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Title: It’s about bloody time
Author: Loeka
Date: 29-05-2020
Language: en
Topics: feminism, feminist, autonomy, gender, reproduction, history, menstruation, menstrual health, womens health, healthcare,
Source: https://konfront.dk/its-about-bloody-time-en-kort-historisk-gennemgang-af-menstruation/

Loeka

It’s about bloody time

The topic of menstruation and menstrual cycles has been drenched in

shame, disgust and indifference for centuries. This as a result of a

patriarchal capitalist system that overmedicalizes menstruation as a

‘’condition’’ or ‘’illness’’ and deems it as something that needs to be

hidden away instead of fostering a culture of understanding and

knowledge. Although the present dialogue around menstruation is moving

towards understanding, neutrality and sometimes even enthusiasm on the

topic, many people are still being taught incorrectly or insufficiently

about menstruation. To move the conversation about it forward we need to

educate ourselves and our comrades. This article is an attempt to

contribute to that.

Content Warning: The first part of this text will address some

historical examples of how women’s health and reproductive health has

been seen and dealt with. It will talk about gender in a binary way.

Since many resources that are available on this topic are written from a

binary point of view, in line with the perspectives of that time (and

current times too), the writing in this text reflects that. In the

second part of the text, which is more of a mini learning opportunity

about menstruation, I have attempted to avoid this kind of binary

thinking that links gender and biology.

How did we get here?

To understand society’s current view on menstruation, some stories of

the past might be helpful. Suppression of women and their knowledge of

their surroundings and their bodies goes way back. The following

examples by no means present a full picture of history, a book would be

needed to achieve that; Rather they are meant to give an idea of what

ridiculous methods and rhetoric have been used to discriminate against

women and their bodies.

In the 1800s an ovariectomy: the removal of one or both ovaries, would

be performed on women who were considered ‘difficult’. Difficult in the

context of the time meaning: being too sexual, argumentative,

strong-willed, or pretty much anything that was not full submission to

men. An ovariectomy, would make women ‘’orderly, industrious and

cleanly’’, as Ehrenreich and English point out in For Her Own Good.

Another common treatment for ‘difficult’ women that Ehrenreich and

English bring up is the ‘rest-cure’. This method was based on an

idealization of a child-like and weak woman. In the Victorian era,

sickness, and with that being weaker bodied, was the measure of

attractiveness. Women would purposefully make themselves sick by

drinking vinegar and arsenic, all in order to achieve the beauty

standard of the time. Middle class women would also be prohibited to

work or educate themselves in order to stay weak and submissive, — this

did not happen to working-class women for obvious economic reasons.

The cause of women’s illness was believed to be the ‘inherent’ conflict

between brain and uterus. The uterus was accepted to be the controlling

organ in a woman’s body. It was a common understanding at the time that

the uterus would keep one from thinking logically and rationally. This

clash between the irrationality of the uterus and the logical thinking

of the mind was believed to cause sickness in women. In short, a woman’s

biology would render her ill by default.

However, women also used this glorification of sickness to their

advantage in some cases. By pretending to be sick for extended periods

of time they could (partially) avoid the responsibilities and burdens of

childbearing and rearing. With that some women turned sickness into

their source of power and control over their own situation. This created

a problem for doctors and the medical industry, because these diagnoses

of sickness in women prevented them from getting pregnant. Following the

logic that a sick person should not get pregnant and carry a child,

since it will harm the child’s health. Children were the main focus of

the medical industry at the time and bearing and raising children was an

important part of being a respectable and good member of society and the

social life. To solve this dilemma, ‘hysteria’ was invented. If it could

be proven that a woman was not sick, but hysteric instead, she could

continue having children.

Later on, in the 1950s, any troubles or pains related to menstruation or

(in)fertility were considered to be caused by, what they referred to as,

‘incomplete feminization’. If women had felt any negative feelings about

their role in society, family, work, etc. the cause was sure to be the

‘rejection of their femininity’. In short, if a woman was unhappy; it

was her own fault, she had caused it herself by not being a perfect

woman who served her husband and family without complaint. Any issues

with menstruation or fertility were seen merely as a bodily response to

a purely mental problem, that/which the woman had caused herself by not

embracing her femininity.

