Browsing Tag

women

Chronic Illness, chronic pain, Guest Posts

Hysteria & Me: An Ancient, Misogynistic Disorder is Killing Women

September 27, 2020
SYMPTOM

By Elizabeth Land Quant

On a December morning in 2017, I woke up face down next to my treadmill. The week before, a rheumatologist at Cleveland Clinic had diagnosed me with fibromyalgia, which she described as an “exercise depravation syndrome,” and told me that aerobic exercise would help my symptoms. “As long as your heart races a little and you sweat,” the doctor’s handout advised.

Now, as I lay on the floor, my heart raced like a trapped bird banging against my chest. I couldn’t take a deep breath. My pants were wet, from urine and sweat, and the nerves in my hands and feet were burning. I needed to throw up. Between the gray-tinged double vision and shaking in my legs, I couldn’t stand up, so I crawled across the floor and slowly pulled myself up the stairs.

After cleaning up my vomit, I vowed to follow my doctor’s advice and try even harder. Her handout said: “First, it is very important to know that even if the pain is worse after exercise, no injury to the body occurs.” But the next day when I tried to exercise things got worse. As the days wore on, I was unable to chew food. My neck muscles would not support my head, and I had to drink my dinner though a straw with my husband’s help. My chest hurt with every breath. I was incontinent, and my intestines became immobile. The burning in my hands and feet got so severe I couldn’t wear socks or gloves. My anxiety and depression were no longer controlled by my meds. I developed double vision and my left eye sagged. I couldn’t take care of my family anymore, or myself.

My husband worked a fulltime job, and we had three teenagers with medical and school needs. With my mother’s and sister’s help, we cobbled together a way to keep everyone fed, up on schoolwork, and attending most doctor’s appointments. Our daughter ran errands for the family after she got off work. My father-in-law picked up our boys from school as much as he could, with Uber as our back up. Dinner was made by anyone who had time that night, or we ordered. I missed countless school events like my son’s football games and my daughter’s high school homecoming coronation, memories we should have made together. I was so thankful that we could get by, but I constantly felt like a burden and a failure.

To get help, I traveled from my home in Minnesota to the Cleveland Clinic with the hope of finding answers for these symptoms. I chose this clinic because its website advertised  a clinic that works “collaboratively with multiple consultants and departments.” But instead of finding answers, after I told her that some of these symptoms had started in childhood, my rheumatologist focused her questions on whether I was traumatized as a child. I didn’t know it at the time, but the rheumatologist that I was seeing is a renowned expert in fibromyalgia, and was head of the Fibromyalgia Clinic at Cleveland Clinic.

“You’ve got severe fibromyalgia. I’m recommending intense psychiatric rehabilitation,” she said.

I found out years later that this rheumatologist conducted a study on how past abuse can indicate the severity of fibromyalgia. Her conclusion was to “recommend that abuse should be inquired about in all patients evaluated for FMS as this may give more clarity to the nature and severity of the FMS presentation and prompt the need for psychological interventions.” This doctor also recommended that severe fibromyalgia patients should not be evaluated for other diseases.

Soon after, back in Minnesota, I was erroneously diagnosed with somatic symptom and related disorders (SSRD), a psychiatric condition that is “characterized by an intense focus on physical (somatic) symptoms that causes significant distress and/or interferes with daily functioning.” They claimed my symptoms were caused by a mental illness and not a physical disease.

For decades, my anxiety, depression and physical symptoms had been attributed by doctors to my own actions. For instance, I was told by a gastroenterologist that my inability to swallow food and my intestinal motility issues were most likely brought on by limiting certain foods from my diet, like gluten and dairy (but if I ate those foods, I got hives and threw up). Other doctors said that my symptoms were present because I “worked and exercised too much and didn’t rest,” or that I was “resting too much” and became deconditioned. I was scolded for being underweight. I was scolded for being overweight. I focused too much attention on my kids and not enough on myself, causing unneeded anxiety. Another doctor said that I focused too much on myself by meditating and googling which vitamins to take, causing an unhealthy obsession with my health. I was told that I just “didn’t like getting older” and was depressed about it. So, all my physical problems – double vision, throwing up, falling down, urinating all over myself – were my fault, and all my therapy sessions, meditation, medicine, exercise, and healthy diet weren’t helping nearly enough, and somehow were making me worse. I had wondered if my kids and husband would be better off without me.

***

I started researching my new diagnoses, and found out that the diagnostic criteria for fibromyalgia and SSRD placed a red flag on patients, primarily women, who have multiple symptoms. Because I fit the criteria for these two diagnoses, I was no longer a candidate for further testing or referral to other specialists. An article in the American Academy of Family Physicians’ magazine states that SSRD “should be considered early in the evaluation of patients with unexplained symptoms to prevent unnecessary interventions and testing.” With approximately 12 million US adults misdiagnosed every year, and women and minorities 20 to 30 percent more likely to be misdiagnosed, how many women are having their “unexplained symptoms” dismissed as part of a somatic illness?

