Blog of the Society for Menstrual Cycle Research

Writing Menopause, An Anthology: Preview #2

April 28th, 2016 by Editor

WritingMenopauseWriting Menopause, a diverse literary collection about menopause to be published in the spring of 2017 by Inanna Publicationswas first introduced to the Society for Menstrual Cycle Research in a session presented at our June 2015 biennial conference in Boston. The anthology includes about fifty works of fiction, creative nonfiction, poetry, interviews, and cross-genre pieces from contributors across Canada and the United States. With this collection, editors Jane Cawthorne and E.D. Morin hope to shine a light on a wide variety of menopause experiences and to shatter common stereotypes. This week at re: Cycling we are pleased to be able to preview excerpts from the collection. Preview #1 included a short prose piece and a poem by Tanya Coovadia. Today’s preview is by SMCR member Heather Dillaway, a piece that was previously published on this blog.


Fact and Fiction: Two Lists by Heather Dillaway

List One: Things Menopausal Women Would Love to Hear That ARE True

  1. what do i want to hear?It’s okay to be glad to be done with menstruation, the threat of pregnancy and the burdens of contraception. It’s also okay to use the menopausal transition to question whether you really wanted kids, whether you had the number of kids you wanted and whether you’ve been satisfied with your reproductive life in general. It’s normal to have all of these thoughts and feelings.
  2. You’re entering the best, most free part of your life! But, it’s okay if it doesn’t feel like that yet.
  3. Menopause does not mean you are old. In fact, potentially you are only half way through your life.
  4. You are not alone. Lots of people have the experiences you do. You are normal!
  5. I understand what you’re going through. (Or, alternatively, I don’t completely understand what you’re going through but I’m willing to listen.)
  6. It’s okay to be confused and frustrated at this time of life, or in any other time of life!
  7. You’ve had an entire lifetime of reproductive experiences and this is simply one more. How you feel about menopause is probably related to how you’ve felt about other reproductive experiences over time. It might be helpful to reflect back on all of the reproductive experiences you’ve had to sort out how you feel about menopause.
  8. Talk to other women you know. Talking about menopause helps everybody.
  9. Menopause and midlife can be as significant or insignificant as you’d like them to be. For some women, these transitions mean very important things but, for others, they mean little. Whatever it means to you is okay.
  10. Researchers are working hard to understand this reproductive transition more fully.

These represent the kind of supportive comments women might want to hear while going through menopause and, in particular, perimenopause. Items on this list also help us acknowledge that our bodies and bodily transitions cause us to reflect on our life stages, our identities and our choices.

List Two: Things Menopausal Women Would Love to Hear But Might NOT Be True

  1. This is guaranteed to be your last menstrual period. You are done! (Or, a related one: You’ve already had the worst. It gets better from here on out!)
  2. Signs and symptoms of menopause will be predictable and will not interrupt your life.
  3. No one will think negatively of you or differently about you if you tell them you’re menopausal.
  4. There are no major side effects to hormone therapies or any other medical treatments you might be considering.
  5. Doctors will be able to help you and will understand your signs and symptoms, if you need relief.
  6. Leaky bodies are no problem! No one will care if your body does what it wants, whenever it wants.
  7. Partners, children, coworkers and others will completely understand what you’re going through.
  8. Middle-aged women are respected in this society and it is truly a benefit to be at this life stage.
  9. There is a clear beginning and a clear end to this transition.
  10. Clinical researchers are researching the parts of menopause that you care about.

This reflects many of our societal norms and biases about our bodies, aging, gender, fertility and so on. This list also attests to the difficulties that menopausal women have in accessing quality health care or getting safe relief from symptoms when needed and notes the potential disconnects between research findings and women’s true needs during this transition.

Heather Dillaway is an associate professor of sociology at Wayne State University in Detroit, Michigan. Her research focuses on women’s menopause and midlife, and she often writes about the everyday experiences of going through these transitions. She teaches about women’s health, families and gender & race inequalities.

Writing Menopause, An Anthology: Preview #1

April 26th, 2016 by Editor

WritingMenopauseWriting Menopause, a diverse literary collection about menopause to be published in the spring of 2017 by Inanna Publicationswas first introduced to the Society for Menstrual Cycle Research in a session presented at our June 2015 biennial conference in Boston. The anthology includes about fifty works of fiction, creative nonfiction, poetry, interviews, and cross-genre pieces from contributors across Canada and the United States. With this collection, editors Jane Cawthorne and E.D. Morin hope to shine a light on a wide variety of menopause experiences and to shatter common stereotypes. This week at re: Cycling we are pleased to be able to preview excerpts from the collection.


