Saturday, March 9, 2013

The debate on menstruation cycles- Rebekah Schott



The debate on menstruation cycles

CAUTION: Boys, this blog does contain information about the menstruation cycle and may contain disturbing discussions. Be prepared I guess.

My aim is to inform you of various facts and studies pertaining to the menstrual cycle. I will offer both sides of the debate and add my own comments on how it affects me and the other girls that surround me.

So, what exactly is menstruation? 

I would describe it as that horrible thing that happens to me once, maybe twice a month, makes me terribly rude, makes my boyfriend steer clear of me for an entire week, makes me crave food, have terrible migraines, eat large amounts of candy/chocolate, gain lots of weight, feel bloated and uncomfortable, and completely controls my life.  

However, Dr. Phillip Owen, obstetrician and gynecologist, says “Menstruation - having periods - is part of the female reproductive cycle that starts when girls become sexually mature at the time of puberty. During a menstrual period, a woman bleeds from her uterus (womb) via the vagina. This lasts anything from three to seven days. Each period commences approximately every 28 days if the woman does not become pregnant during a given cycle. “

An objective view.

Why do women menstruate?

Dr. Phillip Owen says,
“Menstruation is a natural process that occurs if an egg is not fertilized. If the egg is fertilized and the woman becomes pregnant, it will fasten itself onto the endometrium, build up of blood. If the egg is not fertilized, however, resultant hormonal changes cause the endometrium to slip away and menstruation begins. Menstrual discharge is composed of the endometrium itself, together with a little fresh blood caused by the breaking of very fine blood vessels within the endometrium as it detaches itself from the inside of the uterus."

"The amount of blood lost due to the normal monthly period is usually less than 80ml. “

80ml is approximately 1/3 a cup. Haha. Who are you kidding? This seems a very low estimate. Many woman I know take iron replacements because they lose so much blood.

So, what are you getting at?

A birth control pill released in 2007, Lybrel, suppresses women’s monthly menstrual cycle for a year.  Some women welcome the pill with open arms, while others feel for various reasons that it should not be taken. A lot of critics think that the menstrual cycle is natural and should not be eliminated. 

“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.” 

Some women and doctors share this concern; however, there are no studies that suggest this. Doctors say they know of no medical reasons why women taking birth control pills should have a period. 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.
Something a lot of advocates don’t know, is that the bleeding you experience on birth control pills is not a real period. When birth control pills first hit the market in the 1960s, women generally took three weeks of active contraceptive pills followed by one week of placebos or no pills. The thinking was that women would find this more acceptable, that they would feel like they were having their normal menses," says Susan Ernst, M.D., chief of gynecology services for the University Health Service at the University of Michigan and clinical instructor in the Department of Obstetrics and Gynecology at the U-M Health System. And now many gynecologists are saying the “withdraw bleeding” that following the three weeks of pills and mimics a normal menstrual cycle is no longer necessary. 

In fact, the practice of suppressing a menstrual period has been going on a long time. Some women never take the placebo pill the fourth week of the month where their withdraw bleeding should occur, and just continue a new packet of birth control pills.
Various methods are described in the table below.









Method
Use
Combined oral contraceptives (including dedicated product Seasonale® and LybrelTM)
Extended or continuous cycles suppress menstruation
Contraceptive vaginal ring (NuvaRing®)
Studies not published, but regimens similar to COCs suppress menstruation
Transdermal contraceptive patch (Ortho Evra®)
Studies not published about safety or efficacy, but regimens similar to COCs suppress menstruation
Depot-medroxyprogesterone actetate injections (Depo-Provera®)
Amenorrhea common with long-term use—50% after 1 year, 90% after 2 years
Levonorgestrel intrauterine system (Mirena®)
Significant (80%–90%) decrease in blood loss; approximately 20% of users amenorrheic by 1 year


The topic has inspired a documentary by Giovanna Chesler, “Period: The End of Menstruation?,” currently screening on college campuses and among feminist groups. Below is a link for a trailer of the documentary.


Pill That Eliminates the Period Gets Mixed Reviews
Ruth Fremson/The New York Times
An audience watching an hourlong documentary film by Giovanna Chesler, “Period: The End of Menstruation?,” at the Bluestockings Bookstore on Allen Street in Manhattan recently.


“We don’t have any long-term studies for what happens if you stop periods for years and years and years,” said Dr. Maria Bustillo, a reproductive endocrinologist in Miami. Dr. Bustillo said there was probably no increased risk over traditional birth control regimens. Although studies are conflicting, some have shown that the birth control pill may increase that risk. 

If we are so scared of the risks of suppressing the menstrual cycle, why are there not more studies that solidify the facts?

With Barr’s Seasonale and Seasonique, the biggest medical problem is that users can have unpredictable and irregular bleeding or “spotting."

To me, spotting is a huge upgrade from a constant flow.

Menstrual suppression may be particularly appealing to women who suffer severe pain, heavy bleeding or emotional problems during their periods. A study by Canadian researchers found that women afflicted by heavy menstrual bleeding give up $1,692 a year in lost wages. Women often feel less effective at work and school during their periods. They limit sexual activity and exercise; wear dark clothes and stay home more. One woman who now uses Seasonale said she had found her periods debilitating before she started taking it. 

“I had some months when I couldn’t get out of bed unless I popped 600 milligrams of Motrin,” said Marcella O’Neal, a department manager for Nordstrom in Atlanta. Ms. O’Neal, 36, said Seasonale had eliminated many of her symptoms — cramping, hot flashes and depression. “I love it, actually,” she said. 

Menstrual benefits of suppressing periods include a reduction in dysmenorrhea, menorrhagia, premenstrual syndrome, and perimenopausal symptoms such as hot flashes, night sweats, and irregular monthly periods.

Nonmenstrual benefits include a reduction in menstrual migraines, endometriosis, breast tenderness, bloating, menstrual migraine, and premenstrual syndrome or premenstrual dysphoric disorder, as well as medical conditions such as endometriosis and acne, and an improved sense of well-being.

One who attended the screening of “Period: The End of Menstruation?,” 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.“I just feel that there’s a reason you’re getting it every month,” she said.

I think it is fine if you don’t want to use the product, however, not every woman feels this way and I think it is our right as woman to have this option. I also understand a lot of the critics are scared of what the affects of suppressing your period may do, however, there should be more studies conducted to find out facts, not just bad feelings. To women who suffer severe pain, heavy bleeding or emotional problems during their periods, the idea that these side-effects can  be eliminated in woman that find themselves “debilitated” during their menstrual cycle seems amazing.

1 comment:

  1. Disallowing personal choice on the grounds of what's "natural" does seem restrictive and confused. The more pressing issue is safety, and you make a good case for women's right to make that call themselves.

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