Blog of the Society for Menstrual Cycle Research

The Last Snowflake

April 24th, 2013 by Heather Dillaway

Photo by Heather Dillaway, April 2013

My kids and I read a book about “the last snowflake” a few years ago. The book was a story about how the last snowflake felt as it hit the ground each winter – lonely because his friends were ahead of him and probably melted already, or maybe carefree and floating on the wind to say the last goodbye to winter. This year my kids and I keep trying to wonder when that last snowflake would fall. Was it a few weeks ago? No. Was it last weekend? No. Well, here it is snowing again today so will I see the last snowflake tonight? At some point this snow has to end – it’s late April! When WILL that last flake fall?
Plenty of people have written and sang about the “last snowflake” (do a web search and you’ll see). It’s a great thing to philosophize about: when will it come, what will it look like, will I miss it, am I ready for what comes after it, and, in general, how do I feel about the transition it represents? Am I glad to see that last snowflake of the season, or am I melancholy about it? Am I ready for the warmer weather, or did I like wearing warm sweaters and fleece pajamas? Do I like winter after all, even though it’s hard and long and seemingly never-ending, until it’s over? I like spring a lot but it’s always so short in Michigan and we head right into hot weather, there’s really not much in-between. Plus spring and summer mean the ramping up of activities and a busier schedule – am I ready for that? A part of me is already missing that last snowflake even though I don’t know if I have seen it yet….but then again, I’m pretty ready for winter to be over. Can I feel two things at once? Can I be sad and glad to see that last snowflake?
Why am I writing about snowflakes? Because I read a piece on the Red Hot Mamas website the other day about a menopausal woman’s last period that reminded me that of my thoughts about last snowflakes. In “A Gentle Good-bye,” Christine Merser talks about how she did not get to say goodbye to her last period at age 42, that it came too fast and she mourns (at least in part) the idea that she’ll never menstruate again. She acknowledges the hardships menstruation sometimes caused and the hassles that were part and parcel of it, but also reminisces in its life-giving qualities and feels a sense of loss. She feels her last period was a “benchmark moment” and suggests that in not knowing that her last period was indeed her last, she did not get to say that “gentle goodbye” that she wanted to say. She also talks about menopause as representing the “October” of her life, signifying ends rather than beginnings, but at the same time wants it to mean new and better things. The idea that the last period cannot be predicted but is hoped for, but then may be bittersweet when it’s finally reached is something that I’ve heard from so many women. Menstruation is hard, especially when it is unpredictable in perimenopause or before, but a part of it is also safe and representative of a kind of stability and identity that is hard to give up. Merser proposes that cessation of menstruation is the “first thing she can’t fix” about her body. Regardless of the freedoms that you might get when it’s over for good or the things about it that you will gladly give up, women aren’t always quite sure they really want to be done with menstruation forever once they sit back and think about its meanings. So they ask, Am I glad to see that last period, or am I melancholy about its passing? Am I ready for the midlife and beyond, or did I like being younger? Am I ready to give up my monthly reminders of womanhood? Do I like menstruation after all, even though it’s hard and long and seemingly never-ending until it’s over? I might like midlife a lot but it seems like it might be short and it might head me right into aging for real, so how long will I really be in this good midlife stage? Does a part of me miss my period before I’ve seen my last one?
Like snow, menstruation can be unpredictable, uncertain, burdensome, and a hassle, and we might all be very happy to say goodbye. BUT, for those of accustomed to the seasons and the good parts of each season, we might also be somewhat sad to see snow and menstruation leave us. Especially if we don’t get to say a chance to say goodbye.
Disclaimer: This analogy probably only works for those who live in Northern climates and are used to the good and bad things that come with snow. And yes, I’m sort of making light of menstruation here, but my feelings about the last snowflake this year are noticeable to me and I thought it might be fun to play with this analogy.

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Posted in Menopause, Menstruation, Perimenopause | 2 Comments »

Understanding Research: Media Reports of Research

April 1st, 2013 by Paula Derry

The Huffington Post published a story last week titled “Last Menstrual Cycle Could Be Predicted With New Model”. The story stated that a research study had just been published about a new method for predicting the end of menstruation in which researchers developed a formula for using the levels of two hormones, estradiol and follicle stimulating hormone (abbreviated FSH), to make this estimate. This “new method for predicting a woman’s last menstrual cycle could have broader implications for menopausal women’s health”. Since “in the year leading up to the final menstrual period, women are met with faster bone loss and a greater risk of heart disease”, if the end of menstruation could be predicted, medical monitoring and interventions would become possibilities. The research was also reported as news on the medical website Medscape.