Two pieces by Tanya Coovadia:

The Things We Carry

Last January, I attended a reading series during which two distinguished male authors, in separate opening remarks, said derogatory things about middle-aged women. I don’t think I would have noticed twenty years ago, but lately, for some reason, I am particularly attuned to discussions regarding women of my uncertain age, especially when they are uttered in tones suggestive of a shameful affliction.

Benign anal tumours, say.

One of these men, after his reading, went on to add further insult. He described the typical bumbling misapprehension of his work by that admiring but clueless fan who, he assured us, in his laconic drawl, was “always a middle-aged woman.” As a late-blooming member of the midlife sisterhood, this incident sparked a poem in me.

And (in a laconic drawl) it’s dedicated to Tim O’Brien.

Always a Middle-Aged Woman

(because middle-aged men are just men)

Striding up
with her staunchly held head
her opinions bared like wrinkled breasts

And those years she wears
a bitter glory of furrows and lines
etched by thousands of erstwhile smiles.

Who do they think they are,
these ladies (and we mean you, ma’am)
thriving so steadily
from their cloak of invisibility

We don’t see your once young face
we never stroked your once shining hair

We can’t hear your
sweet, barely caught breath
because you’re
Blatantly!
middle-aged

As though ageing is some kind of victory
as though youth and beauty
are not mandatory

As though you can bring
something new to the world
when your womb is too old to care.

My mirror,
I,
we,
you
reflect this, true

We lift our jowls toward our ears
and smile
a spasm, a rictus. Of youth.

Tanya Coovadia is a technical writer, blogger and angry-letter-writer-cum-fictionalist who occasionally dabbles in poetry. She’s a Canadian transplant to Florida who, during the writing of this poem, realized her interminable hot flashes were not weather-related after all. Ms. Coovadia has an MFA in Creative Writing from Pine Manor College in Boston. Her first collection of short fiction, Pelee Island Stories, recently won an IPPY award.

Premenopause / Early Menopause / Primary Ovarian Insufficiency (or Failure) / Perimenopause / Menopause / Postmenopause: Why these names matter

April 5th, 2016 by Editor

Making sense of the many names for women’s reproductive aging by Dr. Jerilynn C. Prior

Jerilynn C. Prior BA, MD, FRCPC, ABIM, ABEM is a Professor of Endocrinology and Metabolism at the University of British Columbia in Vancouver, B.C. She is the founder (2002) and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research(CeMCOR).

The process of aging of women’s reproductive system, like puberty and most biological transitions, occurs in a generally standardized but variable way and over many years. Also, there are broad age ranges at which we consider something normal or not. Then add on top of that cultural presuppositions, chief among them that “menopause means estrogen deficiency” (rather than that menopausal estrogen and progesterone levels are normally low), and we have real confusion and a situation that is not helpful1 for women or for their communication with health care providers.

I will do my best to describe some of these standardized ways that women’s physiology changes during reproductive aging. I will mention the current terms and the words that have some physiological relevance and should be used. Because I am a physician, I believe that understanding of “the story” of life phases and the “why” of experiences is helpful. It is also necessary to appreciate the whole woman in her social, cultural, physical and experiential environments markedly influence her experiences.

After extensive research to understand mine and my patient’s puzzling midlife experiences, I learned that the ovaries start to make less Inhibin (really Inhibin B) while cycles are still regular2;3. Inhibin is small hormone made in the follicular cells surrounding stored eggs; its job is to control levels of follicle stimulating hormone (FSH). Because FSH stimulates follicles to grow, Inhibin is necessary to limit the number of stimulated follicles and to prevent us having litters. As shown (Figure below), by very early perimenopause there are fewer remaining ovarian follicles (B), Inhibin is decreased and this allows higher FSH levels and more stimulated follicles. Since each recruited follicle makes some estrogen, levels rise and the higher estrogen levels are also not reliably able to control FSH3.

