Gender Bender: Redefining the Curse of Menstruation

May 22, 2007 — -- The curse. Aunt Flo. Riding the Crimson Wave. And, in British-bashing Australia, the red coats are coming! Women across the centuries have had names for their monthly "friend" — some laced with humor and many whispered in tones of taboo.

Just this week, the Food and Drug Administration approved the birth control pill Lybrel, for the first time giving women the option not to have a period. Period.

It's unclear whether women will embrace this new pill, which contains the same formulations of estrogen and progestin used for birth control pills for decades, but its arrival marks yet another step toward the blurring of the genders.

As 21st century women dominate the universities and continue to climb the executive ladder, and metro-sexual men explore their feminine side, it's harder to define what it means to be a woman.

"There are women out there who cannot reproduce, and yet, they are not less of a woman," said Lizzy Holmgren, 21, and a recent graduate of the University of Colorado, who said she would not hesitate to take the new pill.

"Womanhood is the appreciation of the ability to give life and to nurture," she said. "Women are the primary caretakers because society has made it OK for us. That's sociological, not biological."

Lybrel, manufactured by Wyeth, halts the growth of the uterine lining, bringing a stop to the monthly changes in the uterus that allow pregnancy -- and periods -- to occur. It is the fourth new oral contraceptive that does not follow a 28-day cycle that mimics menstruation.

Other pills, like Yaz and Seasonale, either reduce the length or frequency of monthly bleeding. Gynecologists say more women are asking for ways to limit or stop their periods. Surveys have shown up to 50 percent of all women would prefer not to have them at all — most would prefer them less often and a majority of doctors have prescribed contraception to prevent periods.

"I would totally take it," said Holmgren, a theater and gender studies major. "I see my period as more of a hassle than anything else."

"There are lots of women who don't get periods because of menopause and transgendered women with breasts who don't get their periods, anyway," she said. "It's not a deciding factor in how I view myself."

For years, women have been lambasted in the workplace for moodiness, weepy spells and sick days that men have attributed to menstruation.

"Men blame a woman's aggression and power to her period," said Holmgren. "Haven't you ever heard the expression, 'never trust anything that bleeds for seven days and doesn't die?' Maybe men would respect women more if they didn't have periods."

But other women worry that taking Lybrel is tantamount to tampering with nature, and some doctors have warned that the pill is not 100 percent effective in preventing pregnancy, particularly for overweight women. Total bleeding stopped in only 80 percent of women in the trials, according to gynecologists. Iron retention can also be a side effect.

"I personally would not opt to take the pill," said Erin Stahl, 28, an educational administrator in New Jersey. "I think it does seem a wee bit unnatural and physically frightening.

"I know there have been clinical trials, but we've seen other drugs put on the market and recalled," she said. "To stop the body cycle naturally going into menopause is more normal than making that change at 18 or 19."

Rachel Jones, a senior researcher at the Guttmacher Institute for reproductive health, told reporters that the inventor of the original pill incorporated a week of bleeding into the regimen, not only to gain support from the Catholic Church, but because many women found it "reassuring."

In 1986, Beverly Strassmann, associate professor of anthropology at the Institute for Social Research at University of Michigan, began a two-year study of menstruating women in West Africa. Keeping a check list of village women's cycles, she noted that those women spent most of their lives not menstruating.

Women in their fertile years were either pregnant, lactating or wet nursing. Menstruation occured primarily in younger teens and women approaching menopause, she said.

According to Strassmann, women do not need to menstruate to stay healthy — rather, it is exposure to hormones during the 28-day cycle that leaves women vulnerable to increased cancer risks.

"The reproductive cancer connection is real," she said, citing studies that have shown celibate nuns have the highest prevalence of breast cancer.

"We shouldn't worry that it's unnatural," said Strassman. "Menstruating every month is not the natural course of events. Some women have been slow to accept that and have been proselytizing that they must have a menstrual cycle every month."

But it is menstruation that has historically set women apart from men. A quirky Web site called the Museum of Menstruation chronicles tales of both humor and shame. It quotes the 19th century Canadian-American physician Sir William Osler as referring to the flow as "the tears of a disappointed uterus."

Today, both men and women have different attitudes toward menstruation. Indie rock vocalist Ani DiFranco sings with 21st century attitude about her monthly cycle: "I woke up one morning covered in blood, like a war — like a warning that I live in a breakable takeable body."

Whether Lybrel is a sign that women have "come a long way, baby" or embraced a "Brave New World," is irrelevant, say sociologists.

The new pill represents new options for women in defining their own identities, said Stuart Michaels, assistant director of the Center for Gender Studies at the University of Chicago. And the term "natural" is defined by cultural values, not biology, he said.

"What is natural is not a simple and absolute determination," said Michaels. "One woman might take the pill ... because it has certain benefits in preventing pregnancy, and she may or may not have any doubts about her femininity."

"Someone else might choose to do this because she doesn't want to menstruate because it makes her feel unfeminine," he said. "It's all about how people experience their own body and think about what it means to be a man or woman."