Blog of the Society for Menstrual Cycle Research

Purse Pads, Halakhic Infertility, Nail Polish for Periods, and More Weekend Links

June 30th, 2012 by Elizabeth Kissling


#bodyliteracy: a hashtag, a title, a meme?

June 28th, 2012 by Laura Wershler

Body Literacy. It’s cool to see a phrase I championed infiltrate the language, be taken up and used by others. Not always referenced, but used. And that’s okay by me. I want #bodyliteracy to become a flourishing Twitter hashtag.

I first used the term in June 2005, just as I arrived at my first Society for Menstrual Cycle Research conference in Boulder, Colorado. A few months later, the origins of this first usage, by myself and colleagues Geraldine Matus and Megan Lalonde, were documented in Femme Fertile, a newsletter published by Justisse Healthworks for Women. I wrote at the time:

The concept of body literacy occurred to me after I read a novel illustrating the disempowering impact of illiteracy. The inability to read diminishes self esteem and opportunities to participate in the exchange of ideas. The connection to the lives of girls and women is obvious — the education of girls is a key strategy in all international development work. It struck me that most educated women in developed countries live with another kind of illiteracy — (we) are not taught to“read” or understand (our) own bodies. On the contrary, (we) are taught to distrust (our) bodies and accept various artificial means to“manage” them.

By my definition, body literacy is acquired by learning to observe, chart and interpret our menstrual cycle events. This life skill (as I call it) helps us understand how our sexual, reproductive and general health and well-being are connected to our menstrual cycles. Body literacy supports, if not compels, our fully informed participation in health-care decision making.

My Femme Fertile colleagues and I continued to write about body literacy, telling personal stories in Stuck in a Body Literacy Gap (Winter 2006) and sharing professional experiences in Body Literacy at Work in the Community.  Our presentation at the 2007 SMCR conference was called Menstrual Cycle Charting: A Path to Body Literacy.

Since then, the phrase has been spreading thanks to SMCR members. Geraldine Matus, who helped develop the concept, incorporated the phrase in the title when she updated her Justisse Method Fertility Awareness and Body Literacy: A User’s Guide, first published in 1989. Research scientist Annie Harvey uses the phrase in her women’s health work at Via Christi Hospitals in Wichita, Kansas. Jerilynn Prior at the Centre for Menstrual Cycle and Ovulation Research says body literacy is ‘as important as reading, writing and arithmetic!‘ Chris Bobel, associate professor of women’s studies, mentioned body literacy in her book ‘New Blood: Third Wave Feminism and the Politics of Menstruation‘ (2010).

Chris’s mention was noted and used in a Psychology Today blog title by Molly Castelloe, The Last Taboo: Menstruation and Body Literacy. It was re-posted on Tumblr.

A recent Google search found other mentions, one of which predates my use of the phrase. I love that the Tathapi Trust Women and Health Resource Development has been advancing the concept in India since 2000.

Sexuality and Fertility Awareness (FA) education as part of ‘body literacy’ is a core area of Tathapi’s work, involving not only bodily experience of the reproductive system but also the socio-cultural and political experience of women’s health.

The PUKAR Youth Fellowship Program in India has used body literacy in its work with teenage girls, while the Institute for Reproductive Health at Georgetown University has a youth initiative focusing on fertility awareness and body literacy.

Body Literacy: Now in a book title, a fledging hashtag on Twitter and, perhaps,  soon to be an Internet meme? I hope so. The word meme, coined by evolutionary biologist and author Richard Dawkins, comes from the Greek word ‘mimeisthai’ meaning to imitate or copy. Please, go for it!

FemFresh Fails — and we think it’s Funny!

June 27th, 2012 by Elizabeth Kissling

Here’s Chella Quint, of Adventures in Menstruating, with more ad busting and shame busting. For even more, see her post at Ms. blog.

Chella Quint is just back from delivering a TEDx Talk, ‘Adventures in Menstruating: Don’t Use Shame to Sell’, link coming soon!

