Sweden’s Year of Menstruation – Is it the Menstrual Decade? Maybe the Menstrual Millennium?

Guest Post by Josefin Persdotter, Gothenburg University

As I write this, it is only hours until the acclaimed Swedish television program Kobra airs an episode about menstruation in art, and as a growing social movement in Sweden. They’ve interviewed none other than menstrual art and activism pioneer Judy Chicago. In the trailer she jokingly exclaims: “Oh, so Scandinavia’s discovered that women menstruate!” And it seems we have. Or at least Swedes seem to have. Sweden’s currently enjoying a kind of menstrual boom. Maybe one could even call it a menstrual revolution. From my (albeit very menstrually focused) horizon I see menstruation everywhere. During the last year it’s gone from (almost) total menstrual silence to it being in national newspapers, magazines, TV, radio, and naturally, all over social media.

I guess one could say it began last summer.  Feminist cartoonist and writer Liv Strömquist (bravely!) did a two-hour radio show about menstruation, depicting menstrual taboos in history, arguing that it ought to be a much larger part of culture. The show aired on prime-time when “everyone” was listening. Being a menstrual activist for many years, I listened with a pounding heart wondering how Sweden would react. Though I’m sure she got some internet hate and many negative comments, the reception from those who liked it seems to have been quite overwhelming for Strömquist, and quite palpable to everyone else.

Instantly, something changed. Just as I had experienced when I met people through my own activism, but this time on a national scale. People began to open up; they shared their own menstrual stories openly on various social media platforms. And they haven’t stopped.

To only name a few of the many amazing things that have happened since then: several menstrual art projects have enjoyed unprecedented attention in the media, menstruation-related diseases make the headlines in the tabloids, several other radio-shows have had menstrually-themed episodes, a menstrual documentary has been made and another one is in post-production, new books about menstruation have been launched and sold out in weeks (!), and on top of that two national organizations for menstruation and PMS respectively have been founded. Menstruation’s become something that’s publicly handled as a truly relevant and important issue.

I may exaggerate a little, but I don’t want to downplay it either,  as I really do think that something rather spectacular has happened. First I called it a menstrual spring, then it became a menstrual year, and now it’s going on year two. Could one dare to hope for a menstrual paradigm shift? Or might the public lose interest? I see no signs of menstrual fatigue, but quite the opposite. More and more people and institutions engage in menstrual issues publicly. The need to talk periods seem to be stronger than ever.

Sweden’s got a small population of about 9 million, speaking an equally small language. This has been a pain in the neck in my menstrual activism, until it wasn’t. I was quite jealous of menstrual activists friends who got to do their work in English or Spanish, having so many millions more that could like, comment, and retweet on social media. But now I’ve begun to think the small size might be a huge advantage. I think we have the size to thank for some of what’s happened. It might be easier to reach everyone, to become in some way part of the media mainstream and have a national impact in a small country like this. Sweden has only a couple of national newspapers, fewer television news shows, etc., compared to larger nations.

I post this to the international menstrual community wondering if I am witnessing something unique, or something universal? Are there currently similar menstrual surges elsewhere as well? And naturally: what’s it been like historically? What can we learn from eachother? What should we think about to make these changes last and become real shifts in the menstruculture?

Yaz and Yasmin: An Unacceptable Level of Risk?

Photo by Flickr user Beautiful Lily // Creative Commons 2.0

Don’t feel bad if you missed last week’s headline news about the deaths of 23 young women from their birth control. It was a top story for CBC news and a few other Canadian sources, but it was barely a blip on the radar of most U.S. news outlets. Yaz and Yasmin, two similar new-generation birth control pills from Bayer, are suspected in the recent deaths of these young Canadian women.

These are among the best selling oral contraceptives in the world, but this is not the first time Yaz and Yasmin have been suspected of causing death or adverse effects. Earlier this year, Bayer agreed to pay up to $24 million to settle claims from plaintiffs with gall bladder injuries caused by the drugs, and the company set aside $1 billion to settle claims from approximately 4,800 women who have suffered blood clots due to Yaz or Yasmin. As of February, 2013, approximately 10,000 lawsuits against Bayer are still pending in the U.S., and an additional 1,200 unfiled claims are pending. The company anticipates additional lawsuits—and additional settlements—regarding blood clot injuries, such as pulmonary embolisms or deep-vein thrombosis.

