By Sneha Rajaram
This is a picture of me in a nativity play, in the role of the angel Gabriel, telling the Virgin Mary that she’s pregnant but not to worry, it’s all good.
I wish I’d remembered this moment thirteen years later, when I didn’t get my period for a hundred days. Like Mary, I was a virgin, but, being of a neurotic disposition, I worried and worried that I might somehow be pregnant.
On the 100th day I resigned myself to my fate and visited a kindly old gynaecologist. After much beating around the bush, I shyly told her that it had been a hundred days, and waited for the pronouncement that an alien was growing in my body.
But she asked me a few questions, mainly about my health, PMS (premenstrual syndrome), and the length of my cycle. Then I had the reassuring experience of being told by a Catholic gynaecologist that I couldn’t possibly be pregnant if I wasn’t sexually active. She examined me, and as the angel Gabriel would have, told me to chill and not jump to any conclusions. She sent me off for an ultrasound, and when the result came back, she said I had polycystic ovary syndrome or PCOS.
That was eight years ago. Since then I’ve had several checkups, a couple of pregnancy scares, and dozens and dozens of awful premenstrual phases. I’ve cried nonstop for seven days every month. I’ve rolled into a ball and howled. I’ve felt the bottom drop out of my world. Then, the day I got my period, I’ve always been miraculously liberated. And I’ve wondered and wondered how a diagnosis of bipolar could accommodate the fact that most of my symptoms occurred in the ten days before my period.
Last year my psychiatrist called her gynaecologist and told her about me. This gynaec diagnosed me with premenstrual dysphoric disorder (PMDD), a severe form of PMS that’s associated with PCOS. I told her I was afraid of taking oral contraceptives – the usual treatment for PCOS – because they weren’t recommended for women with a family history of breast cancer. But she prescribed one kind of birth control pill that wouldn’t affect that. It. Changed. My. Life.
Here’s what I learned from taking birth control for the last nine months:
1. Menstruation isn’t Necessary to Our Health
We don’t actually need periods at all. Most birth control pills have a 21/28 or 24/28 cycle, meaning that one takes the pill for 21 (or 24) days and then skips it for seven (or four) days, taking a placebo instead. Hormone withdrawal during the placebo phase induces a period. But this is only done so that the woman feels ‘normal’.
2. The ‘Period’ that Birth Control Creates isn’t Really a Period at All
It’s called a ‘withdrawal bleed’. Its sole purpose is to make us feel ‘natural’. As if it feels natural to any prepubescent girl to get her period for the first time. The world feeds women so many myths about our bodies that it’s hard to keep up – and one of them is that womanhood is inextricably linked to menstruation. Not only does this exclude transwomen from womanhood, but it also perpetuates the myth of the femininity – which, funnily enough, seems to be a male creation. And it works a bit like this:
Step 1: Tell women they gotta have periods else they ain’t women.
Step 2: Tell them they’re Venus figurines and repositories of fertility – in short, goddesses.
Step 3: Do yoni pooja. With a stone yoni and rituals. (God forbid that yoni pooja translate into actual cunnilingus on a real live woman.) And worship the blood that emerges miraculously from a temple idol’s yoni.
Step 4: Forbid women from entering temples while menstruating.
Step 5: Completely fail to notice the irony – to the extent that irony-deficient women have to take irony supplements if they bleed too much during their period.
Step 6: Read The Da Vinci Code and praise the male author for capturing the ‘sacred feminine’ in his book.
3. The Side Effects of Birth Control Pills are Scary. But they Could be Worth it
There are a bunch of side effects, none of them pleasant. The only one I would take seriously right now, that outweighs the unpleasantness of PMDD, is cancer. But I’m told the risk isn’t high enough right now, and maybe after a couple of years I will reconsider taking the pill I’m on right now. For the time being, I’m going with Wikipedia, who tells us that
It is generally accepted that the health risks of oral contraceptives are lower than those from pregnancy and birth, and “the health benefits of any method of contraception are far greater than any risks from the method”.
