Blog of the Society for Menstrual Cycle Research

Women’s Reproductive Health journal explores postmenopausal hormone therapy

June 17th, 2015 by Laura Wershler

Free access to Women’s Reproductive Health, the journal launched by the Society for Menstrual Cycle Research in 2014, is available to all SMCR members. To become a member of the society or to obtain a subscription contact info@menstruationresearch.org.  For media, submission, and other inquires about the journal contact editor Joan C. Chrisler at jcchr@conncoll.edu.

 

Guest Post by Joan C. Chrisler

The spring 2015 issue of Women’s Reproductive Health contains our first special section: on postmenopausal hormone therapy. The section contains a thought-provoking anchor article by menopause expert, psychologist Paula Derry. It is followed by short commentaries by a multidisciplinary group of menopause experts–a physician, a sociologist, an anthropologist, and a nurse. This set of papers would make an excellent reading assignment for a women’s health course, and it is sure to generate class discussion. The issue also contains two other research reports: one on women’s experiences with gynecological examinations, and the other on the relative absence of mentions of menstruation in novels aimed at adolescent girls because publishers are worried about challenges by parents and school boards that could hurt sales. The issue is rounded out with three book reviews.

 

Women’s Reproductive Health

Volume 2, Number 1 (Spring 2015)

Special Section on Postmenopausal Hormone Therapy

Article
Evidence-based Medicine, Postmenopausal Hormone Therapy, and the Women’s Health Initiative – Paula Derry

Commentaries
The Science of Marketing: How Pharmaceutical Companies Manipulated Medical Discourse on Menopause – Adriane Fugh-Berman

Medicalization Survived the Women’s Health Initiative…but Has Discourse Opened up? – Heather Dillaway

Animal Models in Menopause Research – Lynette Leidy Sievert

Lost in Translation? – Nancy Fugate Woods

Articles
A Multi-method Approach to Women’s Experiences of Reproductive Health Screening – Arezou Ghane, Kate Sweeny, & William L. Dunlop

The Censoring of Menstruation in Adolescent Literature: A Growing Problem – Carissa Pokorny-Golden

Book Reviews
Investigating the Ubiquitous: The Everyday Use of Hormonal Contraceptives – Marie C. Hansen

Menstruation’s Cultural History – David Linton

WomanCode: Caveat Emptor – Elizabeth Rowe

Joan C. Chrisler is a professor of psychology at Connecticut College and the founding editor of Women’s Reproductive Health. Her special areas of interest include PMS, attitudes toward menstruation and menopause, sociocultural aspects of menstruation, and cognitive and behavioral changes across the menstrual cycle.

Menstrual management for women with disabilities, menstrual hygiene taboos, and menstrual cycle awareness

May 28th, 2015 by Laura Wershler

These two concurrent sessions address the menstrual-related challenges of women with disabilities, menstrual hygiene taboos and practices around the world,  and the concept of gynaecological self-help at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston.

 

Menstrual Management, Friday, June 5th:

Women with Spinal Cord Injuries Talk about Menopause
Heather Dillaway, Wayne State University

Using data from interviews with 20 women with spinal cord injury, I illustrate how disabled women may think about and experience menopause. Overall, interviewees think positively about menopause as a release from the hassles of menstruation, but face unique experiences when dealing with perimenopausal symptoms. I also discuss their concerns about aging.

“Kahani Her Mahine Ki” – A Menstruation Kit for the visually impaired women
Sadhvi Thukral, National Institute of Design

“I am constantly worried that my dress will stain during my period, I cannot see.”

“I will never be able to tell the colour of my discharge during menstruation or when I need to change my cloth. To be safe, I change every few hours.”

These are unique anxieties of visually impaired young women.

A large gap exists in the area of “Communication for Menstruation” for the visually impaired. This design degree project was an attempt to fill this gap by developing a product for menstruation that would meet the needs of visually impaired girls and women.