Research results are often reported as news stories, as though these results are facts. However, “dog bites man” and “man bites dog” are facts, but research results are not facts in the same way. They are “evidence” that most often must be evaluated, understood, and put into the context of many other studies. There could very well be disagreement about whether a study’s methods really did accurately make a point, or whether the conclusions the researchers drew from their work were justified. Sadly, it happens all too often that research does not make the point that the headlines claim.

Photo by clarita // morgueFile

Here, we have a study by a respected researcher at a major institution, UCLA, funded by a grant from the National Institutes of Health and other prestigious grantors. However, we do not have the information with which to understand what the researchers actually did. UCLA issued a press release which states that the study “suggests” a way to predict the final period. The Medscape article states that “A new model MAY [my emphasis] help physicians determine how far a woman is from her final menstrual period”.

Suggests? May? I have no idea what this means. As a researcher, I want to look at the published article to see what was actually done. However, the publisher does not make a free copy of the article available. Anyone who wants to look at the published article—a researcher or an informed consumer—would need to pay the publisher $37.00 to access this 20-page article for one day. Predicting the last menstrual period from hormone levels, which is what is claimed, is something other researchers have tried but failed to do, so how these researchers worked with the difficult problems is an important question.

Assume for a moment that the model was a big success, and it did predict the last menstrual period. The idea that this has important implications for women’s health is stated as though it were another fact. However, this is not a fact; this is a complicated and controversial area. Bone density does decrease in the years surrounding menopause, but professionals disagree about how big an effect this has on bone disease. For example, current guidelines recommend testing bone density beginning at age 65, 15 years after the average age of menopause, because this is when the fracture rate has significantly increased. Heart disease risk factors may increase on average in the years surrounding menopause, but professionals disagree about whether menopause is important compared with other factors associated with aging.

Assume for a moment that bone disease really is an important negative health consequence of menopause. Whether interventions would be found that must be started in the year or two before menopause is another speculation. Such interventions might be found or might not. Predicting the last menstrual period, even if the claim is valid that a method to do so has been found, is a long way from preventing disease.

The medical satirist Andrew Vickers wrote an article called “News On Cancer Drug Fails to Raise False Hopes”, which begins: “A recent article on a novel cancer therapy has rocked the newspaper industry by giving a balanced and cautious review of an early-phase trial”. Satirists make extreme statements to make a point. Media reports are often written to sound definite and to portray a study as really important. A cautious approach to medical news is to withhold judgment unless the methodology of the study is clear and the context of the study is understood.

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Posted in Health Care, Hormones, Media, Menopause, New Research | No Comments »

Medicating the Postmenopausal Vagina

March 4th, 2013 by Paula Derry

On February 26, 2013, the Food and Drug Administration issued a news release saying that it had approved a medication called Osphena to treat a problem called postmenopausal dyspareunia (pain during sexual intercourse associated with changes in the vagina after menopause). The medical website Medscape reported that the news release had been issued. How to read these announcements? It seems as though FDA approval should be enough to know that a medication is safe and effective.   However, what are some guidelines in reading and evaluating this announcement?

First, some background: After menopause, when estrogen levels decline, tissues (cells) of the vaginal lining can become thinner, drier (thus providing less lubrication during intercourse), and less elastic or flexible.

This can result in pain during intercourse, feelings of burning or soreness, inflammation, and irritation.

Andreyeva by Ilya Repin // Public Domain via Wikimedia Commons

There are a variety of solutions for dealing with this.  Regular sexual stimulation (intercourse, masturbation) is recommended to keep vaginal tissues healthy.  Water-based lubricants can help reduce discomfort during intercourse.  Expanded views of sexual pleasure that don’t include intercourse might work around the problem. Leaving enough time to become aroused during intercourse (extended foreplay), communication between partners about when sex is painful and when not, can also help. Herbs like dong quai and black cohosh are recommended, especially by complementary/alternative practitioners, although the herbs  lack a research base. A low-dose estrogen applied to the vaginal area (as a cream, tablet, etc.), is effective. Local application minimizes estrogen being absorbed into the bloodstream, traveling through the body, and having effects, some of them potentially negative, distant to the vagina. There is, however, controversy about some estrogen being absorbed.

Now, to the FDA announcement:  The FDA requires proof of a medication’s safety and effectiveness before it is approved.  According to the news release: “Osphena’s safety and effectiveness were established in three clinical studies of 1,889 postmenopausal women with symptoms of vulvar and vaginal atrophy. Women were randomly assigned to receive Osphena or a placebo. After 12 weeks of treatment, results from the first two trials showed a statistically significant improvement of dyspareunia in Osphena-treated women compared with women receiving placebo. Results from the third study support Osphena’s long-term safety in treating dyspareunia.”