menopauseDiagram

Legend: The ovaries are shown as a stylized oval with follicles in various degrees of maturation. A. shows what is occurring in the follicular phase of a premenopausal ovary; B. illustrates the normal changes that occur in perimenopause. Reprinted from Prior Endocrine Reviews 1990

The same normal reproductive aging pattern of lower Inhibin, higher FSH and estrogen occurs when the ovary is injured; this can be by chemotherapy or radiotherapy for cancer, partial removal, more rapidly than normal after hysterectomy or tubal ligation/removal and in those with immune or genetic problems. The chaos of women’s reproductive aging occurs for these Inhibin-related reasons but also because the hypothalamic-pituitary ovarian feedbacks are disrupted (so a normal midcycle estrogen peak may not trigger the luteinizing hormone (LH) peak or the LH peak may not stimulate ovulation4). An FSH level, even one that is taken on cycle day 3, is not diagnostic of perimenopause. That estrogen levels average 20% higher in perimenopausal than in premenopausal women 3, I learned from a systematic review of studies within each of several centres; but symptomatic women may have double or triple normal cycle phase-specific levels that create the “perimenopausal ovarian hyperstimulation syndrome” because this situation resembles an adverse effect that may occur in IVF 3.

With this understanding we can define the three terms for normal reproductive life phases, the term used for perimenopause or menopause that comes too early and also identify some inappropriate labels.

Premenopause is the entire time (usually 30-40 years) from the first menstruation (menarche) until the changes of perimenopause start.

Perimenopause begins when cycles are still regular (called very early perimenopause and this phase lasts 2-5 years) but an observant woman notices typical experience changes5. Because the current official classification of reproductive aging begins with irregular cycles6, no one knows at what age on average this may start; likely it is normal from as young as age 35. At least three of nine typical experience changes, especially the start of night sweats, sleep problems or heavy flow, can be used to determine that you have begun this phase5. Additional potential perimenopause changes are: increased cramps, increased premenstrual physical and emotional unwanted experiences, shorter cycles (usually ≤25 days), increased or new breast tenderness, increased or new migraines and weight gain without important changes in exercise or food intake7. Perimenopause’s early menopausal transition starts when cycles become irregular and lasts a year or so; the late menopause transition begins with the first skipped cycle (60 days without flow) and late perimenopause is the year after the last flow.

Menopause is the life phase that lasts from a year after the final flow for the rest of women’s lives. It is normal for both estrogen and progesterone levels to be low. Hot flushes/flashes and night sweats may continue for many years but heavy flow, cramps, breast tenderness, premenstrual-type symptoms and severe migraine are usually gone.  (The term “postmenopause” is sometimes used interchangeably with menopause but is double-speak and refers to an erroneous use of the word “menopause” to mean the literal final menstrual flow).

Are menopause stereotypes still selling?

December 26th, 2015 by David Linton

The holiday season brings plenty of opportunities to celebrate as well as to reflect on our lives, our society, and the state of the world. So, here’s an opportunity to reflect on the state of the menstrual ecology, a look back at a post from three years ago, published on Aug. 6, 2012. This piece was about a book that, as the copyright page states, was “Published by Hallmark Books, a division of Hallmark Cards, Inc.” The publication date was 2008 and it was also credited to a company called Celestial Arts which still lists it in their catalog. However, it does not currently appear in the Hallmark online catalog and it is impossible to tell if any Hallmark stores still carry it. Which brings up some interesting questions. Has Hallmark dropped the product and, if so, why? Have they become more period and menopause positive – or at least less negative?  What prompted the publication of such a negative view of women in the first place? In any event, even the publication history of a trivial item such as this can yield insights into much larger issues and attitudes. That’s what makes studying the social construction of the menstrual cycle such a constantly fascinating topic.

HALLMARK – When you care enough to send the very . . . ??

Hallmark greeting cards and related trinkets have long exemplified wholesome, up-tempo, Norman Rockwell-styled sentimentality, often packaged in clichéd verses and trite images of puppies, kittens, flowers, babies, sunsets and other references guaranteed to elicit a smile, a tear, or a warm glow. However, as rude humor has spread its influence, expressed most vividly and viciously in celebrity roasts and the Comedy Central show, Tosh .0, Hallmark was not to be left behind. A visit to the racks of cards, books, and novelties at your local card shop reveals a wide variety of snarky items offering cheap shots at a wide variety of groups, hobbies, and practices.

