Harare, Zimbabwe (News of the South) – No matter why a woman is seeing a doctor—be it for a headache or for a broken toe—she can reliably expect to be asked the date of her last period within the first minute of her consultation.
Because of the confused looks I get when I reply with “May 2012,” I started prefacing my answer with an explanation that I have a Mirena IUD, an intra-uterine device used for birth control that lessens periods for some women and eliminates them completely for others.
I fall into the latter category. Though most nurses and doctors move along after this response, a nurse recently looked at me in undisguised disapproval and asked, “But what about when you want children?” I told her that I would take it out when I want children.
“But doesn’t it feel unnatural to not have a period?” she asked. I told her it feels great to not have a period. She shook her head and said, “Just seems strange to have a foreign object in your body like that.” I replied, “Yeah, like a baby.” She stopped asking questions at that point.
Though this particular nurse was especially harsh, she is hardly alone in her suspicion of birth-control methods that prevent women from monthly bleeding. Friends ask if I am constantly worried that I’m pregnant. Men I am not even exclusively dating wonder if I worry about infertility. The word “unnatural” comes up often.
A brief look at the language used to talk about menstruation reflects how closely it’s tied to the concept of female identity. “You’re becoming a woman!” people exclaim to adolescents experiencing their periods for the first time.
“Feminine products” is the euphemism of choice for pads and tampons at the drugstore though there are plenty of aisles worth of feminine-coded products available—razors, makeup, and shampoos marketed toward women with the design of helping them look “feminine.” (This focus on the “femininity” of periods also completely ignores the existence of trans men who menstruate.)
All of these products have the purpose of eliminating or disguising those functions of the body that have been deemed “unfeminine” like growing body hair and sweating, just as menstrual products are designed to make the period as undetectable as possible.
Periods can be painful and messy, and while they are considered a marker of female identity, there are also social pressures to keep them invisible on account of their “ick” factor. So there are some who find eliminating periods altogether to be their best option.
“There is no medical reason why a woman has to menstruate every month,” said Alyssa Dweck, an assistant clinical professor of OB/GYN at Mt. Sinai School of Medicine in New York. “And there is nothing wrong with tweaking the system if bleeding is difficult for women.”
Cherry Collier, an executive coach based in Marietta, Georgia, was such a woman. Her doctor suggested a hysterectomy when, after she reported heavy bleeding, he discovered three fibroids in her uterus.
Because she was still of child-bearing age, she sought alternative opinions and learned that she could stock up on birth-control pills, skip the placebo week and be on a continuous hormone dose that would eliminate her periods and alleviate her suffering. “It was so liberating and so exciting. The result is the period is lighter, less painful, and it is so different because I chose how to handle it,” she told me.
Carolyn Thompson, an OB/GYN and fellow at the American College of Obstetricians and Gynecologists, told me via email that this method is both safe and was especially common before the introduction of “extended cycle” birth-control pills like Seasonalle, Seasonique, and Quartette.
These brands are specifically packaged to enable skipping periods but are hormonally the same as other birth-control pills. “There are some women whom we would prefer to avoid periods: those who have migraines, severe bleeding/cramping, endometriosis,” Thompson said.
“There are also many women who just don’t want to have a period every month and who take the pill continuously. This carries no harm, either short- or long-term.”
Before at-home pregnancy tests, it made more sense that women wanted their periods as reassurance against pregnancy.
“When people were designing the pill, they asked women what they wanted, and women said they wanted to have a period to confirm they’re not pregnant,” says James Segars, director of the division of reproductive science and women’s health research at Johns Hopkins University’s department of gynecology and obstetrics, “The period you have on birth-control pills is totally pharmacologic.”
The pill was only the beginning of women taking control, not only of their fertility, but of their periods. Though “that time of the month” is shorthand for the period, many people have irregular and unpredictable periods that the introduction of the pill helped to regulate. People with particularly heavy bleeding or conditions like endometriosis can expect them to become more manageable with the pill.
Periods, as natural as they are, can profoundly disrupt someone’s daily life when they are accompanied by pain or excessive bleeding that necessitates devoting time and energy to their care. -The Atlantic
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