When One Less Becomes One More

June 26th, 2012 by Elizabeth Kissling

Abnormal Pap Smears, Cervical Dysplasia and Cervical Cancer Spike Post-HPV Vaccination

Guest Post by Leslie Botha, Women’s Health Freedom Coalition Coordinator, Natural Solutions Foundation,
and Janny Stokvis, VAERS Research Analyst


In 2006, the HPV vaccine Gardasil touted to prevent cervical cancer was introduced to a public generally unaware of the Human Papillomavirus or its threat to adolescent girls and women. However, the public was quickly informed of the dangers of the virus when Merck launched an aggressive advertising campaign designed to capture the attention of girls/women ages 9 to 26 with a catchy jingle and their now famous line: “One Less Girl to Get Cervical Cancer.” Adolescent girls were dancing and singing that they will be ‘one less girl’ in unison with the award-winning TV commercial.

According to Neon Tommy, the online publication for the Annenberg School for Communication and Journalism, USC, the promotion was successful. In 2008 Merck’s marketing techniques even earned Gardasil a “pharmaceutical brand of the year” award from Pharmaceutical Executive for its ‘savvy disease education,’ and for building ‘a market out of thin air’.

Six years later, it appears that ‘one less’ is now turning into ‘one more’ as reports of abnormal pap smears, cervical dysplasia and cervical cancer are appearing in the HPV vaccine targeted market.

Table prepared and provided by authors

As of May 12, 2012 the Vaccine Adverse Event Reporting System (VAERS) showed there have been 26,050 reports of adverse events (including 849 reports from boys/men ages nine to 26) post-HPV vaccination. The National Vaccine Information Center (NVIC) estimates only 1 to 10% of the vaccine-injured are reporting.

Of concern is the significant increase in reporting for cervical abnormalities reported to VAERS each month. Of even more concern is that the American College of Obstetrics and Gynecology has raised pap testing guidelines to age 21 leaving many adolescents without proper cervical screening tools post-vaccination. Yet a significant number of events are being reported by an age group that typically does not develop cervical cancer until age 50 or older. According to Stokvis, some of the reports of cervical abnormalities are occurring four to five years post-vaccination.

Abnormal Pap Smears: 490 (greatest number of incident reports age 14 to 26)
Cervical Dysplasia: 195 (greatest number of incident reports age 14 to 26)
Cervical Cancer: 56 (greatest number of incident reports age 16 to 26)

In January 2012, the American Journal of Obstetrics and Gynecology published the ATHENA HPV study announcing the results of a large cervical cancer screening trial, enrolling 47,208 women 21 years of age or older at 61 clinical sites throughout the United States. The authors reported that in a sub group of 12,852 young women, the HPV vaccine reduced HPV-16 infections only 0.6% in vaccinated women vs. unvaccinated women. Most disturbing are the data that showed other high-risk HPV infections were diagnosed in vaccinated women 2.6% to 6.2% more frequently than unvaccinated women. In fact, the study reported that the increased rate of infections by carcinogenic HPV types in vaccinated women (other than those targeted by Gardasil®) is four to ten times higher than the reduction in HPV 16/18 infections.

Why are these numbers of great concern? According to 2005 -2009 data reported by the National Cancer Institute,

The median age at diagnosis for cancer of the cervix uteri was 48 years of age. Approximately 0.2% were diagnosed under age 20; 14.0% between 20 and 34; 25.9% between 35 and 44; 23.9% between 45 and 54; 16.7% between 55 and 64; 10.7% between 65 and 74; 6.1% between 75 and 84; and 2.6% 85+ years of age.

The problem is that the FDA has not recommended a reliable HPV screening assessment prior to the mass vaccination program. In addition, the CDC estimates 25,000,000 people have been previously exposed to HPV.

