Ask Me About My Uterus Page 18

  The problem with a woman’s “blood” was really not the problem at all: vaginas were the problem. To extrapolate, women’s sexuality was the problem. Women having agency of their bodies was the problem. And while these social mores were certainly explicit through other teachings, menstruation took on a symbolic quality for womanly wiles, for female evils, for the feminine mystique. The lore of a creature—whether witch or siren or selkie—who could bleed for a week and not die endures.

  A researcher and academic named Sara Read shed some much-needed light on the menstrual practices of yore in her paper “‘Thy Righteousness Is but a Menstrual Clout’: Sanitary Practices and Prejudice in Early Modern England.” Indeed, as she introduces her topic, she points out that there’s no great wealth of information on the subject. First-person accounts by women throughout history are limited by a peculiar social paradox: menstruation is both mundane and wildly taboo.

  Throughout history, men have told very specific tales about menstruation—either from the “informed” medical perspective or as a salacious literary device on the part of poets and philosophers. Read, in fact, cites several poems, one of which is “By All Love’s Soft, Yet Mighty Powers,” by John Wilmot, Earl of Rochester, which begins thusly:

  By all love’s soft, yet mighty powers,

  It is a thing unfit,

  That men should fuck in time of flowers,

  Or when the smock’s beshit.

  Rochester’s charming little ditty goes on to recount his experience of having sex with a prostitute, who he is disgusted to find is on her period (the “time of flowers”). Rochester goes on to elucidate that while he enjoys sex with prostitutes, what would really get him rock-hard would be if the woman would stop up her menstrual flow while they were doing it so his dick wouldn’t get a nosebleed (in the poem he does actually make this exact comparison).

  The boner-crushing qualities of menstruation hardly began with Rochester: Read also reminds us of the story of Hypatia, a Greek mathematician and astronomer in the fourth century, a woman who did not suffer fuckboys gladly.

  As the legend goes, one of Hypatia’s students became infatuated with her, his lust becoming all the more aggressive the more she rebuffed him. She, naturally, grew weary of his attempts to pressure her into having sex she didn’t want to have, so she showed him her bloodied menstrual rags and told him he was a pig. The feminine mystique having been shattered, he was immediately and irreparably repulsed by her.

  One could argue that the lad was equally repulsed by Hypatia’s strength, and probably also humiliated by the fact that she had no interest in him whatsoever. What ultimately translated into culture from that event was that menstruation was a sure-fire way to cure lust. That’s a bias that still exists today, despite the fact that we essentially accept menstruation as an inevitable, and therefore natural, part of life.

  It’s interesting that so many women have held onto the belief, or instinct even, that menstruation is natural, when history has dictated that to bleed is not just unnatural, but condemnable. One might wonder if viewing menstruation as natural is less about accepting biological purpose and more a matter of ownership. Of identity, even.

  Whether one can learn to be at peace with her period on a personal level or not, menstruation still puts women at many practical disadvantages—some of which, over the past few decades, have proven life threatening.

  An editorial published in the British Journal of Sports Medicine called out clinical researchers in a study on exercise that blatantly excluded women. The rationale for leaving them out? Because they get periods. “A review of 1,382 sport and exercise research studies involving over 6 million participants, from 2011 to 2013, found the representation of women to be 39%,” wrote the authors. “The complexities of the menstrual cycle are considered major barriers to the inclusion of women in clinical trials.”

  This isn’t really news to anyone, as the writers of this editorial continue to point out: historically, clinical trials (especially for those testing out new, yet-to-be-approved drugs) were done exclusively in men. Testing on women, it was argued, risked damaging an unborn fetus that she didn’t know existed. Women were also perceived as being more “physiologically variable”—which is not necessarily untrue or even unfair. Men don’t have a cyclical physiological experience akin to menstruation. One could argue (and they do in the rationales for these studies) that using only men would yield more consistent results. More consistent results mean the study is done faster and more accurately, which equals less money spent.

