Why can't we talk about periods? | Jen Gunter

Summary

In this powerful talk, the speaker recounts her personal struggles with menstruation and societal taboos surrounding it. She challenges the shame and misinformation by explaining the biological processes behind periods and advocating for better education and understanding. The speaker humorously dismantles myths about 'menotoxin' and the patriarchal oppression of women through menstruation, while also discussing the physical aspects of periods, including cramps and period diarrhea. She emphasizes the importance of addressing menstrual pain and ending the era of menstrual taboos through knowledge and open conversation.

Takeaways

• 😣 The speaker experienced severe menstrual symptoms as a teenager, including cramps, leakage, and period diarrhea, which led to missed school days.
• 🤔 She questioned the societal taboos around menstruation, comparing it to other bodily functions that are not considered shameful or dirty.
• 😅 A lack of open discussion and education about menstruation was highlighted, with the speaker's own mother and doctor providing little help or understanding.
• 😓 The speaker humorously critiqued the size of early menstrual products and the segregation of menstrual products in stores, pointing out the absurdity of 'feminine hygiene aisles'.
• 🤯 Menstruation has been historically misunderstood and stigmatized, with myths about women's ability to spoil crops or wilt flowers perpetuated by religion and pseudoscientific ideas like 'menotoxin'.
• 🧬 Menstruation is a unique process among mammals, involving the building and shedding of the uterine lining in the absence of pregnancy, and is not inherently toxic.
• 🩸 The menstrual cycle involves 30 to 90 milliliters of blood loss, which is necessary for a thick uterine lining that can support a potential pregnancy.
• 💪 The uterine contractions during menstruation are comparable in pressure to those during the second stage of labor, explaining the severity of menstrual cramps.
• 🛑 There are effective treatments for menstrual pain, including TENS units, nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal contraception, which can reduce pain and blood loss.
• 🚫 The speaker advocates for an end to menstrual taboos and the importance of knowledge and open conversation about menstruation for women's health and empowerment.

Q & A

What were the speaker's personal experiences with menstruation during her teenage years?

The speaker experienced severe menstrual cramps, blood leakage onto clothes and bed sheets, and period diarrhea, which led to missing school one to two days a month.

Why did the speaker feel that menstruation was treated differently compared to other bodily functions?

The speaker questioned why menstruation was considered different since other bodily functions like eating or walking did not lead to leakage of fluids.

What was the advice given by the doctor when the speaker sought help for her heavy periods?

The doctor advised the speaker to eat liver when she sought help for her heavy periods.

Why did the speaker feel that the societal approach to menstruation was problematic?

The speaker felt that the societal approach to menstruation was problematic because it was surrounded by shame and silence, which prevented open discussion and education about it.

What historical beliefs contributed to the stigmatization of menstruation according to the speaker?

Historical beliefs that contributed to the stigmatization of menstruation included the idea that women could spoil crops, milk, or wilt flowers, and purity myths from religious beliefs.

What was the concept of 'menotoxin' mentioned in the 1920s and '30s, and why was it problematic?

The concept of 'menotoxin' was a belief that women elaborated a toxic substance during menstruation that could wilt flowers, which was problematic because it was based on a lack of diversity in medical opinions and perpetuated myths about menstruation.

How does the speaker explain the biological process of menstruation?

The speaker explains that menstruation involves the brain triggering the ovary to produce an egg, estrogen building up the uterine lining, and if pregnancy doesn't occur, the lining is shed, causing bleeding.

Why does the speaker argue that the thick uterine lining is necessary for menstruation?

The speaker argues that a thick uterine lining is necessary to provide an obstacle course for embryos, ensuring only the highest quality embryos implant, as part of evolution's strategy to maximize beneficial outcomes for pregnancy.

What is the pressure generated in the uterus during menstruation, as mentioned by the speaker?

The pressure generated in the uterus during menstruation is 120 millimeters of mercury, which is comparable to the pressure during the second stage of labor when pushing.

What are some ways the speaker suggests to address menstrual pain?

The speaker suggests using a TENS unit, nonsteroidal anti-inflammatory medications, and hormonal contraception to address menstrual pain.

Why does the speaker emphasize the importance of discussing menstruation openly?

