Sunday, April 22, 2007

How could you write any less intelligently about menstruation?

I know nothing about Stephanie Saul, and I don't know anything about having a period. I know a lot about living with someone who has them and constantly complains about them, and yet doesn't really have any interest in not having them. I can accept that sort of doublethink just fine. God knows I probably exhibit behavior and attitudes at least that discordant.

Let me be absolutely clear: If a woman has a complicated relationship with her menstrual cycle that relates to her identity and personal relationship with her body, that's great. Seriously. I don't bleed. I don't know what it's like. If there's something symbolic about it for you, that's cool. If it helps you understand your relationship to your body, awesome. I can at least imagine it on a literary level. I can't think of any exact analog for a guy's relationship with his sexual anatomy, but if there was one, I bet I'd have a complicated relationship with it too.

But if a woman doesn't have a complicated relationship with her menstrual cycle, then my God, why does she have to bleed if she doesn't want to? Since when has feminism become about limiting a woman's choice?

So here's a brutal jump-around fisking of Ms. Saul's pseudofeminist drollery.

For many women, a birth control pill that eliminates monthly menstruation might seem a welcome milestone. But others view their periods as fundamental symbols of fertility and health, researchers have found. Rather than loathing their periods, women evidently carry on complex love-hate relationships with them.
Oh my God! Women don't agree on everything! Holy shit, there's more than one valid opinion on a matter in this world! How will we ever survive until next week without our unity?
This ambivalence is one reason that a decision expected next month by the Food and Drug Administration has engendered controversy. The agency is expected to approve the first contraceptive pill that is designed to eliminate periods as long as a woman takes it.
Alberto Gonzales: controversy. Gun control on college campuses: controversy. Approving a new birth control pill that ruins the old misogynistic proverb "never trust something that bleeds for a week and doesn't die?": Yawn.
“My concern is that the menstrual cycle is an outward sign of something that’s going on hormonally in the body,” said Christine L. Hitchcock, a researcher at the University of British Columbia. Ms. Hitchcock said she worries about “the idea that you can turn your body on and off like a tap.”
Two points here. The first one, valid. Amenorrhea is an outward sign that something isn't working quite right, and this pill would mask that. Valid point. The second one, the "turning your body on and off like a tap" thing, is this woman for real? Who cares? If people want to contemplate the symbolic nature of their own menstrual cycle (which I certainly do not oppose), that's cool. But to unilaterally say that every woman out there, whether she finds her cycle to be something personally important to her or not, should necessarily have to have the thing, with only poetry to back you up, is pretty dumb.
That viewpoint is apparently one reason some already available birth control pills that can enable women to have only four periods a year have not captured a larger share of the oral contraceptive market.
Oh my God! The market can handle a diversity of goods!
“It’s not an easy decision for a woman to give up her monthly menses,” said Ronny Gal, an analyst at Sanford C. Bernstein & Company.
Or its just not a necessary decision. If a woman is on a birth control regimen that works for her, and the benefit of not having a period isn't worth having to fiddle with that regimen, that seems pretty reasonable to me.
Doctors say they know of no medical reason women taking birth control pills need to have a period. The monthly bleeding that women on pills experience is not a real period, in fact.
Okay, this is when Ms. Saul really loses my vote. "Hey birth control pill users, you phonies, you don't even have real periods!!! That's not blood dripping from you for five days every month, that's really just cherry slurpee the drug company implanted in you while you were asleep! Fooled you!"

What the hell? No, you don't have an egg to shed when you're on the pill, because you don't ovulate. But you still shed some endometrial tissue, and unless I just totally failed my GYN rotation, I'm pretty sure that constitutes a "real" period. Labeling an on-the-pill period as "fake" seems a little, well, nutty? To make such a claim, you either a) have a really bad understanding of science, b) believe everything you're told, or c) have a very specific agenda.
And studies have found no extra health risks associated with pills that stop menstruation, although some doctors caution that little research has been conducted on long-term effects.
Welcome to drug research. How do you conduct research on long-term effects if people don't take the medication for long periods of time? It's not like we have a colony of research-people on the moon we can feed Seasonale for the next fifty years to see if they grow an extra arm on their head or something, and then get back in our space ship-time machine to come back to 2007 to tell everybody that it's totally safe, except for that arm-growing-out-of-your-head thing. We don't have long-term research on most of the birth control regimens in existence now, as most research I've seen just lumps OCPs into one big catch-all category. That might be totally appropriate, but maybe this progestin analog causes arms to grow out your head, and another one doesn't. We won't know for fifty years.
The topic has, however, inspired an hourlong documentary by Giovanna Chesler, “Period: The End of Menstruation?,” currently screening on college campuses and among feminist groups.