The book Sweetening The Pill elaborates on this: ‘’Misogynistic medical

understanding of female biology was used as justification for women’s

oppression. Embracing this view of female biology required embracing and

accepting the oppression. Women were likely to do anything to avoid

being confronted by their own femaleness when it was defined in such

limited and negative terms. It could be said that women were rejecting

the concept of femininity presented to them by society, a concept they

had no part in creating. Their unhappiness with their standing in

society was protest and not pathology. Menstrual health issues and

infertility were not self-inflicted and psychosomatic, although such

issues may have been worsened by chronic stress. By blaming women, the

medical establishment was divorcing women from their own bodies and

making the female body an object of and a source for fear and

oppression. If they had physical health issues women were told to blame

themselves and their faulty, weak bodies.’’

The control of the medical field over bodies with a uterus is still

prevalent. The divorcing of women from their bodies that is mentioned in

the quote still exists today. Think about young people (from the age of

±12 years old) being prescribed the pill for a number of reasons that

could be dealt with in other manners. Think about NGO’s forcing

Long-Acting Reversible Contraception (LARC’s) on women in low-income

countries, sometimes even through bribes or intimidation (see Betsy

Hartmann, Reproductive Rights and Wrongs: The Global Politics of

Population Control for more information). Think about the invalidation

of pain, the lack of attention for and treatment of endometriosis and

polycystic ovary syndrome (PCOS). Endometriosis is a condition where

cells from the endometrium (uterus lining) grow outside the uterus,

often in the fallopian tubes or ovaries, it can cause a lot of pain.

PCOS is a condition caused by high levels of androgen hormones. Symptoms

of PCOS are diverse, ranging from excess hair growth to menstrual pain

and difficulty getting pregnant. Both endometriosis and PCOS are

shockingly common (PCOS has a prevalence of 4–12% in people with uteri,

and endometriosis a prevalence of ±10%, exact percentages depend on the

study and research method) and talked about surprisingly little. Think

about the people worrying and going to the doctor, thinking they have a

vaginal infection or urinary tract infection (UTI), because they mistake

their perfectly healthy cervical fluid for the symptom of an infection.

Think about people shamefully trying to hide away a tampon, pad or

menstrual cup when going to the toilet, because god-help-us if anyone

realizes the person in menstruating, many people seem to think it is a

purely private matter that should not be visible to anyone.

Let me point out here that experiences and reports from Black Indigenous

People of Colour (BIPOC) with a uterus show that their suffering,

invalidation and oppression is significantly higher than that of white

people. Which should be a surprise to no one. One study shows, for

example, that twice as many white women are diagnosed with endometriosis

as Black Indigenous Women of Colour (BIWOC). This is not because it is

less prevalent in BIWOC, but simply because doctors do not diagnose it

at the same rate. Meaning many more BIPOC with a uterus are walking

around with untreated endometriosis. Doctors and medical professionals

invalidate symptoms and suffering from BIPOC, as many personal

experiences and research support.

In short, many people with a uterus still experience oppression that

stems from sexist views on their bodies. The ways the medical industry

and patriarchal systems control bodies and minds is often not as blatant

as it was in previous centuries. However, it has merely transformed; the

control now shows up in the form of pushing the pill and LARCs on people

as the one solution, the focus on people with a uterus when it comes to

fertility problems (guess what, often fertility problems occur in people

with penises too), the general misogynist perception of PMS, etc.

Progress has obviously been made from the examples mentioned before, but

there is much work left to be done too.

Learning the basic

The lack of education we receive about bodies with a uterus has

significant consequences. It leads to a lot of misdiagnosing on the

doctor’s part, much suffering, both physical and mental for untreated

and invalidated symptoms, a general confusion of what is happening in

one’s body, unwanted pregnancies, a feeling of powerlessness, shame,

guilt and disgust. So, let’s start with educating ourselves.

The following part will outline how menstruation works and what signs we

can observe in regard to menstruation that can tell us valuable

information about our menstrual health. Many reading this will now

think, okay cool, but not for me, since I a) already know this or b)

don’t have a uterus or don’t menstruate so this is not interesting to

me. Bear with me, because I think for most people there will be

something to learn either way. If you don’t menstruate or have a uterus

yourself, learning more about it is an important part of being a good

friend, ally or comrade to those you know who do.

I’ll be writing from the assumption that you have a basic understanding

of the biology of reproductive systems, if you are unsure try searching

for ‘’reproductive systems/organs’’, it will give you the needed

information. I want to dismantle the myth that most of us are taught

that cycles are 28 days and that ovulation occurs on the 14^(th) day.

Although for a few people this might hold true, for most people this is

far from accurate. Therefor I will not be explaining the cycle in these

terms, rather I will give much broader windows of time for each phase,

which leaves more space for people to observe their bodies and find out

what is true for them.