The kit “Kahani Her Mahine Ki” (The Same Story Every Month) covers the subject of menstruation and how to manage during periods and has the following features:

1. Tactile diagrams and material in the form of Information Slates, with labels of the different body parts. Each slate has text for the sighted and Braille for the visually impaired. 2. A life size human body model for demonstration.

What they do, what we do, what I do: A critical review of five contemporary international surveys of menstrual management practices and technologies. How can these surveys inform Western practice? What areas remain to be surveyed?
Susannah Clemence, Independent researcher

This critical review compares the catalogues of contemporary menstrual management techniques from around the World, presented in Sommer et al (2013), House et al (2012), Kjellen et al (2012), Bharadwai and Patkar (2004) and Finley’s (1995-2015) Museum of Menstruation.

The purpose is to test how well-documented are contemporary practices across the World, and what areas remain yet unrecorded. The rationale is that diverse technologies and conduct, with their implicit beliefs and attitudes, grant us reference points from which to examine, critique and improve our own practices.

The review shows that there are large gaps in documented knowledge. Furthermore, other than the Museum of Menstruation, existing surveys tend to be rooted in development agendas of Western origin and tend to a deficit perspective of non-Western practices.

 

Menstrual Hygiene, Saturday, June 6th

A Vicious Cycle of Silence: The perpetuation of the menstrual hygiene ‘taboo’ and the implications for the realisation of the human rights of women and girls
Emily Wilson-Smith, Kampala International University & Robyn Boosey, University of Bristol 

Despite the impact of poor menstrual hygiene on the rights of women and girls it has remained largely neglected by International stakeholders. A document analysis of the core international human rights treaties and relevant human rights body reports found an overwhelming silence and an analysis of the existing references revealed an inadequate framework for addressing menstrual hygiene.

Improving Menstrual Health and Hygiene in India: Another critical path way for women emancipation
K Yadagiri, Centre for Economic and Social Studies,UNICEF Division for Child Studies 

Gynecological Self-Help Isn’t Just a Good Feeling – What we learned when we systematically studied our own menstrual cycles – and how you can learn MORE now!
Kathy Hodge, Feminist Women’s Health Center

In 1975, nine members of the Feminist Women’s Health Center collective met daily for over a month, recording changes in our vaginas and cervixes and their secretions, for PAP and ferning smears, charting moods and basal body temperature. We raised questions, some of which remain open and ripe for future woman-controlled research.

 Menstrual Hygiene Management practices in Slums: It’s impacts on the Women and Adolescent Girl’s Health – A Case study of Greater Hyderabad Municipal Corporation Slums, Telangana State, INDIA
Venu Madhav Sharma, Centre for Economic and Social Studies

Media Release and Registration for the SMCR Boston Conference on Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

Experiencing Menopause: Sexuality, desire and literary exploration

April 27th, 2015 by Laura Wershler

Three paper presentations on Menopause at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston will explore sexuality and the menopausal woman, as well as personal menopausal experiences as collected in a literary anthology.

1. Sex and the Menopausal Woman: Resisting Representations of the Abject Asexual Woman
     Presented by Jane Ussher and Janette Perz, Centre for Health Research, School of Medicine, University of Western Sydney 

Drawing on qualitative research conducted with women at midlife, and those who have experienced premature menopause after cancer, we argue that sexuality can continue to be a positive experience for women throughout adult life and into old age.

Medical discourse has traditionally positioned the menopausal transition as a time of sexual atrophy and loss of femininity, with hormonal replacement as the solution. In contrast, feminist critics have argued that women’s experience of sexual embodiment during menopause is culturally and relationally mediated, tied to discursive constructions of aging and sexuality, which are negotiated by women.

This paper will present a critical examination of women’s experiences of sexuality during and after the menopausal transition, drawing on in-depth one-to-one interviews we have conducted with 21 women at midlife, and 39 women who have experienced premature menopause as a consequence of cancer treatment.

