Talking Menstruation with Toni

Toni Weschler used to be my neighbor, a fact that caused me to squee more than a little loudly and scare the bejeezus out⁠ of my pets when I first discovered it. Sadly, we didn't connect as often as I wish we had before I moved out of Seattle and to a more remote island outside the city.

A while back, I sent Toni some questions for Scarleteen, and many months later, she apologized for sending them to me so late. Now I owe her an even bigger apology for publishing them far later than that!

If you don't know who Toni is, she's the author of Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement and Reproductive Health, which is pretty much THE book for people who want to chart fertility⁠ , and the book I used to learn how to do it well in my 20's. She also wrote a great book about menstruation⁠ and charting⁠ for teen women, called Cycle Savvy: The Smart Teen's Guide to the Mysteries of Her Body. She's an amazingly dedicated and energetic person who also just happens to really, really like chocolate croissants.

You've dedicated your life's work to menstrual charting: why do you think charting, and awareness of menstrual⁠ cycles, is so important? In a word, it’s incredibly empowering. In addition to helping to increase self-esteem by helping women to take control of their bodies and appreciate their incredible intricacies, charting is infinitely practical. It’s wonderful as an overall means of maintaining gynecological health, as a method of natural birth control⁠ , and as an aid to pregnancy⁠ achievement.

What myths about menstruation do you think do us the most harm? Ovulation occurs on Day 14 First and foremost, I’d say the myth that ovulation⁠ occurs on Day 14. Not only is this myth responsible for more unplanned pregnancies, but also for untold numbers of women not being able to conceive.

The issue of unplanned pregnancies is huge. Unfortunately, most of us grow up hearing that the egg is released on Day 14, so if we just avoid that one day of our cycle, we can prevent pregnancy, right? Wrong! First of all, not all women ovulate on Day 14. Secondly, even if some women do ovulate on Day 14, the day of ovulation may vary from cycle to cycle. Thirdly, sperm⁠ can live up to 5 days inside the woman’s body, so if a woman has sex⁠ on Monday, she can still get pregnant that following Friday!

The opposite ramification of this myth pertains to the issue of infertility, which can feel even more overwhelming for scores of women desiring to get pregnant. Again, a woman may ovulate on Day 14, but could just as well ovulate on any other day. So she could theoretically try for years to get pregnant by timing intercourse⁠ for that one mythical day, only to discover that she never ovulates then, but rather weeks later!

A normal menstrual cycle⁠ is 28 days Actually, a normal menstrual cycle can vary from about 24-36 days. Not only do cycles vary substantially among girls and women, but they often vary within each individual person. There are numerous things that can impact a cycle. One of the most unfortunate results of this myth is the needless anxiety that it causes people who are led to believe over and over again that they may be pregnant because their periods are “late.”

Vaginal discharge⁠ is a symptom of an infection⁠ Wrong, wrong, wrong. Yes, it’s true that discharge can be a sign of an infection if it is accompanied by itching, odor, or inflammation, but the female body has a predictable way of revealing how healthy it really is. Every cycle, when a girl or woman is about to release an egg, she will produce a wet, slippery substance for several days leading up to ovulation. It is called cervical fluid, and is absolutely healthy!

So rather than feeling shame or running to the gynecologist⁠ every cycle when you produce this normal cervical fluid, take pride in the fact that your body is doing what it was designed to do!

A lot of young women tell us they want to avoid touching themselves genitally, an obvious problem in a lot of ways, but also when it comes to charting and menstruation. What do you think about that, and what do you think can help? It’s so sad that in our society, boys are often raised to take pride in their bodies, especially their penises, while girls are taught to not even discuss what’s “down there.” So is it any wonder that girls feel uncomfortable with the idea of looking at their vulva⁠ , let alone touching it?

One of the best ways to help girls get over their squeamishness is to give them a mirror and encourage them to look at their vulva in private, after having taken a shower or bath. Once they feel comfortable in just looking at their external anatomy⁠ , they will probably feel more relaxed about touching their vaginal lips and exploring their bodies more.

Another way to help girls get over their squeamishness is to help them appreciate how amazing their female bodies really are. Once they learn all the incredible things their bodies do every cycle, they will take much more pride in them and undoubtedly want to get to know them better.

Do you see any trends in increases of reproductive health problems for young women, and if so, do you think they really are new, or are instead only just being diagnosed now (or, of course, misdiagnosed)? Girls are tending to have sex earlier in the last few generations. And whenever someone has sex, their chances of contracting an STI⁠ increases. The younger a girl is when she starts to have sex, the more partners she will probably have, increasing her chances of developing a reproductive problem that could ultimately affect her fertility when she is older.

What makes this situation especially problematic is that the cervix⁠ in young girls is not fully developed, so that the most vulnerable part is most exposed to pathogens that can cause infections, reproductive problems, and even cancer.

Polycystic Ovarian Syndrome (PCOS) is a different situation. It is only relatively recently that physicians have started learning about the condition and its pervasiveness. Fortunately, girls are now being diagnosed and treated earlier, before it has a chance to impact them so negatively.

How do you feel about menstrual suppression, especially for younger women? In a word (or two): Bad news! For starters, there hasn’t been any research yet on the long-term health effects of suppressing periods in women in general, and teens in particular. History has already shown us that hormone replacement therapy (HRT) had potentially disastrous effects on women, but its repercussions were discovered only after years and years of use.

What we do know is that periods are necessary to rid the body of excess iron which can help lower a woman’s risk for cardiovascular disease. In addition, periods wash away bacteria inside the reproductive tract. And probably most importantly for teens, suppression of menstruation is likely to interfere with bone and breast⁠ development, as well as long-term fertility.

And, of course, periods are nature’s way of alerting a woman to the fact that she is not pregnant. Without them, it would be next to impossible to know if or when a woman got pregnant.

Finally, girls should grow up understanding the amazing ways their bodies work. Menstruation is an indication of the health of their bodies, not something to be eliminated!