How did we get to this point in the twenty-first century where women are still repeatedly dismissed and misdiagnosed? Women are less likely to be administered pain medicine than men in emergency room settings. Women have a 50% higher chance than men of getting an incorrect diagnosis after a heart attack, and they are 30 % more likely to have a stroke misdiagnosed. Black women and other women of color face even larger disparities in the health care system compared to white women because of racial bias and discrimination. Stigma and discrimination against Transgender people limit their access to healthcare, negatively affecting their mental and physical health. A study “Women With Pain” found that “women with chronic pain conditions are more likely to be wrongly diagnosed with mental health conditions than men and prescribed psychotropic drugs, as doctors dismissed their symptoms as hysterics.”

This brought me right back to college, where a professor asked the question “what is the Greek word for uterus?” When no one answered, he paused for a dramatic beat, and then said, “Hystera. Where we get the word hysteria.” As the women in the class shifted lower into their seats, the men laughed, loudly. There even was a celebratory high five. I will never forget the absolute mortification I felt, and how instinctively I hurried to cover my scars under my shirt from multiple endometriosis and ovarian cyst surgeries. I felt betrayed by my own body.

***

In ancient Egypt, Greece, and Rome, hysteria was considered a women’s condition whose physical symptoms were thought to be attributed to a wandering uterus. Over time, the blame of these various hysteria symptoms shifted from a physical cause to a mental one. In the late 1800’s, the psychoanalyst Sigmund Freud posited that a woman’s psychological stress “converted” into physical symptoms that caused a hysterical state. Also during the Victorian Era, new diagnostic terms like “Briquet’s Syndrome,” named after French physician Paul Briquet, were given to women experiencing hysteria symptoms such as nausea, dizziness, fast heartbeat, pain all over, blurry vision, and weakness. Briquet’s Syndrome was renamed somatization disorder, which eventually became somatic symptom and related disorders. Hysteria was officially removed from the Diagnostic and Statistical Manual of Mental Disorders in 1980, but the stigma of a woman’s illness with a name meaning “melodramatic or attention seeking behavior” still remains.

***

At numerous doctor’s appointments, I was given the Patient Health Questionnaire – 15 (PHQ-15), a tool frequently used to diagnose fibromyalgia, SSRD and multiple mental illnesses, which has symptoms that are also associated with diseases that primarily affect women. The tool listed 15 symptoms and a rating scale of how severely these symptoms affected your life. Each time I checked off most if not all of the symptoms listed, including chest pain, fatigue, heart pounding, nausea, pain, shortness of breath, and stomach pain (refer to chart for complete list). In filling out the PHQ-15, I thought I was helping the doctor get closer to a diagnosis and treatment. Instead, I was checking off a list of “somatic symptoms” that pointed them away from a physical illness and toward a psychiatric disorder like SSRD. Small fiber neuropathy, autoimmune disease, ovarian cancer, autonomic dysfunction, heart disease, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Ehlers-Danlos syndromes, and now long-term Covid 19, conditions that affect millions of women, all have symptoms listed on the PHQ-15, and on screening questions for fibromyalgia. Another devastating problem with this set up is that more and more women are afraid of speaking up about their mental health symptoms, like I was, for fear of their physical symptoms being overlooked, or labelled as psychosomatic.

Women with mental illness, and I include myself in this group, are at risk of their mental health diagnoses being used as a red flag, halting the diagnostic process of their physical symptoms being looked into as part of a physical disease. More than 1 in 5 women in the US have experienced a mental health condition in the past year.  In our modern understanding of mental health, we believe that physical symptoms often manifest as a result of a mental health disorder. The problem is not that doctors identify mental health disorders as one potential cause of physical symptoms. The problem is that those same physical symptoms could also be caused by a number of physical diseases. This is the point where the effective process of a proper diagnosis breaks down. Instead of testing and ruling out physical disease, many doctors jump to the assumption of the absence of physical disease. Having a mental illness does not make us immune to having a physical disease.

Seventy-five percent of Americans with autoimmune disease are women, according to the American Autoimmune Related Disease Association and it takes on average three years and four doctors to get a diagnosis of an autoimmune disease. The study “Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics” shows that even though 89% of women with early stages of ovarian cancer have a distinct set of symptoms (bloating, abdominal pain, urinary symptoms, fatigue, back pain, constipation) that they report to a doctor, “only 20% percent of cases are caught in an early stage.” How many of these women were dismissed by their doctors because their symptoms fit a somatic illness or were written off as general reproductive issues that halted further testing?

***

About a month after the Cleveland Clinic appointment, my family and I went on vacation in Florida. I almost didn’t go, but this was the only time we could coordinate a trip with all five of us. I spent most of my time in the bathroom, throwing up sips of water I kept trying to swallow. I took anti-nausea meds, Tylenol, Ativan and Imodium to sit with my family by the pool, until I would have to lie down on the bathroom tiles again.