Theoretical thematic analysis was used to identify three themes across the women’s accounts: ‘Intrapsychic negotiation of sexual and embodied change’; ‘Feeling sexy or frumpy: Body image and the male gaze’; ‘Indifference or desire? The relational context of sexuality during menopause’. Through this analysis, we challenge myths and misconceptions about the inevitability of sexual decline at menopause, as well as normalise the embodied changes that some women experience–whether menopause is premature, or occurs at midlife. We argue that sexual difficulties or disinterest reported by women during and after menopause are more strongly associated with psycho-social factors than hormonal status, in particular psychological well-being, relationship context and a woman’s negotiation of cultural constructions of sex, aging, and femininity. However, sexuality can continue to be a positive experience for women throughout adult life and into old age, with many menopausal women reporting increased sexual desire and response, as well as re-negotiation of sexual activities in the context of embodied change. This undermines the bio-medical construction of menopause as a time of inevitable sexual atrophy and decay.

2. Writing Menopause: Creating an Anthology
     Presented by Jane Cawthorne and E. D. Morin

The editors will discuss their process of envisioning and creating a new literary anthology that considers the diverse experience of menopause from various points of view. The anthology is composed of new works of poetry, short fiction, interviews, creative non-fiction, and cross-genre pieces, along with several previously published creative works that were chosen to round out the collection.

Although the editors make no claims that this work is in any way definitive, their focus instead was to create a venue for more stories and to encourage a richer vocabulary about this important transition within a literary context. The editors have observed that few literary representations of menopause exist. They will explain how they arrived at wanting to create this collection, as well as the submission process, the criteria used in accepting submissions, and how the shape of the collection shifted organically with the nature of submissions received. They will reflect on what types of submissions they would not accept, what they think the volume says about menopause, and how their own ideas about menopause were changed during the process. A few excerpts will be read.

3. Sexuality and Post-Menopausal  Women:  Desirability and Desire
     Presented by Maureen C. McHugh, and Camille J. Interligi,  Department of Psychology, Indiana University of Pennsylvania

Ageist cultural messages portray old bodies as ugly, asexual and undesirable (Calasanti & Slevin, 2001; Furman, 1997), and yet not engaging in sufficient partner sex is viewed as a sexual dysfunction.  How do contradictory cultural messages about the sexuality of older women impact their sense of themselves as sexual beings?

Aging threatens women’s sense of themselves as women, as sexual beings, and as sexually desirable (Clarke, 2011). Ageist cultural messages convey the cultural value placed on youthfulness and portray old bodies as ugly, asexual and undesirable (Calasanti & Slevin, 2001; Furman, 1997). Stereotyped as experiencing physical and sexual decline, and viewed as asexual, older women’s sexual interest may be deemed inappropriate. Yet not engaging in sufficient partner sex is seen as a dysfunction (McHugh, 2006).  Who says how much sex is enough? How do contradictory cultural messages about the sexuality of older women impact their sense of themselves as sexual beings?

Male Menopause, Andropause and now “Manopause”?

August 22nd, 2014 by Heather Dillaway

August 18, 2014 cover of TIME magazine

By now, everyone has probably seen this week’s TIME cover story. The magazine’s August 18th cover photo showed a topless, seemingly frumpy, middle-aged man worried about his loss of testosterone and (therefore) manhood under the title, “Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry”. The cover story details the booming testosterone (“Low-T”) industry in the U.S., describing the reasons why middle-aged men might go to the growing number of Low-T clinics for treatment. While the article draws some interesting parallels to the hormone therapy industries that have targeted women and highlights some of the important risks and unknowns about Low-T treatments, there are some interesting gaps and missteps in the article that are worth detailing.

First, if we are going to talk about a male menopause, can we please pick one term? This author of this article refers to male menopause, andropause, and then titles his article “manopause.” So, which is it? Having all of these terms floating around is just confusing. As we know from research on women’s menopause, having more than one term or having vague terms for a health condition just leads to confusion. This article adds to the confusion over terminology.

Second, the article is titled “Manopause” but really has little to do with this supposed testosterone “deficiency” condition. The article is mostly about the growing Low-T industry and men’s search to remain youthful. It is more about potential treatments for testosterone deficiency than anything else. Anyone looking for information on what “manopause” is would be misled by the title and would not find any answers in this article. At most, readers learn that men who are worried about aging might have low testosterone. Readers will not gather comprehensive information about manopause, andropause, male menopause, or male aging.