Notice, first, that the drug’s effectiveness was tested for 12 weeks. This is not an unusual amount of time for such a study, but it is not very much time. Notice also that women treated with Osphena had a “statistically significant” improvement. As I discussed in a previous post, “statistically significant” means “unlikely to have occurred by chance.” In other words, there was evidence that Osphena  really did have an effect, but we don’t know how big an effect—it might be very large or very small.

Safety was established by studying the experiences of women for one year: however, one year is not a long time for side effects to develop. Osphena is a systemic medication. That means it is not applied locally in the vaginal area, it is ingested as a pill so that it travels to all parts of the body in the bloodstream. It is a selective estrogen-receptor modulator, or SERM. SERMs act like estrogen in some places in the body while not in others. The idea is that a SERM like Osphena would act like estrogen in keeping vaginal cells healthy while not acting like estrogen to increase health risks like certain cancers. However, more time than a year might be needed for health problems to show up. Indeed, the FDA news release stated that “Osphena is being approved with a boxed warning alerting women and health care professionals that the drug, which acts like estrogen on vaginal tissues, has shown it can stimulate the lining of the uterus (endometrium) and cause it to thicken…. Women should see their health care professional if they experience any unusual bleeding as it may be a sign of endometrial cancer or a condition that can lead to it.” The FDA announcement also stated that “Common side effects reported during clinical trials included hot flush/flashes, vaginal discharge, muscle spasms, genital discharge and excessive sweating” and that Osphena should be prescribed for the “shortest duration consistent with treatment goals and risks for the individual woman.”  Continue reading...

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Posted in Menopause, Pharmaceutical, Sex | 4 Comments »

Menopausal Junk

February 28th, 2013 by Heather Dillaway

In response to my last blog entry about Helena Bonham Carter, Paula Derry commented that we treat menopause as a “junk category,” tossing in any symptom we can’t explain or don’t want to attribute to anything else. So true. In fact, Anne Fausto-Sterling said this long ago about menopause – that tons of symptoms were attributed to menopause when in fact only hot flashes really had a link to this life stage. BUT, we keep on attributing anything and everything to menopause.

    Photo by Flickr user Caterina // Creative Commons 2.0

  • Gaining weight at midlife? Must be menopause.
  • Sad or angry at midlife? Must be menopause.
  • Hairy at midlife? Must be menopause.
  • Dry at midlife? Must be menopause.
  • Blurry eyes at midlife? Must be menopause.
  • Headaches at midlife? Must be menopause.
  • Big boobs at midlife? Must be menopause.
  • Constipated at midlife? Must be menopause.
  • Have a symptom you can’t explain at midlife? Must be menopause.
  • Turned 50? Must be menopause. (Yes, see, it’s ridiculous.)

And the list goes on. And on. And on.

Okay, so, yes, menopause is a junk category because symptoms (junk) are just thrown in and declared “menopausal” (“perimenopausal”) at every turn. Just like when women go to the doctor and are given pregnancy tests no matter what their symptoms (“must be pregnant”). Ah, the fun of the reproductive life course.

BUT, I would say that there is another kind of “junk” that I see at menopause. I’ve interviewed menopausal women for 12 years now, and one of the hardest things is separating out menopause from all the other things (junk) going on in women’s lives as they make this transition. It is so hard to figure out what menopause really is and what it really means for women because it is surrounded by so much other “junk” at midlife. When you ask women about how they feel about menopause, they tell you but they also contextualize how they feel by telling you about:

  • their kids (the kids that live with them and the ones that have left)
  • their partners (current ones, ex-partners, and ones they wish they had)
  • their jobs (the ones they hate and the ones they care about)
  • their friends (the ones who support them and the ones who don’t)
  • their aging parents (and how hard it is to take care of them)
  • their worries about future aging
  • their doctors (good and bad)
  • their youth
  • their aches and pains
  • their bodies (the parts they like and don’t like)
  • their history of menstruation and other reproductive experiences…

You get the picture.
You have to wade through all of this to understand menopause. Sometimes it feels like junk clogging up their lives and clogging up the path to figuring out what menopause is really like. At the end of the day menopause is such a narrow part of most middle-aged women’s lives, but it is tied in with so much other midlife stuff that it’s hard to separate out. When you ask women about menopause, it’s sort of like asking someone, “How are you?”, on one of their busiest days. The answer you get back is surrounded and dictated by the junk in their lives and, unless you understand that going in, it might seem like menopause itself is a junk-filled process. But maybe it’s not. Despite all the news articles that predict new symptoms and conditions at menopause, and despite all of the midlife contexts that surround menopause, maybe menopause itself is very simple if we can weed out everything that’s not really menopause… What do YOU think?  Continue reading...

