Sunday, July 22, 2007

The New York Times Bars Facts From Op-Eds

And Karen Houppert's menstrual suppression op-ed is the perfect case study.

Here's how you, too, can strip your article of facts in 5 easy steps:

1. Don't bother to know what Lybrel is or how it works.

[Lybrel] is as effective at preventing pregnancy as the other pills already out there (about 98 percent) but boasts one advantage: Women who take it will never get their periods.

Incorrect. The one advantage Lybrel boasts isn't period suppression.

All [combination] birth control pills, from the first brands that were available in the 1960s to Lybrel have the exact same effect on the menstrual period: Women who take them never get their periods.

The difference between Lybrel and the other pills already out there is that women who take Lybrel will never induce an withdrawal bleeding episode. Lybrel does away with the monthly bleed by eliminating the placebo pills.

I've mentioned this before but one more time, exclusively for New York Times op-ed columnists: the menstrual period and withdrawal bleeding are not one and the same thing.

It's an important distinction to get, otherwise you run the risk of wasting an entire op-ed column attacking the wrong bogeyman. [When it comes to Lybrel, you want to misinform your readers about eliminating monthly withdrawal bleeds, not about menstrual suppression.]

2. Make sure you can't tell the difference between scientific research and opinion and propaganda.

Ms. Houppert goes on and on about the existence of scientific proof, rashes of studies and flurries of research, but when it comes time to be specific all she has to offer are the observations of a British doctor and a propaganda film. Personal opinions, even those of a physician, and government films are not scientific proof of anything to do with the menstrual period.

Ms. Houppert does have one reference to some actual studies (those from Wyeth showing that menstruating women feel less effective at work, take more sick days, don’t exercise and wear dark clothes more often) and a mention that premenstrual syndrome studies appeared in the medical literature in 1953. And still she manages to ignore the scientific method and relies instead on name calling and innuendo to support her assertions.

Studies on how menstruating women feel and what they wear tell menstruating women feel and what they wear. They're not part of the proof that Western civilization...hinges on our ability to wrangle our messy cycles to the ground and stomp ’em out once and for all. Also, describing PMS as an affliction and implying that the date of publication for the early studies on PMS somehow taints their validity, still not a valid method of scientific critique.

One more thing.

Someone cynical might suggest that research highlighting menstruation’s distressing consequences bubbles to the surface every time the public feels anxious over women’s expanding roles.

And someone cynical (oh, who are we kidding? That would be me.) might suggest that nebulously sourced innuendo bubbles to the op-ed pages of The New York Times every time a writer is too too lazy to look up data to support her assertions.

3. Avoid knowing the indications for menstrual suppression.

While [menstrual suppression] may be good news for the 8 percent of women who have debilitating periods (a constellation of symptoms known as premenstrual dysphoric disorder), the rest of us may be puzzled by the fuss.

And there will be none other more puzzled by the fuss, of course, than the 7.8 million teenage girls and women who suffer from iron deficiency, 3.3 million of which have a more severe form called iron-deficiency anemia. [The main cause of iron-deficiency anemia in premenopausal women is blood lost during menses.] Or those with heavy bleeding and pain (dysmenorrhea), endometriosis, or epilepsy.

Since menstrual disorders are the most common gynecologic problems suffered by women in the United States Ms. Houppert's ignorance of the routine indications for menstrual suppression is appalling.

What's also appalling is Ms. Houppert's cheery assumption that menstrual suppression may be good news only for women who suffer from period-related problem. 'Cause as we all know, if you're female, unless you're suffering or you're at death's door you're not worthy to take advantage of anything medicine has to offer.

If you are one of the millions of women who don't have bothersome periods, but who, for whatever reason, would like to suppress your period just to benefit your lifestyle, off with your head!

4. Be unaware of women's attitudes about the period.

Sure, getting our periods can be a bother sometimes, but after the traumatic moment of menarche — "How can this be happening to me when the sixth-grade pool party is tomorrow and I have no idea where that tampon goes?" — most of us get used to it.

It just is.

Actually what just is is presumptuousness. Assume your views of the period magically apply to most women, ignore all the available evidence and, presto, you're on the op-ed pages of The New York Times. Nice gig if you can tolerate it, but utterly unconnected to reality.

