Fourteen million Americans can’t be wrong

At the end of her lively, well-researched and wide-ranging inquiry into the ‘hush’ she believes surrounds the subject of menstruation in America, Karen Houppert thinks about her reluctance to discuss the subject of her book with the men she knows. ‘I tell them I’m writing a book. If they pursue the matter, I tell them that I’m working on a book about menstruation – never “periods”, because “menstruation” at least sounds slightly clinical and scientific and weighty.’ My first response to this confession was surprise – Houppert’s writing is not at all euphemistic, but straightforward, bold and funny – followed, I’m sorry to admit, by disapproval: what sort of Village Voice staff reporter is ashamed to say the word ‘period’ in front of men? But the truth is I know just how she felt. My first response on being offered The Curse for review was ‘Oh no, is that what comes to editors’ minds when they cast about for a book for me? Blood, cramps, mess?’ That both feminist writer and feminist reviewer confess to an ill-defined unease about their topic – it’s trivial, it’s embarrassing, it marks a woman as too irreducibly her body, as just too female – suggests that Houppert is on to something when she says that menstruation is the last taboo.

In taking on the subject, Houppert violates the central tenet of what she calls ‘menstrual etiquette’, the complex code of female behaviour intended to spare others, i.e. men, the awareness that women have periods, let alone, heaven forfend, that a particular woman is having her period right now – as, at any moment, about one in four females between the ages of roughly twelve and fifty is doing. Menstrual etiquette explains why, as Germaine Greer pointed out in the 1970s, a woman in a restaurant takes her entire handbag with her to the ladies’ room, instead of simply carrying a tampon in her hand: something, it has just occurred to me, I have still not seen a woman do in mixed company, three decades after The Female Eunuch. One doesn’t want to offend, of course, but whom would it offend, and why? When you think of the openness, even glee, with which once unmentionable body parts and functions are now regarded in the United States – whether it’s the elder President Bush’s celebrated up-chuck in the lap of the Prime Minister of Japan, or the supposed peculiarities of President Clinton’s penis, let alone the exhibitionist fiestas of reality TV and the Web – it seems curious that women still strive to keep secret something that, in a general way, everyone already knows is happening, something that is, moreover, a sign of fertility, good health and youth. As if it were too awful even to be mocked, menstruation is largely absent from dirty jokes or crude humour: have you ever seen a fake used tampon in those party stores that offer plastic turds, puddles of vomit, severed fingers as props for practical jokes? Bob Dole pitches Viagra, and various superannuated movie stars can be seen on American TV promoting adult diapers, but in 1997 when Johnson & Johnson went looking for a celebrity spokesmodel for Stayfree, its new line of menstrual pad, it had a hard time finding anyone willing to be identified with the product. Even the Spice Girls turned them down – so much for girl power. But then, Johnson & Johnson, best known for baby powder and No More Tears shampoo, didn’t even want its own name used in Stayfree advertising.

Americans may no longer believe, as they once did, that menstruating women can spoil meat, but they still see menstruation in a generally negative light. In a way, that’s not surprising, since there’s isn’t much research on healthy menstruation in normal women. (The US Government’s interest is mostly focused on the question that occupied Newt Gingrich: does menstruation render women unfit for combat?) When the experts focus their attention on menstruation, it’s usually to emphasise its pathology: studies on angry, depressed and unreasonable women fill the pages of professional journals. Houppert was able to find only one poll measuring ordinary American attitudes – a 1981 telephone survey conducted for Tampax (now Tambrands). According to this poll, men and women had similar ‘negative’ and ‘confused’ ideas.

More than one-quarter thought that women could not function normally at work while menstruating, with 8 per cent (that would have been 14 million Americans!) saying that women should make an effort to stay away from others when they’re having their periods. Thirty-five per cent said they thought menstruation affected a woman’s ability to think, 30 per cent thought women should cut down on their physical activities while menstruating, 49 per cent said that women had a different scent at that time, and 27 per cent said menstruating women looked different. Half thought women shouldn’t have sexual intercourse during their periods, and 22 per cent believed that swimming while menstruating was harmful. Two-thirds of those surveyed said that women should not mention their periods in the office or in social situations – that included veiled references to stomach pains or headaches – and more than one-third thought women should conceal the fact that they were menstruating from their families (for example, by hiding sanitary products). Interestingly, men were more likely than women to think it was OK to talk openly about periods (38 per cent, as opposed to 27 per cent). Thirty-one per cent of the women surveyed reported not knowing what menstruation was the first time they had their period, and 43 per cent of the women had had negative responses to their first period, saying that they felt scared, confused, terrible, panicky or ill.