In September 2011, Norwegian immunologist, Charlotte Haug, M.D., Ph.D. raised the issue of potential HPV virus replacement in her opinion paper in the New Scientist titled: “We Need to Talk about HPV Vaccination Seriously

There is another serious question that may be answered sooner:  what effect will the vaccine have on the other cancer-causing strains of HPV? Nature never leaves a void, so if HPV-16 and HPV-18 are suppressed by an effective vaccine, other strains of the virus will take their place. The question is, will these strains cause cervical cancer?

Dr. Haug noted that vaccinated women showed an increased number of precancerous lesions caused by strains of HPV other than HPV-16 and HPV-18. She also wrote “…the results are not statistically significant, but if the trend is real – and further clinical trials should tell us in a few years – there is reason for serious concern.”

Even in 2009, a voice of concern by medical researchers about virus replacement was raised:

However, the biological mechanisms of different HPV types are not yet fully understood, and the significance of cross-protection is limited by a small number of lesions, short study period, and lack of data on ICC. It is worth noting that following HPV vaccine implementation, other high-risk HPV types than HPV 16 and 18 could replace the biological niche of HPV 16 and 18, thereby causing a relatively greater proportion of cervical cancer and cervical cancer precursors cases [9,10]. If this occurs, there is a potential to offset the benefits of vaccination. HPV vaccination evaluation programs should consider this possibility and evaluate changes in HPV type distribution in high-grade lesions and ICC over time relative to HPV types found in the general population with documentation of HPV vaccination history. Long-term follow-up during further vaccine evaluation is expected to address those two issues.

The “Choosing Wisely” Campaign: Don’t Routinely Test for Osteoporosis Until Age 65

June 25th, 2012 by Paula Derry

On June 13, 2012, the medical website Medscape posted an interview with the president of the American Academy of Family Physicians (AAFP) on AAFP’s involvement with the “Choosing Wisely” campaign.   “Choosing Wisely,” according to the article, is an initiative of the American Board of Internal Medicine Foundation that has come up with evidence-based recommendations from 9 organizations about questionable medical tests and procedures.  The organizations are mainstream medical groups like AAFP. The goal is to use these recommendations as the basis for discussions between doctors and patients.

According to the article, one of AAFP’s top five recommendations is that women should not be routinely screened for osteoporosis at the time of menopause.  In fact, except for women who have high risk factors, screening should not begin until age sixty-five. The same recommendation was made by a Choosing Wisely group in 2011 and was also the judgment of the U.S. Preventive Services Task Force. This is in contrast to a common practice among physicians to order a DEXA screening test to measure bone mineral density (BMD) around the time of menopause and to prescribe medication for women who score low on the test beginning at this time

Here’s some background:  The word “osteoporosis” at one time meant a medical condition in which bones are fragile and break easily; low bone mineral density was a risk factor for osteoporosis.  However, low BMD also came to mean that a person had the disease itself rather than a risk factor for it.  “Osteopenia” means that BMD is not as low as in osteoporosis but lower than a statistically-defined normal amount.   One perspective by physicians and medical groups has been that since menopause and the transition to menopause are associated with declining BMD, it makes sense to test BMD at this time and to begin treating women, often with medication, if a screening test shows low bone density.  Osteopenia as well as osteoporosis might be treated.  A different perspective is that osteoporosis involves bone becoming so fragile that it fractures; BMD is only one of the factors that contribute to bone fragility; many factors (including lifestyle) contribute to bone strength and to whether a woman will break a bone.  Further, since osteopenia is defined statistically, it may not really indicate a problem (as in Lake Wobegon, where everyone wanted their children to be above average).

What are factors indicating osteoporosis or risk of osteoporosis before age 65? Some of them are:  if a bone fractures for what seems like no good reason (e.g., if you haven’t had a hard fall or something else like it); if you’ve lost height; if you’ve been prescribed steroids for long periods of time; if you have certain other diseases like thyroid problems.    There are many other factors that statistically predict increase risk.  FRAX is an online tool that can be used to estimate risk. However, it is based on things like sex, height, weight, and medical history and does not take lifestyle measures (whether you exercise, have ways to avoid falls, etc.) into account.  Many websites have additional information (e.g., National Institutes of Health, National Women’s Health Network).

