Blog of the Society for Menstrual Cycle Research

Depo Provera and menstrual management

April 8th, 2014 by Holly Grigg-Spall

Melinda Gates speaking at the London Summit on Family Planning; Photograph courtesy Wikimedia Commons

A few weeks back I did an interview with Leslie Botha regarding the distribution of Depo Provera to women in developing countries. Recently Leslie shared with me an email she received from someone working in a family planning clinic in Karnataka, India. He described how he was providing the Depo Provera injection to women and finding that, after they stopped using it, they were not experiencing menstruation for up to nine months. He asked for advice – “what is the procedure to give them normal monthly menses….is there any medicine?”

I have written previously about one potential problem of providing women with Depo Provera – the possibility of continuous spotting and bleeding that would not only be distressing with no warning that this might happen and no medical support, but could also be difficult to navigate in a place with poor sanitation or with strong menstrual taboos. As women in developed countries are so very rarely counseled on side effects of hormonal methods of contraception, it seems unlikely women in developing countries receive such information. As we know, some women will instead experience their periods stopping entirely during use of the shot and, as we see from this email and from the comments on other posts written for this blog, long after use.

In this context I find it interesting that the Gates Foundation’s programs for contraception access have a very public focus on Depo Provera. The method was mentioned again by Melinda Gates in a recent TED interview and when she was interviewed as ‘Glamor magazine Woman of the Year’ the shot was front-and-center of the discussion of her work. Yet the Foundation also funds programs that provide support for menstrual management and sanitation.  Continuous bleeding from the shot, or cessation of bleeding altogether, would seem to be an important connecting factor between these two campaigns.

Much has been written on the menstrual taboo in India and how this holds women back. In the US we have come to embrace menstrual suppression as great for our health and our progress as women. We see menstruation as holding women back in a variety of ways. However, in India could lack of menstruation also be seen as a positive outcome? Instead of dealing with the menstrual taboo with expensive programs that provide sanitary products and education, might suppressing menstruation entirely be seen as a far more cost-effective solution? It may seem like a stretch, but I am surprised this has not been brought up during debates about the need for contraceptive access in developing countries. Yet of course, the menstrual taboo may well extend to absence of menstruation – a woman who does not experience her period might also be treated suspiciously or poorly.

When Melinda Gates says women “prefer” and “request” Depo Provera I always wonder whether that’s after they’ve been told how it works (perhaps described as a six-month invisible contraception) or after they’ve had their first shot or after they’ve been on it for two years and then, via FDA guidelines, must find an alternative? How much follow up is there? As the self-injectable version is released widely how will women be counseled? Gates argues that the invisibility of the method is part of the draw as women do not have to tell their partners they are using contraception, but what happens when they bleed continuously or stop entirely?

It seems to me like there might be a real lack of communication – both between medical practitioners and their patients, drug providers and the practitioners, and those who fund these programs with everyone involved. It is often argued that the risks of pregnancy and childbirth in developing countries justify almost any means to prevent pregnancy – including the use of birth control methods that cause health issues. How much feedback are groups like the Gates Foundation getting on women’s preferences if they seem to be so unaware of the potential problems, even those that would greatly impact their wider work?

Men(ses) At War

February 25th, 2014 by David Linton

Taboos against menstrual sex are probably rooted in an inchoate understanding that there is less likelihood of conception during menstruation. If procreation and tribal survival are the goals, then delaying sexual congress until ovulation makes sense, especially if the men and women involved are going to be reliably available to one another continuously. But, what if the window of sexual availability is open for a limited amount of time; what if it could close at any moment—permanently?

This is the situation facing men and women during war time mobilization. Soldiers are given brief furloughs following basic training before new assignments or prior to being deployed to a war zone. Such leaves are fraught with anxiety and questions: How long will the man be gone? Will he be wounded? Will he come back alive? The emotional stress of the moment is profound.