Third, this article only addresses research on testosterone “deficiency” in a cursory manner. Readers looking for actual evidence of decreasing testosterone in midlife or the need for Low-T treatment should make sure to consult scientific studies of such things. Since this is TIME magazine, this is not a source of any real information on these subjects. As another commenter reports, the author’s reference to “foggy science” is also misplaced; while we do not have complete answers, there are real studies to be found on this subject.

Fourth, there are comparisons made to women’s menopause, hormone therapy for women, and how women handle their midlife transitions in this article. While it makes sense to compare endocrinological changes in women’s and men’s bodies and burgeoning hormone replacement industries for midlife women and men, comparisons about how women and men “handle” their midlife transitions are a bit misplaced and subjective here. The author states that “women handle their [bodily] betrayal more matter-of-factly – a nip, a tuck, a tint, maybe, but not a Vegas condo”. The author argues that, “judging by the demographic profile of sports-car buyers,” men don’t deal well with testosterone deficiency and bodily change. As someone who has studied women’s bodies and women’s menopause for almost 20 years, I think this comparison masks the variation in how women or men might experience these transitions and reifies gender dichotomies that help no one in the long run. Women DO have trouble with bodily change at times. And the majority of men still forgo Low-T treatments. The author would have done better if he had steered away from these gendered generalizations about how individuals “handle” midlife.

A commenter at HealthNewsReview.Org asks, Does Manopause Really Warrant one of TIME’s 52 Covers This Year? This is a great question. The power of pharmaceutical industries in this country means that topics like this get more press than is probably warranted (especially in light of all of the topics that could have had this front page, such as Ebola, Ferguson, Parkinson’s or ALS disease, foreign conflicts, etc.). Some scholars argue that we are experiencing the “pharmaceuticalization” of society, which puts industries like the Low-T industry front and center and makes us think in terms of “deficiency”, “disease”, and “replacement”. Pharmaceuticalization reinforces ideas about the importance of youthfulness and unchanging bodies and makes the onset of midlife problematic in general. We are actively urged to fight bodily change (here termed bodily “betrayal”) despite how normal it is.

Lately I’ve also seen a lot of press on men and masculinity. NPR has been running an “All Things Considered” series on boys and men this summer, detailing the hardships and unique experiences that boys and men have. I also read that a group of middle aged men recently got together to create a play called “Four Play” to combat the hype around Menopause: The Musical – to make sure that men have their stage too. In Detroit this summer we’ve also been tangoing with groups of Men’s Rights Activists who feel that feminists are taking over the world. To me, the “Manopause” cover of TIME magazine falls right in line with other recent attention to “men’s issues”. To me, this is all a backlash against attention given to women’s issues. In some cases I don’t even think it’s a conscious or calculated backlash but it still presents as one.

Overall, I’m indifferent about this TIME story. I don’t think it warrants the cover photo or the cover story but it is interesting to find out about a growing testosterone industry. Nonetheless the hype around the story concerns me because I keep thinking about what’s lurking behind the hype. For instance, we have to think about the gendered dynamics behind these stories and media portrayals, for gender forms an important backdrop here and can hinder the pursuit of real knowledge about these midlife transitions. Gender ideologies are what make testosterone (and estrogen) important in the first place. In addition, I do think we need to settle on one term for male menopause/andropause/manopause and why it might be important for us to think about. Finally, we really need to think about what pharmaceuticalization means for all of us.

Waiting

August 20th, 2014 by Heather Dillaway

re-blogging re:Cycling

In celebration of our fifth anniversary, we are republishing some of our favorite posts. This post by Heather Dillaway originally appeared October 28, 2010.

