In Our Control (27 page)

In 1976, a British veterinarian named R. V. Short published an influential essay, “The Evolution of Human Reproduction.”
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He argued that continual menstruation is a by-product of modern life rather than a natural evolutionary event. This perspective was based, among other factors, on the lack of menstruation in other nonhuman primates and on the much more limited menstruation of women in particular “primitive” societies. The conclusion was clear to Short: perpetual periods were not, evolutionarily speaking, the biological rule. And the problems they caused, including increased cancer risks, anemia, and premenstrual syndrome, “highlighted the importance of developing a non-steroidal contraceptive that would allow a woman to return to the reproductive state that was the norm for our primitive ancestors—amenorrhea.”
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Short’s ideas also grew out of his beliefs about population control. The 1960s and 1970s saw a growth of political concern about the potential ramifications of third world population growth. In a 1972 essay Short wrote, “Many economists have predicted that the rich nations of the world are destined to grow richer at the expense of the poor nations, who are doomed to become poorer. It seems doubtful that mankind could survive the ensuing racial and national tensions if there was to be an increasing polarization between the haves and the have-nots.”
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His solution
to this impending international class war: simply reduce high birth rates in poor countries. In light of this, the argument in favor of curtailing menstruation with hormones for the benefit of preventing anemia and other nutritional problems in women in non-Western nations takes on new significance.

Medically, Short relied heavily on the work of Dr. Katharina Dalton, particularly with regard to PMS and its potential to encourage crime and antisocial behavior in women. Although women have experienced some premenstrual complaints, including variable moods, for thousands of years, it was Dalton who gave the set of symptoms a name in 1953. This British doctor worked tirelessly for decades to publicize the condition that she christened, and in addition to opening a clinic, she penned the popular handbook
Once a Month
in 1978. The book drips with overheated descriptions of hormone-crazed women wreaking havoc; Karen Houppert writes that it “reads as if hordes of angry women are ripping at our social fabric with bared teeth.”
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Although revered by some, Dalton has been broadly criticized for questionable methodologies and bad science: “The problems with Dalton’s research are numerous, ranging from a lack of control groups to the use of non-representative samples to unjustified conclusions to unwarranted universalizations.”
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However dubious the political underpinnings of Short’s work and however shaky the science, his conclusions about menstruation and evolution were popular. Among the mainstream gynecological opinion makers to take up his theories were the editors of
Williams Obstetrics
, a leading gynecological textbook. Zahra Meghani notes that the book characterizes bleeding as “an inherent hormonal disorder.” She adds that the “implication is that menstrual suppressant contraceptives ought to be used as ‘treatment’ for all females of childbearing age, barring those contemplating pregnancy.”
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By the 1980s, drugmakers still had not capitalized on a potential market for period suppression (and even Depo-Provera would not be approved in the United States for another decade). In part, this was because research suggested that women did not want to get rid of periods. A 1983 World Health Organization study that looked at female populations in ten nations found that despite common menstrual complaints and negative cultural perceptions of bleeding, women perceived the event as natural and had no desire to suppress it.

Elsimar Coutinho believed this was because women harbored misperceptions of the event—they still believed, as classical thinkers did, that it freed the body from toxins. Others felt it served as a signifier of femininity and youth. To the doctor’s mind, periods served few positive purposes and caused many problems. It was a desire to correct “mistaken” beliefs that led to the publication of Coutinho’s influential book
Is Menstruation Obsolete?

Written in Blood: The Case against Bleeding

In
Is Menstruation Obsolete?
Coutinho and Segal start from Short’s evolutionary argument against periods and expand it with additional medical and cultural justifications.

The most controversial and powerful claim remains, of course, that menstruation is somehow fundamentally unnatural. Prehistoric women, the book argues, would have had few, if any, menstrual periods. This was for two reasons. First, those ancient females would have been perpetually pregnant and lactating (which provides some natural prevention of periods). Second, when they weren’t busy birthing and breastfeeding, our ancestors were on the move. They were walking and gathering and eating a lot less food than us, all factors that could have contributed to a level of body fat low enough to prevent menstruation. Today, our stagnant, infertile, modern lives have made our bodies behave in ways that nature and evolution never intended. Segal writes, “It has also not escaped scientific attention over the years that modern woman, endowed with essentially the same gene pool as her Stone Age ancestors, has a totally different reproductive pattern.”
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While certainly it is true that women had more babies before the advent of reliable, readily available birth control, it is always valuable to be skeptical of scientific claims based on imagined but unprovable histories. Canadian health activist Kathleen O’Grady writes, “There are questions concerning the accuracy of Coutinho’s perpetually pregnant ancient woman. We have little evidence to pronounce conclusively that women rarely menstruated in the past. Rather we have ample evidence to suppose that women were regularly practicing birth control methods (and hence menstruating) in countless cultures.”
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The prehistoric woman is a favorite character in any scientific or political rationale that seeks to establish something “natural” about women’s bodies. This happens, at least in part, because of her relative evolutionary proximity to the animal world and her lack of surviving cultural artifacts. There are, of course, already logical flaws in this theory: first, it assumes that animals lack culture; and second, it assumes that just because evidence of culture as exemplified by surviving artifacts does not exist now, it never did. In fact, it is the lack of hard evidence about ancient peoples that makes them particularly useful for promoting social agendas about how bodies should be and what they should do. We can easily imagine these distant ancestors across the hazy imprecision of time; they must certainly have been closer to some imagined origin where humans lived totally as nature intended.