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Posted in Menopause, Perimenopause | 4 Comments »

Big Breasts, Menopause, and Helena Bonham Carter

January 31st, 2013 by Heather Dillaway


Another sign of menopause to add to the list: big breasts. Or so Helena Bonham Carter suggests in a recent interview. She suggests that she did not have big breasts until menopause and that it is “the one benefit of menopause.” But before this comment, she said that she wished they “didn’t stick out as much.” Apparently menopause and big breasts are a mixed blessing.

I’m fascinated by celebrities mentioning menopause these days. Actresses from the UK recently seem to be much more outgoing about their menopausal statuses than actresses from the US (see my previous post about Sinead O’Connor), at least from my followings of celebrity gossip (which, admittedly, is not very thorough). The idea that they are talking about it in passing, in simple conversation, is illustrative of the fact that menopause is not as hidden as it once was.

On the other hand, in this particular case, reading between the lines, Helena Bonham Carter says very directly that larger breasts are “the one benefit” of menopause, inferring that there are many more negatives. Further, the idea that the only benefit is appearance-based is not only interesting but also problematic in its reaffirmation of gendered norms about the necessity for women to look good for others. Finally, it is also clear from her comment that having big breasts – something that is often sought after in our highly sexualized, male-dominated culture – is maybe uncomfortable for women in public and that women’s bodies are indeed on display and women know it. Sure, she could have said that she wished her breasts didn’t stick out as much because they got in the way of her physical movement through space, but I doubt it. I think she made this comment more because of her discomfort with others’ gazes upon her body.

So, what does this all say about menopause? Or about big breasts? I think Helena Bonham Carter’s comments confirm the following: First, menopausal women are definitely still thinking (for better or worse) about their appearances. Second, women are intimately aware of the size of their breasts and understand that they are for public viewing (whether they like it or not). Third, big breasts are seemingly better than small ones, at least according to our various and intersecting gender norms. Fourth, Helena Bonham Carter doesn’t think there are any other benefits to menopause (a dismal thought), and we know she’s not the only one. (But aren’t there plenty of benefits? Come on….Sinead O’Connor thinks so…) Fifth, and despite some of the above conclusions, women aren’t necessarily hiding their menopausal status anymore.

I know, I’ve taken two sentences out of Helena Bonham Carter’s mouth and inferred lots of things, but am I that off base? I don’t think so, but feel free to comment!

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Posted in Celebrities, Communication, Menopause | 10 Comments »

Bored by Research Updates and News Headlines

January 3rd, 2013 by Heather Dillaway

"— Allons, à ton tour, ma petite... vas-y ! — Non, Papa ; si on devient si vilaine que ça en un an, j'aime mieux pas entrer".

By Achille Lemot (1846-1909) [Public domain], via Wikimedia Commons

Sometimes I think biomedical researchers and media spokespersons are just searching to find the pathology in our lives. Not that we don’t know this already, especially when it comes to women’s health. Because of how medicalization works, of course anything that veers from the defined “norm” for women (here, a young woman who menstruates every 28 days like clockwork) is pathological. Thus, menopausal women are pathological by definition. But, sometimes this gets pretty depressing, and really, it’s not very accurate considering that the vast majority of women go through menopause at some point during the midlife (so doesn’t that make menopause pretty normal and non-pathological?). In my Google alerts last week, here were the “menopause” headlines:

Diet, Exercise Post Menopause Help Reduce Risk of Breast Cancer
Medical Daily

Menopause linked to higher brain aneurysm risk
abc7.com

Healthy lifestyle during menopause may decrease breast cancer risk later on
Medical Xpress

Weight-y menopause
The Star Online

Diet To Overcome Menopause Problems
BoldSky

I do understand that there are many more health risks in middle age and beyond, and that changing/waning hormone levels at menopause induces different concerns/risks than women might have faced before menopause. Researchers, doctors, and media spokespersons have made it crystal clear over the past few decades that this is the case. But, as feminist and social science researchers have urged us to get beyond the “menopause as death” or “menopause as problem” perspectives, it seems that we’re not making much progress in thinking differently or more broadly about this transition. As I read the articles on menopause leading to more breast cancer risk, risk of brain aneurysm, and risk of weight gain, it is reaffirmed in my mind that we’ve made very little progress in broadening the dialogue (at least the published and mainstream dialogue) on this important life stage.

Sure, this life stage is filled with problems, risks, and interesting situations, but what life stage isn’t? Isn’t there published research coming out on ANYTHING ELSE about menopause? I want to read about something different! Readers, feel free to comment about any other interesting stuff you’ve read about menopause recently because I for one am searching for new takes on menopause. Seriously, people, was there nothing else new last week on menopause? As we head into 2013 I’m hoping for something new.