The study was conducted a long time ago, culturally speaking, but Houppert’s immersion in advertisements, teen magazines, newspaper articles, popular literature and more recent studies has not persuaded her that there has been a dramatic change of attitude, despite three decades of feminism. Interviewing pre-teens at a girls-only summer camp nearly twenty years later, she found the same attitudes flourishing. Not only did a number of girls still believe swimming, bathing or showering during the menses was harmful, their counsellors – college-educated women in their late twenties – thought so too. Blame a kind of guided ignorance: in American schools, menstruation is usually explained in a single lesson, unlike other important subjects, whether the solar system or trigonometry, which are taught in age-appropriate ways many times over in the course of a school career. (As Houppert drily notes of the baffling circumlocutions typical of the feminine hygiene lecture, it is very hard to explain menstruation without explaining sex.) Besides, the curriculum for that single hour of menstrual education is likely to be provided by the menstrual-products industry itself. The focus is not on debunking contemporary myths – for example, that any display of ill-temper on the part of a human female can be safely attributed to her menstrual cycle – but on promoting tampons and urging girls to redoubled efforts at hygiene during this ‘special time of the month’. Like so many products aimed at women, from deodorants to diets to self-help books, the tampon business helps to create the very anxieties it claims to allay. Where else do women get the idea that menstrual odour is something they need to be vigilant about? Certainly not from having smelled it on other women.

Considering what a physical and social milestone menarche is, it is interesting how little attention it gets in the adult-written literature of adolescence. According to Houppert, Judy Blume’s Are You There, God? It’s Me, Margaret is the only book read by prepubescent girls in which menstruation is central – and it clearly fills a need, since with more than six million copies sold, it’s the sixth-bestselling children’s book of all time. (The campers mentioned above referred to it simply as ‘the book’.) Like most of Blume’s protagonists, 11-year-old Margaret is an engaging young person who wonders if she’s normal: she’s just moved to a new town in the suburbs, her parents are agnostics from different religious backgrounds, and when, oh when will she get her period? Margaret joins a small band of girls at school called the Pre-Teen Sensations, who promise to tell each other everything about menstruation, just as soon as it occurs – this enables Blume to describe it from a girl’s-eye (rather than doctor’s-eye or mother’s-eye) view. The Pre-Teen Sensations don’t want to hear about Fallopian tubes, and they don’t want bland reassurance, either. They want to know what it feels like. Naturally, parents across the country have tried to ban the book from school libraries.

Stephen King’s Carrie, devoured by high-school students of both sexes (four million copies sold), is at the other end of the spectrum. Carrie is a social misfit in every way: she’s so out of things that her fundamentalist mother hasn’t even told her about menstruation. (Interestingly, in both books the discussion of menstruation is connected to the theme of Judeo-Christianity, the historical source in the West of the view that menstruation is unclean, a badge of inferiority and a curse – although in Genesis God curses Eve with pain in childbirth, not the menses.) When Carrie gets her first period – in the locker room, in front of other girls – the popular kids at her school make fun of her. But Carrie’s wound is her bow: menarche releases her latent telekinetic powers and in the book’s thrilling climax, she gets total revenge. For boys, Houppert speculates, the book may be a misogynistic gross-out. But for girls the appeal is different: ‘Carrie converts a liability (menstruation, or becoming a woman) into an asset (power, more specifically the power to destroy, a decidedly unfeminine and unnurturing fantasy).’ Maybe so, but Houppert overlooks the fact that even from the girl reader’s perspective, Carrie’s story is not a reversal of the taboo but its confirmation: periods are still connected with disruption, the uncanny and death – including Carrie’s death.

