman Studies, published in 2005. The comments on the OBOS post indicate that many women took Depo-Provera without full knowledge of the potential for serious side effects while taking it, or of what to expect while coming off the drug.

Considering that Depo-Provera completely suppresses normal reproductive endocrine function, it is not surprising that many women experience extreme or confusing symptoms once stopping it. Take Lissa’s comment for example, posted on February 21, 2011:

Omg I thought I was tripping. I have been on depo for a year and stopped in jan. My breasts constantly hurt, I put on weight, have hot flashes, and sleeping problems. I pray everyday my cycle returns and stops playing with me. I only spot lightly.

Two and a half years after publication, the original article continues to garner monthly comments. I’ve read most of them and have yet to see one that offers concrete advice or a referral to resources that provide information and support to women looking for both. One such resource is Coming Off The Pill, the Patch, the Shot and Other Hormonal Contraceptives, a comprehensive, clinical-based guide to assist women transition back to menstruation and fertility, written by Megan Lalonde and Geraldine Matus.

Lalonde, a Holistic Reproductive Health Practitioner, and Certified Professional Midwife, helps women establish healthy, ovulatory cycles after using hormonal contraception. She says that women who’ve used Depo-Provera generally experience the most obvious symptoms and have the hardest time returning to fertility.  She finds that every client’s experience is different and will be affected by the status of their cycles before taking the drug, and their overall health. “It can take time to regain normal menstrual cycles, from a few months to 18 months, in my experience,” says Lalonde. “Some women have minimal symptoms while their own cycles resume, while others might have significant symptoms, including mood changes, unusual spotting and breast tenderness.”

The comments to the Our Bodies Ourselves blog post demonstrate that many women are not finding the acknowledgement and support they need to understand and manage the post-Depo transition. Some are disheartening to read, like this comment by Judy from April 12, 2011, and this recent one posted by Melani on March 21, 2012.

In my last re: Cycling post, I asked for input on the Coming Off the Pill Mind Map I created. I’ll be making a few revisions thanks to the thoughtful feedback readers have provided. I had assumed that this guide would be applicable to all methods of hormonal birth control but, after reading these women’s comments about their Depo-Provera experiences, it appears this contraceptive may require its own branch on the mind map.

Fog Warning Ahead

March 29th, 2012 by Heather Dillaway

As I embark on my 40th year I look ahead to menopause. I guess there is a good chance I’m approaching some foggy years. Brain fog, that is.

In the past week a flurry of online news articles review new research findings on the “brain fog” that many perimenopausal women experience. The brain fog is more easily understood as a slight memory problem, if you take the time to read through the various news stories. A new study analyzed how 75 individual women, aged 40 to 60, rated their memory performance based on factors like how often they forgot details and how serious their forgetfulness was. Researchers also gathered information about the women’s overall health, mood and hormone levels, as well as other menopausal symptoms, and tried to figure out the extent to which this “brain fog” exists. According to news reports, about 41 percent of the women in the study reported having forgetfulness that was “serious,” and those who felt that their memory problems were serious were more likely to score poorly on tests of working memory and attention. Some women who rated their memory problems as serious also reported some depression and other symptoms like hot flashes and sleeping problems. Other researchers suggest that the memory problems women experience are related to changing levels of estrogen in a woman’s body at menopause, but interestingly this new study did not find links to changing hormone levels.

The whole notion of “brain fog” is interesting, and I am suspicious of it as a strictly menopausal symptom. What about the brain fog we all experience when we’re tired or sick or just way too busy? Defining brain fog as a “menopausal” (really, perimenopausal) symptom further defines middle-aged women as somehow less than functional and set them up to be taken less seriously.

