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The notion that menstruation is a rather unpleasant, if not the rationale and the means to make menstruation disappear downright toxic, process has been around for a very long time. completely! The solution is simple: just give all women a con- So has the belief that the source of all women's suffering resides tinuous low-dose birth control pill. What progress! with her ovaries, uterus and menstrual flow. The science of Dr Coutinho's theory has many physicians and researchers medicine is notoriously misogynist. waxing lyrical, agreeing that there's no reason why women can't While it would be comforting to think that living in the 21st opt for fewer periods by extending the use of the Pill. Whether century guaranteed a more enlightened appreciation of women's for easing health problems such as migraines or eliminating the physiology, it would appear that we may have to wait another inconvenience and messiness not to mention the expense of century or two for that momentous event finally to occur. menstruation, the Pill can now be taken continuously for 84 When it comes to understanding and appreciating the wonders days followed by a seven-day break. In this manner, women of the female physiology, modern medicine is moving at a gal- will only have a bleed four times a year. loping snail's pace. Dr Freedolph Anderson, lead researcher of the trials for the A recent syndicated column by a highly respected Australian new continuous contraceptive pill Seasonale, which will make medical doctor was titled "Period Disease". A question from a its debut in 2004, says: "We have more than 30 years' experi- reader was posed to him: "My doctor told me recently that ence of prolonged period suppression with [intravenous contra- monthly periods are now regarded by some as a 'disease' and ceptive] Depo-Provera; we know there are no health deficits and totally preventable. Is this true?" His sagacious reply: "Why that women don't develop gynaecological problems from not should women be burdened with loss of valuable blood each menstruating." month, which is often not manufactured in similar amounts, Dr John Eden, Associate Professor of Reproductive often leading to anaemia and chronic tiredness? Taking the Endocrinology at the University of New South Wales in active ingredients of the oral contraceptive pill daily, with no Sydney, Australia, reiterates that point of view: "Women are seven-day break, solves the problems." The short answer to that often healthier if they are on the Pill..."° question of whether monthly periods are a disease was a whole- So, now that medicine has conquered menstruation and drug hearted "Yes".* companies' glossy marketing campaigns have succeeded in The sentiment that periods are a extolling the Pill's ever growing vir- disease—or at least a most unwel- tuosity, what has actually been come, unproven and unsafe physio- achieved for all the young women logical process—seems to reflect a who are being seduced by these growing trend amongst members of promises? Are women really health- - 7 . . : 19 Lac . mote new scientific developments | _cilfl8 a8 young as thirteen od suppression with Depo-Prover that can supposedly liberate women are now prescribed the Pill een perfectly safe over those 30- from their age-long debilitation, i plus years? Is this really a great vic- oo eee for treating acne. tory, or a catastrophe of unparalleled Leading the charge to stamp out proportions for modern women? menstruation is the work of Dr Elsimar Coutinho, Professor of Gynaecology, Obstetrics and Since 1960, when the US Food Human Reproduction at the and Drug Administration approved it Universidade Federal da Bahia in Brazil, as recounted in his for contraception, the Pill has been one of the most popular book, Is Menstruation Obsolete ?* methods of preventing pregnancy. But in recent years, reminis- Dr Coutinho argues that regular monthly bleeding is not the cent of the off-label uses of HRT, oral contraceptives have "natural" state of women and that it actually places them at risk —_ increasingly been prescribed for adolescent girls and young of several medical conditions of varying severity. The author | women for noncontraceptive purposes. maintains that while menstruation may be culturally significant, There is no doubt that doctors consider the Pill the best solu- it is not medically meaningful. He asserts that prehistoric tion to address a long list of young women's hormonal difficul- women had fewer than 160 periods in their lifetime. (The mind ties. This day and age, there's a plethora of options: the com- boggles at how rigorous the scientific method actually was in bined low-dose Pill made with oestrogen and progestin; the the conduct of that research.) On the other hand, modern progestin-only mini-Pill; and the three-year implant or injection. Shocking Facts about the Pill women, who start menstruating earlier and spend less time Far beyond its initial purpose as a contraceptive drug for pregnant, have more than 400 menstrual cycles. As the champi- short-term use, the Pill has become the darling of the medical on of women's freedom, he believes that 21st century women world for treating just about any hormonal problem a girl may should be able to choose the timing and frequency of their peri- have, and then some. To date, the Pill is prescribed to help ods, just as they can now choose the timing and frequency of teenagers attack acne, "regulate" their periods, eliminate painful childbirth. From a medical point of view he sees menstruation periods and treat PMS, endometriosis, migraines, ovarian cysts as a failed process, having no beneficial effects; indeed, it can and polycystic ovaries. Girls as young as thirteen are now pre- even be harmful to many women's health. scribed the Pill for treating acne. In a nutshell, Dr Coutinho's work suggests that the most med- The Pill has been touted by the medical profession as one of ically advanced "treatment" for menstruation would be its total the most effective and powerful preventive medicines around. cessation in all women of reproductive age. The correct med- But is it? ical terminology is chemical castration. In December 2002, the US federal government published the The intricate and profoundly complicated female reproductive 10th edition of its biennial "Report on Carcinogens", which is system, which has undergone many hundreds of thousands of | mandated by Congress as a way for the government to help years of evolutionary fine-tuning, has now been declared obso- keep the public informed about substances or exposures that are lete. Like a top-class magician, medical science now professes known to cause human cancers. Added to the list of "known" Girls as young as thirteen are now prescribed the Pill for treating acne. 18 = NEXUS www.nexusmagazine.com FEBRUARY — MARCH 2003