There is no way to know if couples in ancient cultures set aside menstrual prohibitions when faced with forced separations. Were love, sexual desire, and fear of loss stronger motivators than taboos and social conditioning? However, there is evidence that in mid-20th Century war times in the USA women were subtly encouraged to set aside any reluctance to engage in sex during their periods. In fact, doing so was framed as a patriotic duty, along with being a reliable worker in the defense plants. The evidence resides in a series of print ads widely distributed in popular magazines shortly after World War II began.

An entire campaign for Kotex products was built around the idea that women should be socially, romantically, and, by implication, sexually available to men home on leave from military service regardless of the status of their menstrual cycle. The most blatant example is an ad that appeared in Woman’s Home Companion and other women’s magazines in 1942 with the provocative heading, “You’re the fun in his furlough.” At the bottom of the ad we see two women working at a defense plant, a job that is made to seem doubly exhausting if the working woman has her period. Her problem is that her boyfriend is home on leave this night and she is thinking she just can’t go on a date. But it’s Kotex to the rescue. She can avoid being “a deserter” (at least it stops short of suggesting she’d be a traitor) if she’d only use the right menstrual product.

The sexual imagery in the ad is remarkably bold as she flaunts the labial folds of her gown and his penis/saber rises to her. The messages of the ad are quite clear: 1) this glamorous woman is menstruating and wearing a Kotex pad; 2) her boyfriend soldier is on leave for a short time; 3) both parties are sexually aroused; 4) they will engage in sexual intercourse this night despite the fact that she is menstruating; 5) the woman has a patriotic duty not to let her period get in the way of his sexual desire.

It is not surprising to think that sex would trump custom and tradition in circumstances such as the one depicted here. What is of greater interest is whether or not once the taboo had been defied in response to the threat of loss in the context of war the participants felt less inclined to return to the traditional ways once peace and stability had been reestablished. That challenging piece of research is yet to be undertaken.

Etiquette for menstruation

November 19th, 2013 by Holly Grigg-Spall

Photo courtesy of sweeteningthepill.com

Recently I was fortunate enough to be asked to lend an excerpt of my recently released book to the UK Sunday Times Style magazine. The mostly fashion-centric Style magazine is not really known for its edginess or risk-taking (except perhaps in the realm of shoe and make-up choices) and so I was happily surprised when the editor told me that the subject matter discussed in my book that she happened to find most interesting was, in fact, menstruation. I had expected her to want to focus on condoms perhaps, or just my personal story, but no, she was keenly interested in what I wrote about periods.

The argument I make in my book is that how we feel about hormonal birth control is inextricably linked to how we feel about menstruation. In a sense, many of the newer methods of hormonal birth control, as well as the newer uses (running packets of pills together, prescriptions for cramps or heavy bleeding) show an effort to get rid of the period completely, rather than just hide it away. I also discuss in the book, briefly, menstruation activism. However, I do defer to the far better work done by the likes of SMCR’s own Chris Bobel who writes on this topic with far more knowledge (not to mention wit).

You can read the feature in full here at my website (it’s otherwise behind an online pay wall and frankly I’m pleased to rob Rupert Murdoch of a few pounds by making it freely available).

In the end, the feature was not exactly an excerpt from my book – more so it was quotes from the book mixed with quotes from a long interview with the editor. Therefore I didn’t quite know what would be published in the magazine. The finished piece covered a range of controversial topics seen here at re:Cycling regularly – menstrual outing, reusable femcare products, the potential health benefits of ovulation…

If the high point of my career was getting the word “patriarchy” into the notoriously right-wing British tabloid The Daily Mail, I think I had another peak seeing this sentence in the Style (notorious for its high priced designer fashion spreads) – “This movement believes the act of stopping and hiding our periods with hormonal contraceptives and sanitary products is a mark of corporate ownership of our bodies.” I take great pride in also getting a discussion of menstrual extraction on to Style’s pages, and therefore onto the breakfast table of approximately one million British people – “an entire period’s worth of menstrual blood could be removed in a few hours instead of being experienced over days.” Well, if we can have Page 3, why not menstrual extraction?