I’ve been thinking a lot lately about the words we use when we’re talking about menstruation or reproductive experiences more generally. I’ve been noticing lately that we use the word “waiting” quite a bit. I have a friend who is “still waiting” for her menstrual cycle to be “normal” again after her second child, and several other friends who are either “waiting” to figure out whether they will get pregnant, “waiting” to be done with their pregnancies, or “waiting” before they can have their last and final kid. I just had my basement waterproofed and one of the basement repairmen told me that his wife had been “waiting” ten months to get a menstrual period and that they were worried about her (this is information he volunteered after I told him I studied women’s health). I started thinking more about how the menopausal women I interview always talk about “waiting” to figure out whether they are really “at menopause,” or “waiting” to figure out if this is really their last menstrual period. Or how so many girls/young women who are sexually active are “waiting” to get their periods so that they can be relieved to know they are not pregnant. Or how women with painful periods, endometriosis, or migraines are waiting until those days are over each month. What does all of this reproductive waiting (waiting for menstruation, waiting for menstruation to be over, waiting for pregnancy, waiting for birth, waiting for menopause) mean?

In all of these instances of reproductive waiting, waiting seems a negative connotation and that seems to stem from the fact that we do not feel in control or in charge of this reproductive time. When I think of the other situations in which I might use the word “waiting”, the same holds true. I tell my kids to “wait their turn” and they don’t like it. And none of us really like waiting in line. Fast food restaurants, frozen dinners, and ATM machines are all in existence because we don’t have time or don’t like to wait. Phrases that we use like “worth the wait” also connote negativity about waiting. So, I finally looked up the actual definition of waiting. Depending on which online dictionary you visit, definitions of “waiting” include: “pause, interval, or delay,” “the act of remaining inactive or stationary,” or “the act of remaining inactive in one place while expecting something.” While some of these definitions do not automatically lend themselves to negativity, waiting is defined mostly as a passive activity that we are forced to participate in, perhaps against our will.


All of this makes me think further about whether women really dislike the waiting or the time that comes with menstruation or other reproductive experiences, and whether women really feel out of control as they engage in their experiences. Is this just a word we use or are we really impatient about menstruation and reproduction? When I think about alternative words that are sometimes used, like “tracking,” other words seem much more agentic in that they put women back in control of their cycles and other reproductive experiences. So, is it just the word “waiting” that has the negative connotation or is that word signifying some larger impatience that we have about reproduction these days? I have a colleague who writes about the “inconveniences” of reproduction and how, in so many ways, we try to avoid the reproductive waiting or reproductive uncertainties we face. For instance, instead of waiting to see when a baby is born, we might plan a c-section so that we can know when we’ll get that baby. Or, now we’re told that if we’re “waiting” more than 6 months to get pregnant that we should probably start taking fertility drugs to shorten our wait or get rid of some of that uncertainty. Or now we can find out that we’re pregnant a couple weeks after conception instead of waiting to see whether we menstruate a few weeks later. We attempt to cut out some of those reproductive waits these days. Menstrual suppression is at least partially popular because then women won’t have to be surprised by their periods or wait to know what bad day their period might fall on.


I think perhaps we do need to be more conscious of the words we use to describe our own and others’ reproductive events. Is “waiting” the correct word to use? Is “tracking” a better word to use because of the agency/active control it implies? Is “experiencing” a broader, less value-laden word to use? What do we really mean when we use these words?

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

We Bring Our Bodies to Work

May 23rd, 2014 by Heather Dillaway

“Woman Working,” courtesy of Open Clip Art

A recent study by researchers at La Trobe University and Monash University in Melbourne, Australia, suggests that working women “need more managerial support [while] going through menopause.” This “Women at Work” study explored the health and wellbeing of working women and women’s satisfaction at work, yet focused on working experiences in or around menopause. The lead researcher, Professor Gavin Jack, reports that “menstrual status did not affect work outcomes” but that “if a woman had one of the major symptoms associated with the menopause — for example weakness or fatigue, disturbed sleep or anxiety, then this did influence how they regarded work.” Jack is further quoted as saying: “What is really important is not the fact of going through the menopause in itself, but the frequency and severity of symptoms which women experience, and how these factors affect their work.”

