Red Tent Sisters

I’ve been using the DivaCup for over 3 years now and I certainly don’t need to be convinced of its many virtues. However, my recent trip to Costa Rica gave me one more reason to love my reusable cup.

I arrived in San Jose on day two of my period. Having recently gone off the pill, my flow was particularly heavy. Unfortunately, there were no bathrooms except for the public washroom in the bus terminal which charged 250 colonnes (about 50 cents). Having arrived with $50 US bills (the banks in Toronto didn’t take into account that these would be rather useless in a third world country where the average meal is less than $4), I was out of luck. I was going to see if I get some change from the ticket booth operator, but our bus arrived before I got the chance. The bus didn’t have a washroom, which would have been fine except the trip was about 4 hours and we didn’t stop once! We finally got onto the ferry, which thankfully had a toilet (that you didn’t have to pay for!) I was grateful that I wasn’t wearing a tampon, since I would have had to worry about toxic shock. Not to mention you aren’t allowed to flush anything (including toilet paper) in Costa Rica because their septic system can’t handle it. While I’m not concerned with hiding my menses, I’m not sure anything else needed to be added to the overflowing garbage bin (don’t get me started on the smell . . .)

Considering I spent the entire week in my bathing suit, I was grateful I didn’t have to wear a pad, nor did I have to scrounge up change to use the bathroom every couple of hours. While I could have done without the cramps on my travels, the Divacup made my period a minor inconvenience, rather than a disaster.

* There are over 100 strains of HPV, 35 of which affect reproductive/genital organs. Some of these 35 are high-risk, which means that, if persistent, they can cause cervical cancer in women. Some are low-risk, which means they are less frequently associated with cancer, but can cause genital warts (which can be treated much like warts on other parts of the body). With a healthy immune system and low risk factors, most women’s bodies fight the infection and eliminate it within 9 to 13 months of contraction.

* Most women with HPV do not contract cervical cancer. Most fatal incidents of cervical cancer affect poor women, women with compromised immune systems, and women who face structural inequities and oppression such as racism, colonialism, and violence in their lives. About 0.002% of the female population – around 400 women – dies of cervical cancer in Canada per year. Death rates are higher in parts of the world where Pap screening is unavailable and where poverty and poor nutrition are prevalent issues.

* Gardasil is the first HPV vaccine approved for use in North America. It prevents infection from strains 6 and 11, which can cause genital warts, and from strains 16 and 18, which can cause cervical cancer. These strains are responsible for 70% of cervical cancer cases. The vaccine does not protect against other types of HPV which account for the final 30% of cervical cancer cases. The vaccine is a preventative measure; it does not cure cancer or warts associated with HPV.

* The vaccine costs about $405 per woman/girl and is a three-injection process. [The vaccine is injected in a girl’s/woman’s arm at two months and six months after the initial injection. It is covered by private health plans, which, of course, is only helpful for women/girls with access to a private health plan.]

* There is some discussion of covering the vaccine through the Canadian health plan, and some suggest that there is not enough evidence that this vaccine is effective/necessary enough to justify the cost to the system. The women’s health network suggests that providing budgetary funding to ensure that all women receive regular Pap tests would be a much better use of funds. This is because cervical cancer is considered 90% preventable with screening and treatment through Pap smears. Also, the vaccine does not eliminate the need for Pap tests because it doesn’t prevent all strains of HPV and does not cure HPV if a woman is already infected at the time of injection.

* The HPV vaccine does not replace the need for safer sex techniques; a woman’s chances of contracting cervical cancer increase with multiple sex partners and earlier initiation of sex. Women who have sex with women are sometimes considered to be not at risk for HPV, but this is a false assumption.

* In Canada, the vaccine is recommended for girls 9-26, particularly for those who have not yet had skin to skin sexual contact, i.e., have not yet had the possibility of being exposed to HPV. [However, women who have had sexual contact can still opt for the vaccine]. There are fewer studies of the effects of the vaccine on the younger age category, so there is some concern about the effects on younger girls. There are also concerns that the long-term effects are not yet clear enough, particularly for young girls.