The editor who did such a great job on this piece was Fleur Britten and in a funny twist of fate I realized, during our conversations, that in my first full time working position after college, at the publishing company Debrett’s in London, I worked as a production assistant on one of her books – Etiquette for Girls. At that time controversy surrounded Fleur’s section on the proper etiquette for one-night stands (I think it was something about getting out quickly, quietly, but leaving a nice handwritten note). So, it made me smile to see her skewer the etiquette of menstruation in the opening paragraph of this piece: “Many women are bored with having to take a whole handbag into the ladies rather than carry a tampon in their hand. Men say “I’m going to take a dump,” but we don’t say, “I’m just going to change my tampon.””

When I was carrying the proofs of Fleur’s book to the printers back some seven years ago, little did I know we would be conspiring to get the British public to say “I am menstruating” today over tea and toast.

Menstrual Phobia on the History Channel

September 17th, 2013 by David Linton

One of the biggest changes in TV programming in the last 20 years has been the rise of programs collectively known as “Reality TV.”  The primary stylistic device in nearly all of these shows consists of cross cutting between “real” moments that the participants are engaged in and their direct address to the audience via the camera during which they comment on the experiences they are having. Whether it’s Mafia Wives or one of the Real Housewives spin offs or a home make over effort, we are meant to believe that the arguments, conversations, redecorating efforts or struggles to survive in the wild are actual, unstaged events that the camera has happened to capture in a documentary kind of moment. The commentary that the participants provide is intended to help the viewers comprehend the motives and inner feelings of the “characters” and to give them opportunities to add editorial interpretations on each other’s behavior.

Despite the fact that many of the reality shows feature women in intimate situations, very few of them include references to the women’s menstrual cycles. The rare exceptions, such as a single episode of Jersey Shore or Sorority Life, are noteworthy not just for their very existence but, as in both of these cases, because they depict menstruation with a smarmy leer.

A show on The History Channel called American Restoration gives the cycle a different spin by focusing on how freaked out men can be about any contact, no matter how distant or benign, with menstrual products. This show consists of weekly stories about a repair and restoration shop called Rick’s Restoration which specializes in restoring broken or antique objects such as cars, antique toys, or equipment to a pristine condition.

In this episode, a woman named Kelly who is part of the family that owns the business arrives with an old 1940s Kotex dispenser that is dinged and scratched and the mechanical innards are broken. A client wants it repaired and painted pink with a red ribbon to be auctioned off at a charity event.

The men who are given the task are appalled. Rick Dale, the head of the company, responds to the challenge by saying, “You gotta be kidding!” and adds, “It’s the first, and hopefully the last, feminine napkin dispenser we ever have to do.”  It goes down hill from there. One man grumbles, “Well, I’m not touchin’ that,” and another carps, “Hell no, I ain’t touchin’ that Kotex machine. Kelly is out of her mind.” Yet he sets about refurbishing the device under full coverage of the camera crew while announcing how shameful it would be if anyone saw him, “I got to get the hell out of this room before anyone finds out I helped Kelly with this one.”

To show just how widespread menstrual contamination can reach, the teenaged son of the owner, a spiked hair youth named Tyler, is sent to the store to buy a variety of products to test out the repaired machine. His take on the assignment is dire, “I hate my life. I don’t know what could be more embarrassing than this [pause] Nothing – NOTH-ING.”

We then see him in a market loading various packages into a shopping cart and wheeling them to the checkout counter while his voice-over says, “I swear, I’m scared for life.” He asks the woman clerk to double bag his purchase before lugging his buys back to the shop.

As the beautifully restored dispenser is revealed, Rick speaks to the camera again, “I got a shop full of guys and getting them to work on something specifically for women was like pulling teeth.”

The show ends on a happy note as the device nets a final bid of $400.00 to go for breast cancer cure and treatment.

Of course, there’s a peculiar contradiction in the arrangements in this show. At the same time that the men protest vociferously that being seen having anything to do with a menstrual product is deeply humiliating they are gladly (we assume) participating in the filming of the show so that potentially thousands of viewers will witness their shame. The moral? Fame Trumps Shame.