By the time we flew home, I was severely dehydrated and doubled over in pain, but refused to go to the ER for fear I would be accused of faking my symptoms for attention or told that this was my fault and I needed to exercise more. My husband begged me to go in, and it was there that a doctor first mentioned “autonomic disorders,” and autoimmune nerve diseases that could be causing my various symptoms. When I got home from the hospital after getting IV fluids, I looked up my medical records from Cleveland Clinic. The doctor who diagnosed me with fibromyalgia wrote in my appointment notes, “has not been diagnosed with small fiber neuropathy,” a disease that could explain most of my symptoms. It would have been so easy for this rheumatologist to refer me to one of the few nerve labs in the country for a biopsy, right in her same clinic.

***

The diagnosis of fibromyalgia has helped many women get symptom relief and disability services, but has also prevented countless women from receiving a correct diagnosis. Studies show that half of fibromyalgia patients are thought to have small fiber neuropathy, a disease that Johns Hopkins describes as damage to the peripheral nervous system, the nerves that send information from the brain and spinal cord to the rest of the body. This damage can cause symptoms ranging from pain, to gastrointestinal issues, to difficulty breathing and an irregular heartbeat.

Fibromyalgia shares many of the same symptoms of small fiber neuropathy (SFN), but the main difference is that SFN can be definitively tested for and treated, whereas the underlying causes of fibromyalgia are unknown and treatments only address symptoms. A quick and painless skin biopsy can confirm the SFN diagnosis, and if positive, further diagnostics can find a medical cause of the neuropathy in the majority of patients. Prompt treatment can prevent further damage to the nerves, and in some cases, the medical cause of small fiber neuropathy can even be cured.

After researching my symptoms, I convinced an open-minded neurologist in Minneapolis to conduct testing including a skin biopsy and a tilt table test. The biopsy revealed severe small fiber neuropathy, and further testing found Post Orthostatic Tachycardia Syndrome (an autonomic disorder that affects heart rate, blood pressure, and causes many other symptoms). I was also diagnosed with Myasthenia Gravis, a progressive, potentially life-threatening neuromuscular disease which can be fatal with too much exertion (so much for “even if the pain is worse after exercise, no injury to the body occurs”). A year later I was diagnosed with a hypothyroid disorder and asthma, both of which I was told I have had for years. I could not have fought for and received the right tests if I didn’t have a good health care plan, time to research, and money to pay for thousands of dollars of out of pocket costs.

I had missed out on so many of my kids’ events, as well as countless birthdays, anniversaries and holidays. If I had been given a tilt table test or a nerve biopsy instead of being continually misdiagnosed, maybe I could have started the right medications and been more present in my children’s lives while they were still growing up.

***

Being disabled itself doesn’t upset or scare me. I learned that I can live a full and happy disabled life by watching my father work and travel the world with his portable oxygen tank in his backpack. I’m angry about all the time I wasted blaming myself for a disease that was not my fault and all the years fighting for tests and medicine that could have slowed down or stopped the progression of these diseases. However, I am privileged to have the resources I need to live a comfortable life that allows me time to take care of myself.  It is unacceptable that in this country only well-to-do people with disabilities are able to live comfortably, while so many people are forced to fight to obtain correct diagnoses, assistance, adequate health care and safe housing.

When doctors are taught to hold back diagnostic testing based on the number of symptoms a patient has, and considering that so many illnesses that affect women have multiple symptoms, including potentially deadly ones like ovarian cancer, it’s not hard to understand why so many women have been misdiagnosed.

Elizabeth Land Quant is an autistic, queer, disabled writer, wife, and mom to three grown kids, two cats and a very spoiled dog. She studied Latin, Greek and political science at St. Olaf College, and splits her time between Minneapolis and Hot Springs, Arkansas. She researches and writes about her experiences with disability, autism, family, and her undying love for TV. Elizabeth writes poetry, fiction and nonfiction and is currently writing her first novel.  She has been published in Disability Acts.

Anti-racist resources, because silence is not an option.

~~~~~~~~~~~~~~~~~~~~

Upcoming events with Jen

~~~~~~~~~~~~~~~~~~~~

THE ALEKSANDER SCHOLARSHIP FUND

Compassion, Fertility, Guest Posts

The Mindful Mother – When are you having a baby?

September 15, 2020
question

By Denise Castro

I recently attended a lecture on mindfulness a few months back and it stopped me dead in my tracks. I learned from our professor that about 46% of our mind wanders when having a conversation. As I write these words I am already going down my to-do list of work, dinner, laundry, mismatched toddler socks and back to these words. Our professor collaborated in neuroscience research that explores the efficacy of mindfulness training on attention, emotional regulation and working memory in high stress professions. He draws upon this expertise in the infusion of mindfulness into the learning environment. As a new mother I am constantly learning about what it means to be me in this new role in addition to the various roles I have played before. My mind wanders even more now that I am a Mother. I realize that I tune in and out of conversations because I am trying to constantly multi-task and cram all the things I need to do in a day which really can lead to program overload. Think Sad Mac symbol used by older-generation Apple Macintosh computers with the black screen of death. Followed by the little annoying horn that you just want to curse out. You keep clicking incessantly, nothing. Okay, time to re-boot. And sometimes that’s necessary. Forcing yourself to re-boot and or even shutdown. Command-Option-Esc.