Menopause001Among them are several items that attempt to poke fun at what are thought to be characteristics of women in some stage of the menstrual cycle, notably PMS or menopause. Setting aside the fact that the items perpetuate the common misuse of the term  menopause when what is meant is perimenopause, consider a small book presently on sale titled, Not Guilty by Reason of Menopause.

HallmarkIt is comprised of more than 50 pages, organized in double-page spreads, each of which offers a completion to the phrase, “You might be menopausal if. . .”

A few examples will suffice:

“. . . you think about the ‘til death do us part line in your wedding vows a little too often.”

“. . . you tell all your children they’re not your favorite.”

“. . . when your husband proposes a romantic vacation, you suggest ice fishing.”

Collectively, it amounts to an anthology of mean-spirited nastiness with little redeeming humor. Women are depicted as crazy, stupid, vicious, obese, and every other negative stereotype imaginable.

And with each insult women are expected to smile sweetly at being the butt of a bad joke. Of course, to express outrage or even mild annoyance with these sorts of put-downs is to risk of being accused of lacking a sense of humor or, worse yet, of being “politically correct,” the favored dismissive term of those who demand that their repugnant values are somehow benign or lacking in impact or intent.

We’ve come a long way from the days of 1910 when Hallmark was founded and especially from 1944 when the company adopted the slogan that is still theirs today, “When you care enough to send the very best.” In this case one might ask, “The very best of what?”

David Linton is an Emeritus Professor at Marymount Manhattan College. He is also Editor of the SMCR Newsletter and a member of the re: Cycling editorial board. His research focus is on media representations of the menstrual cycle as well as how women and men relate to one another around the presence of menstruation.

Women’s Reproductive Health journal explores postmenopausal hormone therapy

June 17th, 2015 by Editor

Free access to Women’s Reproductive Health, the journal launched by the Society for Menstrual Cycle Research in 2014, is available to all SMCR members. To become a member of the society or to obtain a subscription contact info@menstruationresearch.org.  For media, submission, and other inquires about the journal contact editor Joan C. Chrisler at jcchr@conncoll.edu.

 

Guest Post by Joan C. Chrisler

The spring 2015 issue of Women’s Reproductive Health contains our first special section: on postmenopausal hormone therapy. The section contains a thought-provoking anchor article by menopause expert, psychologist Paula Derry. It is followed by short commentaries by a multidisciplinary group of menopause experts–a physician, a sociologist, an anthropologist, and a nurse. This set of papers would make an excellent reading assignment for a women’s health course, and it is sure to generate class discussion. The issue also contains two other research reports: one on women’s experiences with gynecological examinations, and the other on the relative absence of mentions of menstruation in novels aimed at adolescent girls because publishers are worried about challenges by parents and school boards that could hurt sales. The issue is rounded out with three book reviews.

 

Women’s Reproductive Health

Volume 2, Number 1 (Spring 2015)

Special Section on Postmenopausal Hormone Therapy

Article
Evidence-based Medicine, Postmenopausal Hormone Therapy, and the Women’s Health Initiative – Paula Derry

Commentaries
The Science of Marketing: How Pharmaceutical Companies Manipulated Medical Discourse on Menopause – Adriane Fugh-Berman

Medicalization Survived the Women’s Health Initiative…but Has Discourse Opened up? – Heather Dillaway

Animal Models in Menopause Research – Lynette Leidy Sievert

Lost in Translation? – Nancy Fugate Woods

Articles
A Multi-method Approach to Women’s Experiences of Reproductive Health Screening – Arezou Ghane, Kate Sweeny, & William L. Dunlop

The Censoring of Menstruation in Adolescent Literature: A Growing Problem – Carissa Pokorny-Golden

Book Reviews
Investigating the Ubiquitous: The Everyday Use of Hormonal Contraceptives – Marie C. Hansen

Menstruation’s Cultural History – David Linton

WomanCode: Caveat Emptor – Elizabeth Rowe

Joan C. Chrisler is a professor of psychology at Connecticut College and the founding editor of Women’s Reproductive Health. Her special areas of interest include PMS, attitudes toward menstruation and menopause, sociocultural aspects of menstruation, and cognitive and behavioral changes across the menstrual cycle.

