Week 12 Flashcards
What is Menstruation?
Regular shedding of superficial lining of uterus (endometrium sheds off) part of menstrual cycle
How common is menstruation in mammals?
2% of mammals thus not common among mammals, rare phenomenon e.g. dog’s menstruation different
Historical views linking menstruation to toxicity and Persistent cultural taboos
ancient cultures believed menstruation involved harmful blood, women isolation
Influence of Freud, Aristotle,
Hippocrates
stigmatization perpetuated by influential figures like Aristotle, Hippocrates = expels impurities from female body
o Inner, middle, outer layer
o Endometrium = inner layer that sheds during menstruation
o Myometrium/muscle layer is thick
o Perimetrium = outer layer/tissue covering while uterus
Cultural Control of
Menstruation
- Menstruation used to justify exclusion, Reason to exclude women from participation in society e.g. religious ceremonies, food prep, public spaces.
- Labeling menstruation as illness. Framed as protection or spiritual protection
- Impact on gender roles and autonomy, Effectively marginalized women.
How long does the menstrual cycle last?
Cycle lasts 21-35 days, variation is normal
Phases: Follicular, Ovulation, Luteal,
Menstruation
* - Hormonal regulation
* - Normal variations
* - Ovulation ≠ universal health marker
Follicular phase:
-Follicles grow from 1st day
-estrogen rises stimulating growth in follicles
-Arterioles show how nutrition supplied, uterine lining builds strength.
-Day 1-14
Ovulation:
-middle of cycle/around day 14
-follicle/mature egg exits ovary to wall of uterus, LH luteinizing hormone peaks causing release.
-Uterus must be blood/nutrient rich for potential pregnancy
-doesn’t occur in every cycle e.g. stressful times, weight loss, shift work, adolescence)
-Not a universal health marker
-Ovulation tracking apps can promote misinformation/anxiety
Luteal phase
-ruptures becomes corpus luteum
-progesterone released thickens uterine lining for preparation of implantation
-If no pregnancy occurs, hormone reduces and menstruation occurs
o Driven by hypothalamus, pituitary gland: responds to hormones released by hypothalamus FSH/LH. Ovaries: estrogen + progesterone
o Variation normal unless excessive bleeding, unnatural pain
o Endometrial tissue responds to hormonal shifts, prepares uterus for pregnancy, sheds when pregnancy doesn’t happen
o Left side shows menstruation, uterus gets fresh start
o Middle shows spiral arteries, uterine glands begins reforming, lining rich in nutrients and blood flow through arteries
o Right shows: luteal phase, glands secreting substances for potential embryo, increase blood flow
o Hormonal functions regulate ovarian function and changes in uterus
o Estrogen gradually rises during follicular
o Progesterone rises after ovulation
o LH increases at ovulation, triggers ovulation (vital for ovulation)
PMS as a construct
-PMS: premenstrual syndrome
-describes range of physical/emotional symptoms e.g. bloating, mood swings, irritability between menstruation. -Used as cultural shorthand to dismiss women’s emotions/cultural norms, undermine women’s role in workplaces
PMDD and psychiatric framing
-premenstrual dysmorphic disorder
- more severe and rare condition (while PMS common)
Pathologizing cycles
-viewed as flaw not function e.g. uterine hurry, hysteria, menstrual neurosis.
-Even today variations in mood and flow labeled as dysregulated.
-Consequences: stigmatization, misinformation about women’s body/anatomy. Feeds into notion that women are less rational
Pharma influence
big role in shaping how menstruation treated, hormonal birth control to suppress/treat menstruation framing periods as burden/disorder e.g. Lifestyle enhancers for menstruation
Dysmenorrhea: Primary vs Secondary
-painful periods
-symptom not diagnosis
-mild to severe/primary and secondary
-Secondary caused by underlying condition e.g. endometriosis
Endometriosis underdiagnosed
-underdiagnosed and misunderstood
-endometrial tissue grows outside of uterus.