Putting this issue aside, though, what I actually find most interesting about all of the news coverage of this study is just how different each report of the study is. I am reminded that we should all be careful of which report we read about a study. For example, the first article I read on this study was placed in the Los Angeles Times and focused on the possible connections between menopausal brain fog, depression, and dementia. I was left feeling like the author of the article inferred that all menopausal women might have depression or dementia and that they should seek treatment. After reading this article I was angry because I felt as if I had been warned that midlife brain fog was the beginning of an inevitable decline for all women. Then I read a WedMD piece that simply described the study and did not concentrate on depression, dementia, or the need for treatment, and I wasn’t really sure what to make of the research study. Finally I read an article by a HealthDay reporter which quoted one of our own, SMCR member Nancy Wood, who reminds readers that “a number of other stressors in life, from work to taking care of children and parents, that pile up around the same time as menopause can hinder memory and ability to concentrate.” In addition, this article’s author states that “memory problems are not necessarily an early sign of dementia” and cognitive ability is regained after other perimenopausal symptoms subside. This third article concluded that the research study is helpful because findings suggest that brain fog is real – that women aren’t crazy – but that it is normal and not that detrimental to women’s long-term cognitive abilities.

Coming Off The Pill: A Mind Map Guide

March 7th, 2012 by Laura Wershler

Everybody can use a good map to help them get to where they’re going. Why not women heading to the land of non-hormonal contraception?

In my post on January 11, 2012 I asked if coming off the pill was a growing trend. I proposed to write a series of posts about the issues associated with the decision to stop using hormonal birth control.  For the purposes of this discussion assume that “coming off the pill” refers to quitting any method of hormonal contraception including the pill, patch, ring, shot, implant or Mirena intrauterine system.

As I was preparing a list of possible topics, I realized that one way to represent the complexity of issues involved in this decision is with a mind map: “a diagram used to represent words, ideas, tasks, or other items linked to and arranged around a central key word or idea.” It also occurred to me that readers could then add to this schematic, filling in important points based on personal or professional experience. So I got out my colored markers, did a little brainstorming and came up with Coming Off the Pill: Mind Map 1.0. I invite readers to comment, offering additions under the key headings I’ve noted and suggesting other categories that should be included.  Could this become a talking, planning or process guide for women considering the transition to non-hormonal birth control methods?

If you’ve thought about or been through the experience of quitting hormonal contraception, or if you’ve helped others through the experience, please contribute to the development of Coming Off The Pill: Mind Map 2.0 by posting your comments and suggestions. (I’ve already thought about other headings I could have included.) Besides providing me with a guide for writing future posts, what other ways can you imagine this mind map might be used?

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What is a hormone?

March 5th, 2012 by Paula Derry

All too often, hormones are portrayed in the media, and even in professional articles, as strangers inside our bodies that control us.   Sometimes hormones are personified as bosses that order our bodies around.  Sometimes they are portrayed as akin in function to gasoline or motor oil, needed to keep the machinery of our body moving or smoothly gliding.  Hormone levels that oscillate rather than maintaining a reassuring stability might be especially suspicious or even uncanny.

Take oxytocin.  According to the website ScienceDaily.com, which summarizes recent scientific studies, the hormone oxytocin is the “cuddle chemical”, promoting positive feelings, especially between mothers and infants, but it also has a “dark side,” promoting envy and gloating.  An oxytocin nasal spray might help shy people behave in a less introverted manner, and can make “surly monkeys treat each other a little more kindly”.

Or, take estrogen.  Teenagers are at the mercy of their “raging hormones.”   Premenstrual syndromes, perimenopausal mood changes, menstrual migraines, and hot flashes have all been attributed to hormones that oscillate (i.e., go up and down), dip, or are present in the wrong amount; thus, the orders barked out by the hormones go awry.   Perimenopausal estrogen changes are feared to destabilize the brain, creating preconditions for cognitive decline, or to increase risks for bone or heart disease.   A recent article (2010, vol. 1204) published by the Annals of the N Y Academy of Sciences was titled  “Estrogen and the aging brain:  An elixir for the weary cortical network?”.  A Science Daily report on estrogen and menopause (Oct. 4, 2011) was entitled “This is your brain on estrogen”.  Of course, not all hormones have this mythic status.  Important as diabetes is as a public health problem, I don’t recall seeing an article entitled “This is your liver on insulin.”

