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Aug. 4th, 2003 06:02 pmCould a woman's period become a thing of the past?
In coming weeks, the Food and Drug Administration is expected to decide whether to approve the first oral contraceptive designed specifically to reduce the number of annual menstrual cycles a woman has. Seasonale, developed by Barr Laboratories, would reduce menstruation to four times a year instead of the typical 13.
Gynecologists say that suppressing the monthly period would mean fewer women would have to worry about bad biological timing spoiling a honeymoon or vacation. More important, they say, it could spare women from pounding headaches, wrenching cramps and other menstruation-related medical troubles.
A growing number of physicians are questioning the necessity of menstruation, sparking fierce debate around the country - from gynecologists' offices to women's studies departments - about its biological role.
"It is a needless loss of blood," concludes Elsimar Coutinho, a Brazilian reproductive biologist, in his provocative book Is Menstruation Obsolete? A few gynecologists go further, arguing that menstruation should be eliminated.
Other experts on women's health disagree and are concerned that not enough is known about the long-term biological effects on the body of menstrual suppression.
"Women very frequently are the targets for things to make their lives better that turn out to be extraordinarily unhealthy," says gynecologist Dr. Justina Trott, director of the Women's Health Services Family Care and Counseling Center in Santa Fe, N.M.
But for now, some women are thrilled at the prospect of fewer periods.
"I'm not going into work every day and worrying, 'Do I have a stain on my skirt or my dress or my pants?' " said Charlene Howard, a North Carolina real estate agent who has been taking part in a clinical trial of Seasonale for more than two years.
The origins and purpose of menstruation have been debated for centuries. In ancient Persia, women whose periods lasted longer than four days were deemed possessed and subjected to 100 lashes to purge the invading demon.
The Roman naturalist Pliny the Elder preached that menstrual blood was a deadly poison, with the power to sour wine, wither crops, rust metal, foul the air and drive dogs mad, among other things.
Not all of the ancient world was so horrified. Galen, an influential Roman physician, often pointed to menstruation as the best argument for bloodletting, a practice once thought to cure a wide variety of ailments.
"Menstruation was seen as nature's way to ... relieve the periodic ills from which some women suffered," Coutinho writes.
But thousands of years later, scientists are no closer to explaining why this monthly bleeding mechanism evolved, although they have determined that it is fairly rare. Only primates, bats and the elephant shrew, an odd, rodent-like creature, are known to experience a monthly bleed akin to that of human females.
A typical woman's cycle begins with a cascade of hormones flooding her uterus and lasts 28 days. The hormones - first estrogen and later progesterone - cause the lining of the pear-shaped organ to plump up in preparation for a fertilized egg. If no egg is fertilized, the flow of progesterone gradually ceases, causing contractions to ripple through the organ.
These contractions, the source of the cramping of which many women complain, rupture tiny blood vessels and cause the newly formed lining to shred and disintegrate. This cast-off tissue, egg and blood make up the period. It lasts three to seven days and can result in the loss of up to 100 milliliters - about seven tablespoons - of blood.
Physical changes
At the heart of the medical debate over menstrual suppression is the question of what number of periods is natural.
Some proponents of suppression point to evidence that modern woman experience far more menstrual cycles than their ancestors. One study estimates that women living in African hunter-gatherer societies had 160 lifetime periods vs. 450 for Western women. The reason is that bush women, unlike their urban counterparts, raise large broods and spend years pregnant or breast-feeding, both of which suppress menstruation.
"It's really not natural to have so many uninterrupted cycles without childbearing," argues Dr. Richard S. Legro, associate professor of obstetrics and gynecology at Penn State College of Medicine. "The human body was not designed to function that way."
The history of the birth control pill also figures into the debate. In The Pill, historian Bernard Asbell notes that the company contracted to supply synthetic hormones to the drug's inventors wanted no part of any medication that interfered with the menstrual cycle.
As a result, the contraceptive was designed to provide a steady supply of hormones for 21 days, followed by a hormone-free week to trigger a period. By providing a monthly period, scientists also hoped that the pill would be more palatable to the Roman Catholic Church, which forbids unnatural birth control.
Another reason to induce a period is to reassure women each month that they are not pregnant.
"Birth control pills were designed to have a period because men thought women needed it, and women thought women needed it," says Dr. Teresa Ann Hoffman, a Catonsville gynecologist.
Old idea, new form
Hoffman notes that the idea of menstrual suppression is not new. Since at least the 1970s, gynecologists have quietly advised their patients on ways to postpone their periods or stop them entirely by taking the active pills in their birth control packets every day. It's something Hoffman has been doing for more than a decade, starting when she was a first-year resident at Franklin Square Hospital Center.
