Sometimes, it actually IS hormones: a story of feminism and medicine

There is a particularly irritating convergence of medical sexism, feminism, and my embodiment that I want to talk about: the idea that it’s sexist to blame problems on PMS, and therefore PMS does not cause problems beyond mild bloating or light cramps. (If that is your reality, congratulations! You won uterine lottery.)

Photo of smiling felted uterus with text “Congratulations on not being pregnant, here’s a taste of childbirth pain anyway”

I recently found out that the Ancient Greeks believed “hysteria” was caused by a free-floating uterus, which roamed the body absorbing liquid from the other organs and causing illness. I think of all the women throughout time — particularly marginalized women — who’ve been dismissed as “hysterical” or “crazy bitches” and it makes me more than a little rage-y.

An image from Beyoncé’s Lemonade. Queen Bey in yellow dress, wielding a baseball bat and surrounded by flames. Part of the power of this song “Hold Up” is that she talks about the way women’s emotions are used against them. (“What’s worse, lookin’ jealous or crazy? / Jealous or crazy? / Or like being walked all over lately, walked all over lately / I’d rather be crazy”). If you want more information about Beyoncé’s genius, please ask a Black woman.

Part of the feminist backlash to millenia of being called hysterical is the idea that (cis) women can do anything despite their periods. (Never mind the fat that not all cis women get periods — hello, menopause, I can’t wait for you! — and plenty of people who are not cis women have periods.)

Compete in the Olympic swimming competition during your period? Check. It’s the ultimate comeback to everyone who made jokes about “blood coming out of her wherever” or said Hillary Clinton was too hormonal to handle nuclear codes. (Never mind that she’s hopefully DONE with PMS by now; I really hope she gets to be done with PMS by now.)

The feminist party line is that periods don’t stop you from doing everything a mediocre white man can do, and probably better. Girl power, woo!

Game of Thrones Meme text: What’s Swooning? / Fainting. / What’s fainting? / When a girl sees blood and collapses. / Why would a girl see blood and collapse? / Not all girls are like you. / Girls see more blood than boys.

Except sometimes…sometimes they do. Sometimes periods are not some mystical moon goddess thing, or even just “a messy annoying thing that I cope with better than any dude would.” Sometimes your uterus CAN have actual medical issues. Shocker.

Thinking back to the laughable idea about what the Ancient Greeks thought “hysteria” was, the uterus floating through one’s body…how different IS that from endometriosis? I mean sure the specifics are super wrong, your literal uterus doesn’t go floating around like Casper the (Bleeding) Ghost. But endometrial tissue, which is supposed to grow inside the uterus, can sprout up on organs throughout the body. And it really hurts when it bleeds, and causes all kinds of problems.

Endometriosis is thought to affect one in ten people with a uterus, and yet the only definitive diagnosis for it is laproscopic surgery. People go years without a diagnosis because they don’t know that the amount of pain they endure during their periods isn’t normal cramps. As endometriosis often runs in families, young people can get a false idea of how painful a period should be from watching relatives silently endure monthly pain.

Adenomyosis is a similar condition, where the endometrial tissue grows into the muscular wall of the uterus. However, the only definitive diagnosis for adenomyosis is a biopsy of a person’s uterus after a hysterectomy. Coincidentally, this is also the only treatment for adenomyosis. We really need to work on research funding for some of these conditions.

Pre-menstrual dysphoric disorder (PMDD) is another under-researched condition that affects people who menstruate. I did not know it existed for fifteen years while I struggled to find a medication that would help my mood swings and depression. I would casually mention to various psychiatric professionals that my suicidal ideation always happened when I had PMS and would magically vanish as soon as I started bleeding.

Sometimes I grieve for the years where we tried treatment after treatment, and nothing really helped. I wonder what I would have done differently, who I would be, if I’d received an accurate diagnosis earlier. (Note: many people take SSRIs for PMDD, and this is also the first-line treatment for depression. However, there are also plenty of people, myself included, who cannot tolerate SSRIs.)

As feminists, we’re taught that it’s sexist to blame a person’s behavior on their hormones or PMS. This is true, in that it is a classic abuse/gaslighting tactic to dismiss a person because they’re “too emotional right now.” Yet that does not mean there is not a correlation between hormones and health.

Since I started taking progesterone to manage PMDD, I’ve gone from monthly cravings for sharp objects to monthly cravings for carbs. I still struggle with depression, but it’s much more rare that I reach that dark place where it seems like everything will be terrible forever. I am still searching for an effective treatment for menstrual cramping and cysts, but that’s another story.

Our feminist narrative around periods and uteri needs to change if we are to ensure people get effective treatment for real medical conditions. The patriarchy will not advocate for new treatments or research without noise, which means recognizing that for many people periods/PMS are painful or a problem. Yes, it is sexist to blame a person’s behavior on their hormones or talk about “blood coming out of their wherever.” That does not mean PMS is something every person can just muscle through. It just means that those of us who cope with immense pain or mood swings are not dealing with a healthy period, but a medical problem that deserves treatment, compassion, and research funding.

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