Menstrual management for women with disabilities, menstrual hygiene taboos, and menstrual cycle awareness

May 28th, 2015 by Editor

These two concurrent sessions address the menstrual-related challenges of women with disabilities, menstrual hygiene taboos and practices around the world,  and the concept of gynaecological self-help at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston.

 

Menstrual Management, Friday, June 5th:

Women with Spinal Cord Injuries Talk about Menopause
Heather Dillaway, Wayne State University

Using data from interviews with 20 women with spinal cord injury, I illustrate how disabled women may think about and experience menopause. Overall, interviewees think positively about menopause as a release from the hassles of menstruation, but face unique experiences when dealing with perimenopausal symptoms. I also discuss their concerns about aging.

“Kahani Her Mahine Ki” – A Menstruation Kit for the visually impaired women
Sadhvi Thukral, National Institute of Design

“I am constantly worried that my dress will stain during my period, I cannot see.”

“I will never be able to tell the colour of my discharge during menstruation or when I need to change my cloth. To be safe, I change every few hours.”

These are unique anxieties of visually impaired young women.

A large gap exists in the area of “Communication for Menstruation” for the visually impaired. This design degree project was an attempt to fill this gap by developing a product for menstruation that would meet the needs of visually impaired girls and women.

The kit “Kahani Her Mahine Ki” (The Same Story Every Month) covers the subject of menstruation and how to manage during periods and has the following features:

1. Tactile diagrams and material in the form of Information Slates, with labels of the different body parts. Each slate has text for the sighted and Braille for the visually impaired. 2. A life size human body model for demonstration.

What they do, what we do, what I do: A critical review of five contemporary international surveys of menstrual management practices and technologies. How can these surveys inform Western practice? What areas remain to be surveyed?
Susannah Clemence, Independent researcher

This critical review compares the catalogues of contemporary menstrual management techniques from around the World, presented in Sommer et al (2013), House et al (2012), Kjellen et al (2012), Bharadwai and Patkar (2004) and Finley’s (1995-2015) Museum of Menstruation.

The purpose is to test how well-documented are contemporary practices across the World, and what areas remain yet unrecorded. The rationale is that diverse technologies and conduct, with their implicit beliefs and attitudes, grant us reference points from which to examine, critique and improve our own practices.

The review shows that there are large gaps in documented knowledge. Furthermore, other than the Museum of Menstruation, existing surveys tend to be rooted in development agendas of Western origin and tend to a deficit perspective of non-Western practices.

 

Menstrual Hygiene, Saturday, June 6th

A Vicious Cycle of Silence: The perpetuation of the menstrual hygiene ‘taboo’ and the implications for the realisation of the human rights of women and girls
Emily Wilson-Smith, Kampala International University & Robyn Boosey, University of Bristol 

Despite the impact of poor menstrual hygiene on the rights of women and girls it has remained largely neglected by International stakeholders. A document analysis of the core international human rights treaties and relevant human rights body reports found an overwhelming silence and an analysis of the existing references revealed an inadequate framework for addressing menstrual hygiene.

Improving Menstrual Health and Hygiene in India: Another critical path way for women emancipation
K Yadagiri, Centre for Economic and Social Studies,UNICEF Division for Child Studies 

Gynecological Self-Help Isn’t Just a Good Feeling – What we learned when we systematically studied our own menstrual cycles – and how you can learn MORE now!
Kathy Hodge, Feminist Women’s Health Center

In 1975, nine members of the Feminist Women’s Health Center collective met daily for over a month, recording changes in our vaginas and cervixes and their secretions, for PAP and ferning smears, charting moods and basal body temperature. We raised questions, some of which remain open and ripe for future woman-controlled research.

 Menstrual Hygiene Management practices in Slums: It’s impacts on the Women and Adolescent Girl’s Health – A Case study of Greater Hyderabad Municipal Corporation Slums, Telangana State, INDIA
Venu Madhav Sharma, Centre for Economic and Social Studies

Media Release and Registration for the SMCR Boston Conference on Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.

Experiencing Menopause: Sexuality, desire and literary exploration

April 27th, 2015 by Editor

Three paper presentations on Menopause at the 21st Biennial Conference of the Society for Menstrual Cycle Research at The Center for Women’s Health and Human Rights, June 4-6, 2015, Suffolk University, Boston will explore sexuality and the menopausal woman, as well as personal menopausal experiences as collected in a literary anthology.