This study has been described in several news sources over the past few weeks, such as the International Menopause Society, Science Daily, and IrishHealth.com. I have many reactions to this research, both positive and negative.

I’ll present my positive feelings first: I appreciate the fact that researchers are talking about the fact that menopausal women are a large part of the workforce and that menopausal experiences matter for individual women. I also applaud the attention given to the fact that workers are human beings with bodies, and that bodies matter. The idea that employers should recognize that paid workers have bodies and that paid workers may be affected by their bodies is an excellent one. I agree that employers should be educated to be more sensitive to menopause and other bodily experiences that their paid workers might have, and simple adjustments in work policies and work environments can go a long way in making employees happier and more productive (plenty of research has already shown this). Finally, and maybe most importantly, as one article in Science Daily notes, “Not enough attention is paid to the experiences which people go through at different stages of life — the workplace treats this very unevenly.” I couldn’t agree more. Especially when it comes to midlife and aging, we forget that paid workers are still dealing with bodily transitions. We forget the range of chronic illnesses that paid workers might have at midlife and beyond, as well as the many normal health transitions that any midlife or aging individual deals with. Anything from the acquisition of bifocals (and learning to see differently through bifocal lenses) to the hassles of dealing with back pain, neck pain, arthritis, hearing impairments, insomnia, etc., can affect one’s work. Not to mention menopause, prostate conditions, and other aging health concerns that can involve a range of different signs, symptoms, and stages. Starting at midlife, it is also much more common to deal with caregiving for elderly parents, divorces and remarriages, putting kids through college (or putting up with adult kids living at home), deaths of parents and spouses/partners,  and other social transitions, and all of these things will impact how a paid worker feels and acts on the job. There is much to pay attention to about paid workers in their 40s, 50s, 60s, and beyond, and I believe that this research is a good start on that. Middle-aged paid workers may be reaching the peaks of their careers and may be excellent at their jobs, but they’re still dealing with a multitude of other life circumstances at the same time. And if they’re not performing well on the job, it may well be because of these very same issues. Paid workers are people, with full lives and physical bodies that they can’t leave at home (no matter how much they try).

I do have to offer my negative reactions to this research as well, however: Whenever I see menopausal women picked out and studied specifically for their difficult symptoms, I worry about how those results will be used by others. Someone skimming the news reports might assume that this research shows that menopausal workers are harder to deal with, or aren’t ideal workers. So, let’s make sure we read this research appropriately: this research does NOT report that the quality of women’s work decreases when they reach perimenopause or menopause. This research only reports that women feel differently about their workplaces and sometimes wish their employers were more supportive of menopausal symptoms. If we don’t read carefully, then we might assume that being menopausal is more deviant than it really is. Working While Menopausal is not typically a negative status, or at least not for most women. Quick news reports also don’t always portray research in full, and I think it’s important to note that women are not always bothered by menopausal signs and symptoms. This was a study that asked primarily about women’s feelings about their workplaces and how health and wellbeing impacted work satisfaction. It is not a study that can give us comprehensive information about women’s menopause experiences. Finally, let’s remember that menopause is just one of many, many health and illness experiences that can affect how people feel and act on the job. Menopause is not necessarily a reason for employers’ alarm, any more than divorce or elderly caregiving or arthritis or back pain is. Rather, employers should be sensitive to the health and wellbeing of all paid workers across the lifespan and recognize that different groups of workers face different health and wellbeing issues.

The M Word—In Multiplex

May 21st, 2014 by Saniya Lee Ghanoui

Saniya Lee Ghanoui and David Linton

Cross-posted from Public Books

Tanna Frederick, Eliza Roberts, and Frances Fisher in The M Word.

We don’t know where the coy linguistic practice of using-while-not-using so-called offensive words by appending the term “word” after its initial letter and preceded by “the”—as in “the N-word”; “the C-word”; “the F-word”; “the R-word”—came from. The practice functions in spoken and written speech the way the “bleep” does on television. Everyone presumably knows what the word in question is and says it silently to themselves whenever they hear or read the euphemism, but a quaint regard for a Victorian notion of what can be said in “polite company” allows the meaning of the expression to be put into play while not offending anyone. Furthermore, the construction is usually reserved for talking about the word rather than using it in its actual grammatical form. As such, it functions as a meta-phrasing, raising consciousness about the need to be sensitive to the potential that words have to hurt or defame their referents.