What evidence we do have supports the notion that prehistoric women lived with culture differently, but just as surely, as we do. In her essay
Childbirth in Prehistory: An Introduction
, archeologist Elisabeth Beausang refutes Coutinho’s claim that childless women were without exception infertile; to this group she adds women who were “socially excluded from the possibility” and “women who for some reason choose not to give birth.” She writes, “The fact that the biological variables can and are manipulated and modified by cultural practices and circumstances has to be acknowledged as a possibility even for prehistoric times.”
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In other words, while they lacked our technologies for pregnancy prevention, they still had the ability to make choices to have or not have sex at certain times, and perhaps to not have sex at all. Women had fewer choices, but they did not completely lack agency.

Perhaps this is the crux of the issue: whenever ancient woman is imagined, she is seen as powerless, completely subject to the harsh controls of the natural world and of the men in her community. It is from this “ideal” that doctors and cultural critics build an idea of what women (and men) should want and how they can make choices about their bodies. Referring back to the arguments of Margaret Lock, we can see that a popular belief in a strict nature/culture binary is easily exploited and coupled with authoritative language to create the impression that certain things are “natural,” and therefore good, as opposed to “unnatural” products of a corrupt, unhealthy postindustrial society.

Coutinho and Segal actually confuse the nature/culture binary even as they use it to justify their claims. In the book’s first chapter they write, “For the hundreds and thousands of years of the prehistoric epoch, with life based on hunting and gathering, the role of women was perceived as producing a child, preferably a man-child.”
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Even as they argue that early women—read “women in their natural state”—don’t menstruate, they betray the preferences of certain cultures for the baby to be a boy.

Zahra Meghani writes that a feminist analysis “reveals that these theorists’ recourse to ideas of evolutionary-suitedness is strategic.” She makes this point humorously, pointing out that that bipedalism—walking upright—“is not categorized as a pathological evolutionary aberration although it is both unique to humans and causes some percentage of the population to experience various physical ailments, such as fallen arches and back pain, impairing their ability to function well in society.”
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And yet there are no cries in the medical community to return to moving on all fours.

Menopause provides another example of the way that women’s histories are reimagined to promote certain cultural perspectives. Even today, the notion that women before the twentieth century didn’t live long enough to cease menstruating persists. In the 1990s, when drug companies had significant interests in pushing hormone treatment for all peri- and postmenopausal women, it was common to hear that menopause wasn’t natural and was a “disease” of modern life that required pills to cure it. Statistical analysis by, among others, Margaret Lock has shown that these claims were based on oversimplification, and in fact, a visit to former centuries would have revealed many gray female heads.

While “natural” does not necessarily mean “correct” or “positive,” it is frequently interpreted this way. Menstrual suppression is often explained in terms of female empowerment, but a hard look at the evolutionary logic behind it betrays a reactionary argument about women and biological destiny. In looking at nonhuman primates, Coutinho and Segal write, “Regardless of the social structures in which they live, it is rare to find a menstruating nonhuman primate free-living in the wild.”
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What are we supposed to assume about life in a “natural” condition from this statement? First, that females do not live alone. Second, that the male primates in their community are in charge. Third, that they do not bleed and are
most likely pregnant. Even though we are talking about apes and not humans, the message is clear.

The Perils of Periods: PMS, Anemia, and Other Menstrual Hazards

Whether or not women
should
get periods, why might they want to avoid them? At the top of the list of reasons is that old scourge of womankind, PMS. On this subject, suppression advocates get nearly hysterical in describing the debilitation women experience. Most of the really dramatic work cited goes back in one way or another to Katharina Dalton. The laundry list of hazards includes common complaints like mood swings, headaches, and menstrual cramps, and moves on to increased rates of suicide, “inattention to cooking recipes, failed examinations, tardiness at classes or meetings, low marks at school, involvement in car accidents, mishaps at home or work, even committing crimes or felonies,”
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and “marital conflicts, mistreatment of children, aggressiveness and work directed indiscriminately toward subordinates and superiors alike, excessive food intake, and alcohol abuse.”
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What woman
wouldn’t
want to prevent such problems? Thank goodness we now have estrogen and progestin pills to keep us from the fate of becoming bad-cooking, child-abusing, husband-hating, boss-disrespecting, fat, alcoholic, suicidal criminals.

Most women have some experience with PMS, and those experiences, however unpleasant, should tell us that this sort of portrait is not only hyperbolic, but absurd and insulting. What becomes clear here is that there exists a deep anxiety over women’s roles. While women have been experiencing premenstrual pains, to greater and lesser extents, for as long as they have been bleeding,
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the subject has received inordinate attention in the last hundred years as our culture has tried to cope with women’s dramatically changing roles. Our preoccupation with PMS is related to a new focus on the importance of women’s hormones over women’s organs in defining biological difference. It constitutes an extension of historical claims about women’s instability and lack of self-control from the limited period of bleeding to the constant flux of the menstrual cycle.

If the period becomes the moment of crisis where all the uncertainties
about who women should be are laid bare, it is clear, looking at this list of symptoms, what we are worried about. When hormonally compromised, this thinking insists, women express distinctly unfeminine behavior, like unharnessed anger, desire, appetites, and a general lack of self-control and grace. If this list of PMS symptoms is to be believed, women are equally unable to perform traditionally male roles. They are noncompliant to authority in job settings, inefficient and clumsy at work, and unable to perform in academic contexts.