  The exact reason that they exclude women (to save money) could potentially cost patients and health-care systems more money in the long run. Why? Because those physiological differences between men and women mean that there are probably differences in their responses to medications, treatment, and surgery. If we study men because they’re easy and cheap to study, we’re leaving out the realities of an entire patient population. A major study showing that aspirin reduced the risk of heart disease and stroke, for example, did not include women. In 1993, it was this study that prompted the ban on women participating in clinical trials to be lifted. That year, Congress passed the National Institutes of Health (NIH) Revitalization Act, mandating that NIH-funded research include women and minorities.

  It probably comes as no surprise, then, that many of the drugs on the market in the 1980s were later withdrawn once people figured out that they didn’t work as well in women, or, in some cases, caused serious side effects.

  Methandrostenolone, for example, also known as Dianabol, a commonly used steroid, became notorious in the Olympic doping scandals—which was pretty much exactly what the physician who began prescribing it to Olympic athletes intended. He had suspected (correctly) that the Russians had been doping their athletes in the 1960s, so he started prescribing steroids to US athletes. The clinical trials for the steroid had been done, of course, in male athletes.

  Dbol, as it was often affectionately called, was basically oral testosterone with a few extra carbon bonds to reduce estrogen conversion. It didn’t actually work out that way, though; instead, it created a potent estrogen in the body. Those large “pecs” in bodybuilders were basically abnormally large breast tissue from excess estrogen, and the weight gain perceived from the steroid was really just water weight from bloating, also caused by the estrogen.

  Those quick gains that are characteristic of steroids are, oddly enough, extremely familiar to most menstruating women. The water weight a woman gains before her period each month can be severe—ten pounds in a day—but it isn’t permanent. The male Olympians using Dbol as a kick-starter for injectable steroid regimens were in for a rude awakening about its long-term side effects. When the drug came under fire for “off-label use,” many of the athletes who were using it were women seeking to compete at a higher level. Since the drug hadn’t been explicitly tested in women, the ill-effects of the drug, as reported by the female cohorts, probably helped get it off the market.

  One would probably expect men and women to have different reactions to steroids, as the drug would be interacting with different existing base hormones. But researchers would later discover that biological sex plays a role in the metabolism of lots of drugs. Everything from antidepressant response to anesthesia complications can be influenced by the physiological differences between women and men. Women, for one thing, have a higher ratio of fat to lean body mass, which means that drugs relying on lipids may be metabolized more quickly in a woman’s body than in a man’s. The implications of such differences are vast—different dosages, for example, may be necessary to achieve the same result.

  Where a woman is in her menstrual cycle also influences how her body metabolizes, well, anything. Researchers know this: that’s why, when they do include women in trials, they design the research so that women will be participating early in their cycles, when their hormones are most similar to a man’s. Periods, then, have become something of an exclusionary pathology.

  Once my period became
a pathology—once it became more of a chronic condition than a monthly visitor, when the ramifications of this so-called natural phenomenon gone rogue started to dictate my every move—I realized that it had already altered me. It had shifted my sense of self, of identity. Endometriosis began to ruin my life long before I had a name for it.

  SIX MONTHS AFTER I RETURNED to Maine, Rebecca—who said she had missed me and consistently worried about me since I’d left school—wanted to come up for the summer, partly to live with me, but also just because she loved Maine. With her helping me out with rent, it seemed doable, at least in the short term. Besides, Maine in the summer was awash with jobs, if only seasonal ones, and I had to find some way to make money—preferably sitting down.

  I settled into a small apartment right after my twentieth birthday. It was tiny, like tiny-house tiny, and had one bed that was situated in a nook, surrounded by walls of bookshelves. The back porch overlooked a nature preserve that was striking in its beauty and untouched serenity. Rebecca came up as soon as school ended, having found a job in Portland, which was a couple hours’ drive away. Having grown up outside of Hartford, she didn’t balk at the commute, not if it meant she could do something she really wanted to do. I found a job in an art gallery. It allowed me to work sitting down, and it was quiet and not very demanding.

