Birth Control's Effect on Menstruation

Holly 4In this exclusive extract from Holly Grigg-Spall’s book, “Sweetening the Pill: Or How We Got Hooked On Hormonal Birth Control” (the inspiration for a documentary project from Ricki Lake and Abby Epstein), the author, who is also our Fierce Woman of the Month, discusses the medical importance of healthy menstruation and reveals how a culture that denies the necessity of this bodily process has developed alongside the growing popularity of hormonal contraceptives.


Many women now only experience the fake period of the hormonal birth control-induced withdrawal bleed as a consequence of long-term use of the birth control pill or hormonal contaceptive devices from their teens onwards. As a result, it is just a small step to the situation we currently inhabit culturally in which not having a period at all is presented as preferential, both medically and socially.

At the release of the continuous oral contraceptive brands such as Seasonique and Lybrel medical practitioners argued that because for much of history women had spent their fertile lives pregnant or breastfeeding, menstruation is in fact biologically unnecessary and potentially dangerous. Their logic is that a functioning uterus and ovaries are more susceptible to going wrong than organs that are “switched off” by hormonal contraceptives.

Within our culture in which periods are generally presented as disgusting and unfeminine women cannot have an opinion on their own periods that is free from this cultural influence. Although some experience overbearing discomfort during menstruation, some do not, and others feel the benefits of experiencing menstruation equal to or outweighing the cramps and inconvenience. Of course this culture  plays its part in what women see as inconvenient and difficult. According to the medical industry we are all disabled by menstruation and the conversation is framed by this ideology.

This way of thinking emerges every few months in a spate of op-eds and news reports. It is given traction by Dr Elisimar M Coutinho’s “Is Menstruation Obsolete?Coutinho is an influential member of the World Health Organization. His research brought about the creation of the Depo Provera injection and implant, as well as other hormonal contraceptive methods. Coutinho’s coauthor on this book was Population Council Scientist Sheldon Segal. With the perpetually pregnant cave woman as their standard for what is natural and good for women and their bodies, they argue for menstrual suppression via pharmaceutical drugs.

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In an attempt to outwit any criticism in the preface it is written, “Some women have interpreted this book as an attack on menstruation and have resented the implication that there is something inherently wrong with the process.” Ignoring much of history to create their own falsified narrative the writers set up their thesis to be a counter a counter-attack to the prevalent belief that menstruation is “natural, normal and beneficial.” They set themselves up as radical proponents of women’s liberation from ignorance and primitivism, but they and their ideas are only products of a long history of misogyny-led medicine. The perpetually pregnant cave woman is the ideal and they argue that women must return to this state albeit artificially through medication.

On this Dr. Elizabeth Kissling writes, “Coutinho documents numerous menstrual maladies, such as premenstrual syndrome, anemia, endometriosis, dysmenorrhea, and menstrual migraine, combined with the anthropological inferences about the menstruation of our Paleolithic ancestors, and concludes “The attitude that menstruation is a ‘natural event’ and therefore beneficial to women in some way has no basis in scientific fact.” Note also that Paleolithic women did not engage in such “unnatural” practices as shaving their legs, having their pubic hair removed with hot wax, or deliberately starving themselves to conform to an idealized body type. These practices all carry health risks, yet contemporary American women are widely encouraged to practice all three.”


There are some, backed by the Society for Menstrual Cycle Research, who argue that menstruation is a sign of good health and should be treated as such. This was once standard medical practice, prior to hormonal contraceptives. Having periods is an indicator of healthiness on a par with blood pressure. In fact, a woman’s cycle ensures her blood pressure is naturally lowered in the second half of the month. Monitoring teenagers and young women’s cycles can ensure the early treatment of any arising health problems.

The Society for Menstrual Cycle Research presented a scientific forum to the New York Academy of Sciences proposing that the menstrual cycle be considered the fifth vital sign. “The menstrual cycle is a window into the general health and wellbeing of women, and not just a reproductive event,” said Dr Paula Hillard at this event, professor of obstetrics & gynecology and pediatrics at the University of Cincinnati College of Medicine. “It can indicate the status of bone health, heart disease, and ovarian failure, as well as long-term fertility.”


If you’d like to see more research done in regards to this topic, you have four more days to fund a Kickstarter campaign that is set to do so with the development of a documentary inspired by Holly’s book and supported by women’s health activists and filmmakers Ricki Lake and Abby Epstein.

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