1. Sex and the Menopausal Woman: Resisting Representations of the Abject Asexual Woman
     Presented by Jane Ussher and Janette Perz, Centre for Health Research, School of Medicine, University of Western Sydney 

Drawing on qualitative research conducted with women at midlife, and those who have experienced premature menopause after cancer, we argue that sexuality can continue to be a positive experience for women throughout adult life and into old age.

Medical discourse has traditionally positioned the menopausal transition as a time of sexual atrophy and loss of femininity, with hormonal replacement as the solution. In contrast, feminist critics have argued that women’s experience of sexual embodiment during menopause is culturally and relationally mediated, tied to discursive constructions of aging and sexuality, which are negotiated by women.

This paper will present a critical examination of women’s experiences of sexuality during and after the menopausal transition, drawing on in-depth one-to-one interviews we have conducted with 21 women at midlife, and 39 women who have experienced premature menopause as a consequence of cancer treatment.

Theoretical thematic analysis was used to identify three themes across the women’s accounts: ‘Intrapsychic negotiation of sexual and embodied change’; ‘Feeling sexy or frumpy: Body image and the male gaze’; ‘Indifference or desire? The relational context of sexuality during menopause’. Through this analysis, we challenge myths and misconceptions about the inevitability of sexual decline at menopause, as well as normalise the embodied changes that some women experience–whether menopause is premature, or occurs at midlife. We argue that sexual difficulties or disinterest reported by women during and after menopause are more strongly associated with psycho-social factors than hormonal status, in particular psychological well-being, relationship context and a woman’s negotiation of cultural constructions of sex, aging, and femininity. However, sexuality can continue to be a positive experience for women throughout adult life and into old age, with many menopausal women reporting increased sexual desire and response, as well as re-negotiation of sexual activities in the context of embodied change. This undermines the bio-medical construction of menopause as a time of inevitable sexual atrophy and decay.

2. Writing Menopause: Creating an Anthology
     Presented by Jane Cawthorne and E. D. Morin

The editors will discuss their process of envisioning and creating a new literary anthology that considers the diverse experience of menopause from various points of view. The anthology is composed of new works of poetry, short fiction, interviews, creative non-fiction, and cross-genre pieces, along with several previously published creative works that were chosen to round out the collection.

Although the editors make no claims that this work is in any way definitive, their focus instead was to create a venue for more stories and to encourage a richer vocabulary about this important transition within a literary context. The editors have observed that few literary representations of menopause exist. They will explain how they arrived at wanting to create this collection, as well as the submission process, the criteria used in accepting submissions, and how the shape of the collection shifted organically with the nature of submissions received. They will reflect on what types of submissions they would not accept, what they think the volume says about menopause, and how their own ideas about menopause were changed during the process. A few excerpts will be read.

3. Sexuality and Post-Menopausal  Women:  Desirability and Desire
     Presented by Maureen C. McHugh, and Camille J. Interligi,  Department of Psychology, Indiana University of Pennsylvania

Ageist cultural messages portray old bodies as ugly, asexual and undesirable (Calasanti & Slevin, 2001; Furman, 1997), and yet not engaging in sufficient partner sex is viewed as a sexual dysfunction.  How do contradictory cultural messages about the sexuality of older women impact their sense of themselves as sexual beings?

Aging threatens women’s sense of themselves as women, as sexual beings, and as sexually desirable (Clarke, 2011). Ageist cultural messages convey the cultural value placed on youthfulness and portray old bodies as ugly, asexual and undesirable (Calasanti & Slevin, 2001; Furman, 1997). Stereotyped as experiencing physical and sexual decline, and viewed as asexual, older women’s sexual interest may be deemed inappropriate. Yet not engaging in sufficient partner sex is seen as a dysfunction (McHugh, 2006).  Who says how much sex is enough? How do contradictory cultural messages about the sexuality of older women impact their sense of themselves as sexual beings?

Limited research on older women’s sexual desire and desirability reflects an androcentric bias. Research has rarely addressed appearance concerns, or the embodied nature of older women’s experiences (Clarke, 2011). Research on older women’s sexuality has emphasized sexual declines, diseases, and dysfunctions.  As the research on older women becomes less ageist, heteronormative and androcentric, we increasingly recognize the complexity and the contextual nature of women’s sexual desirability (Clark, 2011) and desire.

