Flow

Introduction

In her book "Flow," Elissa Stein takes readers on a journey through the often misunderstood and taboo subject of menstruation. With an average of 450 periods in a woman's lifetime, it's surprising how little many women know about this natural bodily function. Stein aims to change that by shedding light on the historical, cultural, and scientific aspects of menstruation.

The book delves into the myths and misconceptions that have surrounded periods for centuries, exploring how these beliefs have shaped societal attitudes and influenced women's experiences. From ancient rituals to modern-day marketing tactics, Stein uncovers the complex relationship between women and their menstrual cycles.

"Flow" is not just a book about periods; it's a call to action for women to better understand their bodies and challenge the stigmas that persist around menstruation. By providing a comprehensive look at this essential aspect of female health, Stein empowers readers to make informed choices and embrace their natural rhythms.

The Historical Taboo of Menstruation

Since ancient times, menstruation has been shrouded in mystery and surrounded by misperceptions. Many cultures viewed it as both sacred and dangerous, leading to conflicting beliefs about its nature and effects.

Ancient Beliefs and Practices

In ancient societies, menstrual blood was often seen as a powerful substance with both positive and negative attributes. Some believed it to be the remains of an unborn child, while others saw it as a toxic matter that needed to be expelled from the body.

Roman philosopher Pliny the Elder, in his book "Natural History" written in AD 77, claimed that menstrual blood could cause various calamities, from miscarriages in horses to the wilting of flowers. These unfounded beliefs persisted for over a thousand years and continue to influence some cultures even today.

Menstrual Huts and Rituals

The perception of menstruation as something unclean led to the practice of isolating menstruating women in special huts. Shockingly, this practice still exists in some parts of the world. Young girls experiencing their first period (menarche) were often subjected to elaborate and sometimes cruel rituals. For example, in British Columbia, girls were forced into the wilderness, while in New Ireland, they were kept in cages for up to four years.

Exclusion from Society

The taboo surrounding menstruation was used as a justification to exclude women from various aspects of society. Even as recently as the 1920s, menstruating women were banned from entering churches, wineries in Germany, and opium labs in Vietnam. Today, some Islamic rituals still prohibit the participation of menstruating women.

These historical beliefs and practices have had a lasting impact on how menstruation is perceived and discussed in contemporary society. By understanding this context, we can begin to challenge and change these outdated notions.

From Hysteria to PMS: The Evolution of Menstrual Understanding

The way society has viewed and diagnosed menstrual-related symptoms has changed dramatically over time, reflecting the evolving understanding of female anatomy and psychology.

Hysteria: A Misunderstood Diagnosis

During the Middle Ages, women exhibiting a range of symptoms – from insomnia to mood swings – were often diagnosed with "hysteria." This catch-all term was used to explain various female ailments, and those suffering from it were sometimes even accused of witchcraft.

The concept of hysteria persisted well into modern times, illustrating the widespread ignorance about female anatomy and sexuality. Even Hippocrates, the "Father of Medicine," believed that hysteria was caused by the uterus moving around a woman's body.

Treating Hysteria

The treatments for hysteria were often bizarre and sometimes harmful. They ranged from using X-rays to applying leeches to a woman's vulva. Perhaps the most infamous treatment involved doctors or midwives manually stimulating a patient's clitoris until orgasm – a practice that was viewed as a purely medical procedure at the time.

The Shift to PMS

It wasn't until 1952 that the American Psychiatric Association dropped the term "hysteria." A year later, the concept of premenstrual syndrome (PMS) emerged as a new way to understand menstrual-related symptoms.

Understanding PMS Today

While we now have a better understanding of some aspects of PMS, such as the cause of menstrual cramps (uterine contractions), there is still much to learn. Surprisingly, there's no conclusive evidence that PMS is entirely hormonal, and many of its symptoms remain poorly understood.

The concept of PMS, along with the more severe condition known as Premenstrual Dysphoric Disorder (PMDD), is largely a Western medical construct. This raises important questions about how we view and treat menstrual-related symptoms across different cultures.

A New Perspective

As our understanding of menstruation continues to evolve, it's important to consider whether the emotional and physiological changes women experience during their cycles should be viewed as problems to be solved or simply accepted as part of the human experience.

Debunking Myths About Menstrual Sex

One of the most persistent taboos surrounding menstruation is the idea of having sex during one's period. However, modern science has found no harm in this practice, despite centuries of religious and cultural prohibitions.

Religious Restrictions

Many religions have historically viewed menstrual sex as a form of contamination. For example:

• In Orthodox Judaism, a woman is considered unclean (niddah) for two weeks covering and following her period. During this time, she and her husband are prohibited from any physical contact, including sex.
• Muslim women are forbidden from having sex with their husbands, fasting, or handling the Koran during menstruation.
• The Bible discourages men from shaking hands with menstruating women.