The history of the birth control pill and its social impact is well documented. First approved by the U.S. Food and Drug Administration in 1960, it quickly became the world’s first “lifestyle drug,” and it has become the one of the most studied drugs in history. It is considered to be so safe that the American Congress of Obstetricians and Gynecologists (ACOG) recently recommended that oral contraceptives be sold without a prescription.

But all hormonal contraceptives–the pill, the patch, the shot and the vaginal ring–carry a risk of blood clots. For most users, this is a minor concern, affecting approximately six of every 10,000 pill users. For users of new-generation pills—that is, pills containing drospirenone, the fourth-generation synthetic progesterone found in Yaz, Yasmin, Ocella and several other brands—the risk jumps to ten of every 10,000 users, although Bayer maintains that their own clinical studies find the risk comparable to older pills. Note, however, that the risk in most of these studies is compared either to other hormonal contraceptives or to pregnancy, not to using effective non-hormonal contraception. As if women’s only choices were to be pregnant or be on the pill.

And it is this matter of women’s choices that brings me to my main point: Why we have we seen so little media attention to the safety profile of Yaz/Yasmin (and hormonal contraceptives more generally)? This isn’t about just a few unlucky Canadian women: Four women in Finland have died, more than 50 U.S. users of Yaz and Yasmin died in just a few years and France reports 20 deaths per year due to birth control pills between 2001 and 2011, with 14 attributed to the new-generation contraceptives. This is a major consumer safety concern, and a women’s health issue.

In an earlier time, this might have led to Congressional investigations, such as the Nelson Pill Hearings, which resulted in FDA-mandated Patient Package Inserts (PPIs)—the printed information about risks, ingredients and side effects included in pill packets, first required for oral contraceptives and then for all prescription drugs. It is hard to imagine today’s Congress calling for such an investigation. Among many other social changes since 1970, drug manufacturers in the U.S. hold more influence over both legislators and consumers, now spending nearly twice as much on promotion as they do on research and development.

A parallel can be found in the health crisis triggered by an outbreak of Toxic Shock Syndrome (TSS) linked to tampon use in 1980. TSS is a potentially fatal infection caused by bacterial toxin Staphylococcus Aureus. A new brand of superabsorbent tampon was linked with 813 cases of TSS, including 38 deaths, that year. By 1983, the number of menstrual-related cases reported to the CDC climbed past 2,200, and manufacturer Proctor & Gamble had “voluntarily” pulled the product from the market before the FDA forced them to do so. The intense media coverage, public concern and outcry from feminist activists pushed the FDA to reclassify tampons as a Class II medical device, an upgrade which meant tampons would require more specific regulation and possibly after-market surveillance. They were much slower to mandate absorbency standards, but eventually did so under court order. These actions resulted in a documented decrease in menstrual-related TSS, although it is important to note that it has not disappeared.

Today, more than 30 years later, young women are again dying from something purported to help them, something that affects mostly women. Thousands more are experiencing life-threatening, health-destroying side-effects, such as blindness, depression and pulmonary embolism. Canada’s professional association of OB-GYNs defended the drug, suggesting that perhaps the recent deaths could be attributed to non-contraceptive reasons for which it was prescribed, such as PCOS or diabetes, both of which are associated with higher risks of blood clots. But there is little evidence of public concern, outside of Yaz/Yasmin user message boards. Even feminist outlets aren’t always covering these issues as vigorously as we might hope.

Yet the birth control pill in general has never been more politicized in the U.S.: In the last year or so, we’ve seen headlines and public debates about insurance coverage of the pill, access to emergency contraception and so-called personhood bills which have been introduced in legislatures in at least eight states. Feminist activists and health care advocates have been working tirelessly to protect access to the pill along with other forms of birth control, as well as the right to end an unintended pregnancy—and feminist journalists have been writing about these activities.