Male Menopause, Andropause and now “Manopause”?

August 22nd, 2014 by Heather Dillaway

August 18, 2014 cover of TIME magazine

By now, everyone has probably seen this week’s TIME cover story. The magazine’s August 18th cover photo showed a topless, seemingly frumpy, middle-aged man worried about his loss of testosterone and (therefore) manhood under the title, “Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry”. The cover story details the booming testosterone (“Low-T”) industry in the U.S., describing the reasons why middle-aged men might go to the growing number of Low-T clinics for treatment. While the article draws some interesting parallels to the hormone therapy industries that have targeted women and highlights some of the important risks and unknowns about Low-T treatments, there are some interesting gaps and missteps in the article that are worth detailing.

First, if we are going to talk about a male menopause, can we please pick one term? This author of this article refers to male menopause, andropause, and then titles his article “manopause.” So, which is it? Having all of these terms floating around is just confusing. As we know from research on women’s menopause, having more than one term or having vague terms for a health condition just leads to confusion. This article adds to the confusion over terminology.

Second, the article is titled “Manopause” but really has little to do with this supposed testosterone “deficiency” condition. The article is mostly about the growing Low-T industry and men’s search to remain youthful. It is more about potential treatments for testosterone deficiency than anything else. Anyone looking for information on what “manopause” is would be misled by the title and would not find any answers in this article. At most, readers learn that men who are worried about aging might have low testosterone. Readers will not gather comprehensive information about manopause, andropause, male menopause, or male aging.

Third, this article only addresses research on testosterone “deficiency” in a cursory manner. Readers looking for actual evidence of decreasing testosterone in midlife or the need for Low-T treatment should make sure to consult scientific studies of such things. Since this is TIME magazine, this is not a source of any real information on these subjects. As another commenter reports, the author’s reference to “foggy science” is also misplaced; while we do not have complete answers, there are real studies to be found on this subject.

Fourth, there are comparisons made to women’s menopause, hormone therapy for women, and how women handle their midlife transitions in this article. While it makes sense to compare endocrinological changes in women’s and men’s bodies and burgeoning hormone replacement industries for midlife women and men, comparisons about how women and men “handle” their midlife transitions are a bit misplaced and subjective here. The author states that “women handle their [bodily] betrayal more matter-of-factly – a nip, a tuck, a tint, maybe, but not a Vegas condo”. The author argues that, “judging by the demographic profile of sports-car buyers,” men don’t deal well with testosterone deficiency and bodily change. As someone who has studied women’s bodies and women’s menopause for almost 20 years, I think this comparison masks the variation in how women or men might experience these transitions and reifies gender dichotomies that help no one in the long run. Women DO have trouble with bodily change at times. And the majority of men still forgo Low-T treatments. The author would have done better if he had steered away from these gendered generalizations about how individuals “handle” midlife.

A commenter at HealthNewsReview.Org asks, Does Manopause Really Warrant one of TIME’s 52 Covers This Year? This is a great question. The power of pharmaceutical industries in this country means that topics like this get more press than is probably warranted (especially in light of all of the topics that could have had this front page, such as Ebola, Ferguson, Parkinson’s or ALS disease, foreign conflicts, etc.). Some scholars argue that we are experiencing the “pharmaceuticalization” of society, which puts industries like the Low-T industry front and center and makes us think in terms of “deficiency”, “disease”, and “replacement”. Pharmaceuticalization reinforces ideas about the importance of youthfulness and unchanging bodies and makes the onset of midlife problematic in general. We are actively urged to fight bodily change (here termed bodily “betrayal”) despite how normal it is.

Lately I’ve also seen a lot of press on men and masculinity. NPR has been running an “All Things Considered” series on boys and men this summer, detailing the hardships and unique experiences that boys and men have. I also read that a group of middle aged men recently got together to create a play called “Four Play” to combat the hype around Menopause: The Musical – to make sure that men have their stage too. In Detroit this summer we’ve also been tangoing with groups of Men’s Rights Activists who feel that feminists are taking over the world. To me, the “Manopause” cover of TIME magazine falls right in line with other recent attention to “men’s issues”. To me, this is all a backlash against attention given to women’s issues. In some cases I don’t even think it’s a conscious or calculated backlash but it still presents as one.