I considered myself rebooted when I attended this Mindfulness lecture. It purposely brought my attention to experiences occurring in the present moment without judgment, and allowing true reflection on my life altering occurrences. I remember mine in that very moment. The voice came and it said Denise – when are you having a baby? I know exactly this person’s voice, the intent behind their question and eyes searching for an answer. Perhaps the voice is merged with mine re-asking the question. The question still remains unanswered. When are you having a baby; always seems like the question your waiting for your biology to answer. “Presently Kendra, my husband’s sperm is pinpointing the egg from the ovulation cycle that I semi tracked and will have 7-28% chance of fertilizing the egg. Will forward you the meeting minutes of that event ASAP”. Did that answer your question? Is that a satisfactory answer? Or simply put whenever the hell my husband’s sperm wants to hook up with the egg. Period. However, instead we always answer cordially with “oh, who knows, maybe soon, we will see what the future holds”. However, what we really mean is it’s none. Of. Your. BUSINESS followed by slight spike in blood pressure, mild twitch to the eye and excusing yourself to the bathroom so you can scream a couple F bombs out loud. The truth behind this question has a multitude of repercussions within our subconscious.  I would know because I once asked a Mother this question. Not being one yet myself I realized it’s actually a really intrusive question. It’s not asking about where she got her cut and color done? It’s so private and deeply personal. To that Mom – I am sorry, I just didn’t know what I was asking.

Sometimes friends and family will ask this question very candidly in an – as- a-matter- of- fact kind of way. I must’ve heard this question a million times for almost a period of two and a half years. When are you having a baby? Perhaps I should’ve written a rap song in response “When are you having a baby – featuring NUNYA – None of your Business Inc. I swear if I had a money jar for every time it was asked I’d probably be a millionaire by now secretly cursing and smiling under my breath. The truth is, that it hurts. That question hurt me. It hurt my very core and it still hurts. When you have a miscarriage this question is your worst enemy. It menaces you like a dark figure in the corner waiting to punch you in the gut. I had been punched several times until no breath was left inside of me. Just when I thought I had recovered it’d be inserted somehow in a conversation that was totally unrelated. Nobody would know that I had miscarried my first baby and had chosen to keep this information to myself as a way to cope and the memory still haunts me.  So when asked, it was as if lightning struck; allowing electric shocks to travel to all the nerve endings in my body and a finishing blow to my heart. Now, this question may pose no immediate threat except- have you ever considered that this person may already be asking herself this question over and over again. Why turns into when, when will it happen turns into what’s wrong with me, and then back to how am I going to answer the why is this happening to me. This turns into a vicious narrative that leave us emotionally depleted and unable to answer. No one in particular may ask you anymore but it doesn’t mean that it stopped it from triggering the auto-renewal of these questions to yourself. It’s like that subscription you never signed up for. Reappearing is our Sad Mac symbol with the little pop up window that reads “When are you having a baby?” Now it’s multiplied into a million damn windows; followed by the super annoying prompting horn. Yes or No reads the little window? F#*@#*# just STOP. Go away! You click incessantly; nothing.  Command-Option-Esc. Shut down. Reboot.

Being mindful of ones journey is so important; I can’t stress it enough. So stop yourself before asking this question. Our emotional regulation is similar to the lines on a seismic chart after an earthquake, erratic upward and downward lines mimicking our fluctuating feelings on the verge of collapsing. We need to train our attention to body language; and being a silent but present comfort to women who may be navigating this period in their lives. Finding a sense of normalcy and peace during the period of conception was one of the most challenging things ever. My mind was like a radio with too many talk show hosts talking over one another essentially asking the same thing. My husband silently watched me month to month doing the math in his head for any signs of a missed period and/or ovulation kit purchases. He never asked the question and I wholeheartedly appreciated it. His silent understanding is what we needed to get through this – together.

At some point we may be the woman at the baby store sobbing into a baby blanket and cradling it when she only meant to get a quick gift for a baby shower, the woman staring at the trash can questioning the three ovulation sticks with smiley positives for ovulation that just didn’t work, the woman whose crippling infertility is breaking her spirit and she’s not sure she can endure anymore needles, the woman who is now considered geriatric after the age of thirty five and has her biological clock ticking fiercely away implying she better hurry or simply miss the motherhood train. There’s the woman who cries out Why?! Dear God. Why! she was unable to carry her baby to full term and bring it home to the now empty bassinet. There’s the woman who has one child and never intended of giving it a sibling; yet we divulge about the “only child syndrome nonsense” or maybe she is trying to conceive once again but your questions just weigh her down; as she is perfectly aware that her body is not the young vessel it was before. Deep breath. Just take another deep breath. And finally the woman who simply did not want children, misjudged and scrutinized for choosing a career instead, simply put -it’s her body and her choice therefore- no baby. There are so many scenarios that need to be considered when we want to ask this question. So perhaps don’t ask it all, instead turn your attention to making it your business in blog and being mindful; you don’t know the power it may give a person to persevere; because at some point in your life you were in their shoes too.