Since the publication of Carol Gilligan and Lyn Mikel Brown’s Meeting at the Crossroads (1992) it has been widely, although not universally, accepted that many girls suffer a dramatic drop in self-esteem and confidence around puberty. For Gilligan, as for Mary Pipher, Peggy Orenstein and countless others, the problem is diffuse in origin: gradually, the girls become aware that their perceptions, experiences and values aren’t honoured by a sexist society and that their prospects are limited in ways that their brothers’ are not. Houppert wonders whether menstruation could be the trigger for the drop in confidence: Anne Frank, for example, seems in the later, post-menarche pages of her diary, to become less sure of herself, more secretive and withdrawn, more conflicted about her early sexual longings. The changes of puberty are gradual, but as Simone de Beauvoir noted, menstruation functions, misleadingly, as a bright line dividing the asexual child from the sexual female: parents treat their daughters differently once they get their periods, allowing them to dress more alluringly and to date boys; and girls, too, see their bodies differently. In a 1983 study, girls who had never menstruated drew pictures of women who were slender and boyish and casually dressed, regardless of their own appearance; when the same girls menstruated, they drew women as curvaceous and big-breasted, decked out in jewellery, high heels, even carrying a bouquet of flowers. Girls seem to reorganise their body images in the direction of greater sexual maturity, according to Sharon Golub, a former president of the Society for Menstrual Cycle Research. But accommodating puberty in a sexist culture is not an easy task, which may be why, according to another study, the likelihood of severe depression doubles in the year after the onset of menstruation. And a decline in the average age at first menstruation, as a result of improved nutrition, from 15 at the end of the 19th century to 12½ today, only makes it worse. Many parents, especially fathers, behave as if a daughter’s childhood is over once she gets her period. That’s rather harsh, even if you’re 14. But what if you’re 11?

In the book’s strongest chapter, Houppert quotes from her own teenage jottings (‘We wish to denounce the widely held opinion that women lack the intense sexual drive that men undoubtedly possess’). Looking at puberty by way of menstruation allows her to make specific connections that are often left general and vague. If the trigger for that drop in confidence is menstruation rather than a more generalised awareness of second-class status, it makes sense that two years later girls should have very high levels of self-confidence: they’ve overcome the hygiene crisis, got used to living in their new bodies, and are able to take pride in themselves again. The menstrual crisis also explains the obsession with incidents of embarrassment and mortification that you see in teenage girls’ magazines. Seventeen’s most popular column, ‘Trauma-rama’, invites readers to ‘share your shame’; Teen has ‘Why Me? Your Horror Stories and Ultimate Embarrassments’; YM has ‘Say Anything: Your Most Humiliating Experiences’. We think of teenage mortification as general angst common to both sexes, but it is hard to imagine a magazine in which boys would write in about, say, getting an erection while standing at the blackboard, or having a wet dream while sleeping on their grandmother’s best sheets. (But then, for similar reasons, there isn’t really a boys’ equivalent to the girls’ magazines.) ‘Most of what I get in the post is about menstruation,’ says one mortification-column editor, who limits herself to one period story a month. The embarrassing incident need not involve leaks or stains: it is enough that someone, especially a boy, knows that you’re having your period. Or will have in the future. Or have had one once. The message that your body will betray you if not rigidly policed is evident in the mores these magazines promote: sex is presented as a temptation to be avoided, its risks are continually emphasised, its normality – half US teenagers have sex while in high school – barely noted.

Houppert claims that menstrual modesty has important consumer and health consequences for girls and women. Sanitary products are used by half the population roughly one week a month for roughly 38 years – at five tampons a day for five days, that works out at some 11,400 tampons over a lifetime – yet there is no list of contents on a box of tampons, and consumer awareness is low: indeed, Houppert writes that the inspiration for The Curse was her discovery that Tambrands had reduced the number of items per box from 40 to 32 while raising the price. Unfortunately for her argument, these pricing ploys are common to many other products: consider the Hershey chocolate bar, today a mere sliver of its robust and satisfying 1970s self at more than twice the cost. If menstrual etiquette explains why women don’t insist on cheaper, purer tampons, what explains the docility of shoppers before the punnet of strawberries sprayed with every pesticide known to man, and the pound-sized can of coffee that only contains 13 oz? Consumer Reports (US circulation four million) rates menstrual products from time to time, so for those who want to research their tampon purchases as if they were buying a car, the information on price and quality is out there.

Still, I share Houppert’s resentment of the fact that menstrual products are taxed like luxuries in the US – is menstruation voluntary, are the poor supposed to stuff themselves with old newspapers? – unlike a vast array of drugstore products from razor blades to chapstick (not to mention condoms and just about any other product made to be bought by men). Menstrual etiquette has its limits: the Australian Government found itself in the midst of a furious outcry last year when it proposed levying a 10 per cent tax on previously tax-free menstrual products and breast-feeding equipment. Red-caped ‘menstrual avengers’ led demonstrations around the country, at one of which the entire Federal Cabinet was pelted with tampons and pads, and politicians were confronted by women carrying signs that read ‘I bleed and I vote’ – one woman even dressed up as a tampon. The tax, brain child of an anti-abortion health minister, went through all the same. I hear that in the UK the tax has just been abolished, although the Chancellor was too embarrassed to mention the fact in his Budget speech.