Here’s another view of hormones:  Most introductory science textbooks define them as chemical messengers, typically released from special tissues called glands, into the bloodstream.  In order for a hormone to affect a cell, the cell must have a receptor for the hormone. If there is no receptor, the hormone does not affect the cell.  If there is a receptor, the hormone changes the rate at which cells work, it does not make cells do things they would not otherwise do.  Hormones are chemical messengers that are involved in coordinating physiology, behavior, and development.

Consider a simple case, a person who is sitting in a chair and wants to stand up.  The muscles in a variety of parts of her body have to work together.  She can’t, for example, lift her buttocks before her feet push down on the ground, or lean so far forward that she falls.  Other parts of the body have to get into the act, also.  For example, her blood pressure must go up before she starts to stand; otherwise she would become dizzy since as she rises less blood reaches her head. Mind and body work together; blood pressure rises in response to her mere intention to get up.  In a similar manner, purposiveness is typically coordinated by hormones, the nervous system, and other players.

The way I think about it is that hormones are team players in complex, multi-determined systems that have a purpose. Hormones help to coordinate what happens in the body, but in normal functioning they do not act alone; they are part of a larger whole. They are more like telephone wires than the content of the conversation.

“Death Loves Menopause”: Heart and Stroke Foundation Sends Wrong Message

February 8th, 2012 by Laura Wershler

The Heart and Stroke Foundation of Canada has inaccurately branded menopause as a killer of women. I will not be sending them a donation.

Last October, the foundation launched a fundraising campaign called Make Death Wait. Magazine and TV ads personify death as a man with a disembodied voice (he sounds like a stalker) who says he loves women (and men) and is coming to get them.

Eileen Melnick McCarthy, director of communications for the foundation, wrote to me in an email that the intent of the campaign is to “wake up Canadians to the threat of heart disease and stroke.” The campaign – urging viewers to “make death wait” by making a donation – has drawn both support and criticism.

Note the stereotypical hot flash reference: The thermostat is set at 15 C (60 F) but reads 23 C (73 F).

Photos of the ad by Laura Wershler

I think the TV ads are creepy, but what disturbed me more was the Death Loves Menopause message in the December issue of Chatelaine, Canada’s oldest women’s magazine. The small print reads: “He loves that menopause makes women more vulnerable to heart disease and stroke.” But is this statement defendable?

Dr. Jerilynn Prior, endocrinologist and scientific director of the Centre for Menstrual Cycle and Ovulation Research, wrote in an article about women’s risk for cardiovascular disease that the assumption heart disease in women is caused by estrogen deficiency associated with menopause  is a myth:

The reasoning behind this notion goes like this—young women have lots of estrogen and don’t get heart attacks. Older menopausal women are “estrogen deficient” and get heart attacks. Therefore, lack of estrogen causes women’s heart disease. That is like saying that headache is an aspirin-deficiency disease!

 

It is true that heart disease and stroke is the #1 killer of women, but the ad’s assertion that it is menopause that makes women more vulnerable raised the ire of women’s health experts I asked for comment.

Joan Starker, a PhD clinical social worker specializing in midlife, menopause, and aging issues, called it “an appalling and shocking advertisement.” Starker says she and her colleagues have “worked hard to shatter negative conceptualizations of menopause and aging. When I viewed this ad, I was left with only one horrifyingly toxic message – menopause equals death – which is ageist and sexist.”

Barbara Mintzes, assistant professor at the University of British Columbia, calls the ad “misleading and inaccurate” and says “there is no sudden shift in the rate of heart disease post- versus pre-menopause (or around age 50), as would be expected if menopause was a major risk factor for heart disease.  As women age our risks of heart disease gradually increase, similarly to ageing in men.”

My fellow blogger, Paula Derry, is a PhD health psychologist who critiques, analyzes, and theorizes about menstruation research/theory, with menopause being one of her specialties. “The idea that women’s risk of heart disease increases after menopause is a common one, yet there is little evidence for any increase in risk, much less that menopause is a key cause of heart disease and death,” she says.

Derry cites a 2011 paper in the British Medical Journal - Ageing, menopause, and ischaemic heart disease mortality in England, Wales, and the United States – that concluded aging rather than menopause was key: “Heart disease mortality in women increased exponentially throughout all ages, with no special step increase at menopausal ages.”

