The menstrual cycle as ‘matter out of place’ within medicine

21 June 2016.

This is the third of three blog posts (post 1, post 2) looking at how the menstruation taboo can undermine the diagnosis of various health issues. This post focuses on the way in which notions about the ‘dangerous’ nature of menstruation have led to a gap in medical knowledge, and research, on the role of the menstrual cycle in ill health.

Mary Douglas’ fantastic book, ‘Purity and Danger; An Analysis of Concepts of Pollution and Taboo’, describes how humans tend to assign symbolic meaning to nearly everything that we encounter, through a communal process of naming and classification. One of the strongest drivers of this categorisation process is to differentiate between things that are harmful, and things that are safe.

However, as Douglas points out, this compulsion can lead us to behave in some odd, and (quite literally) discriminatory ways.

How do you feel when you look at your dinner just before starting to eat? Now think about how you feel about exactly the same food when you are scraping the leftovers into the bin? How do you feel about brushing your hair, as opposed to pulling it out of the shower drain?

Yuk! But why?
Yuk! But why?

Neither of these examples (recently cooked food, or loose hair) are actually dangerous, but our sense of disgust is triggered because the object, or ‘matter’, has moved away from its socially-determined ‘safe’ context, category, or ‘place’. And so, this phenomenon is sometimes referred to as matter out of place.

menstrual_taboo

We now know that menstruation is a non-dangerous, non-infectious, non-injurious, non-life-threatening process of renewal, but still the menstruation taboo persists, even in the UK, even in 2016…

This shows the power of taboo, how fear and distrust can outweigh reason when it comes to categorising human experience, even in the modern ‘scientific’ age.

sarah_maple_menstruate_with_pride
‘Menstruate with pride’ by Sarah Maple, 2010. Note the expression on the little girl’s face… She has not yet learnt about the menstruation taboo.

It is possible that the taboo placed on menstruation has ‘contaminated’ our classification of the menstrual cycle, as a whole. I know from experience that when I mention my research on the menstrual cycle, most people directly equate this with menstruation, i.e. the bleeding part of the cycle, only.

medical_taboo

(*Please see the previous post about how this simplified definition of PMS can be misleading.)

So, even though we know that the menstrual cycle is a complex hormonal system, interacting with other hormonal responses (e.g. involving cortisol, adrenaline, serotonin etc.), and can trigger symptoms of ill health at various points during the cycle, this knowledge still seems somewhat overshadowed by the more visible, and perhaps shocking, part of the cycle- menstruation.

marksloanmdThis might explain why, despite the fact that ‘women of reproductive age’ are disproportionately affected by a range of health issues that all interact with the menstrual cycle (and hormonal medication), existing menstrual cycle research tends to be split across different specialisms, based on the main symptoms experienced, i.e. anxiety/ depression symptoms are dealt with by psychiatry; digestive symptoms are dealt with by gastroenterology; and migraine and fatigue symptoms are dealt with by neurology.

danger_sign

By promoting the use of a symptom diary, Menstrual Matters hopes to encourage patients and doctors to consider the menstrual cycle (and/ or hormonal medication) during diagnosis (especially for symptoms of anxiety, depression, Irritable Bowel Syndrome (IBS), migraine and chronic fatigue). We also hope to encourage specialist clinicians and researchers to share their knowledge and experience across thematic areas, by creating the world’s first platform consolidating research on the role of the menstrual cycle in ill health.

Perhaps the menstrual cycle will one day have a proper ‘place’ within medicine?


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