Can what you don’t know about tampons hurt you? Houppert thinks it already has. In 1980, a number of cases of toxic shock syndrome in menstruating women were traced to Procter & Gamble’s new super-absorbent Rely tampon. The company quickly withdrew the product, but toxic shock persisted. Rely, it turned out, was not the cause of toxic shock, but one of several convenient mediums in which the toxic-shock bacterium, Staphylococcus aureus, could grow. On the other hand, as Houppert points out, the viscous rayon that helped the bacterium to flourish in Rely is still used in every mass-market brand of tampons. Furthermore, the leading brands all contain dioxin residue (a by-product of the chlorine-bleaching process used in the manufacture of rayon). Houppert suggests that prolonged contact with the chemical may be implicated in the increased incidence of endometriosis – a condition from which more than five million American women suffer – and possibly in infertility. It’s a theory – and given that almost all research into the effects of tampons is funded by tampon manufacturers, it’s likely to remain a theory.

Every generation thinks that the stigma and myths surrounding menstruation have at last been relegated to the musty past, that now sweet reason reigns. Houppert takes a dim view of such notions of progress; and if you think of the way Prozac, renamed Sarafem, is being marketed as the cure for Premenstrual Dysphoric Disorder (PMDD), an extreme form of PMS which supposedly affects between 3 and 10 per cent of American women, it does indeed seem that we have come round to a medicalised version of the old meat-spoiling stereotype. The notion that women are less competent before or during their periods was exploded in 1914 by Leta Stetter Hollingworth, who gave 23 women a battery of tests over the course of several months and found no discernible pattern to the results. Yet it persists. Women themselves constantly attribute clumsiness and bad moods to PMS, as if they would invariably be calm and cheerful and supercompetent were it not for the menstrual cycle. Forget squalling kids, demanding husbands, boring and underpaid jobs; forget responsibility without authority – the very definition of stress. Could it be that PMS is the way some women permit themselves to express feelings they have all month long?

That said, and at the risk of sounding like one of those women who are always announcing a new dawn for women, I’d argue that menstrual views really are changing. This year Tambrands, a company so modest about its product that there aren’t any signs pointing the way to its factory, sponsored the Madison Square Garden gala benefit performance of The Vagina Monologues at which attractive young women offered elegant metallic tampon-holders as freebies to ticketholders, so much more convenient for those ladies’ room visits than carting your whole big bag. I think of it this way: as a girl my grandmother prided herself on the fact that the rags hanging on the washing line were so well laundered that no one in her shtetl could tell what they were used for; my 13-year-old daughter flips wet tampons at the kitchen ceiling, where they stick for weeks, their strings hanging down like the tails of fluffy white mice. From shameful secrecy to silly humour: there’s almost a century of social change packed into that shift.

Houppert wishes menstruation were regarded more like sneezing or having a cold, one of the inconvenient but basically insignificant things that happen to bodies, with menstrual blood no bigger a deal than snot. Leaving aside the fact that menstruation, unlike the sniffles, is not a sickness, it is hard to imagine the vagina ever being regarded like the nose – and would equating menstrual blood with snot be an upgrade? Not everyone is repelled by menstrual blood, and some are rather excited by it. ‘I like ketchup with my french fries,’ a truckdriver told a friend of mine. Prince Charles wanted to be Camilla Parker Bowles’s tampon – not her hankie.

There’s been a flurry of articles in the past year about the use of birth control pills to suppress menstruation on the grounds that women’s bodies were designed to have many fewer periods than most women now have – for most of our species’ existence women were constantly pregnant or lactating – and that the modern pattern of near-constant exposure to the menstrual cycle increases the risk of oestrogen-related cancers and other illnesses. An unofficial survey on the Museum of Menstruation website (one of many websites dedicated to menstruation – who knew?) is running heavily in favour of dispensing with periods altogether.

Is it too utopian, too 1970s-feminist to see that as a loss? It’s silly to romanticise menstruation – getting together with your fellow communards to fertilise the vegetable patch with your monthlies – but to see it only in terms of cramps and leaks is taking practicality very far. Periods are about important things: fertility, sex, time. When my daughter starts to menstruate, I’d like her to see it as something positive, a sign that the plumbing is in good working order – maybe even something to think about.