-Diagnosis can take 10 yrs bc symptoms dismissed as bad periods
Pain dismissal
gaslighting of pain where ppl viewed as exaggerating, weak, emotional
Gender bias in medicine
long understudied women’s pain, less likely to receive pain relief bc of historical dismissal
Defining heavy flow
Bleeding Norms
* - Defining heavy flow
* - Menorrhagia
* - Variability
* - Lack of patient education
-80 mL per menstrual cycle
-Heavy flow if clots larger than a quarter, needing double protection, waking at night, bleeding through, fatigue or dizziness
-Menorrhagia: excessive bleeding can be caused by endometrium issues, thyroid issues, bleeding disorders e.g. vonyml bron disease clotting factor insufficient
-Underdiagnosis when ppl don’t know whats normal
Menstrual Products & Access
* - Pads, tampons, cups, discs
* - Environmental impact
* - Menstrual equity
* - Access disparities
o Can take up to 5-800 yrs to decompose
o Menstrual equity: everyone has access to safe, culturally safe products e.g. clean water, private bathrooms, free products
o Access disparities: many countries still taxed as luxury items, not available in schools, shelters, prisons. Leads ppl to use products longer than recommended
Period Poverty
o Lack of access to menstrual products and even limited period education
o Leads to missed school, work, community participation e.g. ppl wo access to products or facilities may stay at home
o Canada 2022 plans to make products free in federally regulated workplaces e.g. BC, ON require free products in schools
o Stigma and reform: dirty, embarrassing, taboo = major sign of neglect. Periods aren’t private problems they’re public concerns
Menstrual Suppression
* - Birth control use
* - Clean body myth
* - Health misconceptions
* - Autonomy & pharma
o Hormonal control: can shorten, lighten, or eradicate menstruation
o Clean body myth makes ppl afraid of suppression
o Fears: infertility, cancer
o Autonomy: pharm companies promote suppression for profit. Should focus on informed choice, transparent data, respect individuals’ experiences
o Combo pill: estrogen + progestin, some pills progestin only
o Pills suppress FSH and LH, tricks ovaries into thinking ovulation happened
o Pregnancy: estrogen and progesterone peak
o 28 days, 28 pills
The Business of Menstruation
* - Industry marketing
* - Shame tactics
* - Rise of ‘femtech’
* - Pink tax
o Industry worth billions globally
o Products: tampons, pads, messages: discrete, clean, fresh promotes idea that mens must be hidden
o Shame tactics: ads show mens embarrassing e.g. show liquid in blue instead of red
o Femtech: digital health tools e.g. apps, wearables, menstrual tracking software. Offer better awareness but many inaccurate, not evidence based
o Pink tax: products for women e.g. mens products often more expensive than similar products for men. Canada removed taxes for mens products in 2015 but some disparities on low income individuals
Menstrual Tracking Apps
* - Privacy issues
* - Inaccurate algorithms
* - Data monetization
* - Regulation debates
o Intimate data: cycle dates, sexual activity dates
o Few apps transparents about where data stored
o Inaccurate algorithms many claim to track without clinical evidence based data, assumption that cycle always 28 days with ovulation at day 14
o Monetization: apps make money by selling data or in app purchases
o Regulation debates: not regulated as medical devices, wellness or lifestyle = gray zone
Bleeding in Public
* - Social reactions
* - Free bleeding
* - Activism
* - Shame vs empowerment
o Social: expected to be private, sanitized/managed, accidental leaks = embarrassment or mockery
o Free bleeding: act of menstruation without products, symbolic power, forces society to face what they try to hide, not universal
o Activism: visibility, policy changes e.g. tax removal free products, challenge stigma in media and education
o Shame vs empowerment: focus on empowering women
Global Perspectives
* - Cultural taboos
* - Period huts
* - Education initiatives
* - NGO roles
o Cultural taboos e.g. source of bad luck, contamination
o Period huts: isolation of menstruating women still happens in some places, unsanitary, cold, dangerous, linked with animal attacks, smoke inhalation. Need global education on menstrual biology to help with acceptance, dignity, confidence
o NGO roles: free products, build sanitary infrastructures
The Role
of Education
* - Sex ed gaps
* - Embodied learning
* - Teaching roles
* - Holistic education
o Sex ed gaps: incomplete, outdated. Students taught bare min. Bio terms only, no societal/emotional aspects. Boys often included entirely when whole society should know
o Embodied learning: teaching thru live experience, body awareness, not just facts, true experiences e.g. tracking cycles for insight not just control, validating range of symptoms, should not just be from school textbooks instead workshops, presentations
o Teaching roles: parents, HCWs, caregivers
Medical Gaps & Misogyny
* - Research deficits
* - Data gaps
* - Exclusion from trials
* - Male-default norms
o Underfunded research, deprioritized e.g. endometriosis or PMDD so common but research not enough
o Til 90s women excluded from trials
o Bias isn’t accidental, centuries of prioritizing male experiences in science
Language & Menstruation
* - Euphemisms
* - Medical vs cultural terms
* - Naming power
* - Period-positive terms
o Euphemism: that time of the month, the curse, code red exist to avoid direct reference to blood, uterus, mens
o Medical terms: dismenoria often absent from public convos while cultural terms vague and humurous detach from biology
o Naming gives control, understanding
o Period positive terms: celebrate mens as natural, gender inclusive terms like menstruator, cycle health instead of female troubles, use realistic red colour