4. Big Pharma Thinks Women are Stupid
This is what my pill sheet looks like:
Note the numbers, because women can’t count to 28 by themselves. Note the arrows telling us that 8 comes after 7, 15 comes after 14, and 22 comes after 21. Note the pink – because women wouldn’t understand pills in any other colour. And note the four placebos in white – because we wouldn’t know how to just not take the pill for four days. And note the optional sticker on top that lets us match the pills to the days of the week, because otherwise we wouldn’t know what the day of the week was.
5. It Probably Really Works for PCOS
I haven’t had a scan since I started the pill. But a friend of mine tells me that after a while of being on the pill, the cysts on her ovaries disappeared. Enough said.
6. It Gives Women Choices
I’m not a blind believer in allopathy. I know that this isn’t a holistic approach to treating menstrual problems, and that all my symptoms will simply resurface if I stop taking the pill. But the minute I hear people tell me that it will wreck my reproductive system, even if they’re right, I can’t listen to that warning without politicizing it. What if I don’t want to use my reproductive system? What’s the big deal about a reproductive system in that case?
For many women, their reproductive system is important. It promises children in the future – and starting a family is one of their dreams. That’s great. But this is why I personally won’t be prioritizing my reproductive system over my mental health (since PMDD makes it an either-or for me):
Simone de Beauvoir, in her seminal feminist work The Second Sex, talks about how human females are a lot more bound to the work of perpetuating the species than human males are, in a society where humans are treated like individuals. She calls this “woman’s subordination to the species”:
[S]he is the most deeply alienated of all the female mammals, and she is the one that refuses this alienation the most violently; in no other [species] is the subordination of the organism to the reproductive function more imperious nor accepted with greater difficulty. Crises of puberty and of the menopause, monthly “curse,” long and often troubled pregnancy, illnesses, and accidents are characteristic of the human female: her destiny appears even more fraught the more she rebels against it by affirming herself as an individual. The male, by comparison, is infinitely more privileged: his genital life does not thwart his personal existence; it unfolds seamlessly, without crises and generally without accident.
(Pssst: Read more on de Beauvoir’s ideas about women’s enslavement to the species here.)
This was written in 1949, but recent research has proved de Beauvoir right. Human menstruation (and that of a few other mammals like certain primates and rodents) is different from the oestrous cycle that some mammals go through – and human pregnancy is much harder on the female body than most other mammalian pregnancies. Suzanne Sadedin, PhD in theoretical evolutionary biology from Monash University, tells us that human menstruation is “a shameful waste of nutrients, disabling, and a dead giveaway to any nearby predators.” So how did we evolve to have such maladaptive reproductive lives?
Sadedin says that it’s because us pregnant humans (and a few other mammals) have a type of placenta called a hemochorial placenta, that puts the foetus’ needs over the mother’s. What does that mean? Sadedin explains:
[T]he growing fetus now has direct, unrestricted access to its mother’s blood supply. It can manufacture hormones and use them to manipulate her. It can, for instance, increase her blood sugar, dilate her arteries, and inflate her blood pressure to provide itself with more nutrients. And it does. Some fetal cells find their way through the placenta and into the mother’s bloodstream. They will grow in her blood and organs, and even in her brain, for the rest of her life, making her a genetic chimera.
In a species like ours, where many cultures put pressure on both men and women to be individuals with individual lives full of achievements, activities and acquisitions, it’s definitely hypocritical (and oppressive) to expect a woman to also have a menstrual cycle and a reproductive life if she doesn’t want to. If oral contraception can free us from this mandate and give us choices, then it could possibly be one of the most feminist things around.
Image credit: ‘Nativity Scene’ courtesy Sneha Rajaram, “Birth Control Pills” by lookcatalog via Flickr by CC/2.0