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Posted in Communication, Media, Menopause, Menstruation, New Research | 7 Comments »

We’re Ripe for the Third Talk, Actually!!

December 20th, 2012 by Ashley Ross

No question – Poise’s Second Talk Campaign is undeniably courageous, taking on Menopause, the Previously Unmentionable. Call me impatient and unappreciative, but I just can’t help mourning the missed opportunity to REALLY empower women, instead of aligning with those unrelenting forces bent on squeezing the Mojo from the second half of our lives.

Seeped as I am in the journey of menopause, (my own, and as co-creator of the Menopausal Mojo Teleseminar program), my curiosity was cautiously piqued when I opened the Poise link in this blog post  last month. (Cautious because, after all, Poise is an incontinence product and the association is not only anxiety provoking but inadvertently quantizes my experience into a demeaning and unimaginative metaphor — something like shame meets discouragement meets insult. Sorry, that’s just how it feels to me. Let it be known, I am not in denial here – it has been a while since I could safely jump on a trampoline with anything in my bladder.)

Nevertheless — someone is talking publicly about menopause. And I am certainly curious to see what aspect of this rich, challenging and potentially transformative experience they are choosing to highlight.

The first thing we see: “8 in 10 women agree, it’s time to change the way we think about menopause”.

YES!!! What we’ve been saying all along, my wonderful co-conspirator, Karen Clothier (creator of the body-mind-spirit focused and unexpectedly successful Menopause the Magical Telesummit) and me. We find ourselves coming back again and again to feeling the urgent need to rebrand menopause. We clearly do want another way to understand peri/menopause. After hundreds of years of agents of the male paradigm systematically dismantling our authority of our experience, using shame to silence our inherent collaborative tendencies, we have lost the language to talk about the transformative experience of our 40’s and 50’s – as we move from fertile women to mature women, from “child bearer’s to bearers of wisdom” (Kristi Meisenbach Boylan The Seven Sacred Rites of Menopause).

Clearly the difficulty begins with the term “menopause” itself. The term was coined in 1812 by the French physician de Gardanne and is defined as (a moment in time) 12 months after the last menstrual period. A little hard to acknowledge a rite of passage when its beginning, middle and end are as elusive, instantaneous and vague as that. But that’s not all, that’s simply the scientific use of the word. Our everyday use of it also describes perimenopause (the 5-10 year period before the Moment-In-Time) as well as post-menopause (an unspecified period after the Moment-In-Time). Confused yet?

Small wonder that we need new, updated language, imagery, descriptions, mythology and role-models — a full-spectrum, holographic map to describe the physical, emotional and spiritual terrain of our midlife experience.

Wait, I’m getting a little ahead of myself. Back to the Poise menopause page, and how it misleads women by reducing this remarkable transition into … yes, you got it … SYMPTOMS. As if symptoms are the menopausal experience. And the successful management of said symptoms is all there is to this phase of our life cycle. Tragically reductionist, when seen from the perspective of how insidiously the media molds our reality. This is brilliantly elucidated in Jennifer Siebel Newsom’s movie Miss Representation, which shows “the media’s limited and often disparaging portrayals of women and girls, which make it difficult for women … to feel powerful.”

“Disparaging”. Hold that thought while we listen to Dr. Jennifer Berman, Poise’s menopause and intimacy expert, describing mood swings. In the clip  “What’s the DEAL with my moodswings”*, does she validate our experience and perhaps suggest that our emotions might be valuable indicators of our experience? Does she acknowledge the virtually universal need of women at this stage to retreat (I would venture to say the developmental milestone in the female psyche to withdraw and self-reflect), and then acknowledge how at odds with our externally driven, production oriented culture this urge is? Perhaps she suggests that THAT might be the reason WHY our moods are swinging – that our emotions are accurately reflecting the environmental imbalance of the whole paradigm? Wouldn’t it be the moment for Poise, and all those interested in empowering women, to ask this crucial question: why are we making menopause all about what’s wrong with us?

Here’s what the good doctor says:   “Moodswings are very common during the perimenopause and menopause.  Women will describe symptoms of feeling more irritable and short fused, more weepy and depressed, more (uh) anxious and sort of, (uh) difficulty concentrating …and that’s very common during perimenopause, and it tends to level out, to some degree, as women approach menopause.”

Firstly, is it just me or is her tone patronizing? Is she explaining anything new here and offering solutions as promised? Is she even answering the question: “What’s the DEAL with my moodswings”?!

Now of course I see what a masterful campaign Poise have created here. They’ve captured an untapped market, have obviously paid close attention to the terms used by women in their focus group and have echoed the aspirations of menopausal women to save us from our Symptoms.