The speaker emphasizes the importance of discussing menstruation openly to break the culture of shame, challenge myths, and ensure that women are not suffering in silence without access to proper knowledge and treatment options.

Outlines

00:00

🩸 Menstruation: A Personal Struggle and Societal Stigma

The speaker recounts her teenage experience with severe menstrual symptoms, including cramps, leakage, and period diarrhea, which led to missed school days. She expresses frustration with the lack of understanding and support from her mother and peers, who avoided discussing menstruation openly. The speaker's visit to a doctor resulted in unhelpful advice, and she criticizes the societal taboos and patriarchal attitudes that contribute to the stigmatization of menstruation. She humorously questions the absurdity of menstrual product marketing and the lack of a dedicated 'anal hygiene aisle' for toilet paper, highlighting the need for open dialogue about periods. The speaker also touches on historical and religious beliefs that have perpetuated myths about menstruation, such as the idea of 'menotoxin' and the notion that women could spoil various things with their presence during menstruation.

05:01

🌱 The Biology of Menstruation and Its Evolutionary Significance

The speaker delves into the biological aspects of menstruation, explaining the process of uterine lining buildup and the role of hormones like estrogen and progesterone. She contrasts menstruation with estrus, highlighting the unique aspects of human reproduction where the ovary, not the embryo, signals the readiness of the uterine lining. The speaker discusses the significant amount of blood lost during menstruation, which is necessary due to the thick uterine lining required for embryo implantation. She uses humor to illustrate the point that if the lining were not shed, it would lead to an unimaginable 'tsunami period.' The speaker also explains the body's mechanism for stopping menstrual bleeding, involving prostaglandins and uterine cramping, which is compared to the pressure experienced during childbirth. She advocates for recognizing menstrual pain as 'typical' and not 'normal,' suggesting that societal attitudes towards menstrual pain should be more supportive and less dismissive.

10:03

💪 Breaking Menstrual Taboos and Embracing Knowledge

The speaker addresses the issue of menstrual pain and the various treatments available, such as TENS units, nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal contraception. She emphasizes the importance of not labeling individuals who experience severe menstrual pain as failures of treatment but rather recognizing that the treatment may not be effective for them. The speaker also mentions endometriosis as a potential cause of painful periods and acknowledges that there may be other, not yet fully understood, biological mechanisms at play. She concludes by asserting that understanding and discussing menstruation should not be a feminist act but a basic human right, and that breaking the curse of menstrual taboos relies on spreading knowledge and encouraging open conversation about women's health.

Keywords

💡Menstruation

Menstruation is the monthly shedding of the uterine lining in humans and some other primates, accompanied by bleeding. In the video, the speaker discusses her personal experiences with painful menstruation, highlighting the societal taboos and lack of understanding surrounding this natural process. The script uses menstruation as a focal point to critique the patriarchal attitudes that stigmatize and oppress women's reproductive health.

💡Menotoxin

The term 'menotoxin' refers to a mythical substance that was once believed to be produced by women during menstruation, causing them to spoil crops or wilt flowers. This concept is debunked in the script, illustrating the historical misinformation and pseudoscience that contributed to the stigmatization of menstruation. The speaker uses the term to highlight the absurdity of past beliefs and the need for accurate scientific understanding.

💡Estrus

Estrus is a period of sexual receptivity and fertility in female mammals, characterized by behavioral and physiological changes. In contrast to menstruation, estrus is the reproductive cycle in most mammals where the uterine lining is prepared for implantation by signals from the embryo. The script mentions estrus to emphasize the uniqueness of menstruation among mammals and to explain the biological processes that differentiate human reproduction.

💡Progesterone

Progesterone is a hormone that plays a crucial role in the menstrual cycle and pregnancy. After ovulation, progesterone acts like 'mortar' to stabilize the uterine lining, preparing it for a potential embryo implantation. The script explains that if pregnancy does not occur, the lack of progesterone leads to the shedding of the uterine lining, resulting in menstruation.

💡Patriarchal society

A patriarchal society is one in which men hold primary power and are dominant in roles of political leadership, moral authority, and social privilege. The speaker argues that patriarchal societies have historically oppressed women and used menstruation as a tool for this oppression by associating it with shame and impurity. This concept is central to the video's critique of societal attitudes towards women's health.

