Speaker 1: Hi, I'm Aaron Welsh and this is This Podcast Will
Speaker 1: Kill You. Welcome everyone to the latest installment in this
Speaker 1: season's book Club miniseries, where we get to read fascinating
Speaker 1: popular science books and then chat with the authors of
Speaker 1: the these amazing books. I have had so much fun
Speaker 1: so far talking about topics such as the origins of sars,
Speaker 1: Covy two, why we should appreciate sweat more, and most recently,
Speaker 1: the disturbing persistence of race science in biological and medical
Speaker 1: research today. And we have got so many more exciting
Speaker 1: books on our schedule over these next few months to
Speaker 1: keep you informed and entertained. We'd also love to hear
Speaker 1: from you about how you're liking these book Club episodes,
Speaker 1: what lingering questions you have that we didn't cover, and
Speaker 1: if there are any books that you'd like to add
Speaker 1: to the list. Just send us a message through our
Speaker 1: contact ust form on our website This Podcast will Kill
Speaker 1: You dot com, or through our email This Podcast will
Speaker 1: Kill You at gmail dot com. All right, podcast business over. Now,
Speaker 1: let's get to what we're going to be talking about today,
Speaker 1: and that is menstruation. Despite the fact that about half
Speaker 1: of the people on this planet have menstruated or will
Speaker 1: menstruate at some point in their lives, and that, as
Speaker 1: UNICEF tells me, one point eight billion people across the
Speaker 1: world menstruate each month. There remains an aura of mystery
Speaker 1: surrounding this completely natural biological function. Conversations about periods, about
Speaker 1: flow duration, cramping, color, or consistency of discharge, they take
Speaker 1: place in hushed tones. Tampons or pads or panteliners are
Speaker 1: passed surreptitiously like sleight of hand style. TV commercials advertising
Speaker 1: menstrual products somehow managed to not mention periods or menstruation
Speaker 1: at all, and instead show people pouring a mysterious blue
Speaker 1: liquid distinctly not menstrual blood, onto various pads or in
Speaker 1: a beaker where it's absorbed by a tampon. The list
Speaker 1: of euphemisms for periods is seemingly never end, and I
Speaker 1: bet you can think of at least three or four
Speaker 1: right off the top of your head that time of
Speaker 1: the month, aunt flow on the rag. These were just
Speaker 1: the first three that popped into my head. And if
Speaker 1: someone does dare to speak openly about menstruation, they are
Speaker 1: often told that they are gross, that periods are disgusting
Speaker 1: and don't make for polite conversation. This widespread shame regarding
Speaker 1: periods so often leads to silence, a silence which serves
Speaker 1: only those who actively want to exert control over menstruators,
Speaker 1: who want to take away their bodily autonomy, and in
Speaker 1: a recently proposed bill in Florida, this silence would be
Speaker 1: legally enforced, with children and their teachers forbidden from talking
Speaker 1: about menstruation in school until sixth grade, at which point
Speaker 1: many of these children would have already started having periods.
Speaker 1: In period The Real Story of Menstruation, published just last week,
Speaker 1: author doctor Kate Clancy, explores the complex origins of these
Speaker 1: attitudes to menstruation and considers their role in the perpetuation
Speaker 1: of period myths, menstruation taboos, and widespread myths and disinformation
Speaker 1: that reveals that what little science does know about periods
Speaker 1: is often less than correct. Doctor Clancy, who is a
Speaker 1: professor of anthropology at the University of Illinois at Urbana
Speaker 1: Champaigne and has worked extensively on the issue of pervasive
Speaker 1: sexual harassment and higher education, presents a compassionate, clear and
Speaker 1: thoughtful examination of menstruation that is at once informative and inspiring.
Speaker 1: Informative for the thorough debunking of long standing period myths
Speaker 1: and clear explanation of biological processes, and inspiring for demonstrating
Speaker 1: that knowledge is power, that knowing the sources of and
Speaker 1: reasons for shame and disinformation is a crucial part of
Speaker 1: imagining a better period future. Doctor Clancy joins me on
Speaker 1: this bonus episode to discuss a bit about these period futures,
Speaker 1: the inspiration behind her book Period, some of the ways
Speaker 1: that different cultures vary in their perceptions of periods, why
Speaker 1: the concept of a quote unquote normal period is both
Speaker 1: untrue and can be harmful, but the sars kvy two
Speaker 1: vaccine revealed about scientific attitudes towards periods, some of the
Speaker 1: different hypotheses for why human's mens street, and so so
Speaker 1: much more. Period is sure to become an instant favorite
Speaker 1: among listeners, and as a longtime admirer of doctor Clancy,
Speaker 1: who has kicked myself for never taking one of her
Speaker 1: classes while I was at the University of Illinois, I
Speaker 1: am so excited for today's episode. If you can already
Speaker 1: tell so On that note, let's get right to the
Speaker 1: interview after this shortbreak. Thank you so very much for
Speaker 1: being here. I was incredibly thrilled when I learned that
Speaker 1: you were writing a book about periods, and that excitement
Speaker 1: was totally justified because period the real story of menstruation,
Speaker 1: is absolutely fantastic. What made you decide to write a
Speaker 1: book about periods and why focus on the aspects you
Speaker 1: did well?
Speaker 2: First, Thank you so much. I'm so glad you liked it.
Speaker 2: That makes me really happy. I will say, it's been
Speaker 2: such an interesting process, going from the book idea to
Speaker 2: book proposal, through multiple drafts and now this finished product.
Speaker 2: And you know, what I want most of all is
Speaker 2: just for people to read it. You know, I hope
Speaker 2: it gets into some hands and that people will read it.
Speaker 2: So that's wonderful to hear. Part of the reason that
Speaker 2: I wanted to write a book about periods was that
Speaker 2: I really noticed a lot of menstrual stigma in my field.
Speaker 2: And when I would discuss menstruation or periods, there would
Speaker 2: be these interesting body language changes in the way I
Speaker 2: spoke to people. They would start to wrinkle their nose,
Speaker 2: that was the big one. They would start to lean back.
Speaker 2: There was a lot of just sort of changes that
Speaker 2: made me realize that even in a scientific context, we
Speaker 2: are often not ready to discuss it. And it's interesting
Speaker 2: to me because my field talks endlessly about menstrual cycles,
Speaker 2: and we have no problem talking about ovaries and eggs
Speaker 2: and estrogen and progesterone, but you start to talk about
Speaker 2: mensis and it suddenly becomes well, let's see if we
Speaker 2: can sort of scientifically talk our way around this being
Speaker 2: unnecessary or of no real consequence to the science of
Speaker 2: menstrual cycles. So I just, I mean, really, I just
Speaker 2: leaned into that.
Speaker 1: It's so interesting. And in your book you discuss how
Speaker 1: attitudes about menstruation in the US tend to be negative
Speaker 1: right falling along, you point out three axes, activity, and communication.
Speaker 1: What do each of these mean and what are some
Speaker 1: of the ultimate consequences of these negative attitudes?