Menstrual Showdowns and Breakthroughs

July 25th, 2013 by David Linton

Is it my imagination or has there been a flood of menstrual references across the blogosphere lately? From fake Russian ads with menses hunting sharks to singers faking leaks on stage to TV sit-com jokes and vodka bottles disguised as tampons it seems that the number of open references to the cycle has hit a tipping point. And though many of the references fall far short of enlightened or positive, the fact that the menstrual closet seems to be wide open might be a sign of greater acceptance of basic biology.

But, sadly, the menstrual product industry continues to disappoint, as a recent ad for U by Kotex demonstrates. The attempt is to broaden the sales of their panty liner by convincing women that not only their menstrual fluid needs to be kept hidden but so does their perspiration, especially if originates in the same part of the body. But almost immediately a response to the ad, by a man, no less, appeared that amounts to a take down of the offending promotion.

Take a look at the ad as well as the response on the ever-reliable BUST web site.

Breaking News: Men Discover Tampons Can Absorb Blood

June 13th, 2012 by Elizabeth Kissling

Photo by henteaser // CC 2.0

Last week at The Art of Manliness, a contributor wrote a post about numerous possible wilderness survival uses of tampons. The post was picked up by the popular site, Boing Boing, and the commenters in both sites added more uses, as well uses for disposable maxi pads (although some contributors seem uncertain of the difference). Many creative uses for disposable femcare products were suggested, and while I can’t personally vouch for (or against) any of them, I offer this post as Public Service Announcement to correct some of the misinformation about tampons and pads that those uses presume.

The use of an opened tampon or a maxi pad for a bandage probably seems obvious to re:Cycling readers, as many are familiar with the history of Kotex, developed when World War I nurses discovered that the cotton cellulose they were using on wounded soldiers was highly absorbent. (The phrase ko-tex stands for cotton texture.) But as a few sharp readers of The Art of Manliness are aware, it has been decades since maxi-pads or tampons of any brand were made of cotton (except, obviously, the all-cotton types sold in health food stores). Pads are made from mostly from wood cellulose fibers, with plastic outer layers made of polypropylene or polyethylene. Some of the newer, improved maxi-pads feature synthetic gels designed to draw blood away from the body — not exactly a feature you’d want in a bandage, when you’re trying to stanch the flow of blood and promote clotting. If you’re bleeding heavily, you’re probably better off tearing off your t-shirt and pressing it against the wound. Tampons are also made of wood cellulose, often with a core of viscose fiber. Viscose fiber is rayon, created by treating cellulose with sodium hydroxide and carbon disulfide.

And although most brands are individually wrapped these days, neither tampons nor pads are sterile. Nor are they produced in sterile conditions. I’d be very leery of using a tampon as a water filter. Surely there are safer, equally portable, emergency filters one could pack in a wilderness survival kit.

Many of the other emergency uses of tampons involved using the fluffy wood pulp as kindling, or otherwise setting them on fire. Now there’s a use I can get behind!

Menstrual Marketing Around the Globe — Israel

May 22nd, 2012 by David Linton

Scary Little Menstruating Girl

[note: Although re:Cycling has an international audience, the following post is written from the perspective of an North American consumer.]

As is well known, cultural practices and attitudes regarding menstruation vary widely from place to place and time to time. re:Cycling has commented on the variety frequently in the past.  Differences also make themselves felt even in advertising and packaging of menstrual products, as the notorious Kotex Beaver ads from Australia demonstrate, despite the fact that the products are manufactured by global, trans-national corporations. Though the fact that the menstrual cycle itself is a world-wide biological phenomenon might suggest that views of its meaning and management would be universal as well, nothing could be further from the truth.