In the urgency of responding defensively to these political attacks—and we must respond—feminists cannot ignore corporate threats. Just as preserving contraceptive and abortion access is critical to women’s health and well-being, so is protecting contraceptive safety.

Cross-posted from Ms. magazine blog.

Selling Sickness: A Call to Action

As our regular readers now know, the Society for Menstrual Cycle Research held its 20th biennial meeting last week in New York. Over the next few weeks, you can expect to see several posts about new research and other exciting events of that conference (yes, the Red Moon Howl was filmed!). I’m going to launch that parade of awesome with the organization’s unanimous decision to endorse the Call to Action developed at the February, 2013, Selling Sickness conference held in Washington, D.C.

The Selling Sickness conference was designed to be part of a global progressive and activist health movement, supported by many allied organizations, including Consumer Union, Association for Women in Psychology, New View Campaign, PLOS, Society for Menstrual Cycle Research, and many others. The conference theme was “People Before Profits”, with topics ranging from to disease-mongering, misleading marketing, ethics in professional education, journalistic standards, over-treatment, new models for drug development and testing, whistleblowers, and how all of these issues affect public health and pocketbook. SMCR was represented by a panel of researchers who presented a symposium titled, “The Medicalization of the Menstrual Cycle”. Presenters Peggy Stubbs, Ingrid Johnston-Robledo, Joan Chrisler, Paula Derry, Holly Grigg-Spall, Elizabeth Kissling, and Chris Bobel discussed how the menstrual cycle is medicalized throughout the life-cycle, and some activist responses.

Many conference contributors met during and after the conference to shape the following Call to Action, and at our organization meeting on Friday, June 7, SMCR membership voted to endorse it as an organization.

Of Menstruators and Manhole Covers

Feminists of a certain age may recall debates about changing sexist language, and the ways feminists were once mocked for insisting on replacing sex-specific terms such as policeman with police officer, fireman with firefighter, stewardess with flight attendant and the so-called generic pronouns he and him with he or she, him or her or they and their. When I tell you that students in my Cultural Studies class last fall asked why Althusser only wrote about men, it’s easy to think those battles have been won. But only about half of the 50 U.S. states have changed their official government documents to use gender-neutral language.

The fact that today’s young people do not understand the generic use of man is just one indicator of the power of language. It matters which words we use to name and describe our world; language both reflects and shapes the way we see the world and our place in it. As a feminist scholar of media and women’s health and sexuality issues, I’ve become increasingly mindful of how labels can be inclusive or exclusive. Anyone who cares about public health usually tries to use the most inclusive labels possible. That’s why blood banks ask if you’ve had sex with men who have sex with men, for example, instead of asking if you’re gay.

Much of my published research deals with media representations of menstruation, so it caught my eye last month when a prominent women’s studies professor posted the following remark on a very active women’s studies mailing list:

There is something a bit problematic going on in menstruation politics. It seems we are required, for sake of politeness to male-bodied transgenders, to pretend that men menstruate too.

She then quoted a paragraph from a book review that referred to radical menstruation and used the term menstruators rather than women or women who menstruate. (Full disclosure: I recognized immediately that the book had to be New Blood: Third-Wave Feminism and the Politics of Menstruation by my good friend Chris Bobel, a brilliant ethnographic study of feminist activism around menstruation.)

I cite this example without naming the professor or the list because I am neither interested in calling out an individual nor shaming a group. I cite it because I want to talk about why it is important to write of menstruators, not merely a matter of politeness to transmen. (It should go without saying that politeness to transmen is also important.)

Menstruation exists at the crossroads of sex and gender, as Chris wrote in New Blood. It is a biological function, but like every other biological function its meanings are cultural, and the biology cannot be separated from the culture. The activists Chris interviewed emphasized two important biological facts often overlooked in our cultural interpretations of menstruation:

1. Not all women menstruate.
2. Not only women menstruate.

Some women don’t menstruate because of diseases, cancers, surgeries, pregnancy (although they may still bleed) or menopause. Other women don’t menstruate because they don’t have functioning uteruses, fallopian tubes or vaginas; maybe they were born that way or maybe they are transwomen. And yes, there are some people who don’t identify as women who do menstruate. Some of them are transmen. Some of them are intersex. Some may have fully functioning uteruses, ovaries and vaginas but may identify as genderqueer, transgender, third gender or something else entirely. They are menstruators, but they are not women.

