Blog of the Society for Menstrual Cycle Research

Bravery and Intellect Over Easy: Scrambled

March 12th, 2010 by Giovanna Chesler

(This post also published at the blog g6pix.)

I’ll try not to sound too fan-girlish here as I write about the documentary Scrambled: A Journey through PCOS by Randi Cecchine, but admittedly, it is a difficult task. For in this film, which chronicles Cecchine’s struggle with Polycystic Ovarian Syndrome, we meet a filmmaker brave enough to show us, wart-hairs and all, the challenges inherent in this disease embodied. She does so with humor, with information, and with space for personal reflection.

As Cecchine and the health practitioners she speaks with share, PCOS is a condition that affects 8% of women but that goes under-diagnosed. Though largely undetected in the women who have PCOS, the first sign of something wrong is the absence or change in the menstrual period. According to Cecchine’s participant Dr. Geoffrey Redmond, an endocrinologist who has studied female hormone problems for over twenty years, PCOS generally shows up during puberty or shortly during the menarche period. In his interview, he argues that a delay of fifteen years in diagnosis typically occurs because “people who care for teenagers are typically not clued into this condition.”

In popular rhetoric on menstruation and menstrual suppression, there are many voices who have argued that having a menstrual period is unnecessary and should be done away with through hormonal birth control regimens (for example, Lybrel, Depo-Provera and Seasonale.) These drugs are often presented as choices to girls and young women close to menarche. Scrambled serves to intercept this discourse by demonstrating how the cycle becomes a sign of imbalance and illness. This film reminds us of the value of attending to the menstrual cycle. In Cecchine’s case, as in the case of the many women she interviews in her film, the lack of a period is a personal introduction to the disease.

Cecchine works with a light yet serious tone. A visit to Harry Finley’s Museum of Menstruation underscores the connections between menstruation, body awareness and PCOS. Yet we are able to marvel and smirk at Finley’s collection of menstrual advertising and decades old menstrual protection products which now live in his basement. As her lived investigation continues, Cecchine meets up with the Polycystic Ovarian Association (PCOSA) at their conference. There her film does remarkable work, as it invites the viewer to join in the conversation. In the scenes around the conference, we see how this film works to invite fellow PCOS women into the information Cecchine has gleaned. Though knowledge will not cure one from the illness, certain techniques shared in the film (like limiting carbohydrate intake) will result in reduced symptoms.

In the recent release of the film, which is self distributed, Scrambled is a two disc set. The first disc includes the documentary, but the second disc is chock-full of informative interviews on a variety of topics. Cecchine profiles Redmond along with many other health workers practicing western, eastern and alternative medicine who speak of the options for treatment. These include diet alterations, drug regimens, psychotherapy, acupuncture and others. In this disc, Cecchine provides the tools for a viewer with PCOS to address her syndrome through many methods. By providing information in this manner, Scrambled becomes a guide and a tool for holistic health on a personal level.

But these treatments comes at an expense. Here Cecchine’s humor bubbles up again when she shares the different techniques, like hair removal, pills, acupuncture treatments and their resulting costs. Yet, the feeling that comes afterward: “Priceless!” Bitingly Cecchine reminds us that being a patient also involves being a consumer. Therein she complicates these treatments as choices and necessities simultaneously.

First, do no harm

October 20th, 2009 by Elizabeth Kissling

When a link to this study, which found that the higher a patient’s BMI, the lower their physician’s respect for them, showed up in my Twitter feed yesterday (thanks, Michelle), I started connecting some dots.

Women delay seeking treatment for menstrual pain due in part to taboos about menstruation and concealment, often waiting and suffering for years. As I learned recently (and reported here), research estimates an average delay between onset of pain and diagnosis of endometriosis of 8 years in the UK and 11 years in the US.

Women (and men) who are considered “overweight” are frequently treated badly by health care practitioners, who tend to focus on the weight as the Cause Of All Illness and Ailments. Regardless of the reason for seeking treatment, fat patients are advised to lose weight. Given this reality, many fat people avoid seeing health care providers altogether, and those who do are less likely to be screened for breast, cervical, and colorectal cancers. Even fat people with college educations and health insurance avoid doctors.

So what happens when fat women have menstrual problems? (Please note that I am following the practice of other advocates of fat acceptance and Health At Every Size (HAES) in using the term fat as a descriptive adjective, not a pejorative.)

Xanthine sought care from a respected gynecologist in her community for her uncomfortably heavy periods. The doctor could not stop talking about her gut: “Cut out the refined starches. Lose some of that gut, yes, at least twenty pounds you could stand to lose. Ha ha! Goodbye!” Xanthine reminded him again of the reason for her pelvic exam, and he changed her prescription for birth control pills.

Gina, a 16-year-old with a history of irregular menstruation who stopped having periods altogether, was advised to join Weight Watchers and to get lap-band surgery.

Because of a career-related relocation, Susanne was unable to receive treatment from the same doctor who diagnosed her Polycystic Ovarian Syndrome (PCOS). Her new gynecologist told her, PCOS isn’t a real disease, it’s been made up by fat women.” This doctor went on to disparage the test results from her previous physician as well as Susanne’s intelligence.

There are more stories, of course. These are just some of the most egregious examples from the collection at First, Do No Harm: Real Stories of Fat Prejudice in Health Care.

I’m left wondering how many women of all sizes suffer in silence. How do any of us even know what counts as “normal” or “abnormal” menstruation??

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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.