"You're working 120 hours a week, and you really don't have time to bleed," she says. Today, many of her patients are blocking their periods, too. "I don't think the tampon people are going to be too happy with us," Hoffman says.
They are likely to be less happy if Seasonale is approved. Studies have shown that many women would be eager to put their periods behind them, mostly for medical reasons such as headaches, intense cramping and heavy menstrual flows.
A 1999 study determined that women with heavy menstrual flows lost an average of $1,692 in annual wages from missed work. Menstruation can also cause problems ranging from severe migraines to anemia to endometriosis, an intensely painful condition that results from the growth of endometrial tissue in abnormal locations. Studies have also linked ovarian cancer to the number of menstrual cycles a woman experiences during her life, although it's unclear why.
Seasonale, which should be available by Christmas if approved, contains the same mix of hormones found in standard birth control pills. The difference is that women take it for 84 consecutive days before seven pill-free days. As a result, women would experience a period once every three months (or once a season, hence the name).
"This is basically about convenience. It's not rocket science," says Dr. William E Gibbons, director of the Jones Institute for Reproductive Medicine in Norfolk, Va., which helped develop and test the contraceptive.
Long-term studies
Gibbons says Seasonale was formulated to allow four periods instead of none because surveys showed that is the number women would prefer.
Clinical studies also found that having a period once every three months reduced instances of spotting and "breakthrough" bleeding, one of the most common side effects of menstrual suppression.
Some experts on women's health say there haven't been enough long-term studies of menstrual suppression to know whether breakthrough bleeding is the only thing about which women have to worry. The few studies that have been conducted have ended too soon for subtle health problems to emerge, they say.
Justina Trott of the Women's Health Services Family Care and Counseling Center in Santa Fe points to the recent evidence that long-term hormone-replacement therapy, long promoted as beneficial, might increase a woman's risk of heart disease, breast cancer and dementia.
Last month, the Society for Menstrual Cycle Research, an interdisciplinary group of women's health advocates, expressed concern over whether long-term menstrual suppression might affect a woman's ability to get pregnant.
Such fears crossed Amanda Nemec's mind last year when her doctor suggested that she take the pill nonstop to prevent severe headaches and cramps.
"I asked her about once a week, 'Are you sure this is OK to do? Are you sure this is OK to do?'" says the 24-year-old Owings Mills resident.
Hoffman says it's a concern women often initially have about menstrual suppression. "They might say, 'Oh, it's not natural,' " she says. "Well, birth control pills are not natural. The fact is, you don't need to bleed."
What do you all feel about this? I got it from the feminist community, which is proving to me that it is not a very cunt-lovin community, especially the person who posted it. I had an arguement with her here and it doesn't seem like she's going to let down or even listen. I would click the "here" link, for then you get my portion of the arguement. How do you feel about this? I want some cunt-lovin ideas on this.
Oh, and here's a link to the actual article.
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Date: 2003-08-04 04:38 pm (UTC)no subject
Date: 2003-08-04 04:41 pm (UTC)when i was on a monophasic pill, my doctor didnt care if i skipped a period or two or three.
i have since been on a triphasic for a few years so i cant skip my period.
but if this gets approved, i am going to look into it and make sure i can take it.
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Date: 2003-08-04 04:53 pm (UTC)If bleeding on a towel works for you, then fine. But it doesn't work for everyone. And I don't think I'm less a cunt lover just because I don't particularly enjoy sitting around in my own blood, regardless of where that blood comes from.
I personally won't use seasonale because I have problems with the pill and mood swings. But if I could use the pill without side effects you can bet I'd jump at the chance to limit the number of painful cycles I have. That doesn't mean I hate my body or am oppressing my uterus or have been co-opted by the evil men of society. It just means that if there's an easy way for me to limit the amount of pain I have in a given year while controlling my fertility, I'm going to jump at that chance.
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Date: 2003-08-04 10:04 pm (UTC)When I made the comment on the other board, I was stating that I don't like the idea of it for MY body. I don't like the idea of birth control or shaving or taking pills for pain or any of that, either, but that doesn't mean I think it shouldn't be there. It is like those who are pro-choice but would never have an abortion. You know?
I also feel that people put too much fear around talking about sweating, pissing, and shitting. Like it's something to not be done or talked about. I am a big sweater (sounds like clothes) and no anti-perspirant I've tried has helped and I'm constantly fearing that someone will make fun of me for the sweat, and they do. As for pissing and shitting, I don't play with that or honour it, but I don't mind talking about it. I feel that it is in a total different area than menstrual blood. I mean, cunt blood is the uterus shedding, not just from what I ate that day or my body trying to cool itself down.