Denise Castro is a Cuban American, a working mother and photographer, who currently resides in Miami. In response to unsolicited advice about how to handle her body after pregnancy, Denise began to blog about what it really means to be a working mom. She has previously written for Scary Mommy and Motherhood: The Real Deal. Denise blogs here. She can also be found on Instagram and Facebook

Anti-racist resources, because silence is not an option.

~~~~~~~~~~~~~~~~~~~~

Upcoming events with Jen

~~~~~~~~~~~~~~~~~~~~

THE ALEKSANDER SCHOLARSHIP FUND

Health, Women

We Must End Period Poverty For All Women And Girls

September 10, 2020
period

By Rita Serra

I chose to backpack around the world as a 22-year-old, pierced-nosed, May You Stay Forever Young-tattooed, Hubba-Bubba pink, blue and purple-haired, flower child. Equipped with a degree in US history and ample youthful exuberance, I was ready to feel the unparalleled freedom of solo travel. My only armor for this eight -month endeavor was my blind faith in good vibes. What could go wrong?

Four months into my wanderlust pilgrimage, airport security procedures had become a mundane chore rather than a cause for stress. With off-handed indifference, I referred to the time spent waiting in lengthy passport control lines as, “the traveler’s tax.” As I stood in the diminutive security line of Lombok International Airport (LOP,) I was pleased to pay these meager taxes that evening.

Measuring forty-seven miles across, the tranquil island of Lombok, Indonesia is relatively untraveled by tourists compared to its neighboring island of Bali, allowing the landscape and pace of life to remain much closer to its organic form. The majority of Lombok consists of rural villages separated by large swatches of undeveloped land. Although LOP is the only airport on Lombok, a single terminal is apt for receiving all domestic and international fights.

I stood in line with a placid smile as I watched the female agents check every pocket of every traveler’s bag with a Swiss watch-maker’s precision. But then, like Isaac Newton and the infamous apple he took to the head, I was struck with a sudden realization that overtook my idle thoughts. In the top pocket of my backpack was a plastic bag that contained; a brick-sized stack of Laotian currency, US dollars, Euros, Cambodian Riels, anti-malaria medication, traveler’s diarrhea pills, and a smaller zip lock bag containing off-brand Advil. The lack of original packaging making it seem as if the Advil could be any drug. In my effort to maximize packing efficiency, I set myself up to look like a suspicious character while attempting to enter a country that regularly applies capital punishment to drug traffickers and drug dealers.

Light-headed, my mind went into a hazardous spin. I oscillated between berating myself for committing such a blunder and conjuring ill-fated visions of myself sitting in an Indonesian jail cell. Stress-induced sweat droplets rose to a beady line of attention along my brow. I pushed past these negative thoughts and began to practice my explanation. Yes ma’am I know this looks weird, but I purchased all of the Laotian money from a friend to save him from a bad exchange rate, as if my inherent altruism would help me out of this situation without issue.

My turn came and an Indonesian woman with soft brown eyes and dark hair pulled into a tight bun, started to rummage through my bag with silent diligence. Standing at 5 foot 10, I towered over this woman by nearly a foot, yet I felt as if I was small enough to fit in a front shirt pocket standing in her authoritative presence. I attempted to hold a pleasant, unsuspecting smile as I wondered if this agent would believe the reason for this money and various pills, some unmarked, was due to my naiveté and not because I was a drug dealer.

The agent used her thumb and right index finger as a pair of tweezers to pluck a tampon out of my bag. Mystified, she raised the tampon until it was even with her eyes and after a few moments of greater inspection, she inquired in English, “What is this?”

I surmised that it must have been unfamiliar packaging throwing her off, so I gave what I though was a simply yet efficient answer, “a tampon.”

The bewildered expression remained suspended across her caramel-toned face. I wondered if my bluntness had been misinterpreted as curt, but then it hit me; she had never seen or heard of a tampon before. A piece of my innocence expired as I explained to this woman, who was at least ten years my senior, what a tampon was and how it is used. Her cheeks pulled back like an accordion, forming elongated, vertical smile lines and the austere formality of her uniformed appearance melted away. With an enlightened sounding, “ahh” the woman placed the tampon back in my bag, forgetting to check the final pocket, and sent me on my way.

I walked through the sliding glass doors and was greeted by the hot, sticky, humid night air like an impassioned lovers kiss. I breathed out a sigh of relief, and inhaled sharply making my lips form a tight O as my mind unpacked what just transpired. What did this woman use while on her menses? Will this woman tell her friends about what she just learned? Her mother? Her sisters? Her daughter?

 I had never considered that a tampon was not basic knowledge for all women. I sat with this profound knowledge for some time, not knowing what to do with it. But the unanswered questions remained, so I launched into conducting research on women’s reproductive health among different countries. In doing so I came across the topic of period poverty.

“Period poverty” refers to the estimated 500 million women and girls around the world who lack the monetary funds and /or access to menstrual products each month. For a myriad of these females, the root causes and devastating effects of period poverty extend much deeper. In developing regions of Africa, Asia, Central, and South America there is a substantial lack of education about women’s reproductive health, what sanitary products are, and how to use them. This issue is often compounded by the absence of hand washing stations and other sanitation facilities, leading women and girls to not be able to manage their menses in a safe, dignified manner. Extending deeper for many women and girls, the crux of period poverty is caused by the long-standing cultural stigma that menstruating women are dirty.