Last March, the American Heart Association issued the Effectiveness-based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update. These guidelines present a long list of risk factors such as obesity, poor diet, physical inactivity, high cholesterol, hypertension and diabetes. Menopause is not included as a risk factor and is mentioned in just one sentence in the document.

As Derry says, “If I were going to donate money to an organization it would not be to one that tried to scare me with what I understand to be inaccurate facts.”

The Heart and Stroke Foundation of Canada should “wake up” to the truth about heart disease and menopause.

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Menopause Tales

February 6th, 2012 by Paula Derry

The philosopher of science Mary Midgley (1995) doesn’t mince words.  She tells us:  “The theory of evolution is not just an inert piece of theoretical science.  It is, and cannot help being, also a powerful folk-tale about human origins.”  Along these lines, stories about reproductive physiology are important folk-tales about what’s natural for women and what their life course should be.

What are the stories about menopause?  One is that living beyond menopause is a biological puzzle. The argument goes like this: Most animals reproduce up until, or close to, the end of their natural life span.  This makes sense, because theoretical biology tells us that animals reproduce as much as possible to leave as many offspring as they can.   Why women live beyond menopause is therefore a puzzle.  One answer is that we can expect to live thirty years past menopause because technological innovations have resulted in the conquest of infectious disease, the generation of great food stores, and other advances. As recently as the turn of the century, the average woman lived 47 years.  Far longer, probably, than our prehistoric forebears:  prehistoric hunter-gatherers were probably old at thirty.  Living many years past menopause is therefore a recent historical development.  Not surprisingly, if aging women are “outliving their ovaries,” menopause is associated with a variety of unpleasant experiences and health problems.

What are some facts relevant to this story?  First, is living past menopause a new historical development?  Well, ….No.  Old age is not an invention of the twentieth century.  Betsy Ross died when she was eighty-four.  Classic Greek and Roman medical writers (including Hippocrates himself) and traditional Eastern medical systems all discuss menopause. In the Old Testament, Sarah laughed when God said she would bear a child even though it had “ceased to be with her after the manner of women.”  Might the Bible have been referring to menopause?

Sign from The Musée Mécanique, a for-profit interactive museum consisting of 20th-century penny arcade games and artifacts located at Fisherman's Wharf in San Francisco, California.

Photo by Thomas Hawk // CC-BY-SA 3.0

What about the idea that prehistoric humans died before menopause? Studies by anthropologists suggest that modern hunter-gatherers do live to old age.  Therefore, perhaps our prehistoric hunter-gatherer forebears did so as well.  Richard Lee (1985), for example, studied the !Kung San in Botswana.  About 10% of the population were over sixty years old, and it was not unusual to find !Kung aged 70 or 80.   Lancaster and King (1985) found, when twenty-four hunter-gatherer and horticulturalist groups were examined, that 53% of the women who lived to age fifteen could expect to still be alive at age 45.

If a small number of older people are found in simpler societies, is this important?   Is ten percent survival so small that for all intents and purposes fifty years is the real limit on lifespan?  Older people, as described by anthropologists, are not viewed by the members of their own societies as oddities.  That is, if living into middle-age and beyond were an anomaly, it is unlikely that people in a society would have expectations about what role an older person should play.  Older people might be viewed as curiosities.  However, older people more typically have important places in their societies.  At least through their fifties and sixties, they are relied on to do important things.  It is relatively common in nonindustrial societies for women to experience positive changes in status when they become middle-aged (Brown, 1985).  In cultures without written legal systems or CEOs, older people often have authority over younger people.  They can be decision-makers about the distribution of property, allocation of jobs, and other social behaviors.  Among the !Kung, for example, older women assign younger relatives what jobs they need to do, arrange marriages, decide on kinship classifications.  In cultures that don’t have books or the internet, older people may be sources of stored and accumulated knowledge, like the location of a watering hole that hasn’t been needed since the last drought thirty years ago (Diamond, 1996), or social and technical skills (Kaplan et al., 2010).

The pill, reduced period pain and the ongoing delusion

January 20th, 2012 by Laura Wershler

Is there a woman over the age of 18 anywhere who doesn’t know that taking the birth control pill can make her periods lighter and less painful? Most women know this, but not many know why. The news stories swirling around a new study about the pill and period pain will not enlighten them.