Speaker 2: Sure, so concealment is, you know, around menstrual concealment. So
Speaker 2: we are taught very early on that for people to
Speaker 2: know we are menstruating or see that we are menstruating
Speaker 2: is shameful. And yet at the same time, there have
Speaker 2: been researchers who've looked at, you know, what are we
Speaker 2: actually taught about menstruation, particularly in the US. These are
Speaker 2: us focused studies, even though most of us are taught
Speaker 2: like what is a menstrual cycle? What is the uterus for?
Speaker 2: Like sort of the health class version menstrual management. So
Speaker 2: how to actually do that concealing is something we're not
Speaker 2: really taught. We're taught that tampons exist, that pads exist.
Speaker 2: Now we have cups and underwear and other options. But
Speaker 2: you know, I don't know. I mean, maybe you have
Speaker 2: a different experience, but my experience of health class was
Speaker 2: definitely not that my male health teacher, who was also
Speaker 2: the basketball coach, was going to be explaining tampon insertion
Speaker 2: to any of us. And yet research has shown that
Speaker 2: that is what people most desperately want to learn when
Speaker 2: it comes to actually learning about periods. So, on the
Speaker 2: one hand, there's all this enforced concealment, and there's this
Speaker 2: shame when we fail to conceal. On the other hand,
Speaker 2: because of the stigma, nobody talks to us about how
Speaker 2: to do that concealing. So, I mean, just imagine how
Speaker 2: many issues are wrapped up in that. Right. Then, in
Speaker 2: terms of activity, there are you know, there are sort
Speaker 2: of these long standing assumptions that during mensis you're more tired,
Speaker 2: or that you might want to withdraw from society or
Speaker 2: do less physical activity. Certainly, when I was younger, it
Speaker 2: was one of the ways you could get out of
Speaker 2: pe or physical education class was to tell your instructor
Speaker 2: you have your period. You know. On the one hand,
Speaker 2: you could see it as a nice thing because it's
Speaker 2: a way of honoring Hey, maybe my body's doing something
Speaker 2: a little different today, maybe it would be nice to rest.
Speaker 2: On the other hand, though, it also is a way
Speaker 2: of withdrawing from society, and so so sort of this
Speaker 2: issue of activity, I think is a big one because
Speaker 2: of the ways that since you're never telling anybody why
Speaker 2: you're doing it, you're just because we're not supposed to
Speaker 2: be talking about when we have our periods. It's sort
Speaker 2: of this secret thing that we just sort of like
Speaker 2: exempt ourselves from the world a little bit more around
Speaker 2: this time. And then again, communication kind of ties these
Speaker 2: all together, because issues of communication mean that even though
Speaker 2: we somehow get this vibe that we're supposed to be concealing,
Speaker 2: we're supposed to be removing ourselves. People aren't supposed to
Speaker 2: know that we have our period. The how and the
Speaker 2: practicalities of it completely escape us, which means many of
Speaker 2: us go through all sorts of rounds of not concealing
Speaker 2: mencies and having very embarrassing stories. You know, I bled
Speaker 2: through my clothes multiple times in middle school and high school,
Speaker 2: and I actually really enjoyed the solidarity of being supported
Speaker 2: by other menstruating people in those moments of people bopping
Speaker 2: shirts with me so I could wrap things around my waist,
Speaker 2: finding tampons or pads when I ran out. I actually
Speaker 2: think that we can notice the broader structural problems here
Speaker 2: while also appreciate that menstruating people have found some very
Speaker 2: clever ways to subvert or undercut these structural problems and
Speaker 2: still support each other.
Speaker 1: Absolutely. I have so many memories of middle school, just
Speaker 1: the horror of a tampon flying out of my backpack
Speaker 1: and like, oh no, someone's gonna see. And in retrospect
Speaker 1: it's like, okay, that's okay, but you don't learn that.
Speaker 1: Growing up, we.
Speaker 2: Watched an in cake movie. I don't know if you
Speaker 2: watched a movie, but when I was in fifth grade,
Speaker 2: so again i'm old. You know, I'm in my forties.
Speaker 2: But the movie we watched in fifth grade as part
Speaker 2: of our sex ed was These Girls were having a sleepover,
Speaker 2: and they were having they were in a tent out
Speaker 2: in the backyard, and one of the middle of the night,
Speaker 2: in the middle of the night, one of them gets
Speaker 2: up and goes inside and comes back and is kind
Speaker 2: of secretive about it. And then in the morning you
Speaker 2: find out one of them got her period. And then
Speaker 2: it's this whole educational thing where the mom is then
Speaker 2: teaching these three girls all about periods. And it's actually
Speaker 2: one of the only ones I've ever seen that even
Speaker 2: talks about like the quantity of menstrul blood or anything.
Speaker 2: So the really like, the really funny scene for me
Speaker 2: that I will just remember for the rest of my life,
Speaker 2: even though it's thirty plus years ago, is the moment
Speaker 2: she's holding up some pancake batter and she says, you know,
Speaker 2: a girl will menstruate about half a cup over the
Speaker 2: course of her period, and then she pours out the
Speaker 2: batter into the shape of the uterus and then starts explaining,
Speaker 2: you know, the functions of the uterus and menstruation on
Speaker 2: this pancake.
Speaker 1: Wow, that's one.
Speaker 2: Of my very strong memories from childhood, is just the
Speaker 2: uterus pancake and the menstrul blood batter That is amazing.
Speaker 1: I have to find that on YouTube and check that out.
Speaker 1: These negative attitudes or menstrual taboos, they're not universal across cultures,
Speaker 1: although it's a common misconception that they are. Why do
Speaker 1: you think this misconception is so common? And what do
Speaker 1: you think are the origins of this Western idea of
Speaker 1: menstruation as being unclean or shameful or something to hide.
Speaker 2: I mean, the main misconception is that who drives the
Speaker 2: majority of science in the world right now in terms
Speaker 2: of what gets the most attention and what dominates right So,
Speaker 2: Western science and Western medicine models and Western language are
Speaker 2: what dominate in science, even if that's not obviously the
Speaker 2: only way to think about westernness or Western science of
Speaker 2: any kind right is it doesn't have to all be
Speaker 2: English language, but in fact the majority of it is.
Speaker 2: So I think a lot of that universality misconception comes
Speaker 2: from the fact that Westerners, particularly white Westerners, and to
Speaker 2: center themselves and everything and just assume that we are
Speaker 2: the norm. To me, that's the biggest piece of it.
Speaker 2: I and that's very tied to settler colonialism. You know,
Speaker 2: the whole practice of settler colonialism is going in where
Speaker 2: people already live, pretending now that this stuff belongs to you,
Speaker 2: and then you know, extracting resources, committing genocide, taking over,
Speaker 2: and often there's you know, there's some cultural appropriation, but
Speaker 2: there's also a ton of cultural erasure, and that's a
Speaker 2: lot of colonialism is about dominance, and so it's not
Speaker 2: surprising then that, you know, we just come to assume
Speaker 2: that a lot of the cultural practices that occur in
Speaker 2: a lot of our societal contexts are universal. I think
Speaker 2: the other thing is that as our ideas of menstrual
Speaker 2: stigma and menstrual taboo have changed over time, I think
Speaker 2: there have been a lot of folks who have at
Speaker 2: first pushed for a more scientific understanding of periods and
Speaker 2: then have expressly tried to neutralize a lot of the
Speaker 2: language and even sometimes create a positive spin in thinking
Speaker 2: about menstruation. And as we've moved in that direction, it
Speaker 2: becomes very comforting to Westerners, again, especially white Westerners, to
Speaker 2: conceive of menstrual stigma as something in the past, or
Speaker 2: even to use really problematic language like this mus be
Speaker 2: a primitive way of thinking because we are modernizing it.