💡Period diarrhea

Period diarrhea refers to the increased bowel movements or loose stools that some women experience during their menstrual cycle. The speaker mentions this condition to highlight the range of symptoms that can accompany menstruation and to emphasize the importance of discussing these experiences openly to combat the culture of shame.

💡Prostaglandins

Prostaglandins are hormone-like substances that contribute to inflammation and pain. During menstruation, the uterine lining releases prostaglandins, which cause the uterus to contract and help to expel the menstrual blood, but also lead to cramps and pain. The script explains the role of prostaglandins in menstrual pain and how certain medications can block their release to alleviate discomfort.

💡TENS unit

A TENS unit, or Transcutaneous Electrical Nerve Stimulation unit, is a device that uses low-voltage electrical currents to relieve pain. The speaker suggests TENS units as a method for managing menstrual pain, illustrating the various treatment options available for women and the importance of addressing menstrual discomfort seriously.

💡Nonsteroidal anti-inflammatory medications (NSAIDs)

NSAIDs are a class of drugs that reduce inflammation and pain. The script discusses how NSAIDs can be effective in reducing menstrual pain by blocking the production of prostaglandins. This highlights the medical approach to managing the symptoms of menstruation and the video's advocacy for accessible pain relief for women.

💡Hormonal contraception

Hormonal contraception refers to birth control methods that use hormones to prevent pregnancy. The speaker mentions that hormonal contraception can lead to a thinner uterine lining, reducing the amount of prostaglandins produced and consequently decreasing menstrual pain and blood volume. This illustrates the script's exploration of reproductive health options and their impact on menstrual experiences.

💡Endometriosis

Endometriosis is a medical condition where the uterine lining grows outside the uterus, causing pain, inflammation, and potential fertility issues. The script addresses endometriosis as a potential cause of painful periods, emphasizing the need for medical understanding and treatment of conditions that can exacerbate menstrual symptoms.

Highlights

The speaker experienced severe menstrual symptoms as a teenager, including cramps, leakage, and missing school.

Menstruation was considered a taboo subject, with no one to provide answers or discuss the experience.

The speaker humorously compares the lack of menstruation discussion to not leaking saliva or joint fluid during normal activities.

Medical advice for heavy periods was outdated and unhelpful, such as being told to eat liver.

The speaker questions the societal norms of buying menstrual products in a 'feminine hygiene aisle'.

Menstruation is framed as a patriarchal tool for oppression, not a natural or medical issue.

Historically, menstruation was linked to myths of impurity and the ability to spoil crops or wilt flowers.

The 1920s and '30s saw the false medical belief in 'menotoxin,' a supposed toxin in menstrual blood.

The importance of being able to discuss menstruation to break societal myths and taboos.

Menstruation is a rare phenomenon among mammals, with only a few species experiencing it.

The biological process of menstruation involves the ovary, estrogen, and uterine lining, explained in detail.

The speaker highlights the evolutionary significance of a thick uterine lining for embryo implantation.

The amount of blood lost during menstruation is significant, averaging 30 to 90 milliliters.

The uterine cramps during menstruation are compared to the pressure experienced during childbirth.

Menstrual pain is considered 'typical' and should be addressed rather than dismissed as 'normal'.

Treatments for menstrual pain include TENS units, nonsteroidal anti-inflammatory drugs, and hormonal contraception.

The speaker addresses the possibility of endometriosis and other conditions causing painful periods.

The importance of open dialogue about menstruation for understanding and improving women's health.

The speaker concludes by declaring the end of menstrual taboos and the need for knowledge to break societal curses.

Transcripts

When I was a teen, I had terrible periods.

I had crippling cramps,

I leaked blood onto my clothes and onto my bed sheets,

and I had period diarrhea.

And I had to miss school one to two days a month,

and I remember sitting on the couch with my heating pads, thinking,

"What's up with this?"

When I ate food, I didn't leak saliva from my salivary glands.

When I went for a walk,

I didn't leak fluid from my knees, "joint fluid."

Why was menstruation so different?

I wanted answers to these questions

but there was no one for me to ask.