These religious restrictions have contributed to the stigma surrounding period sex and menstruation in general.

The Reality of Menstrual Sex

Despite these long-standing taboos, scientific research has shown that having sex during menstruation is both safe and normal. In fact, a 2002 study at Yale University suggested that women who experience orgasms while menstruating may be less likely to suffer from endometriosis, a painful condition where uterine lining grows outside the uterus.

Overcoming Shame and Stigma

Unfortunately, the lack of open discussion about menstruation and related topics has led to persistent feelings of shame for many women. By challenging these taboos and promoting education about menstrual health, we can help create a more accepting and informed society.

The Impact of Femcare Products on Women's Rights

The development of feminine care products has played a significant role in advancing women's rights and participation in society.

Life Before Modern Femcare Products

Before the invention of tampons and pads, women had to rely on makeshift solutions that were often uncomfortable and impractical. These included:

• Rags strapped between the thighs
• Moss, leaves, and sheepskin
• Rubber-lined aprons and bloomers (for wealthy women)

The lack of effective menstrual products made it challenging for women to fully participate in daily activities and societal events.

The Birth of Modern Femcare

In 1920, two significant events occurred:

1. Kotex pads, made from leftover WWI bandage material, became commercially available.
2. The Nineteenth Amendment was enacted, granting women the right to vote in the United States.

While these early pads were a great advancement, they were still bulky and required elastic belts and pins to hold them in place.

Further Advancements

In the 1970s, self-adhesive pads were introduced by brands like Carefree and Stayfree. This coincided with the women's liberation movement, which fought for equal rights in areas such as pay and reproductive health.

Global Impact

The availability of femcare products has had a profound impact on women's education and career opportunities in the Western world. However, in some parts of the world, such as Sub-Saharan Africa, the lack of access to these products still causes young girls to miss 10 to 20 percent of school days.

The Double-Edged Sword of Femcare Advertising

While the increased visibility of menstrual products through advertising has brought periods into the public consciousness, it has also perpetuated harmful stereotypes and shame surrounding menstruation.

Unrealistic Portrayals

Femcare ads typically feature beautiful women in pristine, often white clothing, set against serene backgrounds. These images suggest that menstruation should be invisible and that women should appear fresh and clean at all times, even during their periods.

The Blue Liquid Phenomenon

Despite the lifting of the ban on femcare ads by the National Association of Broadcasters in 1972, menstrual blood is still represented by a blue liquid in commercials. This practice implies that real menstrual blood is too unclean or offensive to be shown on television.

Exploiting Insecurities

Marketing campaigns have not only played on women's insecurities about their periods but have also created new anxieties, such as concerns about vaginal odors. This has led to the promotion of potentially harmful products like douches.

The Dangers of Douching

Since the 1930s, the femcare industry has marketed douches as a solution to non-existent vaginal odor problems, even suggesting they could solve marital issues. Popular douche products have included:

• Zonite (a diluted bleach solution)
• Lysol (the same chemical used for household cleaning)
• Water and vinegar mixtures

These products can disrupt the body's natural pH balance and lead to various health issues, including bacterial vaginosis, yeast infections, and pelvic inflammatory disease.

Despite the proven risks and ineffectiveness of douching, 20 to 40 percent of American women still report using these products regularly. This statistic highlights the deep-rooted insecurities that have been cultivated by years of misleading marketing.

The Knowledge Gap in Menstrual Health

Many women lack basic knowledge about their menstrual cycles and how they relate to pregnancy. This information gap is largely due to the persistent shame and taboo surrounding menstruation in American culture.

Misconceptions About Late Periods

While a late period is often associated with pregnancy, it can indicate various other conditions, such as:

• Stress
• Perimenopause
• Ongoing ovulation

Menstruation Without Ovulation (and Vice Versa)

Many people are unaware that:

• Women can menstruate without ovulating, especially in the first two years after menarche (up to 80% of cycles may not include ovulation).
• Women can ovulate without menstruating, leading to potential pregnancies in women who haven't had periods for months.

Pregnancy Risks During Menstruation

Contrary to popular belief, it is possible to become pregnant while having sex during menstruation. This is because:

• Sperm can survive in the vagina for several days.
• Ovulation can occur soon after the end of a period.
• Heavy spotting during ovulation can be mistaken for a period.

The Role of Big Business

The lack of comprehensive menstrual education is partly due to the influence of large companies that prioritize selling products over providing accurate information about women's natural bodily processes.

The Truth About Bleeding on Birth Control

Over 100 million women worldwide use birth control pills, but many are unaware that the bleeding they experience while on the pill is not a true menstrual period.

Understanding Natural Menstruation

A natural menstrual cycle involves several steps:

1. The brain signals egg follicles in the ovaries to begin ripening.
2. Around day 13, another signal triggers ovulation.
3. The released egg travels through the fallopian tubes to the uterus.
4. If fertilization doesn't occur, the egg dissolves, and the uterine lining is shed through menstruation.