This year, Henry Jaglom, the Woody Allen of the West Coast, has cleverly appropriated the practice by applying it to another value-laden, emotionally charged topic: menopause. And while the word “menopause” itself is not as socially verboten as the four words alluded to above, the taboo phenomenon itself is, in some ways, just as culturally vexed and discomforting as the subjects of the other coded expressions.

Jaglom’s decision to name his new film (his 19th feature) The M Word cleverly appropriates the semantic maneuver to several ends. He invites the audience to think about the function of the hyphenation gambit in all its manifestations while at the same time bringing menopause out of its closet for some close scrutiny.

The plot device Jaglom utilizes for this purpose is the “film-within-a-film” construction employed in The Truman ShowThe Artist, and Boogie Nights. Here, as in those films, the nature of the medium itself and the way it shapes the behavior of individuals becomes both metaphor and content. In The M Word, a character named Moxie (Tanna Frederick) sets out to make a documentary television series—inspired by her menopausal mother and two aunts—that involves interviewing a variety of women (and one man) about their experiences and views on menopause for a TV documentary called “The M Word,” which is also the title of the (non-documentary) film we, in turn, are watching in the theater. (The film is actually about perimenopause but, as is common in every-day speech, uses the word “menopause” instead. To avoid further confusion and at the risk of perpetuating this mislabeling, we will use the term of the filmmaker’s choice as well.)

Moxie is an actor on a children’s television show at the fictional KZAM network in Los Angeles, where the staff seem to have one thing in common: most of them are menopausal women. The appropriately named Moxie pitches her idea for “The M Word” at a crucial time—her station is bleeding money and a New York–based “suit,” Charlie Moon (Michael Imperioli), is flown in to assess the situation (someone is embezzling funds from the station) and make any necessary employee cuts. And this is where the title’s second meaning comes into play: money. The parallel between the menopausal women and the “menopausal” television station is obvious: both are on their last legs and losing to younger and fresher women/programming. The discussions about money are handled in the same delicate way as menopause; it is something no one wants to talk about but everyone knows what is happening. Moxie, however, brings both M-words out of the closet.

The documentary includes many zany exchanges, as when Moxie asks her mother “What are you feeling right now?” and her mother (Frances Fisher), experiencing a hot flash, fans herself with a head of romaine lettuce and responds, “I’m feeling quite wet.” But it is this type of pep that serves Moxie well when she organizes an impromptu sit-in to save her colleagues’ jobs immediately after Charlie fires a good portion of the staff.

By this time a romance has developed between Moxie and Charlie that pits menopause against money with—spoiler alert—both coming out victorious in the end. The film also includes a good deal of commentary on PMS, as the menopausal women interviewed in the documentary reflect on their experiences as younger women. (These interview shots are humorously intercut with a scene of a debilitated Moxie struggling with her cramps.) Making the comparison between the painful menstrual cramps they used to have and the effects of menopause they are currently experiencing, the film presents the women as now free to enjoy their lives as older women and to face menopause as a rebirth.

What’s In A Name?

March 27th, 2014 by Heather Dillaway

This month an important Sage research journal, Menopause International, “the flagship journal of the British Menopause Society (BMS),” changes its name to Post Reproductive Health. The Co-Editors of this journal are quoted in talking about this name change:

“Women’s healthcare has been changing dramatically over the past decade. No longer do we see menopause management only about the alleviation of menopausal symptomatology, we also deal with an enormous breadth of life-changing medical issues. As Editors of Menopause International, we felt that now is the time for the name and scope of the journal to change; thus moving firmly into a new, exciting and dynamic area. We wish to cover Post Reproductive Health in all its glory – we even hope to include some articles on ageing in men. Our name change is a reflection of this development in scope and focus.”