My mother knew nothing about menstruation

except that it was dirty and shameful and I shouldn't talk about it.

I asked girlfriends

and everybody spoke in euphemisms.

And finally, when I got the courage to go to the doctor

and talk about my heavy periods,

I was told to eat liver.

(Laughter)

And when I went to the drug store to buy my menstrual products,

my 48-pack of super maxi pads,

back in the day when they were the size of a tissue box, each pad --

(Laughter)

You know what I'm talking about.

You have no idea how far absorbent technology has come.

(Laughter)

I used to have to buy my menstrual products

in the feminine hygiene aisle.

And I remember standing there, thinking,

"Well, why don't I buy toilet paper in the anal hygiene aisle?"

(Laughter)

Like, what's up with that?

Why can't we talk about periods?

And it's not about the blood, as Freud would have you say,

because if it were,

there would be an ear, nose and throat surgeon up here right now,

talking about the taboos of nose bleeds, right?

And it's not even about periods,

because otherwise, when we got rid of our toxic, shameful periods

when we became menopausal,

we'd be elevated to a higher social status.

(Laughter)

(Applause)

It's just a patriarchal society is invested in oppressing women,

and at different points in our lives, different things are used.

And menstruation is used

during what we in medicine call the reproductive years.

It's been around since pretty much the beginning of time,

many cultures thought that women could spoil crops

or milk, or wilt flowers.

And then when religion came along,

purity myths only made that worse.

And medicine wasn't any help.

In the 1920s and '30s

there was the idea that women elaborated something called a menotoxin.

We could wilt flowers just by walking by.

(Laughter)

And that's what happens when there's no diversity, right.

Because there was no woman to put her hand up and go,

"Well, actually, that doesn't happen."

And when you can't talk about what's happening to your body,

how do you break these myths?

Because you don't even need to be a doctor

to say that periods aren't toxic.

If they were, why would an embryo implant in a toxic swill?

And if we all had this secret menotoxin,

we could be laying waste to crops and spoiling milk.

(Laughter)

Why would we have not used our X-Women powers to get the vote sooner?

(Laughter)

(Applause)

Even now,

when I tweet about period diarrhea,

as one does,

(Laughter)

I mention that it affects 28 percent of women.

And every single time, someone approaches me and says,

"I thought I was the only one."

That's how effective that culture of shame is,

that women can't even share their experiences.

So I began to think,

"Well, what if everybody knew about periods like a gynecologist?

Wouldn't that be great?"

Then you would all know what I know,

you'd know that menstruation

is a pretty unique phenomenon among mammals.

Most mammals have estrus.

Humans, some primates,

some bats,

the elephant shrew and the spiny mouse menstruate.

And with menstruation what happens is the brain triggers the ovary

to start producing an egg.

Estrogen is released

and it starts to build up the lining of the uterus,

cell upon cell, like bricks.

And what happens if you build a brick wall too high without mortar?

Well, it's unstable.

So what happens when you ovulate?

You release a hormone called progesterone,

which is progestational, it gets the uterus ready.

It acts like a mortar and it holds those bricks together.

It also causes some changes

to make the lining more hospitable for implantation.

If there's no pregnancy,

(Whoosh)

lining comes out,

there's bleeding from the blood vessels and that's the period.

And I always find this point really interesting.

Because with estrus,

the final signaling to get the lining of the uterus ready

actually comes from the embryo.

But with menstruation,

that choice comes from the ovary.

It's as if choice is coded in to our reproductive tracts.

(Cheering and applause)

OK, so now we know why the blood is there.

And it's a pretty significant amount.

It's 30 to 90 milliliters of blood,

which is one to three ounces,

and it can be more,

and I know it seems like it's more a lot of the times.

I know.

So why do we have so much blood?

And why doesn't it just stay there till the next cycle, right?

Like, you didn't get pregnant, so why can't it hang around?

Well imagine if each month it got thicker and thicker and thicker, right,

like, imagine what tsunami period that would be.

(Laughter)

We can't reabsorb it, because it's too much.

And it's too much because we need a thick uterine lining

for a very specific reason.

Pregnancy exerts a significant biological toll on our bodies.

There is maternal mortality,

there is the toll of breastfeeding

and there is the toll of raising a child until it is independent.