The above information, except for the square brackets […] which contain my own input, was collected and then paraphrased from the following source: The Canadian Women’s Health Network. “Gardasil: What you need to know about the HPV vaccine. Pap tests still the best tool in preventing cervical cancer.” by Women and Health Protection and the Canadian Women's Health Network, with assistance from Judy Norsigian, Alicia Priest, and Robin Barnett. http://www.cwhn.ca/resources/cwhn/hpv.html

A side of the debate that I’m particularly interested in is the ‘moral panic’ side. Some people are suggesting that providing the vaccine for girls as young as 9 in Canada (and the US recommends routine vaccination for girls at ages 11 and 12) would encourage promiscuity and give girls this age ‘permission’ to have sex at an early age and with multiple partners. However, Gardasil and health care providers recommending it don’t make a claim that the vaccine replaces safer-sex practices, and, to my knowledge, there is no evidence that vaccination is associated with girls’ decisions to become sexually active, to have multiple sex partners, or to discontinue use of safer-sex practices.

At a grad student conference that I attended last spring, a colleague raised the question that since the vaccine addresses HPV, which can cause, but is not the same as, cervical cancer, why is there not a similar initiative to provide routine vaccinations to boys as well, since boys can/do spread HPV? Certainly boys will not contract cervical cancer as a result of HPV, but is there a kind of policing/controlling of female bodies going on when boys are not held equally responsible for the spread of the virus? This follows a tradition of placing the burden of responsibility for birth control and safer-sex practices on women and girls, as well as a social attitude that women/girls can’t demand the same kind of conscientiousness about safe sex from their male partners that they are supposed/expected to have themselves.

There are so many sides to the debate: the issue of long-term effects/insufficient studies (although the vaccine has been approved); the cost of the vaccine and whether it should be paid for by the Canadian health plan when there is perhaps insufficient evidence that the vaccine is more effective in the prevention of cervical cancer – which effects few Canadian women fatally – than regular Pap screening is. This issue is inflamed by the fact that the vaccine does not replace Pap screening, and that, as it is, not all women even have access to regular Pap tests. However, I also find the suggestion a little questionable that, essentially, not enough women are dying to justify the allocation of federal funds (although certainly I understand the point that there are few health funds already, and that putting them toward Gardasil might not be the best way to spend what little we have). Further, while privately distributed, the cost of the vaccine is prohibitive for poor women who are more likely to die from cervical cancer. There are also the social and ‘moral’ concerns about female sexuality: from the Right that vaccination would increase sexual promiscuity among girls, and from the Left that vaccination represents more control of women’s/girl’s bodies. And certainly the debate is larger than these already tangled issues; the HPV vaccine is currently a contentious and complex debate. The decision to be vaccinated (or not) is a personal one to be made by individual girls/women in consultation with a trusted health-care provider.

During my first week in South Korea I attended an orientation session on "how to teach conversational English and how to adapt to Korean culture". During one class the facilitator was showing us how to use a word search engine ... enter a word and words that are most often used with the first word will appear. For example, enter smile and whimsical, wry, happy etc. comes up. After some group work the facilitator said "I looked up woman and it's not the greatest corresponding words but look up here on the screen and you can see what came up", and he rattled off a few words. Turns out that menstruating was one of the words ... not surprising since a large part of the female population, especially those people commonly referred to as women, are menstruators. An outgoing, very loud young woman a few rows behind me said "ewww gross". EXCUSE ME??!! Not as loud as her but loud enough that others around me could hear I said "all women do it, why is it gross?!" Still in shock and still shaking my head I sarcastically said to my pair of female table mates "I'm menstruating - does that make me gross? Should i go to my room and stay there?" Saying that makes obvious how ridiculous the first woman's comment was. The funny/interesting/unfortunate thing is that probably more people had a reaction like hers rather than a reaction like mine. Sheesh. Cheers, E.