This name change may seem very insignificant to most people but, for me, a change in name signifies major steps in conceptual thinking, research practice, and (potentially) everyday health care. While I have some problems with the new name (I’ll get to those in a minute), the idea that menopause researchers and practitioners are beginning to see menopause as part of a broader life course transition is phenomenal. It signifies the willingness of many in the business of studying and treating menopause to think more broadly about reproductive aging. It also indicates that many now understand that menopause is not necessarily the “endpoint” of or “final frontier” in one’s reproductive health care needs. Perhaps it also means that we might acknowledge that perimenopausal symptoms are more than single, isolated, “fixable” events and that they may be related to larger, long-term bodily changes. The very idea that “post reproductive health” is important is one that I support and advocate, and I see this as evidence of the realization that there is life after menstruating and having babies. What’s more, the re-branded journal seeks to include research on men’s health too, perhaps signifying that researchers and practitioners acknowledge the sometimes non-gendered aspects of “reproductive” or “post-reproductive” health. Everyone needs health attention, no matter what their life course stage.

What I can still critique about the name change, though, is that the new name of this journal suggests that menopause and other midlife or aging stages are thought of as “post”-reproductive. In my opinion, it is really that we live on a reproductive continuum, that we are never really “post” anything, that prior life stages always continue to affect us and that there are not strict endpoints to the menopausal transition in the way that the word “post-reproductive” might suggest. Reproductive aging as a transition could take as much as 30 years or more, and women report still having signs and symptoms of “menopause” into their 60s and beyond. According to existing research our “late” reproductive years begin in our 30s and don’t end until….what? our 60s? our 70s? The word “post-reproductive” suggests an “end” that maybe doesn’t really exist ever. Here is a link to an article I wrote on this idea of the elusive “end” to menopause, and I think it is important to think about how the word “post” may not be the best way to describe how we live our midlife and older years. We may still have “reproductive” health needs way into our 70s, 80s, and beyond, so how can we think of ourselves as “post” anything?

With this said, however, I still am very happy to see the current name change of the journal, Post Reproductive Health, because I believe it signifies a very important change in the right direction, and I hope to see many more moves like this as we contemplate what midlife and aging health really is.

A Letter to My Mom: I am Sorry I Was A Brat

February 17th, 2014 by Chris Bobel

Photo courtesy someecards.com

Dear Mom,

I owe you an apology.

Remember when you were perimenopausal (or as we called it, “going through menopause”)? Remember when you experienced hot flashes? And remember when you did, how we, your loving family, either 1) ignored 2) trivialized or 3) mocked you? Your hot flashes were a constant source of humor around our house and I recall you joining the fun.

But I am betting that while you were yukking it up, you felt lonely and misunderstood. I think you were just ‘being a good sport’ because what choice did you have?

You deserved better.

I admit that until recently, until I began hotflashing myself, I forgot about your transition and how we responded to it. But now that I am living with my own body thermostat on the fritz, I get it.

Now that I am consumed by cycles of heat and chill with no warning, I am having a major A HA ! moment. Now that I find myself waking in the night, my pillow wet, my face wetter, my sleep disrupted, I am time traveling to our sunny kitchen on 2nd Street—you: flapping your blouse, face flushed. Me: rolling my eyes.

I feel badly that I did not appreciate that this process is HARD. I feel badly that I made fun of you, thinking you just a silly old woman whining about something meaningless.

In short, I was a total brat.

Sure. I did not have models for compassionate support. It seems that the discourse of peri/menopausel has two nodes 1) joking  2) patholgizing—another distorted binary that fails to capture the complexity of human experience.

I know that today, struggling through my own perimenopause, I need some simple understanding. I am normal. This is normal. AND this normal reproductive transition can suck to high heaven.

While, we don’t need to stop the clocks or call the midwife, I would like some acknowledgement (minus the sexist aging jokes, please) that doesn’t make me  (or my body) the butt of a joke.

You deserved better when it was your time, Mom, and I am so sorry you didn’t get it.

Love, Chrisi

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.