The Atlantic recently published an article titled “Women Don’t Need to Have Periods” by Alana Massey. Upon seeing it, my attention was immediately piqued. Having a period—or menstruation—is such an integral part of the female biology. Could it be possible that such a thing can be so simply put in the category of “unnecessary”?
Massey explains that while it may seem strange or unnatural, there is no medical reason why women need to have their periods. In particular, she notes, periods can be safely suppressed though the use of an intrauterine device (IUD)–a small, T-shaped plastic device inserted into the uterus—or other hormonal contraceptives such as the birth control pill.
Massey argues that, should a woman suffer from painful periods or heavy bleeding, not having a period would be life-changing. She shares that her last period was more than three years ago, and she has never felt better about not having to deal with that monthly inconvenience:
“And because I want to champion women’s choices rather than limit them, I won’t suggest that those who feel like radiant goddesses when they’re united in blood should eliminate their periods,” Massey states. “But I’d like to remind people of another word commonly associated with women’s monthly bleeding: The Curse. I’ll take unnatural over hexed any day of the month.”
This is a tough situation. Massey has a point: Monthly bleeding can be inconvenient, and symptoms associated with menstruation can certainly be uncomfortable. It’s natural to want to avoid discomfort. For women with painful periods, many would agree that it does feel like a “curse.” But I think her argument is missing a larger concern: Quick fixes are never as good as addressing the root problem.
The Underlying Cause
If you have abnormal periods, including heavy or painful bleeding, it could be that you have a medical condition, and an IUD or hormonal contraceptive will not heal that underlying condition. They only mask or treat the symptoms.
For example, some women who have painful periods may have a condition called endometriosis.
According to the Oxford Journal of Human Reproduction, endometriosis is the growth of endometrial tissue outside of the uterus, typically throughout the abdomen in areas including the fallopian tubes, ovaries, bladder, and bowels. The most common and debilitating symptom of endometriosis is pelvic pain. This chronic condition can lead to internal adhesions and contributes to infertility.
The Reproductive Science journal states that about 10 percent of all women of reproductive age have this disorder, which equals about 176 million women throughout the world.
And no one really knows how to treat it.
“It’s a difficult thing to manage because we don’t know what causes it,” says Dr. Amina White, an OB-GYN at Reply OB-GYN & Fertility in Cary, North Carolina. “We don’t even understand why it forms.” IUDs and other hormonal contraceptives do not cure it.
There Is No Quick Fix
If you have painful periods, it can certainly be a relief to ease that pain. But the conversation should not stop there. Should we be satisfied with treatments that relieve some symptoms but give us no hope of actually curing our problem?
Despite Massey’s claims to the contrary, those of us who don’t necessarily agree with her on this topic aren’t just trying to celebrate our blood and frolic around as “radiant goddesses.” In promoting various contraceptives to mask symptoms of painful or heavy bleeding, we’re promoting a Band-Aid solution to a serious health issue. For a condition so rife with stigma and misdiagnoses, this is unacceptable.
For example, in 2011 researchers from the World Endometriosis Research Foundation found that women with endometriosis experienced an average delay of seven years from symptom onset until they were finally diagnosed and treated.
Menstruation and subsequent fertility are huge—life-altering—concerns for women (and their partners). The same due diligence should be applied to research in this field as it would be in any other. Some of us want a real cure for a real disorder. Chalking up these desires as part of a silly, feminist ideal is condescending.
“There is much we still don’t understand about women’s reproductive health and infertility,” says Dr. Elizabeth Jensen, Ph.D., reproductive and perinatal epidemiologist and assistant professor at the Wake Forest School of Medicine. “For example, why some women experience endometriosis or why some couples experience infertility.”
Jensen continues, “But we have a personal responsibility as researchers and clinicians to work toward an improved understanding of the factors contributing to these issues. Women, and their partners, also deserve the opportunity to become more engaged in their own health and health care.”