Overall, I’m indifferent about this TIME story. I don’t think it warrants the cover photo or the cover story but it is interesting to find out about a growing testosterone industry. Nonetheless the hype around the story concerns me because I keep thinking about what’s lurking behind the hype. For instance, we have to think about the gendered dynamics behind these stories and media portrayals, for gender forms an important backdrop here and can hinder the pursuit of real knowledge about these midlife transitions. Gender ideologies are what make testosterone (and estrogen) important in the first place. In addition, I do think we need to settle on one term for male menopause/andropause/manopause and why it might be important for us to think about. Finally, we really need to think about what pharmaceuticalization means for all of us.

Waiting

August 20th, 2014 by Heather Dillaway

re-blogging re:Cycling

In celebration of our fifth anniversary, we are republishing some of our favorite posts. This post by Heather Dillaway originally appeared October 28, 2010.

I’ve been thinking a lot lately about the words we use when we’re talking about menstruation or reproductive experiences more generally. I’ve been noticing lately that we use the word “waiting” quite a bit. I have a friend who is “still waiting” for her menstrual cycle to be “normal” again after her second child, and several other friends who are either “waiting” to figure out whether they will get pregnant, “waiting” to be done with their pregnancies, or “waiting” before they can have their last and final kid. I just had my basement waterproofed and one of the basement repairmen told me that his wife had been “waiting” ten months to get a menstrual period and that they were worried about her (this is information he volunteered after I told him I studied women’s health). I started thinking more about how the menopausal women I interview always talk about “waiting” to figure out whether they are really “at menopause,” or “waiting” to figure out if this is really their last menstrual period. Or how so many girls/young women who are sexually active are “waiting” to get their periods so that they can be relieved to know they are not pregnant. Or how women with painful periods, endometriosis, or migraines are waiting until those days are over each month. What does all of this reproductive waiting (waiting for menstruation, waiting for menstruation to be over, waiting for pregnancy, waiting for birth, waiting for menopause) mean?

In all of these instances of reproductive waiting, waiting seems a negative connotation and that seems to stem from the fact that we do not feel in control or in charge of this reproductive time. When I think of the other situations in which I might use the word “waiting”, the same holds true. I tell my kids to “wait their turn” and they don’t like it. And none of us really like waiting in line. Fast food restaurants, frozen dinners, and ATM machines are all in existence because we don’t have time or don’t like to wait. Phrases that we use like “worth the wait” also connote negativity about waiting. So, I finally looked up the actual definition of waiting. Depending on which online dictionary you visit, definitions of “waiting” include: “pause, interval, or delay,” “the act of remaining inactive or stationary,” or “the act of remaining inactive in one place while expecting something.” While some of these definitions do not automatically lend themselves to negativity, waiting is defined mostly as a passive activity that we are forced to participate in, perhaps against our will.


All of this makes me think further about whether women really dislike the waiting or the time that comes with menstruation or other reproductive experiences, and whether women really feel out of control as they engage in their experiences. Is this just a word we use or are we really impatient about menstruation and reproduction? When I think about alternative words that are sometimes used, like “tracking,” other words seem much more agentic in that they put women back in control of their cycles and other reproductive experiences. So, is it just the word “waiting” that has the negative connotation or is that word signifying some larger impatience that we have about reproduction these days? I have a colleague who writes about the “inconveniences” of reproduction and how, in so many ways, we try to avoid the reproductive waiting or reproductive uncertainties we face. For instance, instead of waiting to see when a baby is born, we might plan a c-section so that we can know when we’ll get that baby. Or, now we’re told that if we’re “waiting” more than 6 months to get pregnant that we should probably start taking fertility drugs to shorten our wait or get rid of some of that uncertainty. Or now we can find out that we’re pregnant a couple weeks after conception instead of waiting to see whether we menstruate a few weeks later. We attempt to cut out some of those reproductive waits these days. Menstrual suppression is at least partially popular because then women won’t have to be surprised by their periods or wait to know what bad day their period might fall on.


I think perhaps we do need to be more conscious of the words we use to describe our own and others’ reproductive events. Is “waiting” the correct word to use? Is “tracking” a better word to use because of the agency/active control it implies? Is “experiencing” a broader, less value-laden word to use? What do we really mean when we use these words?

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

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.