How much more interesting would it be if they used the global reach and collective power of the internet to invite us to create new language and ways to define our midlife experience that go beyond complaining about hot flashes (see “personal stories” on the site)? Ladies, instead of letting them reduce our experience to managing our symptoms, let’s demand inspiring stories about how we are stepping into the second half of our lives with the Mojo that comes from accessing our collective wisdom, our wizened humor and our well-earned self-respect. Now that’s a branding campaign worth following.

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Posted in Advertising, Communication, Media, Menopause, Perimenopause | 3 Comments »

Getting from the Average to the Individual When Reading Reports of Research

December 10th, 2012 by Paula Derry

We are unique individuals. Or, we are like everyone else. Which is it? For menstrual periods and the menopausal transition, as perhaps for most things, we’re a little bit of both. For me, keeping in mind that both are somehow true, and understanding the ways in which each is true, is a crucial but tricky business. Scientific findings are often reported as though they are universal truths. “The normal menstrual cycle is regular and occurs every 28 days.” “Depression is more likely during the transition to menopause.” However, research most typically examines groups of people, and results are most often average findings. A discrepancy between the average and the range of real experience isn’t surprising.

Take, for example, a study of the transition to menopause. This was longitudinal research—that is, the same group of women was studied for many years, and the patterns of change in their menstrual cycles over time could be documented. The authors conclude that there are three stages in the transition to menopause. At first women experience, perhaps beginning in their thirties, subtle changes in menstrual flow (like periods becoming heavier or lighter) without cycle length becoming irregular. Next, periods become irregular. Finally, women skip periods in the run-up to menopause. The stages are based on what, in the authors’ words, occurs “most frequently”; the average or frequent result is the basis for understanding the underlying pattern. Yet there is also a lot of variation. As reported in the article, only 39% of the women progressed in a forward manner through the three stages. Almost half seesawed back and forth. In addition, it is known that a significant minority of women report that they have gone from regular cycle lengths straight to menopause without a time of menstrual irregularity. I remember that when I first read this study I felt a certain comfort that changes in my body, like lighter periods and other changes, were predictable and fit into a pattern that other women experience. Yet, on the other hand, the findings can’t be used as a blueprint for what is supposed to happen. We share experiences with others, but we’re also unique individuals.

The average menstrual cycle is said to be 28 days—well, I don’t know many women with a 28-day cycle, and while some women describe themselves as “regular as clockwork” other women are bewildered that anyone could think that the cycle was regular. Rates of depression have been found in many studies to increase during the menopausal transition. However, the great majority of women do not become depressed (the “relative risk” has increased, but the “absolute risk” remains low). Knowing that the rate increases might suggest to a woman that she consider this possibility, but does not answer the question of whether she will become depressed, or, if she does, whether her depression is related to perimenopause or something else.

In trying to use scientific facts to understand ourselves or the world around us, the difference between the particular and the general, the predictable and the unpredictable, is important. Our individual behavior and physiology aren’t random or without form, but neither are they completely predictable.

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Posted in Menopause, Menstruation, New Research | 2 Comments »

Useful Gifts to Buy this Holiday Season

December 6th, 2012 by Heather Dillaway

The other day a Huffington Post article crossed my desk, titled, “Gift Guide 2012: What To Get The Menopausal Women In Your Life.” According to this article, here are some of the things menopausal women (read: perimenopausal women) might want this December:

  1. Coldfront cooling palm packs (to relieve sweaty palms)
  2. A personal desk fan (for those hot flashes at work)
  3. A “menopause gift basket” filled with healthy treats and goodies, maybe also including vitamins, and alternative remedies for relief, “to stabilize mood and help the body adjust to hormonal changes.”
  4. A Feel Cooler Cooling Mattress Pad or Cooling Pillow that interacts with your nightly body temperatures to cool you down (for night sweats)
  5. Cool Sensations Moisture Wicking Bed Sheets (reportedly for those floods of night sweats you might get)
  6. Hot Girls Pearls – cooling beads to wear around your neck (for hot flashes) – apparently these have even made it onto Oprah’s Show
  7. Tickets to Menopause the Musical
  8. Sweat-wicking pajamas (there are lots of different brands, again to deal with night sweats)

Clearly the theme here is that menopausal women get hot and need relief. Fair enough, for many menopausal women this would be true. But this list got me thinking: what might I add to this list? Here are some I thought of:

  1. Humorous gifts, such as books of jokes about menopause and aging?
  2. Books about menopause
  3. Cookbooks that specialize in natural eating?
  4. A yoga gift certificate? Or other exercise certificate?