Some reasons behind recommending that women should not routinely be screened for osteoporosis until age 65 are:  the rate of fracture does not go up until after age 65; there is little evidence that using medication helps women with osteopenia; the medications used to treat osteoporosis are good medicines for women who need them but carry risks, so women who don’t clearly need them or will benefit from them shouldn’t be using them.   Thus, the Choosing Wisely initiative recommends that unless a woman has high risk factors to suspect osteoporosis, screening tests should not be ordered until a woman is 65.



Uteruses, Vaginas, and More Weekend Links

June 23rd, 2012 by Elizabeth Kissling

Models by Megan Assaf

Sorry, You’ll Never Get the Good Blood…

June 21st, 2012 by Heather Dillaway

Photo by Mark Sylvester, Courtesy of and ©Free Range Stock

How do you tell a preschool-aged boy that he’ll never menstruate?

I thought I was doing a great thing. Ever since my daughter was born I’ve spun a positive story about menstruation for her. Even when she was 2 and 3 years old I’d tell her it was the “good blood,” the blood that meant you were healthy and could maybe have babies some day if you wanted them. Now she is 7 years old and I continue to tell her that the good blood is a healthy thing and that someday soon she will have it too. I came up with the idea to call it “good blood” because I didn’t want her to think of it as something I was hiding or sad about. I wanted her to be informed and think positively about her future as a woman.

BUT, my son is now 4 and he has been listening to the same story. About a year ago he asked me when he would get the good blood. I tried to tell him that he would not get it and he cried and said he wanted to be able to be healthy like us. He said he wanted to be able to have babies some day. Still today he talks to me sometimes about the fact that he won’t get the good blood and he is sad.

I’ve thought a lot about how to be a good parent to a girl and a boy. I’m a firm believer that gender is mostly created by us and, despite biological or physiological differences between women and men, we can change how people act, think, and orient themselves if we want to. At least in part. Yet I think that talking about the “good blood” backfired on me to some extent. In redefining menstruation as positive for my daughter, I left my son by the wayside a bit. I still struggle with what to do about this. How do I redefine menstruation in a positive way without making my son feel bad?

I’d love to hear readers’ own stories about this, because I think this is something we should talk about more fully. How do moms talk to their little boys about menstruation? And when they talk about it, what do they say? Boys will grow up to have so many privileges that women don’t have but you can’t explain that to a 4-year-old very easily. And sure, you can say, “Everyone’s different and special in their own way,” but that’s a pretty empty statement for a 4-year-old who’s keeping track of all the things that others get that they don’t.

So, starting with the assumption that boys should learn something about menstruation and eventually will find out that they will not menstruate, how do you say, “Sorry, you’ll never get the good blood” in a positive and productive way?
I’m looking forward to the responses on this post!

Adventures in Building a Fertility Awareness Charting App

June 20th, 2012 by Kati Bicknell

I’m obsessed with fertility charting, and in my search for a Fertility Awareness app that met my needs, my husband and I created one.  The most important thing to us are our users, and their feedback is gold. We learned the hard way that women want to chart on their phones, not their computers. We want to avoid the mistake of thinking “we know best” again.  So what our customers say to us is taken very seriously. But sometimes they ask for things that we don’t want to give them!

I received a question from one of the women who downloaded our app, asking me if there was a way to enter temperatures measured to the 1/100th of a degree, (like 97.34).  She didn’t want to round to the tenth of a degree (97.3)  and risk throwing off her chart.  We thought we understood her concern.  If you’re taking your temperature every morning, you want that exact temperature to go in your chart! Rounding seems like it might throw off the chart. Right?

Well that depends on if you’re measuring in Fahrenheit or Celsius.  If you’re measuring in Celsius you must measure to .05 of a degree to catch the temperature shift.  In Fahrenheit you only need to measure to tenth (0.1) of a degree. Measuring to the hundredth (.01) of a degree is too small of an increment to make any important difference on your chart.