Speaker 2: And then that continues to reinforce this idea. Well, since
Speaker 2: this is in the past, I bet this is what
Speaker 2: happens to those other cultures that are less modern than ours.
Speaker 2: So I think there's a couple different things going on,
Speaker 2: where again, it's all about colonialism, and it's all about
Speaker 2: these ways in which we are just trying to believe
Speaker 2: that wherever we're at is the best place to be
Speaker 2: in the most sort of evolved or modern take on things.
Speaker 1: So, speaking of misconceptions, let's turn towards this idea of
Speaker 1: quote unquote normal periods. Why do we have this idea
Speaker 1: and why is it still often top maybe two separate questions,
Speaker 1: that a normal period comes every twenty eight days and
Speaker 1: you belied for four to five of them, and anything
Speaker 1: outside of that is too heavy or too light, or
Speaker 1: too long or too short. Why is it so important
Speaker 1: to discuss variability in periods or normal patterns rather than
Speaker 1: a normal period?
Speaker 2: Right, So, this concept of normality is actually one with
Speaker 2: a eugenic origin. And when we say it used to
Speaker 2: be that the term normal meant normal in terms of
Speaker 2: functional though. A normal kidney is a kidney that is
Speaker 2: functioning as it should be. A normal liver is one
Speaker 2: that is functioning in the way that it was intended, right,
Speaker 2: So again it was just a It just sort of
Speaker 2: meant functionality. It began to be co opted and thought
Speaker 2: of differently, in particular among people who liked to start
Speaker 2: to imagine some people are better than other people, or
Speaker 2: some processes are better than other processes. And so again,
Speaker 2: these concepts of normality came directly from people who had
Speaker 2: who believed in eugenics, promoted eugenics, wanted to believe that
Speaker 2: some people fell within a normal range or were statistically average,
Speaker 2: and that to be statistically average is the desired trait.
Speaker 2: And I think that's kind of it's kind of a
Speaker 2: weird concept, right, because in some ways we have these
Speaker 2: concepts of ideals, and we also have these concepts of average,
Speaker 2: But what happens really often is that they get really
Speaker 2: conflated and we start to see the average is ideal.
Speaker 2: How does that happen because when we create this idea
Speaker 2: of average, we only include some people in the calculation.
Speaker 2: So you know, if you're trying to figure out the
Speaker 2: ideal body type and you only include thin, white, able bodied,
Speaker 2: cisgender women between the ages of eighteen and twenty, you're
Speaker 2: going to get an average of that group. That then
Speaker 2: if you try to say that that's the average for everybody,
Speaker 2: is really not going to seem right at all. So
Speaker 2: that's how those things start to get conflated. So with
Speaker 2: the menstrual cycle, it's the same sort of an issue
Speaker 2: where the way that we've calculated or assessed normal and
Speaker 2: average has been from a very limited understanding of menstrual cycles.
Speaker 2: This idea that the best menstrual cycle to have is
Speaker 2: one that is twenty eight days long and always ovulates
Speaker 2: that it's really not the right notion. Menstrual cycles should vary.
Speaker 2: They should be really variable and long and largely in
Speaker 2: ovulatory when you're a teenager. Even in your twenties, they
Speaker 2: should still actually be the hormone should probably be on
Speaker 2: the lower side, and you're still going to have some
Speaker 2: n ovulations. Thirties are when the body really kind of
Speaker 2: hits its stride, and so like mid twenties to mid thirties,
Speaker 2: maybe even into late thirties, is when you're seeing something
Speaker 2: closest to what we often say is sort of the
Speaker 2: normal cycle. Even then, up to a third of the
Speaker 2: time you're not ovulating, so it doesn't look anything like
Speaker 2: the norm, and then things start to shift, you know,
Speaker 2: late thirties into forties, and as we head into menopause,
Speaker 2: we start to have a completely different range that you
Speaker 2: can see among completely healthy people. So again I use
Speaker 2: age as this one example, but there are so many
Speaker 2: other ways we can also sort of parse these different
Speaker 2: patterns and start to learn that this textbook that we
Speaker 2: keep being shown doesn't actually represent a whole lot of people.
Speaker 2: And in fact, when we look at menstrual cycles in
Speaker 2: our lab, it's really hard to ever find anybody who
Speaker 2: looks like that, even among people in our rural Polish
Speaker 2: population who've had twelve children, who clearly have no problem
Speaker 2: getting pregnant, superfertile, but their menstrual cycles don't look like that.
Speaker 1: So when scientists and researchers began to take a closer
Speaker 1: look at periods, you know, during the time when eugenics
Speaker 1: began to rise in popularity as well, it also resulted
Speaker 1: in many researchers proposing different hypotheses for the reasons humans menstruate,
Speaker 1: and those hypotheses have changed, and there have been new ones,
Speaker 1: and you know, other ones have gone out of out
Speaker 1: of style. Can you take us on a brief tour
Speaker 1: through some of these ideas about the evolution of menstruation,
Speaker 1: and do you think it's likely that there's a one
Speaker 1: size fits all hypothesis that will eventually come to light
Speaker 1: or do you think it's just going to be difficult
Speaker 1: because there are so many different drivers for the evolution
Speaker 1: and persistence of menstruation in humans.
Speaker 2: I kind of want to answer the second question first,
Speaker 2: which is that there is never going to be I
Speaker 2: don't think one perfect explanation for why menstruation evolved, and
Speaker 2: the reason for that is that there isn't really a
Speaker 2: good one for any trait that's evolved, and that there's
Speaker 2: a fundamental problem when we create incentive structures in science
Speaker 2: that require that we have, you know, the Clancy hypothesis
Speaker 2: or the whoever you know, like the reason that we
Speaker 2: have these ideas of the quote prime mover hypothesis so
Speaker 2: much in evolutionary biology is that people want to stake
Speaker 2: their professional claims on being the one who figured out
Speaker 2: the answer. But the reality is that most of these
Speaker 2: traits are operating under a number of different competing forces.
Speaker 2: So I'm going to give the punchline of where I
Speaker 2: of what I think is going on, which is that
Speaker 2: I think there are two main really three main hypotheses,
Speaker 2: all of which have some truth to them in terms
Speaker 2: of why humans, in particular killer menstruate as copiously as
Speaker 2: they do. We have Beverly Strassman's hypothesis on energy economy
Speaker 2: that came through in the nineteen nineties. I think what
Speaker 2: was really important about it is that, in addition to
Speaker 2: the fact that she did some work to discount a
Speaker 2: hypothesis i'll talk about in a minute, we also use
Speaker 2: it as an opportunity to say, you know, there is
Speaker 2: a lot of energy expenditure that goes into creating, so
Speaker 2: proliferating the lining of the uterus and then differentiating it.