Do I make any sense?
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Date: 2003-08-04 05:06 pm (UTC)This sounds like another case of that.
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Date: 2003-08-04 05:11 pm (UTC)no subject
Date: 2003-08-04 10:06 pm (UTC)no subject
Date: 2003-08-05 09:34 am (UTC)no subject
Date: 2003-08-04 05:14 pm (UTC)I'm Celtic Wiccan with Shamanistic influences and quite in touch with the moon and her phases. I cannot imagine why bleeding on a monthly basis would affect my spiritual development in any way. If my IUD wasn't effective until 2006, I'd definitely consider Seasonale or another birth control pill with similar effects.
But that's just my opinion and in the end, we all have to chose our own path. I really don't think it's some vast conspiracy to offer us multiple paths.
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Date: 2003-08-04 10:17 pm (UTC)I totally understand the need of relief of the pain related to periods. That is why I feel that perhaps more studies to find relief for that is better than stopping your period all together. I have a very regular period, but my friend didn't have her period for months and months (6 months, then she went on birth control) and she said she felt dirty and groggy, like her cunt wasn't pleased with her. I fear that the pill may do something bad to the uterus, and I fear that, but I also feel that it should be available. I feel it should be thoroughly researched before it is released. It would really suck if there was a mass destruction of tons of womyn's uterus'. Heh. So, not a conspiracy, but I don't approve of it for myself. Myself, myself, myself. You know?
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Date: 2003-08-05 07:11 am (UTC)Let's hope things look up soon.
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Date: 2003-08-04 05:27 pm (UTC)However. I don't see a need for there to be a particular pill aimed towards the goal of skipping periods. It's perfectly possible to do it with the available BCPs, so why does there have to be a separate pill? This worries me a little because women might take it *only* for the reason of skipping their cycle, and not for contraceptive or other (bad cramps, etc) reasons. I don't think women should go on it just to skip their periods. There are many risks associated with the pill, and if you're not even using it to solve a problem... why take it at all? It would be much easier to just deal with the "grossness" or whatever that makes women uncomfortable with their periods.
As far as the arguments on the feminist community... I refrained from even commenting there, because it's clear some people have their fingers in their ears. Ugh.
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Date: 2003-08-04 05:29 pm (UTC)It is expensive! I don't feel comfortable using the Keeper because, as I've heard, it's messy, and sometimes I do not have a private bathroom.
Tampons and pads are NOT cheap. They are expensive fuckers and I hate paying for them.
I've no intentions of sitting in my own blood, though I think I wear tampson and pads less often than most woman. When I'm on the pill my period are regular and seem to be lighter, and so if I wear a tampon during work, and come home, I can usually get through the night without any spilling, or at least very little, so I sleep with old clothes on.
But at the same time, I don't really want to sit in my blood. Fine if you want to, but not everyone wants to do that!
Fuck, the pill is expensive, but at least it serves a good purpose: Helping me to stay baby-free for the time being.
If that pill becomes an option for me then, yes, I would use it. I have VERY little side effects from the pill, for one.
Also, when I'm NOT on the pill, my periods are WAY out of wack. I may have one every month, I may only have one every 4. That stinks. And so, I'm on the pill to regulate that
....except, it's not even a "real" period to begin with, so what is the point, anyway?
I need to be on the pill so I don't get pregnant, and using only condoms is not an option, and I've no desire for anything permanent at the moment (IUD, etc>), since I'm happy with the pill.
I see no problem with it. It should be a CHOICE. If you don't want to take it, don't, but I see it as a good thing.
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Date: 2003-08-04 10:25 pm (UTC)no subject
Date: 2003-08-04 05:41 pm (UTC)Not to say that hormonal bc doesn't have any benefits, even in the long term, because it does. But I don't see that those benefits (i.e., reduced risk of ovarian cancer) would also be comparatively increased by upping the amount of hormones (because, for example, you're still prevented from ovulating on the conventional pill).
At the end of the day, breast tumours and heart attacks are not acceptable prices for greater convenience. I fully expect to not be shocked when 10 years from now we discover that menstrual suppression is a really bad idea.
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Date: 2003-08-04 05:50 pm (UTC)Similarly, with pain, not everyone who doesn't like dealing with it has been tricked by the man. I just couldn't cope with the pain of my periods before I started on the pill, and I am a masochist, for pete's sake. A female body, I have found, is not necessarily the most comfortable thing to live in. Women naturally have much higher pain tolerances than men because it is naturally expected we will endure so much more pain than they will in our lives. It's not fair to ask people to enjoy and celebrate that.
