Women's Health

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The PCOS Plan

The PCOS Plan

Prevent and Reverse Polycystic Ovary Syndrome through Diet and Fasting
edition:Paperback
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The Vagina Bible

The Vagina Bible

The vulva and the vagina--separating the myth from the medicine
edition:Paperback
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Excerpt

Introduction
 
I have a vagenda: for every woman to be empowered with accurate information about the vagina and vulva.
 
One of the core tenets of medicine is informed consent. We doctors provide information about risks and benefits and then, armed with that information, our patients make choices that work for their bodies. This only works when the information is accurate and unbiased. Finding this kind of data can be challenging, as we have quickly passed through the age of information and seem to be stalled in the age of misinformation.
 
Snake oil and the lure of a quick fix have been around for a long time,and so false, fantastical medical claims are nothing new. However, sorting myth from medicine is getting harder and harder.
 
In addition to social media feeds that constantly display medical messaging of variable quality, there are the demands of a headline-driven news cycle that constantly requires new content—even when it doesn’t exist. With women’s bodies, there are even more forces of misdirection at work. Pseudoscience and those who peddle it are invested in misinformation,but so is the patriarchy.
 
Obsessions with reproductive tract purity and cleansing date back to a time when a woman’s worth was measured by her virginity and how many children she might bear. A vagina and uterus were currency. Playing on these fears awakens something visceral. It’s no wonder the words “pure,” “natural,” and “clean” are used so often to market products to women.
 
Members of the media and celebrity influencers tap into these fears with articles about and products to prevent vaginal mayhem, as if the vagina (which evolved to stretch and tear to deliver a baby long before suture material was invented) is somehow so fragile that it is constantly in a state of near catastrophe.
 
Why The Vagina Bible instead of The Vagina and Vulva Bible? Because that is how we collectively talk about the lower reproductive tract (the vagina and vulva). Medically, the vagina is only the inside, but language evolves and words take on new meaning. For example, “catfish” and “text” both have additional meanings that I could never have imagined when I was growing up. “Gut” is from the Old English for the intestinal tract, usually meaning the lower part (from the stomach on down) but not always.
 
It’s actually a very imprecise term; yet it has been embraced by the medical community and is even the name of a leading journal dedicated to the study of the alimentary (digestive) tract, the liver, biliary tree, and pancreas.
 
I have been in medicine for thirty-three years, and I’ve been a gynecologist for twenty-four of them. I’ve listened to a lot of women, and I know the questions they ask as well as the ones they want to ask but don’t quite know how. The Vagina Bible is everything I want women to know about their vulvas and vaginas. It is my answer to every woman who has listened to me pass on information in the office or online and then wondered, “How did I not know this?”
 
You can read the book in order from front to back or visit specific chapters or even sections as they speak to you. It’s all good! I hope over the years many pages will become worn as you go back to double-check what a doctor told you in the office, to research a product that makes wild claims about improving vaginas and vulvas, or help a friend or sexual partner out with an anatomy lesson.
 
Misinforming women about their bodies serves no one. And I’m here to help end it.
Jen Gunter, MD

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Hormone Power

Hormone Power

Transform Your Diet, Transform Your Life
edition:Paperback
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Heavy Flow

Heavy Flow

Breaking the Curse of Menstruation
edition:Paperback
also available: eBook
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Excerpt

Introduction

I was, somewhat ironically, in health class when it happened. I didn’t even have to look to know what was happening — the telltale warmth spreading from between my legs told me exactly what I needed to know.

My pad was leaking.

I excused myself from the classroom, tucked a fresh pad into the sleeve of my sweater and stealthily inspected the chair I had been sitting on to make sure there was no blood on it. Thankfully, there was not — my classmates were still talking about the girl who stained a chair the term before. I shuffled my way to the washroom, keeping my legs tightly crossed to avoid another gush of blood and any further leakage.

Sure enough, I had soaked through my pad and stained both my underwear and my jeans. I changed into a fresh pad, but the damage was done — the blood was visible on the outside. Mortified, I spent the rest of the day with my winter jacket tied around my waist. While the bloodstain had been concealed, the jacket-around-the-waist trick was pretty much like sending out a bat signal to every other student in my school that my pad had leaked.

Does this sound like a familiar story? I’m sure anyone reading this book has a period horror story of their own; whether it’s the classic leaky pad in middle school, a bloodstain on the sheets of a new lover’s bed, or a tampon rolling out of your bag at the most inopportune time. Having someone know you’re on your period — or worse, actually seeing the blood evidence — is embarrassing.

