Blood Simple

(this was the article I could not finish in time for BAM...it lacks *pop and finish*)

How many times do we cut our finger and immediately put the finger into our mouths? It's a funny question because it relates to blood and we have many negative reactions to blood. We fear it, are threatened by it and sometimes it makes us a little sick to our stomachs to see too much. Yet over half the population sees blood 12 times a year for 30-35 childbearing years and those women are considered the more likely to have faint-hearted reactions to seeing it.

Sometimes blood equals death, but for women of childbearing age, blood equals life or at least signals the ability to create life. Menstruation happens at the end of a fertility cycle each month for women but is considered impolite and unpleasant to talk about. It is a time when cultural or religious dogma teach us that we are physically unclean and leads to our need to hide our menses from society. Even the term, hygeine products, teach us that we must keep our status hidden by protecting society from odor and the site of blood. Most girls fear that they will bleed accidently and be caught not with their pants down, but with blood on them. Odor, if it exists at all, must be masked with perfume and absorbtion must be maintained with wings and coatings and super-sized tampons. Some males and females prefer to keep themselves from sex, even when AIDS contraction is out of the question because of their fear of the mess of blood.

Menstruation is big business. Of the 240 million americans, over 125 million are women all of which will experience menstruation from menarche at approximately age 12 to menopause at approximately 50. During those 28 years, with the exceptions of pregnancies and skipped periods, they will deal with it 12 times a year and buy 360 boxes of tampons or pads in their lives. This generates a constant revenue of approximately $1000 per woman equalling $1.25 billion dollars in the US alone. There are alternatives to big market tampons and pads that include the more environmentally correct sponges, fabric pads and menstrual cups, all of which can be washed and reused.

The hot topic these days is menstrual suppression. In the fall of 2003, the FDA approved Seasonale, a birth control pill set up to limit the amount a periods a woman gets to four a year. In this heated debate is the argument whether suppressing the menstrual cycle is healthy overall for women.

Drs. John Rock and Gregory Pincus developed the Pill in the 1950's. It was designed to introduce progesterone into the body for three weeks thereby preventing the ovaries from releasing an egg and stopping the uterus from building a bed of tissue for the fertilized egg to attach. Essentially it worked by creating a "pregnancy", using the hormone developed by the body to stop another egg from being released while the body was already in pregnancy. If fertilization does not occur, the uterus sloughs off the extra tissue and blood and releases it, which is the definition of menses. The development of the Pill incuded a week of placebo which would allow breakthrough bleeding and the accompanying symptoms of a real menstruation. This "faux" period was created to make women more comfortable with the naturalness of their regular cycle. It was also expected by Dr. Rock, a devout Catholic, to be approved by the Church as it was an extenuation of the rhythm method. It did not kill sperm or mutilate the organs or frustrate the process like a diaphram. If the rhythm method worked by avoiding the fertile periods of the menstrual cycle, the Pill extended that period indefinitely. Dr. Rock knew then that the Pill could be taken without interruption and avoid menses altogether but he found it important to maintain what was normal.

The Catholic Church never did get on board with the Pill or any other artificial methods for birth control and it took 40 plus years for someone to merely remarket the Pill without the placebo week so that women could take it continuously for 84 days before having a break for bleeding. It's chemical makeup is exactly that of the Pill and yet the debate is just starting to heat up.

Many women find the idea of four periods a year to be a blessing and are signing up to take Seasonale or merely manipulating the current version of oral contraceptives as doctors have been quietly instructing their patients for years to avoid periods during an important event such as a wedding or a vacation. The Society of Menstrual Cycle Research issued a position paper in June 2003 against widespread use of Seasonale. They feel that not enough research has been done on bone density, blood clots and strokes as well as attitudes, concerns and preferences of women on this subject. Curiously, they do not recognize that during the 40 plus years the Pill has been available, women have been taking it for upwards of 15 years and have only had the "faux" periods that occur while ovulation is suppressed. And controlled studies with women taking placebos only would be useless as any subject would realize in a month that she was taking the real thing. Their position is based on what they believe is normal. But what really is normal?

The truth is, in the past, women did not begin menstruation as early nor did it last as long as menopause started much earlier. As birth control was not practiced regularly (children were the destiny of wives) or was ineffective, pregnancies and breastfeeeding limited the number of times a woman had her period. In this age, American women have on average 2.2 children and don't necessarily breastfeed or they cut the time of breastfeeding shorter and have far more periods than their historical counterparts. A study was done in 1986 by Beverly Straussman in Africa with the Dogon tribe of Mali where birth control is not used at all. What she found was that between a late menarche and early menopause, women were pregnant and breast feeding much of the time and only had approximately 100 periods in their lifetimes. This is in contrast to the 350-400 times of Western women.

Also argued is ovulation itself can incur pregnancy as the ovary bursts through the uterine wall which needs to be repaired each time. As women age, cell division slows down giving cells more time to deviate and turn cancerous. Women who take the pill for ten years cut the risk of ovarian cancer by 70% and her endometrian cancer risk by 60%. These cancers are relatively modern diseases, part of a century in which women have come to menstruate 400 times in their lives. [John Rock's Error, Gladwell dot.com]

Dr. Nelson Souscasaux, GYN, argues that since the Pill creates only faux periods, one or two "real" ones whould be taken per year in order to "renew" the uterus. Though he concedes that menstrual suppression is necessary in the case of endometreosis, he believes continuous use will contribute to female attitudes towards menstruation as unnecessary and unpleasant. He recommends psychotherapy as an alternative to suppression, as if women must menstruate in order to feel fully female.

And that's the case for the argument: it's natural and must be endured and if you can't get with it, you need therapy. What a crock! Women who responded on the bulletin board at MUM (Museum of Menstruation and Women's Health www.mum.org) overwhelmingly embraced the idea of less periods. They envy men who don't have to have them or put up with them. When women pursue careers and are not interested in lifelong pregnancies and breastfeeding, menses gets in the way. A significant drop in production for women (i.e. sick days) is a direct result of the pain and uncomfortability of menstruation which inhibits their ability to compete with men in the workforce. A recent survey (fully funded by Barr Laboratories, makers of Seasonale) resulted in numbers as high as 75% interest in finding out how to suppress periods with birth control. Letters to MUM mirrored the high proportion of women who'd love to live without their periods and find it absurd that a period is any definition of womanhood. They aren't ashamed and don't need therapy, they just don't want headaches, backaches, bleeding, irritability and aggravation. Who would want that? And why is tolerating it even thought of as necessary due to *nature* except to continue to cripple women in their pursuit of lives beyond having children? I think it falls right into line with pregnancy as punishment for having sex and periods are a constant reminder that women should remain slaves to biology.