And evolution --

(Laughter)

That goes on longer for some of us than others.

(Laughter)

But evolution knows about risk-benefit ratio.

And so evolution wants to maximize the chance of a beneficial outcome.

And how do you maximize the chance of a beneficial outcome?

You try to get the highest quality embryos.

And how do you get the highest quality embryos?

You make them work for it.

You give them an obstacle course.

So over the millennia that we have evolved,

it's been a little bit like an arms race in the uterus,

the lining getting thicker and thicker and thicker,

and the embryo getting more invasive

until we reach this détente

with the lining of the uterus that we have.

So we have this thick uterine lining

and now it's got to come out,

and how do you stop bleeding?

Well, you stop a nose bleed by pinching it,

if you cut your leg, you put pressure on it.

We stop bleeding with pressure.

When we menstruate,

the lining of the uterus releases substances

that are made into chemicals called prostaglandins

and other inflammatory mediators.

And they make the uterus cramp down,

they make it squeeze on those blood vessels

to stop the bleeding.

They might also change blood flow to the uterus

and also cause inflammation and that makes pain worse.

And so you say, "OK, how much pressure is generated?"

And from studies where some incredible women

have volunteered to have pressure catheters

put in their uterus

that they wear their whole menstrual cycle --

God bless them, because we wouldn't have this knowledge without,

and it's very important knowledge,

because the pressure that's generated in the uterus

during menstruation

is 120 millimeters of mercury.

"Well what's that," you say.

Well, it's the amount of pressure that's generated

during the second stage of labor when you're pushing.

(Audience gasps)

Right.

Which, for those of you who haven't had an unmedicated delivery,

that's what it's like when the blood pressure cuff

is not quite as tight as it was at the beginning,

but it's still pretty tight,

and you wish it would stop.

So that kind of makes it different, right?

If you start thinking about the pain of menstruation,

we wouldn't say if someone needed to miss school

because they were in the second stage of labor and pushing,

we wouldn't call them weak.

We'd be like, "Oh my God, you made it that far," right?

(Laughter)

And we wouldn't deny pain control

to women who have typical pain of labor, right?

So it's important for us to call this pain "typical" instead of "normal,"

because when we say it's normal, it's easier to dismiss.

As opposed to saying it's typical, and we should address it.

And we do have some ways to address menstrual pain.

One way is with something called a TENS unit,

which you can wear under your clothes

and it sends an electrical impulse to the nerves and muscles

and no one really knows how it works,

but we think it might be the gate theory of pain,

which is counterirritation.

It's the same reason why, if you hurt yourself, you rub it.

Vibration travels faster to your brain than pain does.

We also have medications

called nonsteroidal anti-inflammatory medications.

And what they do is they block the release of prostaglandins.

They can reduce menstrual pain for 80 percent of women.

They also reduce the volume of blood by 30 to 40 percent

and they can help with period diarrhea.

And we also have hormonal contraception,

which gives us a thinner lining of the uterus,

so there's less prostaglandins produced

and with less blood, there's less need for cramping.

Now, if those treatments fail you --

and it's important to use that word choice,

because we never fail the treatment,

the treatment fails us.

If that treatment fails you,

you could be amongst the people

who have a resistance to nonsteroidal anti-inflammatories.

We don't quite understand,

but there are some complex mechanisms

why those medications just don't work for some women.

It's also possible that you could have

another reason for painful periods.

You could have a condition called endometriosis,

where the lining of the uterus is growing in the pelvic cavity,

causing inflammation and scar tissue and adhesions.

And there may be other mechanisms we don't quite understand yet,

because it's a possibility that pain thresholds could be different

due to very complex biological mechanisms.

But we're only going to find that out by talking about it.

It shouldn't be an act of feminism

to know how your body works.

It shouldn't --

(Applause)

It shouldn't be an act of feminism

to ask for help when you're suffering.

The era of menstrual taboos is over.

(Cheers and applause)

The only curse here

is the ability to convince half the population

that the very biological machinery that perpetuates the species,

that gives everything that we have,

is somehow dirty or toxic.

And I'm not going to stand for it.

(Applause)

And the way we break that curse?

It's knowledge.

Thank you.

(Cheers and applause)