Kita and package of Kotex YoungConsider an ongoing marketing campaign that originated in Israel that features a cartoon character named Kita. To the best of my knowledge this campaign has not been adapted for use in the United States, nor, in my opinion, is it likely to find a place in American advertising nor on American market shelves. The spookiness of the cartoon girl who resembles a Japanese anime character seems strangely unlike the way that American consumers commonly depict young teens in a menstrual context. Even the lettering of “Young” and the way the term is used are unfamiliar to American eyes. Of course, the term “Normal Plus” is meaningless but that’s not unusual in advertising everywhere. And all the shades of red and the display of hearts across the bottom of the package are unfamiliar to American consumers as well. In fact, the menstrual taboos in America have resulted (with few exceptions) in a near absence of red, other than in carefully planted touches such as the ribbon on Mother Nature’s menstrual gift box in Tampax Pearl ads, the hair and lipstick of the magician in the Always pad ads, and the big red dot in many Kotex ads.

The Kita campaign began with careful planning and design. As this promotional video from McCann-Erickson, the Tel Aviv ad agency behind the campaign, explains, it began with the creation of a character and an internet world based on notions of what the target consumers – 10 to 13 year old girls – are thought to love most: shopping, the Internet, shopping, clothing, and, of course, in addition to shopping, more shopping. The character of Kita (“the coolest friend any girl could want”), who narrates her own creation and success story, speaks in a voice that is derived from the American “Valley girl” model, complete with plenty of “like” phrases, a few “awesomes,” an “as if” and a “duh” or two. How Kita immigrated from the San Fernando Valley to Tel Aviv is a mystery, although her native voice does come through a few times via some non-Valley pronunciations. (She pronounces “Kotex” as though it were spelled “Kodex.”) According to the boastful promotional video clip, Kita has achieved remarkably high market saturation. It claims that, “95% of Israeli girls know me and love me” and that “1 of every 2 Israeli girls (12-15) has a profile in Kita City.” Furthermore, since the launch in 2007, the “Kotex market share grew by 56%.” If this is what it takes — a menstrual role model who babbles in clichés, is consumed with consuming, wallows in the trivial, yet does so with seeming self-confidence and menstrual cycle savoir faire — to break down even an iota of menstrual shame and insecurity, who are we to object? And the fact that Kita has become a transnational, widely identified cultural meme, as the agency seems to claim, then maybe her next assignment should be to promote world peace. Ya never know!

KOTEX IS IN THE HOUSE! (or, Is the House?)

April 27th, 2012 by David Linton

Despite occasional efforts by manufacturers of menstrual pads and tampons (the giants of the menstrual-industrial complex – thanks, President Eisenhower) to present period-positive images, they still seem unable to resist representing menstruation as an undesirable, embarrassing phenomenon. Women, particularly teens, are expected to grin and bear it as best they can while enduring their monthly misery.  Consider a recent example.

A few weeks ago, the small college where I work received 12 large cartons from a firm called Brand Connections, which apparently specializes in managing promotional campaigns that involve providing free samples of products.  Each carton contained 72 box-like items made up to look like thick text books but with a cover that closely resembled a copy of Teen or Seventeen magazine.  In large letters on the spine and front are the words, “GET REAL.”  The instruction sheet in each carton included warnings that the contents “may not be suitable for children” and that selling the items rather than giving them away “may result in civil and/or criminal prosecution.”  And, in bold type, the page states, “This box contains FREE House of Kotex samples!”  The college authorities were directed to, “Please hand out the House of Kotex samples to your Universities [sic] female students for their enjoyment.”

 

However, the contents of the package itself were a bit more ambivalent about any connection between menstrual products and enjoyment.

The box opens to disclose, on the right side, two plastic pouches, one white containing a pad and a panty liner, and one black containing a pad, a wipe and a tampon.  On the left, emulating a feature popular in teen girl magazines, is a six item quiz in which girls are asked to choose favorite shoes, lip gloss colors, eye shade, date wear and weekend entertainment.  The sixth item, “Being on your period is. . .” provides the following choices:

  1. the worst
  2. not so bad
  3. part of life
  4. super annoying

If one picks 1. or 4., one is directed to the black pouch; if one chooses 2. or 3., the white pouch is for you.