  Summer in Maine is extremely gradual: you get a few weeks at the beginning where it might be eighty degrees during the day, but it dips down to forty or fifty degrees at night. Eventually, one day in mid-June you languidly realize that it’s almost 9 p.m. and it’s still light outside. Memories of the pink light in Estelle’s backyard would find me from time to time as I looked out at the trees in my own backyard, listening to the cicadas sing. The summer meandered on and so did I until one day in early July, when my entire life changed again: I fell in love for the first time, and it was anything but gradual.

  There was a coffee shop in town that I frequented during the off-season because it was quiet and had a warm, homey aesthetic. By the height of summer, I was working downtown right across the street, amid the throngs of tourists. The café became my sanctuary, even as it filled up with unfamiliar faces.

  One morning I was there having brunch with my friend Julia, and she leaned over the table rather conspiratorially and informed me that the barista wanted to ask me out. I had no idea where she’d gotten this idea from. If he had been kind to me, it was surely only because he was hoping for a good tip, and I couldn’t blame him. But beyond that—why would any man in his right mind make a pass at me? I was a hot mess. I looked as shitty as I felt most days. Not that I had ever been particularly good-looking. I never had been, and it had never bothered me all that much. I figured that being smart was enough for what I wanted out of life, and if that didn’t entice a man, then, whatever, I’d live alone with half a dozen dogs and get to maintain my preference for sleeping with a fan year-round. Perfect!

  When I took our plates up to the counter before we left, I suppose I made eyes at him. He asked where I went to school; even though I’d left, I told him Sarah Lawrence. I was still hoping that one day I’d go back, somehow. Besides, I had studied there, it wasn’t exactly a lie.

  A few days later, I showed up to work only to get a call from my boss saying that we weren’t opening up for a few hours because her daughter was having a baby. She said, “Go get a cup of coffee, I’ll call in a bit.”

  So I walked across the street to the café. There he was, smiling away, entertaining customers. I thought perhaps I had imagined it, but I could have sworn his eyes lit up when he saw me. He brought coffee to my table and some of it slopped onto my lap. He apologized profusely, but I brushed it off. As we sat there, I tried to sip my coffee the way a woman might like to be seen with a glass of wine—gracefully, and with a practiced air of judging whether or not she’s had too much. I caught him staring at me and I smiled. When he asked me to dinner, I said yes.

  Although I readily accepted the invitation, I was nervous about having to explain almost immediately that I couldn’t really eat anything. It was either that or risk vomiting all over him mid-date, which might be highly arousing in some obscure mammalian courting rituals, but not with humans.

  We went to a deli on the corner, a place that always made me salivate because it was full of things like onions and red peppers, which I hadn’t eaten in years. I nibbled at a depressingly bland sandwich and got periodically lost in his big, sparkling blue eyes. Though we had only just met, and didn’t even know any of the same people, we immediately felt a strange kinship. I was so comfortable around him that I joked that maybe we had known one another in a previous life. He told me my aura was purple. We laughed and exchanged numbers.

  That weekend, I wrote in my journal, “Max—the boy—wants to take me sailing tomorrow.” I found myself thinking of him, daydreaming, even: the certain air with which he entered a room, his gait quick but not hurried, directed but not premeditated. He had a dancer’s sureness on his feet. His hands were nimble, finely tuned. Steady. I fell in love with him easily. Then I started to fall into this new kind of love with the entire world around me, which, for the first time since I’d gotten sick, seemed to be spinning madly on once again. I also hoped I might acquire a little self-love in the process—a process which I, of course, heavily romanticized. With his help, I wondered, would I learn to see the beauty in the soft rocking of my pelvis as I strode down the street? Or in the way my fingers wrapped themselves around a doorknob? What, I wondered, would it feel like to be regarded as unequivocally lovely? To be truly elegant? Would he find himself captivated by watching me sleepily pour coffee, yawning unselfconsciously in his presence? Would he tremble pleasantly at the sound of my throaty laugh, perceiving it as silvery echoes filling the room and making him laugh, too?