Speaker 2: And that's like hundreds of calories. And so rather than
Speaker 2: maintaining that indefinitely for some possible implantation, really we should
Speaker 2: get rid of it when we don't need it and
Speaker 2: start over. So the energy explanation, I mean energetics rides
Speaker 2: through so much of evolution that I think it's it
Speaker 2: would be silly to say that that has absolutely no bearing.
Speaker 2: The next one is terminal differentiation, which is the one.
Speaker 2: This is Colin finn. This is the one people like
Speaker 2: the best. But I think again. Is one of really
Speaker 2: three great hypotheses that are all all valuable, and point
Speaker 2: is really just like a physiological inevitability one, which is
Speaker 2: that you know, if you're going to grow this endometrium,
Speaker 2: you're going to differentiate it into this particular set of cells,
Speaker 2: this particular structure that's great for implantation. It probably has
Speaker 2: an expiration date right most cells that once they differentiate.
Speaker 2: That's where that term terminal differentiation comes from. Once cells
Speaker 2: sort of get to a certain point, they can't really
Speaker 2: like back up and do something else. So once they've
Speaker 2: hit that point and you've kind of passed some receptive
Speaker 2: window by which it's maybe not going to be as
Speaker 2: effective for implantation to work, it makes sense for these
Speaker 2: cells to die so that you can kind of start
Speaker 2: over again. So that's where the terminal differentiation idea comes from.
Speaker 2: Once it differentiates, you know, if it's not used, we
Speaker 2: kind of have to just start over. The third one,
Speaker 2: which is a newer idea that I think is incredibly valuable,
Speaker 2: is from Brozens and others looking at what's called preconditioning,
Speaker 2: which is basically this idea that menstruation is practice when
Speaker 2: you grow and differentiate that endometrium. What you see is
Speaker 2: that the more and more you do it, the better
Speaker 2: those structures get, and potentially the more receptive the endometrium
Speaker 2: is for implantation, it means that the implantation process might
Speaker 2: go better. And we have some really interesting lines of
Speaker 2: evidence to support this, in particular around preeclamsia. So preeclamsia
Speaker 2: is a condition of pregnancy that is a hypertensive So
Speaker 2: it's a blood pressure disorder, and it's incredibly dangerous. It
Speaker 2: has killed many people, many pregnant people, and you know,
Speaker 2: as your heart, as your blood pressure starts to go up,
Speaker 2: really the only fix is to give birth, so it
Speaker 2: can lead to premature birth, and even then that may
Speaker 2: not be enough if you don't catch it early enough.
Speaker 2: And there we now do have some drugs that will
Speaker 2: help people survive preeclamsia. But I mean, if you're a
Speaker 2: down to an Abby fan, you know that one of
Speaker 2: the beloved sisters dies of a clampsia, which is the
Speaker 2: you know, the downstream version of preclamcy. So we know
Speaker 2: now that part of what causes preeclamsia is likely sort
Speaker 2: of not good enough invasion of the trophoblasts. So basically
Speaker 2: like the maternal fetal contact isn't quite as good. And
Speaker 2: increasingly we also know that one of the means by
Speaker 2: which preeclamsy is more common is in younger people, the
Speaker 2: people who have had fewer menstrual cycles, people for whom
Speaker 2: it's their first birth, you know, they haven't had a
Speaker 2: lot of implantations. There's other mechanisms too, but that's one
Speaker 2: of the really big ones is it's more common in
Speaker 2: sort of first timers and people who just tend to
Speaker 2: be on the younger side. There's also some evidence that
Speaker 2: people who are longtime contraceptive users who also have fewer
Speaker 2: periods that way, are also at slightly higher risk. So
Speaker 2: all of that said indicates that you know, when you
Speaker 2: remove menstruation as practice, you increase the risk for some
Speaker 2: of these pregnancy conditions. So to me, that's like a
Speaker 2: really compelling reason for preconditioning being a great explanation for
Speaker 2: why we menstrate is that we need it in order
Speaker 2: to build up the actual deellular architecture to make it
Speaker 2: an effective place for implantation to happen. There are so
Speaker 2: many people now who are starting to sort of move
Speaker 2: in that direction and try to understand the function of menstruation.
Speaker 2: Now that we understand that it actually has a purpose,
Speaker 2: I think, to me, the problem with the terminal differentiation
Speaker 2: hypothesis is where it's led a lot of people to
Speaker 2: go is to say menstruation is non adaptive and useless
Speaker 2: because it's just this thing that comes out of the
Speaker 2: body because of these other functions, because of cycling itself
Speaker 2: being adaptive, but like periods itself aren't. But menstrual blood
Speaker 2: and menstrual tissue are crucial to the component to endometrial
Speaker 2: cycling and are necessary for the healing processes to be
Speaker 2: occurring simultaneously with the removal of menstrual tissue. So to
Speaker 2: say that that stuff's not important is kind of weird, Like,
Speaker 2: of course it's important. It's part of the whole process, right.
Speaker 2: You can't just decide when part of the process is
Speaker 2: an important because you think it's gross. So that's sort
Speaker 2: of like the big picture where we are today. But
Speaker 2: I think what's interesting to think about. I'll give a
Speaker 2: briefer version of how we got there in terms of
Speaker 2: how we got there, and I think the reason that
Speaker 2: the terminal differentiation one became so compelling, and again the
Speaker 2: title of it was literally a non adaptive consequence of
Speaker 2: uterine evolution or something, and people really leaned into that
Speaker 2: non adaptive consequence. Is that some of the early ideas
Speaker 2: about menstruation being adaptive were pretty crummy. We have the menotoxin,
Speaker 2: which really just you know, came straight out of a
Speaker 2: lot of Christian beliefs that menstruation's dirty and so you
Speaker 2: have to get the dirty stuff out of you because
Speaker 2: women are dirty. You know. That's where a lot of
Speaker 2: that came from. Those beliefs persist today, but they aren't
Speaker 2: studied all that much anymore, thankfully. But the menotoxin throughout
Speaker 2: the entire twentieth century was considered a significant means of
Speaker 2: understanding menstruation. And my favorite counter to that was margie
Speaker 2: Profits hypothesis of sperm borne pathogens. So she says, yeah, sure,
Speaker 2: menstruation's dirty. The reason it's dirty actually is that dudes
Speaker 2: are dirty and they send their dirty sperm in here,
Speaker 2: and then we got to clean it all up because
Speaker 2: we don't want to get those pathogens. We don't want
Speaker 2: to get sexually transmitted diseases. So menstruation, in her hypothesis,
Speaker 2: is to remove the pathogens that sperm are sending up,
Speaker 2: not that mensies itself is dirty. And so part of
Speaker 2: the reason that I think the terminal differentiation idea in
Speaker 2: particular was seen as so refreshing is it was trying
Speaker 2: to get out of that adaptation evolution conversation at all
Speaker 2: and say, look, it's not any of that stuff, It's
Speaker 2: just this basic biological phenomenon. So I think it made
Speaker 2: an important contribution in that way. But it also did
Speaker 2: what happens all the time to things that we gender
Speaker 2: feminine or that are more common in female bodies, which
Speaker 2: is that we call a lot of those functions useless.