I’m writing this blog entry on a flight between Toronto and Seoul and it’s in response to something I just read. My friend bought me some trashy magazines featuring the latest exploits of Hollywood stars for something to peruse when my brain went mush from too much sitting and not enough sleep ... a point in time somewhere between the 8th and 12th hour of the flight! Magazines like Star and In Touch are not my usual reading material - among other things I think these magazines are incredibly invasive of people’s lives - but I was very touched that my friend would send me off with a care package and so on route I decided to crack the covers of the magazines. Here’s my commentary about Britney Spears, motherhood and the social web we weave - the web that we make and that also makes us.

When I was walking through the airport terminal a magazine’s cover story caught my eye; supposedly Britney Spears doesn’t want her boys back. Low and behold Britney was also the cover story for the In Touch magazine my friend bought me. Word on the street is that Britney doesn’t want to have custody of her boys right now and has said that once she is well she doesn’t plan on fighting Kevin [her ex-husband and father of her boys] for custody. The magazine pretty much takes these statements and paints a demonizing image of her - HOW COULD SHE NOT WANT HER BOYS BACK??!!!!

The point of this blog is not to focus more attention on Britney Spears. I think she deserves a break from being trashed, evaluated, scrutinized etc. The reason I brought up Britney was because I wanted to use her story to illuminate a social phenomenon. Overall, in the current North American socio-political context it is expected that women want to become mothers; that they are unhappy and unfilled if they can’t or choose not to become mothers; that anyone who is a mother instinctually feels drawn to be a “good” mother; and that xy and z are what make a “good” mother. Women who don’t live up to the “good” mother standard or who don’t want to be mothers, or who are happy being the secondary rather than the primary caregiver of their child[ren] tend to be thought of as “off”, unwell, not normal or in Britney’s case, sick.

Britney may very well be sick but isn’t that all the more reason to be congratulating her for knowing her boundaries and that she is unable to be the primary caregiver for her boys instead of demonizing her for - heaven forbid - not wanting her boys back ... Which in the current social context is taken as meaning “I don’t care what happens to my boys” instead of “I am prepared to be the secondary caregiver. Or I am happy/happier being the secondary caregiver”.

I think “the Britney” situation points out just how much we still associate womanhood with mothering and mothering with selfless unending devotion. The fact that Britney supposedly doesn’t want her boys back is an easy way for the magazines to grab people’s attention. This is the case because news of any woman - any mother - not being fully committed to being a mother is newsworthy. Britney’s supposed “confession” has the power to shock us and it is in examining why her statement shocks us that we can learn more about the society we live in and assumptions about motherhood.

Cheers - e.

I am about to embark on a rather large trip … next week I am going to be flying to South Korea to begin a year long teaching contract. Luckily I have a few friends over there already. Recently I was talking on the phone with one of my friend’s mom and she was giving me advice on what to pack based on what she’s heard from her daughter. [Bare with me, this is getting around to something relevant to the store!!]

In a bubbly, extrovert’s voice she said “you won’t need to take a wide variety of work clothes, the women tend to wear almost a uniform of black pants or black skirt and a suit jacket, day in and day out.” “That’s great news” I said. “I was getting concerned about my luggage limit … packing for four seasons, and both work and play is challenging! I figure I’ll try to pack my smaller suitcase with clothes and my larger with the other ‘life’ stuff, like toiletries etc.”. In her booming voice she responded “they don’t have the same brands so if you have a favourite brand of shampoo then you might want to take it but ‘Suzy’ has found a bunch decent brands there … ooooh but they supposedly do have some familiar brands for face cleansers and other facial products … “. She paused momentarily and her voice suddenly dropped in volume “you might want to stock up on your favourite brand of tampons or pads because I don’t know what they have over there. They might have similar products but I don’t know and ‘Suzy’ didn’t say …”. Her voice rose again and she continued on with some other comments.