  Later that first week, I added to my journal: “Max took me sailing. He wants to date me. I know because of his hands. I’m terrified.”

  I was still a virgin at twenty. The last boyfriend I had had was during my senior year of high school. The enduring memory I have of him was the one night we spent together at his apartment. It was a few weeks before I left for college: a grotesquely hot summer night, which is usually the setting for these stories. We spoke in hushed tones in his darkened living room, smoking American Spirits and listening to music. Outside, in an act of nature’s compassion, it began to rain.

  It was late, and I didn’t want to drive on sweaty roads, so I let him tuck me in on his couch. Not long after he went down the hall to his bedroom, I followed, intending to linger desirably in his darkened doorway—when a familiar twist in my gut reminded me that I was on my period. So, I stood semi-awkwardly in the doorway instead. A fan blew hopelessly in the corner of his too-small, sweltering room. He cracked a window and put on some music—Explosions in the Sky. I still remember it. “Your Hand in Mine” was the song. He slung his arm around my waist and we listened to the storm outside. I stayed awake long after he fell asleep, worrying that I’d bleed all over his bed in the night. As I lay there, I was awash with the feeling of being felt. When I woke up the next morning, he made me breakfast. The tenderness of that memory is almost more revealing to me than when I did eventually lose my virginity. The gift of human contact he gave me was quintessential and irreplaceable.

  I wasn’t someone who had been regularly hugged or kissed as a child. Physical affection of any kind, while I yearned for it, eluded me. This had been one of those defects I’d identified about myself years ago in therapy with Jane; I had certainly wanted to work on it, but I just hadn’t had that many opportunities. Sarah Lawrence hadn’t exactly been the epicenter of heat-seeking, hot-blooded, heterosexual men—nor was the dance world.

  Nor were the options in small-town Maine particularly bountiful. Even if they had been, given my state of ill-health, I had very little faith that a summer flirtation would amount to anything, though Rebecca had warned me not to overthink it. Max and I had experienced an undeniable spark. I had never felt like that about a
nother person before. I’d never experienced the pull of passionate physical attraction. We didn’t even have to be close enough to touch: if he merely stepped into my orbit when we were walking down the street, or reached over to shift his car into gear and nearly grazed my thigh, my entire body became aglow.

  One night, he picked me up for dinner and then took an unfamiliar turn on our way back. I asked where we were going, and he said, “I’m trying to maintain a modicum of surprise here.” I snorted at his ten-point vocabulary word and fell a little bit more for him. He took me to one of his favorite places, a slant of rocky shoreline that overlooked the harbor. It was kind of hidden away, accessible by a beaten dirt path through the woods, and was, I admit, rather romantic.

  He opened his arms to me, so that I could settle against his chest to watch the sun set. The minute I sank back into his arms, I was plagued with a feeling of emptiness. I couldn’t feel his arms, I could only feel myself. After a few very long moments spent like this, he sighed.

  “If I let myself, I’m going to fall madly in love with you,” he said. “But I’m afraid that you won’t be able to love me back.”

  I turned my face to look up at him, completely breathless. “The only thing I’m sure of,” he continued, “is that if I let myself fall in love with you, I will never love anyone as intensely again.”

  For once in my life I was speechless. Fighting the urge to come up with something equally amorous to say, I willed myself to be in that moment, to live in it, to feel it. When I got home that night, I wrote down every single second of it in my journal, recognizing, I suppose, that something quite serious had happened to me.

  The following evening, Rebecca was out for the night working, so Max came over. We talked for hours without running out of things to say. Talking led to kissing, which I was extremely bad at and I knew it. He was patient. He tried to provide some guidance, though he did find it amusing that I seemed to be able to only kiss with my head tilted one way. I assured him that I was very good at taking direction and a quick study. I was a dancer who was, admittedly, not as good at improvisation as some. But if you gave me the choreography and an idea of what the dance was meant to convey, I could pick it up. This made sense to him, but he explained—a bit to my dismay—that what made kissing fun was the unexpected.