Blood, Spite, and Fears
The strange feminist reaction to Lybrel
Gonzales v. Carhart, the partial-birth abortion case, wasn't the only controversy involving reproductive rights last week. While feminists were tearing apart Justice Kennedy's ruling ("Creepy" and "paternalistic," cried Ann Friedman at Feministing. "Supremes Declare Women Less Intelligent Than Legislators," snarked very angry blogger, BitchPh.D.), another—albeit smaller—storm was brewing over Lybrel, a new continuous-use oral contraceptive.
In a much talked about article in the New York Times last Friday, reporter Stephanie Saul investigated the "ambivalence" women feel about the drug (which is expected to be approved by the FDA next month), and waxed poetic about the "complex love-hate relationship" women supposedly have with their periods-though that "love-hate" relationship doesn't seem to be all that complex. According to a study by Lybrel's manufacturer, Wyeth, over two-thirds of women said they were interested in putting an end to "the curse." Those findings were supported by a report by Linda C. Andrist, a professor at the MGH Institute of Health Professions in Boston.
But women's nonchalance about Lybrel did not sit well with a few self-appointed arbiters of women's health, who apparently (and ironically) think they know better than individual women when it comes to decisions about their own reproduction. Andist tisked-tisked the respondents for their readiness to give up their periods, saying "We don't want to confront our bodily functions anymore. We're too busy."
Granola-types, like Anna C. Yang, a holistic nurse and director of the California-based nonprofit Red Web Foundation, hinted at possible harm to women's self-esteem. "The focus of our group is to create positive attitudes toward the menstrual cycle; suppressing it wouldn't be positive," she said. Giovanna Chesler, a media production professor at the University of California, San Diego, was so terrified by Lybrel and its likes that she immediately stopped taking birth control. "When a girl does not understand her body, how does that negatively effect her sense of self?," she asks. That question sparked her new documentary, Period: The End of Menstruation, an exploration of how "women's bodies have been controlled and contained by the medical industry," and the latest cause célèbre at college women's centers. Even poor Anne Frank got dragged into the fight to testify to the joys of the "sweet secret" of menstruation.
The article also revived an earlier feud among feminist bloggers over Barr Pharmaceuticals' Seasonale, which limits bleeding to four times a year. Commentators worried that there hasn't been enough long-term research, and that women couldn't properly weigh the risks of taking the new pill. Melissa McEwan of the now defunct Shakespeare's Sister (and one of the "resigned" Edwards bloggers) frets that these drugs are just another way for women to better accommodate men: "[T]here's a part of me who wonders how much women are getting rid of their periods for their own convenience as opposed to the convenience of male sex partners."
Others, like Chesler, seem to share the bizarre idea that Big Pharma is a hotbed of misogyny. Marketing for the drugs, feminists argue, will imply that women's bodies are "unclean" and in need of treatment. Deanna Zandt at Alternet warns that "Periods have always been treated as a disease to be cured, and now we're really taking it to the next level. Perhaps if all us girls stop bleeding, we'll be more like men, and more acceptable and successful." Leslie Botha, a member of the Society for Menstrual Cycle Research and the proprietress of the truly wacky website, Holy Hormomes!, concurs: To suppress the menstrual cycle is "to suppress our fundamental nature and pay the pharmaceutical companies in the process." Feminists also darkly insinuated that pharmaceutical companies don't fully vet drugs meant for women. As one paranoid commenter at Feministing wrote, "On a more cynical note, Organon (the company that makes NuvaRing) has been working on a male Pill for years… you'd better believe the FDA will make sure it's safe. Sigh."
Points for creativity though must go to Rachel Sullivan, a sociology professor and contributor to the progressive blog, Alas (a site so politically correct it designates special comment threads for "progressive anti-racists"). According to Sullivan, Lybrel "is really an ingenious way to help the fight against birth control." Apparently, in response to right-wing attacks on contraception, Big Pharma is trying to protect its bottom line by redefining birth control as period control. Women will then start lying that they only use the pill to control their cycle, not to prevent pregnancy, thereby re-enshrining the double standard and shame about female sexuality and leading finally to some kind of gender dystopia that will make The Handmaid's Tale look mild by comparison.
But if menstrual suppression is the way to female oppression, I hate to break it to Sullivan, et al., but we're already there. That's because women who are currently taking the regular old Pill are already suppressing their period. And they've been doing it since 1960 when the Pill was first introduced.
As Ema, the OB/GYN blogger at The Well-Timed Period explains, women on the Pill do not ovulate, and their hormone levels do not fluctuate, keeping the uterine lining thin: "No build-up of the lining means no periodic shedding. No shedding means no menstrual period." The monthly bleeding women experience on the Pill is a "withdrawal bleed", or a fake period-one that is medically-induced by destabilizing the thin uterine lining. So women taking Seasonale or Lybrel are simply decreasing the frequency-or doing away with altogether-the monthly withdrawal bleed. Women on the monthly-regimen pill can achieve (and have, for years) the same effect by skipping their placebo pills and starting right away on a new pack. The only real difference between the old Pill and the new extended regimens is the packaging.
Early developers of contraceptives were aware that the frequency of the withdrawal bleed could be manipulated but chose to keep the monthly "period" in hopes of winning the approval of the Catholic Church. "In view of the ability of this compound to prevent menstrual bleeding as long as it is taken," Dr. Gregory Pincus, one of the Pill's developers, wrote in 1958, "a cycle of any desired length could presumably be produced." In fact, the Pill was originally submitted, in 1957, to the FDA as treatment for menstrual disorders and infertility, not as a contraceptive.
Moreover, since the new contraceptives are not significantly different from the regular Pill, worries about their safety are overblown. According to the FDA, more studies have been done on the side effects of the Pill than any other medicine in history. While there have been concerns that the Pill increases the risk of breast and cervical cancers, a number of studies have found no link. (However, the Pill does help to prevent cancer of the ovaries and of the endometrium.) A 1977 study examined a tri-cycle regimen (the same regimen as Seasonale) and found that the most common side effect was breakthrough bleeding and spotting (a common side effect with regular Pill use, and one that diminishes over time). More than 80 percent of women wanted to remain on the regimen.
The new extended cycle also helps to reduce unwanted pregnancies. "The most dangerous time in terms of pill taking is to forget to take pills at the beginning of a new packet: in other words to extend the pill-free week," Peter Bowen- Simpkins of the Royal College of Obstetricians and Gynaecologists told The Age. "The longer you extend it the more dangerous it gets. So, of course if you are taking one of these prolonged cycles then this will remove some of that risk."
Fortunately, not all feminists are so, well, paternalistic. Ann Friedman, for one, reminded supposed pro-choice advocates of choice. "This is just another birth control option," she wrote. "We shouldn't knock 'not menstruating' just because some of us aren't comfortable with that choice."
Feminists might want to keep that in mind while they condemn Justice Kennedy for not trusting women to make decisions about their own bodies. And they can leave Anne Frank out of it.
Cheryl Miller is a writer living in Washington, D.C.
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