I’d love to hear from readers about other ideas for menopause-related holiday gifts.
Then I got to thinking again: If my daughter had reached menarche already, what kinds of holiday gifts could I get her that relate to her life stage? Here are some of the ideas I thought of, and I definitely need help from readers to expand this list:

  1. Pretty reusable (washable) maxi pads (e.g., Lunapads)
  2. A cool bag to carry maxi-pads around in
  3. A cool tampon case (like the ones that Uncommon Goods sells)
  4. Cool new (extra) underwear
  5. A special calendar for her to use to track her periods
  6. New Moon Girls’ magazine (or just an online membership to New Moon Girls)
  7. The book, Our Bodies Ourselves, or other books on puberty and menstruation

So, readers, what else belongs on this list? Those of you already buying for Hannukah and Christmas might have some great ideas…..please chime in!

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Posted in Girls, Menarche, Menopause, Menstruation | 4 Comments »

#periodtalk: Let’s keep talking about menstruation

November 14th, 2012 by Laura Wershler

Bloggers at re:Cycling often challenge and invite readers to open up and talk about our menstrual experiences.

In a September post, Heather Dillaway asked : “Why don’t we talk about the important variations in our menstrual cycles?” In another, she wrote about the “second talk” Poise ads that encourage women to share their perimenopause experiences.

Chris Bobel wrote in defense of hating her period, sparking a lively discussion and much support for both her honesty and her call for “a more (not less) pluralistic menstrual discourse.”

Alexandra Jacoby has been writing a series of posts exploring things about our bodies we tend not to talk about.  From Tell me again why we can’t talk about body stuff to her last post asking readers for suggestions on How to menstruate while camping , she is opening the door ever wider to menstrual cycle conversations.

We do our bit at re: Cycling to get people thinking and talking about menstruation from a broad range of perspectives, including the personal.  And, happily, we are not alone in bringing “period talk” out in the open.

Last Friday, I participated in a #periodtalk Tweet Chat, a monthly event hosted by Be Prepared Period, a website dedicated to providing accurate, helpful information about menstruation to girls, women and parents. One of Friday’s guests was Suzan Hutchinson (@periodwise), the Director of Connectivity for You Are Loved, a non-profit organization “focused on raising awareness about tampon related Toxic Shock Syndrome and providing factual information about menstruation.” You Are Loved has been an ongoing #periodtalk participant. Suzan, a self-described “menstrual cycle activist since youth,” herself experienced TSS.

Suzan’s topic was menstrual understanding; her introductory Tweets shared some of her story:

I began my menstrual journey at age 15 with a belted pad & knowledge that a week each month my body would betray me.

No one talked about periods. I thought my experience was unique – that I was odd. Embarrassment kept me silent.

Suzan eventually came to view her period as just one part of her menstrual cycle, and she brought this cycle perspective to the Tweet Chat. In a post-chat phone conversation, Suzan told me that she has seen how #periodtalk has helped others lose their embarrassment in talking about periods. “I’ve watched women who started out not being able to contribute become menstrual activists, bringing other women to the chats.”

She also told me about the day #periodtalk trended worldwide on Twitter. It was September 14, 2012 and the topic was Back to School: Periods101. A blog post at Lunapads.com describes what happened:

 Today #PeriodTalk had it’s big moment when it reached trending topic status worldwide. A pretty big accomplishment for a bunch of folks chatting about a topic which is usually so “hush-hush”. Of course the taboo-nature of the topic brought the trolls out of the woodwork and some pretty nasty things were said by a few crass individuals. Participants in #PeriodTalk were admonished for talking openly about something, which was in their opinion, not appropriate for the internet….seriously? Not appropriate for the internet? Have these people *seen* the internet?

Too bad for the trolls. Talking openly about our menstrual cycles is here to stay. We’ll keep doing it at re:Cycling and #periodtalk is thriving at Be Prepared Period. They have also launched an online Period Talk  forum where girls and parents can ask questions and get answers about anything related to menstruation and puberty.

The next #periodtalk Tweet Chat – on the topic of Non-Profits and Menstruation – is on Friday, December 14, 2012. Check it out.  Continue reading...

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Posted in Activism, Communication, FemCare, Girls, Internet, Menarche, Menopause, Menstruation, Perimenopause, Reusable menstrual products, Toxic Shock Syndrome | 2 Comments »

Hot Flashes Are Weird

November 12th, 2012 by Paula Derry

I have two pretty contradictory sets of opinions about hot flashes. In a previous blog post, I emphasized one of them. Namely, that flashes are a mind/body phenomenon in which a woman’s interpretation of her physical experiences are central to her being distressed or not, of being able to cope or not, of what an experience is and means. A woman can identify her “real” self with her thoughts or her body, or she can experience her embodied self as a totality. In my first set of attitudes, the diversity of physical experiences is part of the mix: The same term, “hot flash,” is used for a wide family of experiences that range from mild to unbearable, from heat to heart palpitations, from empowerment to anxiety. However, in my second set of opinions, physical experience is front and central, and my thoughts can be summarized as follows: Hot flashes are weird.

