Don't mess with it


Dear Andrea:

In last week's response to "Pill or No Pill," I'm glad that you mentioned that playing around with endocrine systems can be harmful. When I was diagnosed with anorexia, the doctors told me that if I kept missing periods, I would be at risk for things like low bone density and osteoporosis. It seems suspect that doctors and pharmaceutical companies are now advocating pills that limit a woman's period to four times a year. What can you tell me about it?


Keeping My Period

PS In regard to "Pill or No Pill," why can't they have sex during her period?

Dear Period:

I don't get a chance to say this very often, but your doctors misspoke. There's no doubt that your endocrine system was messed up good while you were anorexic, but it wasn't the missing periods that were doing the damage. Both the amenorrhea (lack of periods) and the potential bone loss were symptoms of messing with your endocrine system. When one hormone gets knocked out, the entire chain is broken, and all sorts of havoc potentially ensues. You weren't menstruating because you weren't ovuutf8g because your ovaries weren't getting the right hormonal cues because your pituitary gland wasn't sending them because your hypothalamus wasn't sending them because you were starving. It's actually a good idea, if you're an ovum, to avoid getting ovulated and fertilized while there's no good material with which to build a baby.

Somewhere in there your ovaries also failed to get the hint to produce lots of estrogen, which is required for the absorption of calcium, and there go your bones. So yes, of course it's potentially dangerous to mess around with your endocrine system, but we should remember that millions of women do just that every day when they take their pill, and they're just fine. Better, even, since they're not having to squeeze out another baby every year or so for the entire span of their reproductive years, the way our "ansisters" did and as women still do wherever reliable birth control is unavailable or forbidden. And speaking of our ancestors ...

We (the Western, industrialized, supermarket-shopping we) are the freaks in a long line of normal people. As any number of evolutionary biologists and other researchers have pointed out recently, it is not at all the natural state of women to menstruate every damn month for 45 (damn) years. Contemporary hunter-gatherer (mostly gatherer) women start late, have a bunch of babies, breast-feed them forever, and die young, totaling about 100 or 150 periods in a lifetime. By contrast, supermarket women reach for the tampon box approximately 450 times. No wonder we're crabby.

So is menstruation natural? Well, obviously, but an argument can be made that not menstruating is even more so. What seems a brute biological fact ("women bleed every month") turns out to be in part a social construct. Isn't that cool? This sort of thinking isn't really new — the developers of the original pill built in the bleedy part, the placebos at the end of the cycle, because they thought not menstruating would freak women out, not because it was medically necessary — but it's not the sort of thing people tend to talk about. It will be, though, by necessity, and soon. As new products make four periods a year or no periods a year (seriously, this one has been extensively studied and so far so good for safety) increasingly popular, menstruation will become a lifestyle choice like any other.

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