As she had started talking about menstrual products a response jumped into my mind, “oh I don’t have to worry about buying menstrual products because I use a Keeper”. The sentence ran through my mind and yet for some reason I didn’t say anything. It ran through my mind again, the moment was still there to say something … yet I still didn’t say anything besides “umm hmm”. Most likely she wouldn’t have known what a Keeper was and yet I didn’t make use of the opportunity to teach her about reusable menstrual products. The opportunity was there to let her know how much I love my Keeper and how awesome it’s been that I haven’t had to worry about buying menstrual products for the past 3 ½ years. I didn’t say anything AND THEN … the moment was past. We were onto other topics and I quickly felt a swift kick in my butt … from myself. WHY HADN’T I SAID ANYTHING!? Argh. That question plagued me after I hung up. Slightly neurotic? Perhaps! J But the fact that I hadn’t corrected her bothered me and it took me a while to start to unravel why.

First of all, I’ll explain why it bothered me. It bothered me because I don’t think menstruation should be a taboo topic yet I treated it like one. If she had said “your eyes are orange and your hair is purple” I would have said “ummm actually my eyes are blue and my hair is dark brown.” If she had said “I saw a pair of size 4 pants on sale at Smart Set” I would have said “too bad, I wear a size 10.” Yet when she said “you might want to consider stocking up on tampons and pads” I didn’t say “oh I don’t use those, I use a Keeper”. Recently my oh-so-insightful brother said “Ellen you’re trying to ignore taboos and do away with them but at the same time you’re aware that there are taboos and that by ignoring them, you are breaking them”. I know I am not alone in experiencing this quandary.

In her book, The Curse: Confronting the Last Unmentionable Taboo: Menstruation [1999] Karen Houppert [book available at the Red Tent Sisters!] writes:

I’ve become aware of the way I self-censor conversations about my work. When women ask me what I’m up to these days, I tell them I’m working on a book about menstruation and the culture of concealment surrounding it …. When men ask me the same question, I tell them that I’m writing a book. … Sometimes I catch myself – “How can you be writing a book about the hush surrounding menstruation and then perpetuate it?” – and make myself frankly describe the book. But the act requires conscious effort. [pages 240 -241]

Shortly after the phone call I told some friends about it. During our conversation two of my friends recounted recent “incidents” of their own that mirrored mine [interestingly all of our encounters were with individuals who were at least 20 years older than us]. All three of us are intelligent, well-spoken feminist educators who are passionate about issues of sexuality, gender, and women’s health, yet all three of us silenced ourselves through self-censorship. In my case, was I trying to avoid embarrassing my friend’s mom by talking about menstrual products in detail? Was I worried I would be embarrassed? Worried that perhaps she would think I was weird? Was I afraid that I would unleash a torrent of information about how horrid I think disposable menstrual products are, perhaps offending her in the process!!?

While I don’t have any firm answers I think that it has been useful to reflect on why my “lie of omission” occurred and why it bothered/bothers me so much. For example, simply by sharing my story with my friends new conversational terrain was opened up and I found out that I am not alone in self-censoring. Nor am I alone in feeling the regret it inspires and the sense of bewilderment why I/we would not speak up and out about issues important to me/us. Most of the time when I speak the space between thinking and speaking tends to be very small – sometimes this gets me in trouble! Ha ha. However, every once in a while, like in the scenario outlined above, I become conscious that my thoughts have hit a filter and I have to make a split second decision. Do I say what my initial and true response is, or do I alter it to make it more socially acceptable? Altering often takes the shape of omitting key details – details that I share loudly and proudly in other situations. Reflecting on incidents of self-censorship can be useful as it helps prepare me to be more true to myself, my priorities and my passions the next time a split second decision – honesty or censorship? – comes along.

Ok, “alternative-menstrual-products-discussion-opportunity” … where are ya? I’m ready and waiting!! E.

Labels: Censorship, Menstrual Cups, Menstrual Products, Menstruation, The Keeper

In a recent edition of a women’s magazine I came across this advertisement. It immediately grabbed my attention because of the birth control pack at the top … here are a few of my thoughts.

My first reaction was that it both creates and responds to the current socio-political context in North America where women’s ability to reproduce has been medicalized. The pill pack represents attempts to medically control fertility and the supplement bottle represents the increasing medicalization of getting and being pregnant.