Ms. Chesler, who teaches documentary making at the University of California, San Diego, said she became concerned about efforts to eliminate menstruation when she first heard about the idea several years ago.

“Women are not sick,” she said. “They don’t need to control their periods for 30 or 40 years.”
Geez, and I thought the "Left Behind" people needed to get a life. No, women are not sick, but they take birth control pills because they'd like to actually be able to enjoy sex without having seventeen children. If stopping ovulation with pills is okay, why is stopping menstruation with pills somehow worse? At least, medically.
There has also been a backlash among groups that celebrate the period as a spiritual or natural process, like the California-based Red Web Foundation. “The focus of our group is to create positive attitudes toward the menstrual cycle; suppressing it wouldn’t be positive,” said Anna C. Yang, a holistic nurse and executive director of the organization.
What a bunch of hippies. Nobody's FORCING this stuff down your throat. If you love your menstrual cycle, knock yourself out. If you want to celebrate your menstrual cycle as a central theme of womanhood, have fun. But leave women alone who don't think it's fun to bleed 20% of the time for thirty years.
Eliminating menstruation is not a completely new concept. Women who take any kind of oral contraceptive do not have real periods.

Because the hormones in pills stop the monthly release of an egg and the buildup of the uterine lining, there is no need for the lining to shed — as occurs during true menstruation.
Not again. Space cadet.
At the alternative Bluestockings Bookstore on the Lower East Side of Manhattan early this month, several dozen women gathered for the New York premiere of “Period: The End of Menstruation?,” Ms. Chesler’s hourlong documentary. It explores the idea of suppressing the menstrual period but leaves the viewer to make up her own mind.

One who attended the screening, Aviva Bergman, a 22-year-old student at Goucher College in Maryland, said she would not use products that suppressed her period because it seemed unnatural.
You know what else is unnatural? Being able to have sex without worrying about getting pregnant. Injecting yourself with insulin because your pancreas doesn't work. Getting a heart transplant. Nuclear bombs. Soy milk.

You know what's perfectly natural? Earthquakes. Floods. Hurricanes. Puppies. Rainbows.

Natural doesn't seem like the best proxy of goodness. Seems like most of us evolved with intellects that can stomach a bit of nuance and context here and there.
“I just feel that there’s a reason you’re getting it every month,” she said.
Feel away! It's your menstrual cycle. Do what you want with it. But it's your menstrual cycle, and not that of the woman sitting next to you. Make your own decisions, and leave other people alone.

Yeah, there's a reason "you're getting it" every month. It's because (oh hell, you can look it up on wikipedia, if you're that interested in reproductive endocrinology). I'm pretty sure there's nothing magical about pulses of GnRH, although I'm not a medical student at Hogwarts, and may be out of my league on this one.

I don't anticipate that anyone is actually going to read down this far. If you did, please keep all these comments in focus with the overriding thesis.
  1. Women should get to decide what they do with their own bodies.
  2. There's nothing feminist about trying to limit the choice of other women for poetic reasons.
  3. We don't know much about the long term effects of suppressing periods indefinitely. but we also don't have much medical reason to think that regimens that suppress periods indefinitely will really be much of a problem in comparison to contraceptive regimens already available.
  4. There's nothing magic about things that are natural. Cancer is natural. Air conditioning is unnatural.
  5. I've never had a period. I'm only qualified to speak about the medical and political implications of this stuff. I do not question anyone's personal experience with menstruation.

1 comment:

Tiny Shrink said...

As a female, I feel I can comment firsthand on the topic, and I'm all about choice. Even my med school female friends are divided on the necessity of having a period, but medically I see no reason why it's bad. In fact, women have been "skipping" periods for years by using conventional OCP's back to back to reschedule an inconvenient menses. The whole "normal 28 day cycle" isn't entirely natural, either. There's nothing wrong with wanting some extra control over your life, "natural" or no. I bet these are the same people who drink unpasteurized "raw" milk with the same "natural" argument.