Or maybe your period horror story doesn’t have to do with a bloodstain, but the pain that is often experienced with menstruation. Period pain is real pain, and it’s estimated that it affects anywhere from 70 percent to 90 percent of people who menstruate.

That’s a hell of a lot of “bad periods,” a term that Meghan Cleary, founder of the aptly named resource website Bad-Periods.com, defines as “a condition enshrined in mystery, myth, cultural shame, taboo and clinical gender bias.”

Never mind bad periods: all periods are enmeshed in the same issues. Full stop.

Despite all our advances as a species, menstruation is something that remains a relative mystery for many humans. We can put a man on the moon, yet almost half of the world’s population is suffering on a monthly basis, often in silence, because of a perfectly natural bodily function. Menstrual cramps are the most common gynecological problem in adolescent girls and are the leading cause of short-term absences from school and work.

In a 1978 essay for Ms. magazine, Gloria Steinem mused that if men could menstruate, “Congress would fund a National Institute of Dysmenorrhea to help stamp out monthly discomforts.” Steinem adds that if men could menstruate they would brag about how long and how much, and menstrual products would be free. For anyone who has ever had a period, the essay is hilarious, but it’s also a bleak commentary on the ways in which menstruation is used as a tool of the patriarchy.

More than forty years later, Steinem’s missive is still relevant.

No such pain institute has been founded, and the options for managing period pain and other related symptoms are still limited — and many have to spend years convincing doctors to take that pain seriously.

We live in a culture that seems to have no taboos left, yet period shame still persists. In a world where the minutiae of our lives are live-tweeted, posted to Instagram, and enshrined online, we wouldn’t dare update our status to “menstruating.”

And menstrual products certainly aren’t free. In fact, quite the opposite — for some they can be downright expensive. The “feminine hygiene” industry brings in about $15 billion in sales worldwide; that figure doesn’t include pain medication and other sundries related to menstruation. There are many people around the world who simply cannot afford to purchase pads or tampons, or don’t have access to them in remote areas, relying instead on rags, grass, newspaper, scraps of fabric, or even cow dung to manage their flow. These found materials are itchy, unhygienic, and unreliable. Rather than risk the shame of having their menstruation exposed, many girls and women simply stay home from school and work.

It’s nothing short of a human rights violation. If that sounds extreme, the United Nations Human Rights Council says the same thing in no uncertain terms: “The lack of access to adequate water and sanitation services, including menstrual hygiene management, and the widespread stigma associated with menstruation, have a negative impact on gender equality and the human rights of women and girls.” (emphasis mine)

During my career as a nutritionist, I’ve developed an interest in menstrual cycles from a health perspective. Although I had a lifelong interest in reproductive health, even sewing my own pads and making zines about toxic ingredients in tampons while I was in high school, I was almost thirty before I learned about how my menstrual cycle really worked and that it was a vital sign, both a promoter and indicator of good health. It wasn’t until I was in nutrition school that I was presented with the idea that period pain wasn’t “normal.”

As a feminist, I see that menstruation is a complex issue that transcends physiology. The more time I spend writing, reading, and researching menstruation, the more I recognize just how far the influence of the menstrual taboo reaches. It’s entwined with feminism and patriarchy, gender and the rights of trans people.

Follow the red thread and you will uncover how the medical system’s paternalistic, “doctor knows best” approach has not just ignored, but denied the pain of so many for centuries and has literally failed women by leaving them out of medical and drug trials because controlling the menstrual cycle is, well, hard — 80 percent of the prescription drugs pulled from the U.S. market between 1997 and 2001 caused more side effects in women than in men.

Go a little further and you’ll see how menstruation is a sister to the conversation around hormonal birth control; cousin to female sexuality, fertility, pregnancy, and abortion. It’s about what we as a society think is okay to do to female bodies.

Menstruation intersects with capitalism, the illusion of consumer choice, and the role that product manufacturers have played in shaping the mainstream conversation around menstruation, for worse and for better.

It is at once a political issue, a cultural issue, a class issue, and a public health issue. Our attitudes toward menstruation mirror our discomfort with seasonality and change, death and renewal. It’s underpinned by centuries of shame and taboo, fear and reverence, misunderstanding and symbolism.

No wonder they call it “The Curse.”

Yet, I believe the curse can be broken.

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Conspiracy of Hope

Conspiracy of Hope

The Truth About Breast Cancer Screening
edition:eBook
also available: Paperback
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Dissident Doctor

Dissident Doctor

Catching Babies and Challenging the Medical Status Quo
edition:Hardcover
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