Speaker 1: Right, So, in terms of the evolutionary significance of menstruation,
Speaker 1: where do you think then something like period suppressors come in. So,
Speaker 1: for instance, if you take continuous birth control packs without
Speaker 1: doing that you know, skipped week, or if you have
Speaker 1: a hormonal IUD where you just stop menstruating, where do
Speaker 1: you think that that conversation should go?
Speaker 2: So two things. One is I think a lot of
Speaker 2: people have really good reasons to want a need to
Speaker 2: suppress their mensies, no matter how positive one might feel.
Speaker 2: By the end of my book about periods, that doesn't
Speaker 2: mean that you then like have to menstrate, you know
Speaker 2: what I mean. Like, this is not a call to say,
Speaker 2: now that we understand periods better, everybody go out there
Speaker 2: and bleed. Right. There are lots of reasons that it
Speaker 2: causes gender dysphoria, that it causes pain, that it messes
Speaker 2: with our schedules, and can we look at these broader
Speaker 2: structural these broader structures and say, why is the world
Speaker 2: set up so that it's so hard for us to bleed?
Speaker 2: Of course, you know, I'm menstruating right now. I'm on
Speaker 2: day two, So I am like, very heavily menstruating as
Speaker 2: we speak, and I am kind of at that stage
Speaker 2: where I'm having to swap out pads. I'm wearing period
Speaker 2: underwear and I have to swap out pads pretty regularly,
Speaker 2: and so it's one of those things where like I'm
Speaker 2: having to look at my schedule, look at my back
Speaker 2: to back meetings and figure out how can I run
Speaker 2: in between multiple meetings to make sure I'm swapping out
Speaker 2: so I'm not, you know, bleeding onto my pants, which
Speaker 2: I have done at work multiple times in my life
Speaker 2: because my meetings have gone too long and I haven't
Speaker 2: gotten a chance to swap things out so you know,
Speaker 2: in anticipation of that and not wanting that to happen.
Speaker 2: You know, Like, I've been running around quite a bit
Speaker 2: to like swap out pads between meetings. So I share
Speaker 2: all of that, and you know, I try whenever I
Speaker 2: am menstruating to be public about when I am. But
Speaker 2: I share all of that to say, like, still, it's
Speaker 2: a giant pain in the butt. Right, and again, even
Speaker 2: if it were, if that's the only reason you don't
Speaker 2: want to do it, that's a good enough reason to
Speaker 2: not want to do it, to the point of, like,
Speaker 2: is suppressing periods bad for you? I think it's an
Speaker 2: open question. I think this pre acclampsia and this question
Speaker 2: of pregnancy practice, it does open up a question of
Speaker 2: if you are someone who wants to reproduce in the future,
Speaker 2: should we be studied doing a better job studying menstruation,
Speaker 2: process of menstruation, and frequency of menstruation to see whether
Speaker 2: some of these hypotheses that we have that are indirectly
Speaker 2: supported by the evidence can actually be shown to be
Speaker 2: like a real causal thing. Right, And so I'm unwilling
Speaker 2: to tell any one person you need to get bleeding
Speaker 2: if you want babies, right, because we just these are
Speaker 2: inferences that we can make from the literature that I
Speaker 2: think are strong. But the thing is is that the
Speaker 2: research hasn't been done to establish this causality. The one
Speaker 2: last point I'll make about this is one of the
Speaker 2: really frustrating things around hormonal contraceptives and IUDs is that
Speaker 2: far more people have unpleasant experiences with it than often
Speaker 2: admit it, and even IUDs have a fairly high discontinuation rate,
Speaker 2: possibly as high as fifty percent depending on the study.
Speaker 2: And discontinuation of an IUD is challenging because the coercive
Speaker 2: pressure of medical doctors to keep you on IUDs is
Speaker 2: so strong that it can be very hard to find
Speaker 2: someone who will remove your iod for you, and so
Speaker 2: you can be having months of distress, lost libido, just
Speaker 2: continuous spotting, not feel like you have whatever the peer
Speaker 2: you know, the experiences that makes you say, I want
Speaker 2: to get this IUD taken out, and you can't find
Speaker 2: someone who's going to do it for you. It is
Speaker 2: a real problem that we make it so hard and
Speaker 2: that we prioritize efficacy over lived experience every single time
Speaker 2: when it comes to these contraceptives. So I'm excited about
Speaker 2: the fact that there are people now starting to think
Speaker 2: about this and say maybe we should care about lived
Speaker 2: experience and side effects as well, and start to think
Speaker 2: about and develop new technologies that allows people to have
Speaker 2: their contraceptive needs met, their suppressive needs met, but without
Speaker 2: having to endure so many other side effects. And again,
Speaker 2: half the people who take them don't have any of
Speaker 2: these problems, right like, So to be clear, there's plenty
Speaker 2: of people I know, plenty of them who are like
Speaker 2: you will take away my IUD from my cold dead hands.
Speaker 2: You know, I never want this thing removed or I
Speaker 2: you know, I'll keep it in as long as I
Speaker 2: possibly can, and then I'll swap it out for a
Speaker 2: new one, which is fantastic. I'm so glad for them,
Speaker 2: But I also know a lot of people are who've
Speaker 2: been miserable, and we just need to make sure that
Speaker 2: we're tending to all of the different people who have
Speaker 2: different experiences.
Speaker 1: Yes, completely agree. Okay, we're going to take a quick
Speaker 1: break right here, but stay tuned. We've gotten more menstrual
Speaker 1: talk for when we get back, including what the deal
Speaker 1: is with the COVID vaccine and periods. Welcome back, everyone,
Speaker 1: So We've talked already about how there isn't really such
Speaker 1: a thing as a quote unquote normal period across the board,
Speaker 1: but people who menstraight often do notice when their period
Speaker 1: is outside of the norm for them. And one recent
Speaker 1: instance of this on a wide scale was breakthrough bleeding
Speaker 1: after getting the Stars Kobe two vaccine. Can you talk
Speaker 1: about your incredibly fascinating research into this pattern, how you
Speaker 1: got interested, what you found, and what sorts of reactions
Speaker 1: you got from the press and public.
Speaker 2: Sure, this has been a real team effort, this project.