The cartons were placed around the campus at strategic locations for young women (or curious young men) to pick up the packets.  One enterprising student rifled a few dozen of the tampon packs to store up a stash of her preferred product for the next few months.

Though the cover photo of two smiling young women and the slangy headline references to bonding, fun, and sharing, as well as the playful references to popular items inside created a sense of happy girlhood, the non-so-subtle way the period was described unfortunately reinforced the nuisance trope that is so deeply engraved in young women already.

Readers are invited to propose alternative options to the last question in the menstrual quiz.

Kotex Tampons Recalled Due to Bacterial Contamination

November 14th, 2011 by Elizabeth Kissling

From parenting.com:

If you’ve got Kotex tampons at home, check your boxes: Kimberly-Clark, Kotex’s parent company, has recalled the brand’s Natural Balance Security Unscented Tampons (Regular Absorbency) in both the 18- and 36-count boxes, reports the U.S. Food and Drug Administration. The recalled tampons were sold at select Walmart stores in Iowa, Kansas, Missouri, Nebraska, New Mexico and Texas; select Fry’s stores in Arizona; and select Smith’s stores in Utah and Arizona.

During the manufacturing process, the tampons were contaminated with the bacterium Enterobacter sakazakii, which can cause UTIs, pelvic inflammatory disease, and potentially life-threatening vaginal infections. There is also a chance that the bacteria can be transmitted between individuals.

Consumers should stop using the tampons immediately and contact a physician if you have used them, or if you experience unusual vaginal discharge, rash, fever, headache, vomiting or abdominal pain, particularly if you have AIDS, are HIV-positive, are pregnant or have cancer or any other existing serious illness.

Consumers should also contact Kimberly-Clark’s Consumer Services Division at 1-800-335-6839 so the necessary information and arrangements can be made to retrieve the unused product.

A full list of products is available at the original post.

Culture-Jamming Kotex

October 5th, 2011 by Elizabeth Kissling

If you’ve been with us for a while, you might remember that we (and our fabulous readers) had a lot to say in the spring of 2010 when Kotex launched U by Kotex (or YOU.BUY.KOTEX, as we came to call it) and its “Break the Cycle” campaign.

In digging up a copy of the “Reality Check” video that launched the campaign for one of my classes this week, I came across this critique of “Reality Check” by an activist/artist identified online only as Annamalprint. She’s a menstrual activist after our own bleedin’ hearts!

The campaign has won many advertising industry awards, and has been credited with increasing Kotex sales by 10%, by the way. We can expect those neon tampons to be around for a while.

The Two Voices of Kotex

August 16th, 2011 by Elizabeth Kissling

This Kotex advertisement appeared in the September, 2011, issue of Ebony magazine.

Slip on stilettos and zip up those skinny jeans. Because there’s nothing so comfortable to a menstruating woman as skin-tight pants, right? At least they’re not white pants.

It is interesting that for one line of products, Kotex is mocking the usual tropes of femcare ads, while deploying those very same clichés for their other line.

 

Tampon Wars

August 12th, 2011 by Elizabeth Kissling

Remember back in February when I made fun of Tampax for explicitly comparing their Tampax Pearl to U by Kotex in their newest print ads? Such direct comparison to the competitor’s product is not a trendy marketing strategy; it hearkens back to the days when Darrin Stephens was a copywriter. (You young-uns can look up that reference.)

I wasn’t the only one who noticed: a recent article in Ad Age says the “30% better protection” strategy has not been used in femcare marketing since Rely tampons were withdrawn from the market in 1980. Not coincidentally, that was the last time Tampax picked up significant market share — a lot of those former Rely users switched to Tampax (Tampax was not owned by P&G at the time, but Rely was).

With the U by Kotex brand apparently winning new customers as well as winning others away from Tampax, how successful will “30% better protection” be as a persuasive strategy? Jack Neff (author of the Ad Age piece) points out that it’s pretty challenging “in a category where absorbency has been tightly regulated by the Food and Drug Administration in the wake of the Rely withdrawal.”

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.