Within numerous communities around the world, the topic of menstruation is taboo. Women in rural India are perceived as impure and unholy, leading to them being treated as lepers and banned from entering temples and participating in prayer during their menses. Considering that the overwhelming majority of India’s population are either devout Hindus or Muslims, two religions based upon praying multiple times a day, the act of menstruating is debilitating to Indian women’s daily lives. In Nepal, woman and girls are forced to undergo the custom of “Chhaupadi” in which females are ostracized from their family homes and made to live and sleep in cramped, window-less huts because they are seen as unclean while on their menses. Due to poor ventilation and snake bits, this practice has claimed the lives of many. Chhaupadi continues today, in defiance of a 2018 law forbidding the dangerous practice. For young ladies in Uganda, they feel they must hide their periods from their brothers and fathers for fear of crippling shame and utter embarrassment.

The disempowerment millions of females suffer through every month is marked by bitter irony because without the act of menstruating, the creation of life would halt all together.

Adding to the gravity of this gender inequality issue, is the fact that period poverty impedes girls’ educational endeavors and constricts their future prospects. Worldwide, millions of girls stay home from because they lack sanitary products and/ or fear becoming a social outcast. One in five American girls have reported staying home from school due to the inability to afford sanitary products. Across Africa, it is estimated that at least one in every ten girls will miss up to fifty days of school a year because of menstruation. These habitual absences cause girl’s grades to suffer and for them to fall behind their male counterparts. Even more damning is the fact that a multitude of girls will drop out of school because they are not able to adequately manage their menses. This is the case for at least twenty percent of girls in India.

Navigating the dust-kissed, stone streets of Morocco, I often happened upon a group of school children walking in their uniforms of white coats, casting the illusion that every one of them was a young scientist on the verge of discovery. In Luang Prabang, Laos I was always tickled to see a young lady zipping through traffic on motorbike with two of her female compadres riding side-saddle, (a feat much more difficult than they made it look.) Their long ponytails waved wildly like streamers in the wind, making them seem so free, despite their school attire of navy-blue jackets, knee-length grey skirts, and nylons.

Of all my carefree experiences interacting with locals, I most fondly reminisce on a day spent in Koh Rong, Cambodia on the beach with a cohort of travelers. Three Khmer children, two boys and one girl, stopped by our blankets after spotting our idol tennis ball. The kids ushered us to our feet by means of animated hand gestures and arranged us in a large circle. Captivated by the childlike-wonderment that marks the lighthearted days of travel, we played a laugh-filled game of catch for nearly an hour.

I occasionally look back with concern at the array of silly-faced selfies of myself and the little girl on the beach in Koh Rong. It is disheartening to imagine her, the girls on the motorbike, or the young ladies in Morocco, who bubbled with life and were free from inhibition, are now routinely filled with shame for simply menstruating. I cannot help but think about all the bright, young ladies around the world whose academic standings have slipped due to the constricting realities of womanhood imposed by their cultures.

Before traveling to Indonesia, I had never equated a tampon with freedom. Awareness is the first step in bridging inequality. From my experience in the airport, I became aware that hygienic products allow women the ability to play sports, receive a full education, work a steady job, participate in religious events, go about their daily life unencumbered, and to rise to the same playing field as male counterparts.

We have made great strides in America in the field of women’s equality and reproductive health thanks to the activism of Margaret Sanger and our other feminine predecessors. In 1960, the FDA approved the use of the pill as contraceptive which was a divisive issue at the time. Many women took the pill in secrecy, afraid of being outcast or labeled as promiscuous. After decades of continued activism, these same women now lead women’s gatherings with pride and conduct ceremonies that celebrate young ladies’ menstruation, and empower them as they cross the threshold into womanhood. Today young girls are taught about menstruation health in school and women have access to an array of contraceptives and sanitary products. Furthermore, there is a Red Tent movement sweeping the nation, where menstruating women and girls are invited to come together and celebrate their menses on a monthly basis. Nevertheless, we still have ground to cover in America when it comes to eliminating period poverty.

Ending period poverty is a matter of accepting and normalizing female biology.

One way to get involved in the movement is to vote. In recent years there has been a large push to remove the “tampon tax.” Although the FDA considers tampons and other menstrual products as medical devices, in forty states they are still subject to sales tax unlike other medical devices. For the women who live in poverty or work low income jobs, removing taxes on sanitary products would make managing their menses less of a struggle. Georgia House of Representative member Debbie Buckner, presented a bill in January 2019 that would make Georgia the eleventh state to remove the “tampon tax,” As of today, activists in Georgia are still working to have this bill passed. Scotland made history in February 2020 by becoming the first country to make period products free to all women.