Speaker 2: The first person to notice that this was something we
Speaker 2: should be paying attention to was Katie Lee, who is
Speaker 2: an assistant professor at Tulane and a former member of
Speaker 2: my lab. Got her PhD here at Illinois, and Katie,
Speaker 2: being affiliated at the time with a medical school, was
Speaker 2: one of the earliest people to get the vaccine. So
Speaker 2: so she was in a group chat with other people
Speaker 2: as they were all going over what side effects did
Speaker 2: you have? What did I have? And a few of
Speaker 2: them were like, weird periods, different, wonder what that's about,
Speaker 2: and you know, and it was sort of from there
Speaker 2: that we began to have this conversation and I'm not
Speaker 2: an IUD user. So for me, I didn't have breakthrough bleeding,
Speaker 2: but I noticed my first period after my first shot,
Speaker 2: I had one of the heaviest periods I've had in
Speaker 2: my life aside, like the only heavier period I can
Speaker 2: think of is after my embryo. Like I had two
Speaker 2: failed embryo transfers before I had my second child. Those
Speaker 2: were incredibly heavy periods, but they were because they were,
Speaker 2: you know, stimulated with hormones and stuff. But like that
Speaker 2: level of heaviness. So I just asked Twitter, you know again,
Speaker 2: one of the reasons that I love and hope I
Speaker 2: will never miss Twitter, hopefully it will stare around in
Speaker 2: some form is that you can learn from and listen
Speaker 2: to so many people by using that space, and it
Speaker 2: went viral. By the end of the day. Katie and
Speaker 2: I were already talking about and mocking up a first
Speaker 2: survey because we thought, you know, we have to look
Speaker 2: at this. There are people who are in distress, there
Speaker 2: are people who are equating it with infertility issues, and
Speaker 2: we immediately were like, you know, we know the biology
Speaker 2: of it enough to be very confident that that's not
Speaker 2: what's going on. But we also knew that just saying
Speaker 2: that wasn't going to be satisfactory. So we thought, we
Speaker 2: really need to do some kind of project that, you know,
Speaker 2: that like gathers this information and allows us to critically
Speaker 2: assess what's going on while also creating opportunities for listening
Speaker 2: and validation. As anthropologists. That's how we create our science.
Speaker 2: That's we also build in reflexive practices so that we
Speaker 2: are discussing our projects and thinking about and adding to
Speaker 2: things based on what our participants say. So we got
Speaker 2: an IRB exemption, and in our little IRB exemption form,
Speaker 2: it was like, you know, how many people do you
Speaker 2: think will participate? And we said, oh, maybe five hundred,
Speaker 2: and we thought that was a stretch, like that would
Speaker 2: be so cool if our survey we got five hundred people.
Speaker 2: I think we had five hundred in the first hour
Speaker 2: it was open. By the time we closed, we had
Speaker 2: Once we did all the data cleaning, I think I
Speaker 2: want to say one hundred twenty thousand individuals. We had
Speaker 2: one hundred and sixty five thousand separate responses, but then
Speaker 2: removing some of the dual ones and stuff, I think
Speaker 2: it went down to about one hundred and twenty thousand,
Speaker 2: and then our first paper, we focused just on the
Speaker 2: first couple of months of data collections, so that was
Speaker 2: thirty nine thousand participants, just numbers that I don't normally
Speaker 2: work with. We had to like try to beg for
Speaker 2: emergency funding from the university, which they were kind enough
Speaker 2: to give us in order to get some RAS to
Speaker 2: help us with all of the data cleaning and so
Speaker 2: this little fun project. Then Katie and I were like,
Speaker 2: maybe we'll get an honors thesis out of it and
Speaker 2: we'll just have our own set. You know, curiosity satisfied
Speaker 2: turned into this ginormous international phenomenon. The other thing I
Speaker 2: want to point out is that, in part because of
Speaker 2: the attention our research was getting, the NIH came up
Speaker 2: with supplementary funding in order to fund people looking at
Speaker 2: this phenomenon, and so then five more projects in addition
Speaker 2: to ours. Ours was never funded by NIH. We've tried
Speaker 2: four times now, but the NIH funded five other projects,
Speaker 2: so that you know, we knew we were not alone
Speaker 2: in doing this, which was really another form of validation
Speaker 2: in many ways. It was great to have multiple people
Speaker 2: looking at this with different data sets and different methodologies.
Speaker 2: And now the papers have all started coming out and
Speaker 2: we're all having all the same findings, which, again, given
Speaker 2: that the initial criticism of our work was you know
Speaker 2: that we were doing it in this way that centered participants,
Speaker 2: and was yes it was snowball sampling. Yes it was
Speaker 2: self selective. It's not a random sample. We aren't comparing
Speaker 2: to people who aren't vaccinated. We didn't do the kinds
Speaker 2: of things that people like to hold up as methodological
Speaker 2: gold standards. But when you're trying to do things as
Speaker 2: it's happening, and you feel you have ethical obligations to
Speaker 2: not create a condition that might encourage people or incentivize
Speaker 2: them to not get vaccinated, you're going to do it
Speaker 2: the way we did it. And again, our find ended
Speaker 2: up being the same as the folks who did perspective work,
Speaker 2: which is that heavier and longer periods did happen in
Speaker 2: a subset of participants who got any of the mRNA vaccines.
Speaker 2: In particular, I can't remember the name of the commission,
Speaker 2: but a European commission has just released a requirement that
Speaker 2: in Europe, at least the two mRNA vaccines must now
Speaker 2: disclose that a potential side effect is heavy menstrual bleeding. Again,
Speaker 2: it's still really validating to see that. Because we were
Speaker 2: able to get that narrative out there, we were able
Speaker 2: to push back on the there's no real biological mechanism
Speaker 2: to explain it, which was what a lot of mds
Speaker 2: were being quoted as saying, and we were able to
Speaker 2: push back on the idea that it was connected to fertility.
Speaker 2: So this is an immune process. It's an immune it's
Speaker 2: a downstream immune effect. Part of immune function is hemostatic,
Speaker 2: is related to changes in bleeding and clotting. So what's
Speaker 2: an organ that does a lot of bleeding and clotting
Speaker 2: the uterus? So in some portion of people, a giant
Speaker 2: immune response is probably going to invoke downstream effect on
Speaker 2: an organ that bleeds in cloths. And in fact, the
Speaker 2: participants that had it happen more so of the heavy bleeders,
Speaker 2: they tended to be a little bit older, and tended
Speaker 2: to be more likely to have already had children, So
Speaker 2: again they had more of that endometrial architecture, so you know,
Speaker 2: we're kind of more primed for something bleedy happening to them.
Speaker 2: So again, our hypotheses were in a lot of ways
Speaker 2: supported by who it seemed to happen to more and
Speaker 2: so it's less about fertility and more about just you're
Speaker 2: just going to have that architecture being like capitalized on
Speaker 2: a little bit more if you've got all this bleedy
Speaker 2: clotdi stuff happening prior to it.
Speaker 1: Yeah, and breakthrough bleeding is something that a lot of
Speaker 1: people experience at various points, but it can be worrying
Speaker 1: or disconcerting at the very least. And I feel like
Speaker 1: when you hear about a vaccine causing breakthrough bleeding, how
Speaker 1: do you reassure people that although the vaccine may have,
Speaker 1: you know, contributed to that or been a cause of that,
Speaker 1: how do you still talk about vaccines being safe? And
Speaker 1: I feel like part of it has to do with
Speaker 1: just talking about periods and period variability and so on.
Speaker 1: But yeah, I was wondering if you could talk a
Speaker 1: little bit more about that potential issue.
Speaker 2: There's a couple of issues. One is that vaccine and
Speaker 2: drug treatment trials typically only ask one question about your period,
Speaker 2: which is when was your last one? And they ask
Speaker 2: that question because they want to know that you're not pregnant.