Another Way . . . a More Natural Way
Thankfully, there is an increasing number of health professionals who are focused on addressing the root causes of conditions such as painful periods—without the use of fertility-suppressing drugs or devices (challenging as that may be). Particularly, many who practice cooperative-restorative reproductive medicine (including NaProTechnology, based on fertility awareness) and naturopathic medicine strongly believe in the power of using the period as a monthly report card for your overall health.
Dr. Lara Briden, ND, a naturopathic doctor practicing in Sydney, Australia, explains, “A real period is the end result of a series of important hormonal events including ovulation and the production of estrogen and progesterone. To speak of the bleed without mentioning hormones is nonsensical to me.”
With endometriosis, Briden believes that the condition may go beyond hormonal imbalance to an immune reaction. “There’s growing evidence that endometriosis is an autoimmune disorder,” she says. “It’s aggravated by estrogen but not caused by estrogen, as far as we know.”
Briden recommends asking your doctor about an anti-inflammatory diet. She also recommends certain supplements that promote hormonal balance. These include turmeric, berberine, selenium, zinc, and natural progesterone. She says that if the endometriosis is severe enough and requires surgery, these diet and lifestyle changes help significantly reduce the chance of recurrence in her patients.
Women who chart the daily signs of their fertility (cervical fluid, for example) know if and when they ovulate. Their providers can tailor their approach based on an individual woman’s cycles using the protocols of NaProTechnology. Mary Chiu, a 37-year-old woman from Houston, Texas, with endometriosis, was amazed by the results of targeted progesterone supplements on certain days after ovulation in each cycle:
“There’s a big difference between looking at our reproductive health as broken versus off-balance. My doctor isn’t leaving me alone. Every month, I’m getting instruction, feedback, and next steps. It would be so easy just to say ‘try IVF’ instead.”
In August, exploratory laparoscopic surgery confirmed Chiu’s diagnosis of stage IV endometriosis. She will have surgery to remove the tissue sometime in the coming months. Afterward, she says she will continue to stick to a strict anti-inflammatory diet.
Additionally, the work of members in the growing International Institute for Restorative Reproductive Medicine provides some hope. This organization of clinicians and researchers is committed to finding ways to correct reproductive abnormalities for conditions such as endometriosis, rather than suppressing, destroying, or bypassing normal function. The mission statement describes some of the benefits of this restorative approach:
“This approach inherently centers on the patient, who becomes an integral part of the care team as they observe and record how their bodies respond. The result is an empowered patient who is able to communicate and [who] understands their condition and any necessary treatments.”
As these and other providers continue to focus more on corrective rather than symptom-masking and fertility-suppressing treatments, perhaps we will continue to get closer to the root of the problem for these women.
Continue the Conversation
We need a better way to get rid of our painful periods other than simply shutting them down. Conditions such as endometriosis are particularly hard to treat, and there is much more research needed. We need more research on holistic approaches. We need more education on how to incorporate diet, supplements, and targeted hormonal treatment based on charting through fertility awareness.
However, none of this investigative work is possible if we continue to accept IUDs and other hormonal contraceptives as the first lines of treatment. There are clues within women’s physiology that, if both women and their doctors are trained to observe them, can help point the way toward true healing. We shouldn’t continue to shroud our menstrual cycles and any abnormalities in mystery.
Women, let’s not settle for these short-term, fertility-suppressing solutions. We know that IUDs and other hormonal contraceptives are not a real cure for a real medical problem. We deserve to be healed, not to be put on a one-size-fits-all, powerful hormone regimen and then whisked out the door. It’s up to us to seek answers beyond the temporary fixes lauded by society. Many of you already are doing so, and I am in awe of your tenacity.
Let’s continue to change the conversation—in popular culture, among our friends, and with our doctors. Let’s continue to empower and educate ourselves. We deserve it.
Nancy DeMaria, MPH, is a maternal and child health consultant from the UNC-Chapel Hill Gillings School of Global Public Health. She lives in Durham, North Carolina, where she is developing a new podcast called Rediscover Fertility.