Studies, surveys and polls have consistently found that most of us don't, in fact, get used to getting a monthly period. The evidence shows that a majority of women would prefer not to bleed every month. [Interestingly, this finding holds true across decades, age groups and countries.]

5. Don't hesitate to make ignorant claims and wild accusations (the more, the better).

Lybrel is landing on pharmacy shelves this month. And now war has been declared on menstruation.

Ignore for a moment the grandiosity of the claim and the type of solid proof it would require. Note what's actually claimed--that a war on menstruation has been declared in support of Lybrel, a Pill brand that has no effect on the menstrual period (in that Pill users don't have periods). Good to know pharam is crafty enough to wage a propaganda war, but inept enough to not know what to indoctrinate us about.

Already the first few volleys in this battle have been exchanged. Gird yourselves, women, for a barrage of advertising and research highlighting the debilitating effects of periods and the joys of menstrual suppression.

Because, obviously, the second Lybrel becomes available, all research highlighting the debilitating effects of periods should cease immediately, and the subject of period-related problems is to became taboo. You know, just to be on the safe side and insure womenfolk are protected from undue influences on their pea-sized brains.

Also, yeepee, the joys of menstrual suppression; just dreamy! Seriously, what is this, an op-ed in the kindergarten newsletter? Does anyone seriously think this level of condescension works on actual women?

So what’s a poor company to do? Re-conceptualize menstruation as a disease in need of treatment.

Let's make this very easy. If Ms. Houppert produces one single instance of a legitimate medical or pharma source equating the normal menstrual period with a disease I'm prepared to eat her hat.

And what’s a poor menstruating woman to do? Get cranky with the prophets who offer to cure us of menstruation; who minimize the complex interplay of hormones and their many roles in our bodies; who gloss over the still unknown long-term effects of menstrual suppression; who promise that cycle-free women are better lovers, mothers, workers.

If you want to be taken seriously, don't project your odd fantasies--prophets who offer to cure us of menstruation, really?--on pharma, or make wild, misguided accusations.

Questioning, for example, the effect of the extra weeks of estrogen exposure with Lybrel shows you've bothered to familiarize yourself with the topic you are venturing an opinion on. Throwing complex interplay of hormones and their many roles in our body around and hoping it will stick only denotes your ignorance of facts.

As does the accusation that the long-term effects of menstrual suppression are still unknown. They're not. [See, this is where knowing what you're talking about comes in handy.]

The effects of menstrual suppression and the effects of eliminating the monthly withdrawal bleed are two distinct issues.

We know that suppressing your period long term is not detrimental (actually, there's evidence it's beneficial, but I digress). And how do we know that? From decades of observing the effects of menstrual suppression in women who, you know, don't menstruate for extended intervals: Pill users, pregnant women, breastfeeding women.

But what about the effects of eliminating the monthly withdrawal bleed? Unlike the menstrual period, withdrawal bleeding is an artificial manipulation. The bleeding frequency isn't intrinsic; it's arbitrarily set (monthly by the Pill's inventors; every 3 months by Seasonale's manufacturer; never by Lybrel's manufacturer).

Briefly, the correct question is, will the shift in bleeding frequency (prolonged hormone exposure) negatively impact, for example, the risk of uterine cancer or cardiovascular side effects? Based on all the available evidence--clinical (long-term) and studies (short-term)--the answer is no. Eliminating the monthly withdrawal bleed is safe.

Bottom line: The menstrual period is a normal body function, not an affliction. You suppress your period to improve your health, if having a period is a health concern, or to benefit your lifestyle, if the period is a simple inconvenience. And you eliminate withdrawal bleeding because there's no reason to bleed monthly while on the Pill.

Now if only The New York Times and its columnists could figure out that, even for op-ed articles about the menstrual period, accuracy still matters, I could.....

You know, I had a few clever endings for that phrase, but if you really think about it, there's nothing funny about this much misinformation, relentlessly repeated and prominently displayed.

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At 12:20 AM, Anonymous Rachel said...

I have no idea where that tampon goes Allow me to suggest that it goes in the hole the blood is coming out of. I'm glad she thinks so highly of women. /snark
What's it going to take to get people to actually do a little reading before publishing this stuff?

At 5:31 AM, Blogger ema said...

Heh. I know the condescension, it is dripping.

At 2:11 PM, Anonymous iron poor said...