Photo credit: Ceridwen, Creative Commons 2.0

A 30-year longitudinal Swedish study has finally proved the worth of what is accepted practice in North America and Europe: the prescribing of combined oral contraceptives (COCs), or birth control pills with synthetic estrogen and progestin, to treat painful periods known clinically as dysmenorrhea.

Of course, pharmaceutical companies that manufacture COCs are probably eager for this research, as prescribing the pill for dysmenorrhea is still an off-label use in the U.S. (unlicensed use in the U.K.). Pill manufacturers may be able to use this finding to lobby the FDA (or equivalent agencies in other nations) to approve the pill as treatment for menstrual pain, leading to increased sales and insurance coverage. Perhaps that’s why news media have been treating this discovery as breaking news.

Take this headline: Yes, the Pill CAN ease the agony of period pain: Scientists confirm what millions of women already know, or this one: The pill ‘does ease period pain’, or this one: Combination oral contraception pills cut menstruation pain, or, really, any of these.

You can read the abstract of the study by Swedish researchers Ingela Lindh, Agneta Andersson Ellström and Ian Milsom, published this week in the journal Human Reproduction, here: The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. The conclusions are simple: “COC use and increasing age, independent of each other, reduced the severity of dysmenorrhoea. COC use reduced the severity of dysmenorrhea more than increasing age and childbirth.”

Forget the age factor for the purposes of this discussion. The fact that COC use reduces the severity of dysmenorrhea is not astounding. This is old news. So says Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, quoted in a USA Today story:

“The study results are not surprising. It’s gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman’s period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill.”

What is astounding is what Dr. Goldstein, and other OBGYNs, didn’t say in responding to the study. That the reason the pill reduces menstrual pain is because the synthetic hormones in the pill shut down a woman’s own menstrual cycle. The “period” women experience when on the pill is technically known as a “withdrawal bleed,” brought on by seven days of placebo pills. While it feels like a period to menstruators, it is not the same physiologically as the period they experience when NOT on the pill. That’s why it doesn’t hurt as much.

The point is, the pill is too often credited with regulating the menstrual cycle. It does no such thing. The pill does not regulate any woman’s menstrual cycle; it supercedes it. This research, and the many news stories that reported it, once again ascribe power to the pill – this time the power to cut menstrual pain. This is an incomplete truth.

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Off the Pill, Off the Magazines

January 12th, 2012 by Elizabeth Kissling

Guest Post by Holly Grigg-Spall

“Less stressed, thinner and more interested in sex.” – but not buying magazines.

In a recent issue of the UK’s Stylist magazine — a weekly women’s glossy that is available for free at tube stations and selected clothing stores — there was an article headlined ‘What does 10 Years On The Pill Do To You?‘ As a result of my on-going blog, Sweetening the Pill, which documents my experience of coming off the contraceptive pill, I was contacted by the writer to provide some quotes for this piece. Unfortunately, I was edited out. As a journalist myself, I understood this situation has little to do with the writer’s choice of content and more to do with the magazine editor’s final say on what was most fitting for the feature. Yet the title question is the very crux of my blog: having taken the Pill for 10 years, stopping as a result of discovering the answer to this very question.

 

Photo Credit: Anthony Easton // CC 2.0

According to the Stylist piece the answer is that the Pill changes your memory skills, lowers your libido, makes you attracted to the wrong kinds of men for you, changes weight distribution, prevents you building muscles, make you retain water, make you depressed and jealous…and how can you tell if this all is just you or the Pill? You can’t and you shouldn’t try to find out, is the message here. We are advised to not take a break from the Pill, not even for a week, and if you are concerned, just ask for a different brand from your doctor. There is no discussion of non-hormonal alternatives. There is also no discussion of the benefits of not taking the Pill, of allowing your body to ovulate once a month.