Calling them menstruators is just like changing other biased language. It helps us tell the truth about our lives, and challenge both gender essentialism and biological determinism. It reminds us that our bodies do not determine our identities, and that we are so much more than merely bodies. Some of us are people who happen to menstruate, some of the time. Using menstruators instead of women also helps make vital health information available to everyone who needs it—not just women.

In Washington, the state where I live, the legislature just unanimously approved a bill that is the fifth and final installment of a multi-year effort to replace male-dominated language from the state code with gender-neutral language. Under the new code, penmanship will become handwriting, freshmen will be first-year students and watchmen will become security guards.

But they still cannot find a gender-neutral term for manhole cover. In a world where we can find a gender-neutral name for men who menstruate, they’re just not trying hard enough.

Cross-posted at Ms. Magazine Blog, February 11, 2013

Period +

httpv://youtu.be/e1x5xvHmhqo

In keeping with the theme of Chris’ Monday post about antidotes to feminist fatigue, I offer vlogger (that’s short for video blogger to those of you who live most of your lives off-line) Laci Green’s newest video, which is about being Period Positive.

Ms. Green also recently posted a take-down of so-called “empowering” femcare ads at her Tumblr site, noting that “when you take a closer look, these images hold the same negative attitudes about menstruation that we see throughout history. These ads subtly, but effectively, communicate that menstruation is embarrassing, gross, and needs to be made “invisible”, that it is a defect you need to “smack down” or defeat, that periods are inconvenient and uncomfortable for men” [emphasis in original].

So take heart, weary feminists, especially re:Cycling readers and other period-positive ladies! You’re not a lone voice crying out in the wilderness.

Occupy Your Period

httpv://youtu.be/N3KU_ngZwkw

The Occupy movement is about equality. Its primary aim is to create a more just world economically, but socially, too, for economic justice and social justice are inextricably linked. The specific focus of each local group may be somewhat different, but Occupiers share a distrust of corporations and financial institutions and concern for erosion of democracy. Globally, this movement suggests another world – another way of doing politics – is possible, as protesters visualize and plan for one.

If you think the Occupy movement has been lying low since they were kicked out of Zuccotti Park last fall, you’re wrong. They’re still going strong, helping New York and New Jersey recover from Hurricane Sandy. Occupy Sandy is a coalition from Occupy Wall Street, 350.org, recovers.org and interoccupy.net. Another off-shoot of Occupy Wall Street started the Rolling Jubilee, a project that buys debt for pennies on the dollar and abolishes it, instead of collecting it. It’s basically the people’s bailout.

If we want to see a new way of menstruating – open, without shame, like Chris wrote about earlier this week, with honest talk Heather has called for, without the the moral panic Breanne’s students reported at NWSA— we must Occupy Menstruation. Even the parts we hate. I like to think all of re:Cycling is part of the Occupation, along with #periodtalk and others who break the silence.

And it wouldn’t hurt if we followed Max’s example above, and protested the economic injustice of it as well.

It’s National Women’s Health Week — Celebrate and Reminisce with the FDA

I admit, I didn’t know that this is National Women’s Health Week until I received a reminder in my inbox from a U.S. FDA mailing list, letting me know about the Food & Drug Administration’s role in promoting Women’s Health. They’ve published a brochure (available in both HTML and PDF versions) commemorating 100 Years of Protecting and Promoting Women’s Health.

Image Source: Public Domain

Society for Menstrual Cycle Research members and other women’s health advocates and activists will want to look through the list of the accomplishments the FDA claims responsibility for and lists as unequivocal improvements in women’s health.

For instance, we’ve had many discussions at re:Cycling about the FDA approval of the pill in 1960 as one holding mixed benefits for women, and not always the best choice for women’s health. The brochure also asserts that in 1970, “FDA initiated the first package insert written for consumers to explain to women the benefits and potential risks of oral contraceptives.” That happened in 1970, but Barbara Seaman, Alice Wolfson, and the other founding mothers of the National Women’s Health Network had more to do with its initiation than the FDA.