Hurray for you! I'm glad there is someone to speak forcefully and with some authority in response to that op-ed.

One devil's advocate point - the author of the op-ed left it unsaid, but her clear fear is that women who would not resort to pills for birth control, would now, chiefly in order to have no monthly bleeding.

I do suspect a hidden agenda related to artificial birth control. Even if the authoress has none, she is worried that women who would go "au natural" will now use pills to have no periods. This will put societal and peer pressure on women who do not suppress if the natural women are freak luddites shirking their duty to be more like men....cycle-free, non-babymaking, brave new women who ironically have lost the secrets of the moon goddess and traded them for a kind of eunochood.

That's her position, really. It may even have a bit of truth in it.

My reproductive years are drawing to a close, but if I had it to do over again, I would have gon the route of menstrual suppression via BCP's...and imainly for the benefit of no monthly bleeding.

I may have looked forward to the psychic and physical relief from PMS that bleeding brought, but my periods are heavy and uncomfortable and very disruptive to the life I would like to lead.

I think stomping the period is a good thing, frankly. But I think it is important to know that women fear being "forced" to regulate their cycles with pills...having something be possible can turn into a duty. There is where the future shock lies.

At 10:37 PM, Anonymous Anonymous said...

Nice commentary - I always learn from your posts. I am a fertile woman who has experimented with several birth control methods and hasn't found the "perfect" one yet. I like condoms a lot but I hate menstruating. I like bitch control pills & Nuvaring a lot, but I hate menstruating. Perhaps I will try Lybrel.

(Forgive me for posting Anon)

At 4:00 PM, Blogger Rachel said...

Anon, please read more on this site. You can use NuvaRing to not have fake periods - I've been doing this for over a year now and it's wonderful! I just switch my ring out for a new one once a month. It's really stabilized my IBS to not have a week of hormone withdrawal every month.

Tangentially, my GP was concerned with my not ever shedding my erstwhile uterine lining, and she convinced me that I should take the ring out occasionally. I just did so for 5 days, which led to some miserable PMS but no bleeding.

At 1:31 AM, Blogger ema said...

iron poor,

Even if that's her fear, it's no excuse to misinform readers, be condescending and make wild accusations. is important to know that women fear being "forced" to regulate their cycles with pills...

The more reason to point out that a) women can, and should, be trusted to make their own health/lifestyle decisions, b) choosing whether or not to menstruate is *not* a communal decision, and c) the menstrual period is just an ordinary body function.

There is where the future shock lies.

Only if we allow it to iron poor, only if we allow it to.


Thank you and no need to apologize.

At 1:40 PM, Anonymous Iron poor said...

I certainly agree with every word of your 1:31 post, Ema.

Though, cynic that I am and human nature being what it is, I suspect the ability to regulate menstruation will someday transmute into something of an obligation to regulate menstruation.

The misinformation and highly charged emotional arguments are typical of those who oppose resort to manipulation of the reproductive cycle. There is some truth in there, however, and I think its useful to comprehend the deeper fears and issues that lead authors such as the op-ed author to resort to such intellectual dishonesty or knee-jerk opining in ignorance of facts.

The author above trusts women, too. She trusts them to not want to menstruate, and it scares her.

At 2:25 PM, Anonymous iron poor said...

I had to go and look up Houppert, and sure enough, she is a member of the menstruate-loud-and-proud party.

One editors blurb from her most famous book (The Curse: Confronting the Last Natural Taboo) sort of sums up her thesis:

"Karen Houppert's fierce and witty examination of menstruation shows how the natural workings of women's bodies-from our periods to our sexuality-are medicalized, sanitized, taken from us and sold back at a profit."

She is very protective of her larger "Truth", (for which I am sure it is expedient to sacrifice the little-t truths you mentiond in your response to her op-ed) that women should be WOMEN and that menstruation is so NORMAL and shouldn't be a secret dirty shame, but that we should EMBRACE OUR BLEEDING. Yeah, ok, honey.

She laments the entrance of PMS into the lexicon, (shoot, I kind of hated its entry into my *life*), and doesn't really seem to approve of modern methods of sopping up the mess.

Yes, appenertly she does fancy herself and expert on menstruation, though she gets so much so wrong. And what I said before goes double -

She does trust women ....will not want their periods, and this scares her.


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