 

My answer to this question was: “The Pill has a whole body impact. Taking the Pill shuts down a woman’s hormone cycle — and the ovulation and menstruation that is an essential part of this cycle — and replaces it with a low stream of synthetic hormones. This has an affect on every organ in the body — the impact is wide-reaching and crudely administered. The peaks, troughs, and plateaus of a woman’s ‘natural’ cycle are wiped out. The monthly hormone cycle is integral to many of the body’s central functions, including the metabolic, immune, and endocrine systems. This changes everything — from your sense of smell to your libido to your ability to absorb vitamins from your food.

 

Many women have said to me that coming off the Pill was ‘life-changing’ and, as someone now two years off the Pill after ten years on, I have to agree with the description. The life-threatening potential effects of the Pill get publicity — the blood clots and strokes — but the quality of life-threatening and the emotional and mental effects are barely discussed. Fatigue, muscle loss, urinary tract infections, bleeding gums, stomach disorders, flu-like symptoms, hair loss — relatively minor physical issues caused by the Pill that together can make life very hard. Depression, anxiety, panic attacks, rage, paranoia — all issues brought on by the Pill, due to a combination of switching off the hormone cycle and vitamin B deficiency. I experienced the whole package and when I wasn’t bordering on nervous breakdown I was flatlining, barely able to feel anything at all.”

 

Is Coming Off the Pill a Growing Trend?

January 11th, 2012 by Laura Wershler

The Internet abounds with articles, posts and forum discussions about coming off the birth control pill. Women are looking for information and advice. Many are trying to get pregnant, others are just done with hormonal contraception.

It’s a topic that interests many of us connected to the Society for Menstrual Cycle Research (SMCR) because of

Created at an a menstrual arts and crafts event, Andrea, 25, said this piece depicts the multiple emotions she feels around menstruation. Photo by Laura Wershler

how the pill and other forms of hormonal contraception impact the menstrual cycles of the women who take these medications. Some of us are experts in menstrual cycle function and dysfunction, most are advocates for healthy, positive menstrual cycle experiences from menarche to menopause.

A recent blog post at nomoredirtylooks.com on the topic of quitting the pill caught our members’ attention.  Re: Cycling blogger Elizabeth Kissling included the post in Weekend Links on November 19.

A young woman in Paris was looking for advice and comments from other blog readers about how to manage the effects of coming off the pill. Siobhan O’Connor, the blog co-editor, shared Paris girl’s story with a graceful, inclusive invitation to readers:

There’s no judgment—implicit or explicit—on anyone who is on or has been on birth control pills. Some people love them, some people have to take them for medical reasons, some people abhor them. Here, we want to talk candidly about what happens when you go off them. Because, whoa. That can be hectic.

The post drew over 80 comments, with a few coming from SMCR members. What struck me was how many women:

1)  had already ditched the pill or were planning to
2) expressed a desire for the return of regular, normal menstrual cycles
3)  were concerned about their skin (it often breaks out after quitting the pill).

SMCR member, endocrinologist and guest blogger Dr. Jerilynn Prior answered the concerns about acne and bad cramps in a comment posted on November 22, and included a link to Centre for Menstrual Cycle and Ovulation Research website where readers can find information about all things related to menstrual cycle health.

Holistic Reproductive Health Practitioner Geraldine Matus, another member, commented on November 26 that it was concerns and experiences like those expressed by posters that prompted her and colleague Megan Lalonde to write the guide: Coming Off the Pill, the Patch, the Shot and Other Hormonal Contraception.

I invited No More Dirty Looks readers to visit this blog to learn more about the menstrual cycle and the issues raised by their online discussion.

Regular visitors to re: Cycling know that we cover a broad range of topics, but bloggers frequently address hormonal contraception as it relates to women’s health issues.

Check out this sampling from the re: cycling archive:

Several of the women who responded to the Paris girl post at nomoredirtylooks.com expressed eagerness to reclaim healthy, ovulatory menstruation and a willingness to learn how to  manage their fertility without the aid of hormonal contraception.

Does the Pill cause prostate cancer?

November 16th, 2011 by Laura Wershler

Of the growing list of reasons why women might want to reconsider using birth control pills, this could well be the strangest.

Researchers at Princess Margaret Hospital in Toronto published a study on Nov. 15  in the BMJ Open Journal in which they found a “strong correlation” between the use of birth control pills and the incidence of prostate cancer worldwide.