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Date: 2003-08-04 10:39 pm (UTC)Obviously, there is a lot of pain involved with having your period and being a womyn. I never said that others shouldn't use the BC pills or the 4-period pill. I said that I don't like the idea. As in, I would never put it on my body. I understand others have higher amounts of pain and issues that prevent them from making this choice. And that if these pills were perfected (I totally understand you on the weird side effects of these pills), these pills would be godsends. I never said that people shouldn't use the pills. I just feel it's not for me.
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Date: 2003-08-04 05:54 pm (UTC)no subject
Date: 2003-08-04 05:58 pm (UTC)to me, that argument was one girl, calling her own bodily functions disgusting and dirty, which i dont think is right at all. that to me was what you were arguing.
correct me if im wrong.
i do, however, think its good that there is a choice for women to be able to skip their periods, if they so choose. i do think its strange that they have to create a separate pill for something any normal monophasic pill can accomplish. i have skipped my period once on the pill and i probably will a time or two more. i like the CHOICE of being able to, however, i dont do it because i think my menses are disgusting or dirty, i do it because its easier when im going to be away from home for an extended period of time (like the woman who was going camping)
-=t
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Date: 2003-08-04 06:10 pm (UTC)And I don't think the "you're oppressed and hate your body" response to people who are squicked by menstruation is generally productive.
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Date: 2003-08-04 06:23 pm (UTC)i dont like the waste tampons make, nor do i like the fact that theyre quite dangerous (toxic shock) and i dont like the way theyre marketed to make us feel unclean. tampax pearl tampons come in a "discreet" package. why does one care if someone sees you carrying a tampon into the bathroom.
im a woman and i bleed every month, and it shouldnt be a secret.
i understand those who think menstruating is a discomfort. i get migraines every month because of it. BUT i dont rush to the bottle of advil every time i feel a cramp coming on, nor do i shell out the extra 3 bucks for tampons that come in discreet packaging. you know?
-=t
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Date: 2003-08-04 06:55 pm (UTC)I understand the point but really I don't see menstruation as anything other than a bodily function. Hell I'm actually in general more comfortable talking about my period than I am my bowel movements and I think the same can be said of many women. I find menstrual blood mildly disgusting because it has a tendency to go places I don't particularly want it (fingers, sheets, underwear) and I just generally find having things drip out of me to be an unpleasant feeling (regardless of what's dripping). However, really the only time I've ever been seriously grossed out by mentrual blood is when I used to use my diaphragm for period sex. A big cup full of blood and spermicide just strikes me as pretty gross (and the two substances together makes for a not so pretty smell too).
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Date: 2003-08-05 11:21 am (UTC)-=t
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Date: 2003-08-04 10:48 pm (UTC)Choice is a choice, I choose not to want the pill for myself. I don't think a lot of people in here saw that.
About the source article...
Date: 2003-08-05 08:59 am (UTC)Don't mind me, I just grumble every time I see complex factual information summed up in soundbytes by careless reporters on a deadline (and I've seen lots of it; I used to be one myself).
*sigh* Best wishes.
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Date: 2003-08-04 07:20 pm (UTC)I also take a lot of issue with the statement that it can save women from ruined honeymoons and vacations. I just think it's so messed up that we have such a taboo on sex during menstruation. If you don't want to because of cramps, that's fine, but if you're not having sex just because you think your blood is all gross, or your partner does, I think that's sad.
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Date: 2003-08-04 07:56 pm (UTC)Honeymoons and vacations (especially beach vacations) both involve special garments: in the one case, sparkling white (so lovely with red spots from leakage!) and in the other, swimsuits and swimming (I don't swim with tampons or sanitary napkins, so I have to make sure blood won't run down my leg when I get out of the water. That's TMI for your companions, too). Besides, weddings and vacations can be such stressful events even without depression, anxiety and irritability from PMS. Why combine the two?
As for me -- I began my periods at age 9. In high school I was routinely depressed -- to the point of suicidal ideation -- and unable to walk from cramps, three days of every month. When I got on the pill at age 17, I couldn't believe the relief I felt -- physical, mental, and emotional. Especially the realization that my monthly blackness was not some internal weakness of character, but hormone shifts beyond the control of therapy or happy thoughts.
Yeah, the Pill was a godsend for me.
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Date: 2003-08-04 08:04 pm (UTC)Why not swim with a tampon in? And I'd have to say that people who don't swim with tampons and have a heavy enough flow that they'd get leakage between the water and the bathroom are probably a special case.