When charting basal body temperature (BBT), the bi-phasic temperature pattern over the course of your cycle tells you if you’re ovulating, when you’re ovulating, and the length and health of your luteal phase.  Post-ovulatory temperatures are usually around 0.3 degrees Fahrenheit higher than the preovulatory temps.  0.3 is larger than 0.01 by a factor of 30. This means that measuring to hundredths of a degree is not necessary to catch the temperature shift.

Typical Rounding Scenario

This graph shows a typical bi-phasic temperature pattern, clearly confirming ovulation.  The red line was graphed using temperatures that were accurate to the 1/100th of a degree.  The blue line is graphed using those same temperatures rounded to the 1/10th of a degree.  As you can see, the difference between the two lines is not enough to obscure a temperature shift on a chart.

We had a moment of deliberation… do we tell our user to just get a different thermometer?  Do we tell her to round her temperatures?  That didn’t seem like great customer service.

We realized that the solution is not to simply tell this woman why what she was concerned with didn’t matter.  From her perspective, rounding temperatures is a pain in the ass and she doesn’t want to do it!  THAT “pain in the ass” factor is the problem that we have to solve.  So, with this realization we decided to add the ability to chart in hundredths to our development plan.

Even though measuring to this accuracy isn’t necessary, if adding the second decimal place on our data screen makes it easier for women to get their data into the chart, we’ll do it!  We want all women to have access to the yummy benefits that are to be had from charting one’s cycle, and we are committed to removing the barriers to that, however it must be done.


Menstrual Sex — Well, Not Quite

June 19th, 2012 by David Linton

Some months ago we published a piece titled “Menstrual Sex: the Last Taboo in Advertising?”  It was an analysis of a magazine ad for Softcups, a disposable menstrual collection cup, and it generated some interesting feedback.  Some reader took exception to the analysis, pointing out that the device and the add didn’t actually deal with menstrual sex since its purpose was to create a situation that eliminated any need to actually encounter menstrual fluids and therefore not having to deal with any of the social or psychological taboos nor with any aesthetic reservations the parties might have about having sex during the period.

Taking into consideration those thoughtful comments, I thought it might be worthwhile to take a look at another ad in the same series.

The tag line for the earlier ad was, “12 hour leak protection so you can sleep.  Or not.” And it showed the legs of a couple lying on top of each other with the women on top glimpsed through an open door, creating a voyeuristic sense of witnessing a private, erotic encounter.  The companion ad uses a similar approach, this time revealing a young couple kissing and holding hands seen through a narrow opening in a pair of thick curtains.  They are back lit by a window and might even be thought to be hiding behind the drapes.

The ad is a semiotician’s delight.  Everything surrounding the couple reads “old fashioned.”  The drapes are dark and tattered; a mantel on the left has a gilded picture frame above it and a small china tea pot on the shelf; to the right is another formal picture frame, floral wall paper and the edge of a deer’s antlers mounted high on the wall; the bottom of the picture fades into darkness.  However, at the bottom edge is a box of the Softcup product, angled in such a way as to appear to be emerging from the dark room.

In addition to the headline, “Do everything you would if you didn’t have your period. We’re not just talking about swimming.” The body text drives home the notion that this is a new product for a new generation that is less squeamish about sex during the period than the original occupants of the room: “The next generation of period protection.”  It goes on to mention “mess-free sex” and the rest of the copy stresses that the cup will contain the menstrual flow so that you can go about your life just as though you didn’t even have a period.

And, ironically, that’s just what turns the ad into a reaffirmation of the anti-period sex stereotype.  Though posing as a hip, new product to appeal to young women who presumably are not hampered by antiquated notions of when in the cycle it is OK to have sex, the ad implies that, just like the long tradition in pad and tampon ads, you can go about your life as though you did not have a period.  In other words, it’s another appeal to “keep him from knowing.”

Menstrual Huts, Metaforms, Movies, and More Weekend Links

June 16th, 2012 by Elizabeth Kissling

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.