How Birth Control Pills Work

Birth control pills typically contain estrogen or a combination of estrogen and progestin. They work by:

1. Tricking the body into thinking it's pregnant for three weeks.
2. Providing placebo pills for one week, which causes a mild version of endometrial shedding.

The Difference Between Natural and Pill-Induced Bleeding

The bleeding experienced while on birth control pills is not a true period because:

• It's a milder version of endometrial shedding.
• The symptoms (cramps, blood flow) are generally less intense.
• It's induced by the withdrawal of hormones rather than the natural menstrual cycle.

Understanding this difference can help women make more informed decisions about their reproductive health and contraceptive choices.

The Pharmaceutical Industry's Influence on Menstruation and Menopause

Pharmaceutical companies have long sought to profit from society's negative perceptions of menstruation and menopause, often promoting products that promise to eliminate or reduce these natural processes.

Manipulating Menstruation

Birth control pills were originally designed with placebo pills to mimic a natural menstrual cycle, as drug companies feared women wouldn't buy a product that completely suppressed menstruation. However, attitudes have shifted, and now there are products designed to stop or reduce periods altogether:

• Yaz
• Lybrel
• Implanon

While these drugs may be beneficial for women with severe menstrual symptoms, they are often marketed as a solution for all women, regardless of whether they experience significant discomfort during their periods.

Exploiting Fears of Menopause

Similar to menstruation, pharmaceutical companies have capitalized on women's fears about menopause and aging. Since the 1930s, they have promoted Hormone Replacement Therapy (HRT) as a way to avoid the symptoms of menopause and signs of aging.

However, long-term use of HRT has been associated with increased risks of:

• Blood clots
• Heart disease
• Stroke
• Breast cancer

Despite these known risks, drug companies continue to market these products aggressively.

The Natural Perspective

It's important to remember that both menstruation and menopause are natural processes that female bodies undergo. While some women may benefit from medical interventions, many experience these changes with minimal discomfort and don't require pharmaceutical solutions.

By promoting a more balanced view of these natural processes, we can help women make informed decisions about their health without succumbing to unnecessary fears or marketing pressures.

Embracing Menstrual Health: A Call to Action

As we've explored the complex history and current state of menstrual health, it's clear that there's still much work to be done in terms of education, awareness, and destigmatization. Here are some key takeaways and actions we can all take to promote better understanding and acceptance of menstruation:

1. Educate Yourself and Others

Take the time to learn about your menstrual cycle and share this knowledge with others. By understanding the biological processes involved, we can dispel myths and misconceptions that have persisted for generations.

2. Challenge Taboos

Don't be afraid to discuss menstruation openly. By normalizing these conversations, we can help break down the barriers of shame and embarrassment that many women still face.

3. Question Marketing Claims

Be critical of advertisements for femcare products and menstrual-related medications. Look beyond the marketing hype and seek out factual, scientific information about these products and their effects on your body.

4. Embrace Your Natural Rhythms

Remember that menstruation is a normal, healthy part of life for most women. While medical interventions can be helpful for those with severe symptoms, it's important to recognize that not every aspect of menstruation needs to be "fixed" or eliminated.

5. Support Access to Femcare Products

Advocate for increased access to menstrual products, especially in underserved communities and developing countries. No one should miss out on education or opportunities due to lack of access to these essential items.

6. Promote Comprehensive Sex Education

Push for comprehensive sex education in schools that includes detailed information about menstruation, reproductive health, and contraception. Knowledge is power, and young people deserve to be well-informed about their bodies.

7. Listen to Your Body

Pay attention to your menstrual cycle and how it affects you. Keep a period diary to track your symptoms, moods, and any changes you notice. This information can be valuable for both you and your healthcare provider.

8. Seek Professional Help When Needed

If you experience severe menstrual symptoms or have concerns about your cycle, don't hesitate to consult with a healthcare professional. Remember that everyone's experience is different, and there's no shame in seeking help.

Conclusion

Elissa Stein's "Flow" provides a comprehensive look at the often-overlooked subject of menstruation, challenging readers to reconsider their perceptions and knowledge about this natural bodily function. By exploring the historical, cultural, and scientific aspects of periods, the book empowers women to better understand their bodies and make informed decisions about their health.

As we move forward, it's crucial to continue the conversation about menstrual health, breaking down taboos and promoting accurate, shame-free education. By embracing our natural rhythms and challenging outdated beliefs, we can create a more inclusive and understanding society for all.

Remember, menstruation is not just a "women's issue" – it's a human issue that affects half the world's population. By fostering open dialogue and promoting menstrual literacy, we can work towards a future where periods are understood, respected, and no longer shrouded in mystery or shame.