It is also an example of how intertwined the processes of medicalization and commercialization are; in other words the extent to which “health” has become something we achieve through commodities.

Lastly, the advertisement “works” because of the normalization of the birth control pill. [And let’s not forget that, although the ad features a generic birth control pill package, there are actually many, many types of birth control pills.] If only a few women were on the pill[s] then the advertisement would be a waste – it would be speaking to a very small target audience. Because a lot of females are on the pill[s] the advertisement speaks to a large audience. If women aren’t on the pill[s] themselves they probably know other females who are and as a result the ad is most likely interpreted as addressing the “normal” female population.

Interestingly the advertisement does hint at the fact that women who come off of the pill[s] may need some assistance to be “healthy” pregnant women. However, because the photo on the label features a woman with a baby the ad doesn’t address the fact that some [many?] women have difficulty conceiving or at least have difficulty regulating their menstrual cycles after they have been on the pill[s].

That’s all for now … E.

The Globe & Mail's Article: Red Flag for Birth Control Patch

http://www.theglobeandmail.com/servlet/story/RTGAM.20080109.wlpatch09/BNStory/specialScienceandHealth/home

My first reaction to reading this article is let’s use the precautionary principle! I have concerns about the long term safety of using any hormonal contraceptive however, I realize that for many young women it is [or at least appears to be] the best option [of a series of bad options]. My concerns are reinforced by the article in which it’s written that “it's well known by the medical community that any hormone-based birth-control method can increase a woman's chances of blood clots, heart attack, stroke and other health problems”. What I learned from the article was that different types of hormonal birth control are cause for differing levels of concern. In fact “the FDA revealed in 2005 that the patch sold in the United States exposes women to 60 per cent more estrogen than birth-control pills do”. There is concern within the environmental cancer movement about the role elevated levels of estrogen plays in various forms of cancer.

Two sentences in particular jumped out at me when I read the article. First of all, the statement that “Janssen-Ortho issued a statement defending the safety of the patch, adding that all hormone-based contraceptive methods could cause health problems” made me cackle. Defending your product because all the products in your field [can] cause health problems is not the way to get my money! Secondly, a woman who got two blood clots in her lungs because of being on the patch said “‘if I had known [the potential risks], I would have had second thoughts,”’. The question is, would she have? We often know the potential risks of using pharmaceutical products [who hasn’t seen those ad’s with a list of potential side effects as long as the commercial itself, or the sheet from Shoppers Drug Mart about the 50 potential side effects of the drug prescribed] and perhaps like this woman said she would, we have second thoughts. Yet so often we plunge ahead anyway because while we don’t like the option presented to us we don’t see any other viable option.

Regarding the birth control patch or even the pill for that matter, we do have another option. This past Saturday I went to Amy’s introductory session about Fertility Awareness Methods [FAM]. Prior to the session “the Rhythm Method” was the only natural form of contraception I knew about and I really only vaguely knew about it; although I knew enough to know that it was considered to be not that reliable. On Saturday I learned about the difference between natural forms of contraception [including but not limited to retrospective methods like the Rhythm Method] and direct observation methods – of which the Justisse Method is one way to learn. While direct observation methods can be used for contraceptive or conception purposes I am not in the market for either; yet I am fascinated by the body literacy one learns through direct observation methods. Did you know that by becoming more intimate with one’s reproductive system and learning how to read its clues you can learn about food intolerances, vitamin deficiencies and overall health?! Whether you decide to rely on the Justisse approach exclusively or not, it is an amazing tool for learning how to work with your body. And regardless of where you are in your relationship with your reproductive system direct observation of your body [from a perspective of awe and respect] can only improve your health. As for helping myself along to my next stage of awareness I bough Justisse’s recently published [and inexpensive!] manual about coming off the pill – something I did long ago but the effects of which, I believe, are still felt by my body.

By Ellen Macro, Red Tent Sister Blogger

Labels: Birth Control, Contraception, Fertility Awareness, Justisse, Patches, Pills