Supporting organizations such as, Alliance for Period Supplies, is another way to get involved in this movement. This organization was founded by U by Kotex and aims at ending period poverty in the US. Support can be a simple as shopping for your own sanitary products. For every U by Kotex purchase, sanitary products are donated to women and girls in need through Alliance for Period Supplies. For people who want to go a step beyond, consider hosting a period supply drive. This is done by linking with your local allied program, (which can be found online through allianceforperiodsupplies.org) food bank or women’s shelter to distribute the collected products. This might be of particular interest to women who have stopped menstruating, but still have unnecessary sanitary products.

On the international level, donating to organizations such as WASH United or the World Bank is a way to help end period poverty. These organization partner with groups such as UNICEF, UN agencies, the Global Water Security and Sanitation Partnership, and other NGO’s to promote advocacy and provide menstrual hygienic management (MHM) education designed to empower woman and remove cultural taboo. They also provide woman and girls with hygienic products and improve conditions for women to manage their menses in a safer, more dignified manor such as providing clean water, constructing hand washing stations, and sanitary facilities.

Finally, spreading the word is a way to promote advocacy and transform period poverty into “period positivity.” Since writing this piece, I have begun discussing period poverty with my male roommates who have all been receptive to discussing the topic. May 25th – 31st 2020 is period poverty awareness week, by sharing stories on social media and using hashtags such as, #EndPeriodPoverty #EndPeriodStigma #WithUSheCan #eachforequal #NoMoreLimits and #MenstruationMatters, we can normalize the topic of menstruation.

As the torch is carried forward in the women’s health and equality movement, we must ensure some women are not getting left in the dark.

Rita Serra graduated from the University of North Carolina Chapel Hill with a degree in US history with a special interest on the social and political moments of 21st century America. For two and a half years, Rita backpacked around the world, often solo, on a quest for human connection, cultural enlightenment, historical intrigue and natures wonderment. After her period of Rolling Stone Embodiment, Rita found herself in Northern California where she currently spends her days writing prose & poetry and farming.

Anti-racist resources, because silence is not an option.

~~~~~~~~~~~~~~~~~~~~

Upcoming events with Jen

~~~~~~~~~~~~~~~~~~~~

THE ALEKSANDER SCHOLARSHIP FUND

aging, Guest Posts, Women

Law And Yoga

September 6, 2020
lawyer

By Jennifer Lauren

I’m lying on the floor in the basement of the Washington Conference Center, my back pressed against my cork yoga mat, wearing Lulu Lemon tights. My feet are bare. I hope no one notices that the snowflake manicure I got before Christmas is starting to chip.

“Extend your left leg. Pull your right knee into your shoulder. Squeeze in to stimulate your right ovary,” the teacher says.

She’s teaching a workshop on “yoga for hormone balance” to 24 over-40 women, all of us lying on our yoga mats, seeking answers to questions we can’t articulate.

“Uddiyana Bandha …” Sanskrit for Kegels, where you pull up your nether-regions tight like you’re trying to hold in pee. “Transfer your attention to your ovaries, and release….”

Two dozen women release breath together. It sounds like a prayer. I translate, their thoughts are my thoughts:

We have everything. We should be happy.

I look out the window, where I see the bottom of the sky scraper next door. I had my own office, with a view, in that building. I was a lawyer. A really good lawyer. I wore designer suits and clutched Starbucks in my perfectly manicured hands. I was 27 and gorgeous and ready to take on the world.

At 41, I teach yoga and write novels no one has published yet. In December, just after I got snowflakes painted on my toes, I put my law license into inactive status so I could …. I’m not sure. Follow my dreams?

I didn’t realize my dreams would lead me to the basement of the Conference Center, focusing on my ovaries. Yet here we are, together.

Before 40, we were brilliant. Beautiful. Now we’re strangers to ourselves. We’ve tried acupuncture and green tea. Yoga and meditation. We quit jobs and took vacations and got divorces. But we still feel “off” in a way we can’t explain.

If we were men, they’d call it a mid-life crisis. We’d buy Porches and sleep with 20-year-olds. But we’re women. We can’t afford Porches because we’re paying for dance team and soccer tournaments. We have no time to sleep with 20-somethings because we’re doing laundry and driving our kids to Taekwondo.

“We’re tired, we’re cranky, we’re doing too much, but it’s never enough,” we say to our doctors. They offer us anti-depressants and tell us to find “me-time.” Go to therapy.

None of it works.

So we sign up for hormone balancing through yoga. We read the Goop website when no one’s looking, although we mock it with our friends. We immerse ourselves in the culture of Elizabeth Gilbert and Brene Brown. Follow your dreams. Manifest your magic. Love greatly.

But most of us have no idea what we want to manifest, much less the power to manifest it. So we flounder to find The Thing We Should Do. Maybe we leave good men. Maybe we sell everything and move to Italy, India, and Indonesia for a year.

Maybe we walk away from well paying, prestigious careers just as we hit our prime.

I was a lawyer. I argued in front of the Ninth Circuit Court of Appeals and externed for the Chief Justice of the Washington State Supreme Court. I second-chaired three jury trials, all with eight-figure demands. We won them all.