[]

A menstrual cycle in short

Basically, menstruation is a cyclical process that prepares the body for

a pregnancy. At the start of every cycle, just after bleeding, the

Follicle Stimulating Hormone (FSH) causes 15–20 eggs (also called ova)

to start maturing in each ovary. The follicles, which the eggs are

wrapped in, start to produce estrogen. Estrogen is the hormone necessary

for ovulation to occur later on in the cycle. Between the maturing egg

inside the follicles a race is now taking place, about which one can

grow the fastest. Ovulation occurs when one of the ovaries releases an

egg from its biggest follicle, the one that won the race. The other

follicles that started to mature will disintegrate. This process can

take anywhere between 8–21 days, even longer for some people. This

mostly depends on how long it takes for your body to reach its estrogen

threshold. High estrogen levels cause an increase in luteinizing hormone

(LH). LH leads to the egg passing from the ovary, through the ovarian

wall into the pelvic cavity. This usually happens within a day or so of

the release of the egg. The fimbria of the fallopian tube (a tube

between the ovary and the uterus) pick up the egg. This is often a very

quick process; it can take less than a minute. The follicle of the egg

that was released will collapse and transform into the corpus luteum

(translated: yellow body). It stays behind in the ovary and starts

producing progesterone, it does this for about 12–16 days. This span of

time between the ovulation and menstruation, when the corpus luteum

produces progesterone is called the luteal phase. For each individual

the luteal phase is about the same amount of days (±2 days). It does not

change under stress or other external factors, since it is within the

ovarian walls which protect it from the influence of external factors,

such as hormones produced by stress. The progesterone produced by the

corpus luteum has multiple functions a) it prevents the release of any

other eggs during this cycle to make sure only one egg is release each

cycle, b) it thickens the endometrium (the uterus lining), until the

corpus luteum disintegrates after 12–16 days, c) it changes the three

main observable fertility sign to change. They are cervical fluid, basal

body temperature (waking temperatures) and the cervical position. After

the corpus luteum disintegrates, progesterone levels lower, the

endometrium won’t be able to sustain itself anymore and will bleed out,

aka ‘the period’, and the whole show will start again.

[]

To clarify all these hormones and when they come in to play, remember

FELOP:

Follicle Stimulating Hormone

Estrogen

Luteunizing Hormone

Ovulation

Progesterone

Delayed cycles

Then something I would like to clarify about delayed periods. I have

seen many people around me misunderstand how periods become delayed,

which is understandable with the little education we get about it. I

would like to clear that up. The duration of time between menstruation

and ovulation vary strongly. This can be due to stress, travel, changing

time(zones), changing rhythms (eg. night work), illness, or many other

external or internal factors. However, the luteal phase, the time

between ovulation and menstruation, barely changes for each individual.

Although different individuals often have a different length of luteal

phase, for each individual it is near constant. Let’s say person A has a

luteal phases of 11 days and person B has a luteal phase of 15 days,

person A’s luteal phase will always be about 11 days and person B’s

luteal phase will always be about 15 days. Practically this means that

if you are looking for reasons that your period is delayed, you need to

be looking at events that happened between menstruation and ovulation.

Often people look at things that happened just before they started

menstruating as the cause of a delayed period, but since the luteal

phase barely changes in duration and is not influenced by stress etc.,

this is not where you should be looking.

Fertilization

An egg is about the size of the full stop at the end of this sentence.

Once an egg is released from the ovary into the pelvic cavity and taken

into the fallopian tube by the fimbria, the egg is alive for a maximum

of 24 hours. In this time fertilization can occur, if this doesn’t

happen the egg disintegrates. If the egg is fertilized, this will happen

in the outer part of the fallopian tube, close to the ovary, where the

egg will be in the hours after ovulation. After fertilization it will

take about a week for the fertilized egg to travel through the fallopian

tube to the uterus. However, fertilization is not that simple. It needs

three things to collaborate: 1) the egg, 2) the sperm and 3) the medium

for the sperm to travel through to the fallopian tubes. This medium is

the cervical fluid, cervical fluid can be of different qualities that

make it easier or harder for sperm to travel to and through the

fallopian tubes. Cervical fluid is produced under the influence of

rising levels of estrogen before ovulation. If cervical fluid quality is

good (so called fertile-quality cervical fluid) sperm can stay alive in

to for up to five days. Cervical fluid is essential in whether

conception happens. This means that you can have penis-in-vagina sex

five days before ovulation and still get pregnant.

There is a lot to say and learn about the three primary fertility signs.

To keep things readable, that will be addressed in a separate article

that will follow soon, hopefully. Learning to observe and understand the

fertility signs can be helpful in understand and learning about your own

cycle.