And here’s another inspiring quote from the FDA brochure:

1980: Making Tampon Use Safer

Problem: In 1980, there were 814 confirmed cases of menstrual related Toxic Shock Syndrome (TSS) and 38 deaths from the disease.
Response: FDA began requiring all tampon packages to include package inserts educating women about the risk of TSS and how to prevent it. In 1997, there were only five confirmed menstrually-related TSS cases and no deaths. The tampon package inserts with TSS information continue to be used today.

Sure, the FDA is proud of those safety rules now, but in 1982 the agency asked the industry to come up with their own voluntary standards because they did NOT want to regulate tampon safety. After years of pressure and organizing from Boston Women’s Health Collective members Esther Rome and Judy Norsigian, activist Jill Wolhander, researcher Nancy Reame, and others to standardize tampon absorbency ratings, the FDA finally enacted regulations in 1989, by court order. Nine years after 38 women died from a tampon-related illness.

Just last year, the FDA could have made another decision that would almost certainly save women’s lives, by removing birth control pills containing the synthetic progesterone drospirenone from the market, but instead the advisory panel voted by a four-person margin that the drugs’ benefit outweighed the risks.

You know what else isn’t on the list? Emergency contraception, a.k.a. the Morning After Pill and Plan B. The agency hemmed and hawed and delayed unconscionably for years, until finally approving it for limited over-the-counter availability in 2006 — a year after Susan Wood walked out of the FDA Office of Women’s Health for good over what she believed to be “willful disregard of scientific evidence showing Plan B to be safe.”

Celebrating organizational achievements that advance and protect women’s health is a fine thing. I’m glad Frances Kelsey withheld approval of Thalidomide in 1960, and for the most part, I’m glad the FDA is on the job. But while we’re celebrating women’s health and reminding everyone to be active, eat healthy, and get preventive health care (if they are so fortunate to have access to health care), let’s also celebrate the activists and advocates that keep agencies like the FDA in line.

You’re Taking WHAT Class???

Guest Post by Alexandra Epstein – Marymount Manhattan College.

how school helped me come out of the menstrual closet

Finally, the time had come where I was choosing my classes for my senior year of college. I had finished my required courses to complete my social work minor, and with only a few required courses left until I complete my psychology major, I had lots of room to choose electives! What to take though? Maybe an art class? Or what about a science class? As I scrolled though my options online, something caught my eye. “The Social Construction and Images of Menstruation”. Honestly, anything to do with the social construction of anything is good in my book, so without even thinking much about it, I registered.

Day one in class, it hit me; I was in a class completely focused on the idea of how menstruation is viewed by society. I was a bit taken aback. As a woman, I had grown up “dealing” with my period, but I had never actually thought about it, or what it meant to me as a woman. Now, I can’t stop. I can’t stop thinking about it, I can’t stop talking about it, I can’t stop reading about it. The idea of the social construction behind menstruation has not left my head since I entered that classroom on the first day of the semester.

Not only has this class opened my mind to a whole new concept, but it has made me more comfortable to openly talk about menstruation and everything that goes along with it. It wasn’t even two months ago that I was so uncomfortable with the concept of the period. I wouldn’t talk about it often with my friends, I would hide my tampons in bags within bags so no one would know that I was on my period, and I thought of my period as a burden and huge inconvenience. Within the past month I have grown to love my period. It is something I am proud to be able to experience. I have become very open with conversation regarding menstruation. I have asked all of my female friends about their first experience with their periods, and all of my male friends if they know how to use a tampon. I love the responses I get. Some people embrace the chance to talk about something we as humans don’t normally talk about. However, most people I talk to become so uncomfortable with the fact that I’m talking about such a taboo topic. They ask me why I choose this class, or why my school even offers such a rare subject to study. What they are most shocked by is the fact that my professor is a male. “A guy teaches that class? Isn’t that awkward?” “No!” I reply, “Its brilliant and insightful and I am in love with it.” Too many people are uncomfortable with this topic. I am making it my mission to take the awkwardness out of menstrual conversations.