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Date: 2003-08-04 08:30 pm (UTC)Also, for me, if I'm on my period, having an orgasm *hurts.* Like, sharp pain. I think it causes cramps for me because of the muscle spasms. My boyfriend is totally comfortable with periods and the like, but he is also hesitant to have sex when I'm on it because he's afraid he'll hurt me or "break something", heh.
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Date: 2003-08-05 08:47 am (UTC)As for swimming with a tampon it-- um, tampons are absorbant. If they're absorbing the blood, they're absorbing the water too, aren't they? Chlorine from swimming pools, pollution or bacteria from sea water or pond water? Chlorine irritates my skin, and I sure don't want a tampon soaking in it and then pressing against the walls of my vagina. I'm sure it's a personal matter, though. If it's never bothered you, there's no reason not to do it. It's not good for me, though.
Yes. I bleed heavily. My period, when I'm not on birth control, lasts eight to nine days (four days on BC). On my first day I bleed so heavily that when I stand in the bathroom to switch tampons or pads, I spatter the floor. I bleed more heavily than the average woman, but i wouldn't say I'm a "special case," since by definition an "average" means that there are plenty of woman to EITHER extreme.
no subject
Date: 2003-08-04 07:50 pm (UTC)To quote briefly,
"Today, the Pill is still often sold in dial packs and taken in 28-day cycles. It remains, in other words, a drug shaped by the dictates of the Catholic Church—by John Rock's desire to make this new method of birth control seem as natural as possible. This was John Rock's error. He was consumed by the idea of the natural. But what he thought was natural wasn't so natural after all, and the Pill he ushered into the world turned out to be something other than what he thought it was. In John Rock's mind the dictates of religion and the principles of science got mixed up, and only now are we beginning to untangle them."
This article goes on to publish the research of Beverly Strassman, a scientist whose studied African tribes to understand what female biology might have been like in the millennia before the modern age. Her discovery? Except when sterile, "normal" ancient women had maybe 100 periods per year. Quoting again (because this is a large article),
"Among the Dogon, she found, a woman, on average, has her first period at the age of sixteen and gives birth eight or nine times. From menarche, the onset of menstruation, to the age of twenty, she averages seven periods a year. Over the next decade and a half, from the age of twenty to the age of thirty-four, she spends so much time either pregnant or breast-feeding (which, among the Dogon, suppresses ovulation for an average of 20 months) that she averages only slightly more than one period per year. Then, from the age of thirty-five until menopause, at around fifty, as her fertility rapidly declines, she averages four menses a year. "
As referenced in contraception online.com (http://www.contraceptiononline.org/contrareport/article01.cfm?art=239), a 20th-century woman bleeds an average of 450 times in her life -- compared with the 160 or so menstrual cycles we experienced for centuries. These figures are not subject to any kind of socio-political skew. Women today live nearly twice as long as ancient peoples; our onset of menstruation is at a dramatically earlier age (partially because of diet, possibly because of hormones in dairy and meat products), and we don't bear anywhere near eight children apiece. Excessive, modern menstruation patterns are almost a boomerang health problem -- we have traded relief from excessive childbearing for menstruation, which many women experience only with severe pain, nausea, hormonally induced depression, migraines, and decreased capacity to function.
I have not seen anyone advocating "nonstop" menstrual suppression (although that's a very popular side effect of Depo Provera for some women). The FDA is approving a drug that reduces menstruation to every 3 months -- a figure more in line with what we know about the pattern around which our bodies evolved.
I fail to see what could be considered "non cunt-loving" about any of this.
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Date: 2003-08-04 10:38 pm (UTC)I read about this a few years ago in the New Yorker; I didn't like the idea then, and I don't like it now. However, I'm lucky to be able to dislike the idea: My periods don't cause me many problems, so there's not really much benefit to skipping cycles. If I had a solid week of heavy flow and debilitating cramps, I'd be singing a different tune.
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Date: 2003-08-04 11:24 pm (UTC)no subject
Date: 2003-08-05 08:03 am (UTC)But I have no objection to women using it. I agree with part of what Demonesque was saying, that it's sort of dippy and (yes) intolerant to equate feminism with loving our menstrual blood. I don't hate mine and I think the shame surrounding menstruation is deeply stupid, but neither do I think that using tampons and taking Midol and ortho-tri-cyclen are in any concievable way anti-feminist or anti-cunt.
(For me, having my period on my honeymoon would not have been a huge deal. But if I had heavy, painful periods, as many women do, it would have been an important problem -- not because of sex, but simply because it would have been a physical problem equivalent to stomach flu.)
no subject
Date: 2003-08-05 10:04 am (UTC)