Speaker 2: And in fact, a lot of vaccine trials and drug
Speaker 2: treatment trials will say you cannot have conceptive sex during
Speaker 2: your participation, and if you are, you must be on
Speaker 2: a hormonal contraceptive for a good reason. Right. They don't
Speaker 2: want a potential fetus exposed during this testing period, because
Speaker 2: that's not the purpose. The purpose is probably in this
Speaker 2: case testing an adult and looking at the effects on
Speaker 2: an adult. But what this does then is that if
Speaker 2: they're potentially masking effects with a contraceptive, and if they
Speaker 2: are then asking no their questions, then they never are
Speaker 2: gathering in of these data about well, what does happen
Speaker 2: to your period after these drugs or vaccines or whatever.
Speaker 2: So the fact that it's not even in the trial
Speaker 2: design is a problem because it means we just don't
Speaker 2: know what's going on. And I think that there are
Speaker 2: sort of three things to think about when we're thinking
Speaker 2: about a new medical treatment of any kind. There is efficacy,
Speaker 2: there's safety, and then there's also just like side effects
Speaker 2: or what I've been calling lived experience. Right, it is
Speaker 2: worth noting that chemotherapy can be very effective for treating
Speaker 2: many cancers and seriously affect quality of life. And if
Speaker 2: it has a really high chance of being effective, you
Speaker 2: will still go through it. Most people are still going
Speaker 2: to say, you know what, this is going to be miserable,
Speaker 2: but it's better than being dead. I am going to
Speaker 2: make this choice, right. So, I think there's this medical
Speaker 2: paternalism that often seems to say, well, we should probably
Speaker 2: not fully inform the ladies of how this might affect them,
Speaker 2: because then they might not do it, and that is
Speaker 2: not what our data supports. So our data support that
Speaker 2: our participants felt incredibly betrayed by not knowing ahead of
Speaker 2: time what to expect. They were not betrayed by having
Speaker 2: side effects like breakthrough bleeding or heavy bleeding. They are
Speaker 2: betrayed by never being told and never being studied. They
Speaker 2: also shared with us many stories of having this heavy
Speaker 2: or breakthrough bleeding and going to their doctors or other
Speaker 2: medical providers and then being mistreated in those sessions where
Speaker 2: they were told it's in your head, you're stressed out,
Speaker 2: it's not real, there's no biological mechanism, or whatever the
Speaker 2: story was, and it was really distressing. Something that we
Speaker 2: have in preparation right now that is really relevant to
Speaker 2: this is that one of my grad students, Uruba Fatima,
Speaker 2: who's just a brilliant qualitative researcher, has been looking at
Speaker 2: doing a sentiment analysis of people's descriptions of their vaccine
Speaker 2: experiences or their post vaccine minstrreul experiences, and she was
Speaker 2: noticing that a huge proportion of the participants had what
Speaker 2: looked like negative and then positive effect appearing, and always
Speaker 2: in that order in their description, and so she didn't
Speaker 2: dive in to figure out, well, why is this happening
Speaker 2: with most people? It's not all negative or all positive,
Speaker 2: and it's never positive then negative, it's negative then positive.
Speaker 2: The negative effect terms were all describing the negative symptoms
Speaker 2: that they were experiencing with their periods. I'm fatigued, I'm tired,
Speaker 2: i don't feel good, you know, various types of negative
Speaker 2: framed experiences of their heavy period. And then the positive
Speaker 2: words were all but I am so grateful to have
Speaker 2: this vaccine. I am so happy to be vaccinated. I
Speaker 2: am so glad that I got the vaccine. I feel
Speaker 2: so lucky. Like all of these incredibly positive words, the
Speaker 2: negative experiences of the vaccine were not driving them to
Speaker 2: have negative sentiment toward the vaccine. What we saw instead
Speaker 2: were the people who had negative experiences with medicine had
Speaker 2: negative sentiment about the vaccine. So this idea that like
Speaker 2: we shouldn't bother looking at this, or we should only
Speaker 2: wait until post emergency authorization to bother to look at
Speaker 2: these adverse effects. I think is really deeply problematic and
Speaker 2: again points to this bigger question of why are we
Speaker 2: so paternalistic towards patients, particularly patients with uteruses.
Speaker 1: Yeah, and hopefully it's something I mean, I always want
Speaker 1: to have.
Speaker 2: Hope.
Speaker 1: Hopefully it's something that will change in the future. And
Speaker 1: in your book you have a chapter on the future
Speaker 1: of periods, which I loved. What positive changes do you
Speaker 1: wish to see in your period future and how do
Speaker 1: we get there?
Speaker 2: That chapter went through so many different variants and really
Speaker 2: where I settled in terms of what I would like
Speaker 2: to see for period futures is more of a recognition
Speaker 2: of our bodies. More generally, you know, there's this concept
Speaker 2: of the body mind. I cite some really a really
Speaker 2: lovely book by doctor Sammy Schalk call body Minds Reimagined.
Speaker 2: And the concept of the body mind is one that
Speaker 2: you see present in science fiction and fantasy quite a bit.
Speaker 2: And in general it is just like a feminist and
Speaker 2: black feminist concept that says, why do we keep believing
Speaker 2: in this Cartesian dualism thing that says, we have a brain,
Speaker 2: we have a body, and we can ignore the needs
Speaker 2: of the body in the pursuit of a life of
Speaker 2: the mind. People that don't have bodies that have a
Speaker 2: lot of needs that might not be a challenging dualism
Speaker 2: to live in. People that have bodies that are tended
Speaker 2: to by other people also might not have too much
Speaker 2: of a problem living with this dualistic life soo In particular,
Speaker 2: white men who maybe have lived their whole lives being
Speaker 2: served by other people, experiencing medicine that allows them to
Speaker 2: be able bodied for longer, perhaps do not ever have
Speaker 2: to menstruate, lactate, or gestate, or recover from any of
Speaker 2: those processes, or be at more risk of conditions that
Speaker 2: come from any of those processes, are going to have
Speaker 2: a much easier time living a life of the mind.
Speaker 2: Like if someone is making me lunch every day and
Speaker 2: typing up all of my notes every day and I
Speaker 2: never have to care for children or just state or anything,
Speaker 2: it's going to be pretty easy. So I think the
Speaker 2: intervention is really we have to do a better job
Speaker 2: acknowledging that there are bodies and working to create communities
Speaker 2: that love and support lots of different bodies. And you know,
Speaker 2: I'm in many ways I'm borrowing from disability justice here
Speaker 2: as well, And I'm saying this in a way that
Speaker 2: acknowledges like this is not me coming up with this idea.
Speaker 2: This is me noticing the work largely of black feminists
Speaker 2: and other women of color working in many activist spaces
Speaker 2: who've been making these points for decades, and so I
Speaker 2: just I'm just sort of trying to bring that to
Speaker 2: an audience that might might not be as familiar with
Speaker 2: that work. But to say that that's I think who
Speaker 2: we should be paying a TENI to and what we
Speaker 2: should be doing is again that we should be creating
Speaker 2: communities of care, acknowledging that we have needs that we have.