One of the possible explanations of how the two are related is the potential impact of the estrogen compound – ethinyloestradiol – that women using the pill secrete in their urine. It has been speculated elsewhere that these endocrine-disrupting substances could end up in our drinking water or get into the food chain.

The Pill, introduced in the 60’s, has been widely used for decades. The study suggests that exposure to these substances over 20 to 30 years could have a clinically significant effect. Researchers said further study of this link is needed.

In 2010 the media was full of stories marking the 50th anniversary of the birth control pill. The Pill at 50: Sex, Freedom and Paradox, rang the headline of a Time Magazine article by Nancy Gibbs. Could rising rates of prostate cancer be part of this paradox?

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Menopause Isn’t for Dummies

September 23rd, 2011 by Elizabeth Kissling

Roseanne’s Nuts was one of the delights of summer 2011, especially for those of us who have missed the comedic talents of Roseanne Barr. If you don’t watch television (or are outside the US), Roseanne’s Nuts is Roseanne Barr’s return to episodic television, this time in the form of a reality show set on the star’s 40-acre macadamia nut farm in Hawaii. When her eponymous sitcom ended in 1997, she made a couple of attempts at talk show hosting, then left L.A. and the limelight to raise her youngest son and macadamias in Hawaii. He’s now a teenager, and the nuts are ready to harvest.

An ongoing thread of the show is Roseanne’s plan to harvest and distribute her nuts as a low-cost protein source for impoverished people. Each episode also has its own self-contained, seemingly unscripted plotline. Unlike many of today’s popular reality shows, however, there are no manipulated showdowns or drunken feuds. Much of the time, Roseanne and her family seem like everyone else’s family — if only the rest of us could live off sitcom residuals and were followed around by a camera crew. There is laughter and teasing, and some conflict underpinned with genuine affection, but everything isn’t always tidily resolved in 22 minutes.

In the Episode #15 (original air date September 10), 58-year-old Roseanne copes with continuing symptoms of menopause. It’s handled so honestly (for the most part) that I’m going to overlook the fact that the episode was titled “Menopause for Dummies”.* The episode opens with Johnny Argent, Roseanne’s manpanion**, sharing a list of menopause symptoms he has found on the internet. Roseanne acknowledges having them all, except for tingling in her extremities, and decides to visit her friend, Dr. Allen, and to investigate whether she should receive hormone treatments. (The full episode can be watched online at Lifetime.com until Oct. 11; preview a short clip at right.)

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Roseanne visits Dr. Allen — on camera, of course — this is a reality show — and explains her concerns. He asks about her libido and her sex life, and she replies, “It’s like an old person’s”. She responds forthrightly to his suggestion that dryness may be the cause of her ‘feminine itching’: “that’s all dried up like a sonofabitch”. Dr. Allen wants to measure Roseanne’s hormone levels with a 24-hour urine test, as he believes that will provide more precise information than any blood test. Roseanne is horrified by his description of her contribution to the procedure (“You pee in a bucket for 24 hours”), but even more horrified by his other recommendation: she needs to exercise.

Roseanne tells the camera — the proxy for us, the audience at home — that she doesn’t know if she’ll go on hormones or not. Her women friends recommend red wine, saying it’s bad for menopause (“because it makes you sweat”) but good for the libido. Her eldest son Jake is delighted to hear that his mom is considering hormones, telling the camera, “After eight years of being batshit crazy, I think she’s finally ready. I’m so happy — once she gets hormones, my life’s gonna be a lot easier.”

Some of my SMCR colleagues who study menopause may cringe at these scenes, but I think they’re representative of the kind of communication many women experience around menopause; that is, well-meaning, if ill-informed, advice from friends and family. It feels like the kinds of conversations lots of us have in our own living rooms and front porches. It is this feeling of unscripted authenticity that draws viewers to Roseanne’s Nuts. I also note the special irony of menopause; after 20 or 30 years of our hormones being blamed for erratic and irritable behavior, we’re now advised to consume hormones to rein in our erratic and irritable “batshit crazy” behavior.

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.