In a conventional view, flashes are simply something that happens because of the hormonal changes surrounding menopause. They are often defined as a transient feeling of heat, sometimes accompanied by sweating or the skin turning red, that typically lasts a few minutes but can persist up to an hour. Flashes are most common in the years surrounding menopause but can begin many years before or occur many years after the final menstrual period. One theory is that fluctuating levels of estrogen affect a part of the brain that controls heat regulation. As a result, small changes in temperature are interpreted by the brain as meaning that the body’s temperature is outside the normal range; the hot flash is the body’s attempt to cool the body down. Alternatively, perhaps the hormonal imbalance affects the brain or other endocrine glands in other ways, or perhaps some women are simply more sensitive to these changes.

However, the experience of flashes is complex. A woman who is overheated for other reasons may not feel like a woman having a hot flash. A flashing woman might feel like she is on fire. Or she may feel hot only in an isolated body part, like her back or earlobes. Or the feeling of heat may start in one part of the body (like her head or upper back) and travel. Some women may not realize their feeling of gentle warmth is caused by a flash until later. Further, there are experiences in addition to that of warmth. The experience might feel like anxiety rather than heat. There may be a sharp physical shock or jolt. Some women, for example, may wake up in the middle of the night with a shock of anxiety and wonder what has threatened them. Some women report other associated sensations such as a racing heart, nausea, and breathlessness. Some feel dizzy, anxious, and unable to concentrate. Others experience cognitions and feelings such as empowerment, anxiety, and catastrophic thoughts.

Flashes are basically not understood. Beneath the scientific generalities, there is no specific understanding of what underlies flashes. They do clearly have something to do with estrogen: they increase in frequency in the years surrounding menopause, and treatment with a hormone medication is helpful. However, while fluctuating estrogen levels are assumed to be causal, clear evidence of this has been notably lacking. Further, flashes are found during the menopausal transition and postmenopausally, two very different hormonal situations, but are not a widespread phenomenon during premenstrual hormone fluctuations. For the minority of women with severe symptoms, there is no understanding that would lead to correction of underlying problems beyond symptomatic treatment with medications like estrogen. Why would a brain center regulating body heat be affected in some women but not others or in the same woman only sometimes? There are speculations that estrogen is needed for brain general health and proper neurotransmitter balance or that some women are “more sensitive” to normal changes in hormone levels. It seems that additional factors must also be at play. The large cross-cultural differences in flash frequency and the large placebo effects of medications are not understood, neither is the role of stress or other psychological or situational factors.  Continue reading...

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Posted in Hormones, Menopause | 2 Comments »

Early Menopause Caused By Makeup?

November 8th, 2012 by Heather Dillaway

It turns out that phthalates – chemicals found in cosmetics, hairspray, packaged food, household cleaners, and other common plastic items – are causing early menopause. At least according to one new study that is getting a lot of hype in the past week or two. A team of researchers from Washington University in St. Louis, MO, studied phthalate levels in blood and urine for over 5,000 women, and those women with the highest levels of pthalates apparently went into menopause an average of at least two years before others.

This study is definitely making news. British news sources are reporting on this study as much as U.S. news sources. Women’s reactions to online news stories about this study are mixed. Women hearing about this study are quick to comment online, saying either (1) how quickly they’ll be running out to buy more makeup (to launch themselves into menopause) or (2) discontinuing their use of makeup (to ward against the effects of pthalates). What I find interesting is how divided women are about whether early menopause is good. Reactions to reports on this study definitely show attitudinal differences among women in that women do not think uniformly about menopause or about the importance of using cosmetics. Women are not  thinking uniformly about how damaging phthalates are to our bodies either.

Of course, by all news reports of this study, phthalates also cause cancer, diabetes, and even feminization of boys (really?), so even if you think early menopause is a good thing you might want to hold off on consuming more phthalates.

What this study (and people’s belief in the study) also reiterates is the fact that our bodies are affected by what we eat, use, and do, as well as what we come into contact with, where we live, etc. Some of the articles reporting on this study focus in on the natural, healthy choices we can make when picking beauty products, household cleaners, prepared food, and other common household items. Who knew there was vegan makeup, for instance? This is all worth a second thought. Sure, we might all want to be done with menstruation sooner than later but phthalate-induced menopause should probably not be our goal.

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Posted in Communication, Internet, Media, Menopause, Menstruation | 1 Comment »

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