Speaker 2: You know, we do these now, Oh everyone gets a
Speaker 2: five minute bio break between Zoom meetings. You can't heat
Speaker 2: up your lunch, eat your lunch, hydrate, use the bathroom,
Speaker 2: swap out a tampon, and also perhaps like pump breast
Speaker 2: milk in a five minute biobreak. And so you know,
Speaker 2: there's starting to be some acknowledgment that we have bodies
Speaker 2: that need to be tended, but we're not going nearly
Speaker 2: far far enough, and so to me, it's more just
Speaker 2: like starting to imagine what are the kinds of futures
Speaker 2: not just for people who have periods, but people who
Speaker 2: have lots of different types of bodies, all of whom
Speaker 2: deserve to be tended so that all of us can
Speaker 2: be present. One of the places I find this most
Speaker 2: distressing is the complete removal of hybrid options and masking
Speaker 2: across most university settings and most other public settings. Now,
Speaker 2: even among scientists who should know the science and know
Speaker 2: that we are living in an airborne pandemic, are still
Speaker 2: walking around unmasked all the time. And what that tells
Speaker 2: people who are immune, compromised, or disabled or would prefer
Speaker 2: to avoid long COVID is that their lives just really
Speaker 2: aren't worth protecting. We're not going to do this minimal
Speaker 2: thing and put this scrap of fabric over our face
Speaker 2: to just make you not just feel more comfortable, but
Speaker 2: be more safe and be made to feel welcome. So
Speaker 2: what are the ways that we can think about that
Speaker 2: when it comes to all the different ways that we
Speaker 2: can protect each other. We can be masking, we can
Speaker 2: be filtering. We can create more time and space for
Speaker 2: people to get places we can create hybrid options. There
Speaker 2: are some people that I know who menstrate so heavily
Speaker 2: that they spend a decent portion of their period just
Speaker 2: sitting on the toilet because they're like, what's the point
Speaker 2: of swapping out tampons? I could just sit here and
Speaker 2: let it come out. Hybrid option would be kind of
Speaker 2: nice for those folks, right, Like, we don't need to
Speaker 2: enforce these ablest returns to work when instead we could
Speaker 2: try to imagine a different future instead of a return
Speaker 2: to a really problematic past.
Speaker 1: What was the process of writing this book? Like, were
Speaker 1: you surprised by anything that you learned while researching it
Speaker 1: or by any of the reactions that you've got when
Speaker 1: you said that I'm writing a book about periods.
Speaker 2: A lot of directions I could go in answering this.
Speaker 2: There's there was a lot of confusion I think in
Speaker 2: my decision to write a book about periods and also
Speaker 2: to write a book period Well, sorry, no pun intended,
Speaker 2: because you know, as a scientist it's not something we
Speaker 2: do as often because it doesn't quote unquote count You know,
Speaker 2: my writing a book does not support my promotion in
Speaker 2: any way. If anything, it detracts because all of the
Speaker 2: years I spent writing revising. I went through two rounds
Speaker 2: of peer review for this book as well, one of
Speaker 2: which took over six months because it was during the
Speaker 2: pandemic and it was really The second one took almost
Speaker 2: as long too, actually, and so you know, it took
Speaker 2: a really long time. It took literal years of my life.
Speaker 2: But we're more mostly book perplexed, like why would you do that?
Speaker 2: And I think once I sort of talked through, well,
Speaker 2: here's why I care, and here's the sort of the
Speaker 2: big idea of the book, that I think people were supportive.
Speaker 2: I think the main thing I was surprised by is
Speaker 2: that I could do it, honestly, because it's you know,
Speaker 2: it's six chapters. It was six really long papers, and
Speaker 2: so thinking through argumentation and stuff when you're trying to
Speaker 2: write six long papers all by yourself is a lot.
Speaker 2: But in terms of, like topically the kinds of things
Speaker 2: that surprised me, I would say a lot of the
Speaker 2: menstrual preconditioning was really exciting and interesting to think through.
Speaker 2: I mean, I think probably the most surprising piece, or
Speaker 2: the most rewarding thing to do in this book was
Speaker 2: how I think in many ways it got to remain
Speaker 2: a feminist book and a book that came from a
Speaker 2: place of what's called feminist objectivity. So trying to expose
Speaker 2: and think about histories, biases, assumptions in play in the literature.
Speaker 2: And when you strip those things away and you move
Speaker 2: away the menotoxins and the terminal differentiation and the eugenic
Speaker 2: concepts of normal and you know, when you pull all
Speaker 2: of that away and you look at what menstruation is,
Speaker 2: it is just one of the coolest things that the
Speaker 2: body does. Like it creates an opportunity for your body
Speaker 2: to practice a thing that it has to get good
Speaker 2: at later. It is simultaneously remodeling and sloughing off at
Speaker 2: the same time, like it is doing all of these
Speaker 2: repair processes that would if anybody gave a crap and
Speaker 2: actually paid attention to in the tissue engineering space, we
Speaker 2: would have already solved so many tissue regeneration questions in
Speaker 2: that discipline. But ew menstruation, so people haven't paid attention
Speaker 2: to it. I mean, I have a collaboration where that
Speaker 2: is something we've been doing for almost ten years. But
Speaker 2: that's because the collaborator is my husband. You know, nobody
Speaker 2: else is going to listen to me about this stuff,
Speaker 2: And so I think for me, that's the thing is that, like,
Speaker 2: it is an incredibly cool process. It is an incredibly
Speaker 2: cool function of the body. And if there hadn't been
Speaker 2: so much bias baked into our understanding of it for
Speaker 2: multiple centuries, this would be a thing taught alongside dinosaur bones,
Speaker 2: This would be a thing taught alongside the planets, Like
Speaker 2: it would be one of those basic functions that everyone
Speaker 2: would be like, Hey, have you guys learned about this?
Speaker 2: Because this is this cool thing that is like all
Speaker 2: of us were in a womb at some point, right,
Speaker 2: we should be really fundamentally curious about what happens in there.
Speaker 2: And how is that's not one of the like that
Speaker 2: there's not an entire high school class just devoted to it,
Speaker 2: you know. So I think that's for me, the sort
Speaker 2: of surprising amazing thing is that, of course I already
Speaker 2: loved this stuff because this is what I do. But
Speaker 2: I think it became even more obvious with feminist objectivity
Speaker 2: that it's even cooler than I thought it was. And
Speaker 2: I think that's my biggest hope for this book is
Speaker 2: that other people will arrive at that same conclusion.
Speaker 1: Doctor Clancy, thank you again so so much for joining me.
Speaker 1: That was absolutely fantastic. And if you listeners also enjoyed
Speaker 1: this conversation and would like to learn more, check out
Speaker 1: our website this podcast will kill You dot com, or
Speaker 1: I'll post a link to where you can find Period,
Speaker 1: the Real Story of Menstruation, as well as a link
Speaker 1: to doctor Clancy's excellent podcast fittingly called Period Podcast and
Speaker 1: don't forget. You can check out our website for all
Speaker 1: sorts of other cool things, including but not limited to, transcripts,
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Speaker 1: and music by Bloodmobile. Speaking of which, thank you to
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Speaker 1: of our episodes. Thank you to Leana Squalacci for our
Speaker 1: amazing audio mixing, and thanks to you listeners for listening.
Speaker 1: I hope that you liked this bonus episode and are
Speaker 1: now so excited to be part of the TPWKY book Club.
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Speaker 3: Until next time, keep washing those hands. M