At 27, I was on top of the world. At 40, I was buried beneath it. I never saw my babies, even when I went “part time.” When I was home I was on my phone, sure I was one missed email away from a malpractice suit. I watched my babies grow into tweens and teens after work, from the driver’s seat of our SUV.

I’d think, what’s wrong with me? I have it all! I should be happy!

But we aren’t happy: stay at home moms, doctors, preschool teachers, artists. We all stare down 40 and ask, what’s wrong with me? We joke about first world problems because we feel guilty admitting we are miserable in our prosperity.

We stare at our phones. At Facebook. Instagram. Twitter. We see the world fawning over British royals in size two suits and something called a “Kardashian.” We look down at our own thickening waists and download the newest couch to 5K ap.

We’ll be happy when we can run that mile/fit into that dress again/the kids go off to school.

Quit that job.

One gorgeous May afternoon, I left my pretty office with a water view behind. I decided I wasn’t a lawyer anymore.

I took yoga teacher training. I signed up for a writer’s retreat. I purposefully ignored the little voice in my head screaming, what the Hell are you doing?

My friends were jealous of the unimaginable indulgence of spare time. “You’re so lucky,” they said.

But who am I? I wonder. Who am I if I’m no longer a lawyer and my kids will be soon able to drive themselves to soccer.

When we were kids, well-meaning adults said we could do it all: career, kids, sexually satisfy our partner, size two jeans, a plush bank account of our own earnings. As we face middle age, it’s no wonder we’re neurotic. We’re all floundering, trying to find our place in a world where we are increasingly irrelevant.

We smile while making homemade gluten-free soy-free cookies after work for the fifth grade picnic at 11 p.m., work deadlines be damned.

We ask, why can’t we be happy?

We meditate. We take more vitamin D. We blame perimenopause, and try to balance our hormones through yoga.

We lie there, pulling our knees against our ovaries and visualizing and end to the unrelenting cycle of do, do, do. Be, be, be.

And we think: I’m so lucky. I have everything. I should be happy.

Jennifer Laures is a recovering trial attorney living near Seattle, Washington. Ever since she wrote her first masterpiece, The Creature, at the age of five, she wanted to be a writer. But life happened, sidetracking her with pesky bills and peskier, but well-loved, children. Jennifer has worked as an award-winning reporter at a nationally recognized newspaper; fundraising director for inner city schools; and civil litigator for 13 years. In May 2019 she quit her day job to write, teach yoga, travel, and chase her dreams. 

Anti-racist resources, because silence is not an option.

~~~~~~~~~~~~~~~~~~~~

Upcoming events with Jen

~~~~~~~~~~~~~~~~~~~~

THE ALEKSANDER SCHOLARSHIP FUND

 

Guest Posts, motherhood

Is Motherhood the Loneliest Time of All?

April 9, 2019
playgrops

By Claire Fitzsimmons

“I need new friends.” That’s what I was thinking as I sat in a café in San Francisco in the middle of the afternoon. I was on my own. Soup and salad. And my two month-old son on my lap.

I expected to feel a lot of things when I had a baby, but not lonely. My childless friends were all at work. My family was all the way in the UK where I’d left them a few years before. It was just my husband, myself and our son, Sam.

I needed mummy friends. But how to do this when my boobs were leaking, I was grumpy from no sleep and I had nothing to say that didn’t begin with my child’s name? I’d tried a couple of things already that clearly weren’t working. I walked through my neighborhood smiling clumsily at new mums. I sat in the playground looking approachable, hoping I’d get picked up. A local playspace had the prospects of a nightclub; tea had replaced vodka tonics and circle time the dance floor. I made eye contact, feigned interest, but it wasn’t happening.

As I was in the United States, this was clearly the moment to be proactive and to join a playgroup, which have become as necessary here to modern parenting as baby yoga, birth announcements and Bugaboos.

I’ve never been on a blind date and I’m not a natural joiner, but I found myself turning up, late (as I always am now), to a playgroup formation convened by my local mother’s group. Faced with a room of 60 women, some with babes in arms and each filled with the bubbling expectancy of new relationships, this was speed-dating, mummy-style. Continue Reading…

Guest Posts, Pregnancy, Relationships

Someday, Baby

September 26, 2018
fire

By Alayna Becker

It’s wildfire season in Spokane, so I’m stuck inside Crosswalk, the teen homeless shelter where I work. I’m the summer employment specialist, hired to help the homeless kids in my group learn to get a job and hopefully keep it. 12 kids are supposed to show up, but only two, Jessica and Reya are here and a third, Makayla is on her way.  Usually we go outside to do the job the city gave us a grant to do – measure the slopes and accessibility of streets all over the downtown area, but today the whole city is obscured by the haze from fires on the edge of town. Walking feels like wading through a swamp.

My title, employment specialist seems ironic because for the past couple of years I’ve been pretty much unemployed. Mainly I participated in medical studies while co-conspirator roommate sold her plasma. I had a job working for a place that did digital investigations on people that were accused of looking at child porn, but when I accidentally saw a picture of a little girl in her pink underwear over the shoulder of one of the other employees, I left and never went back. Continue Reading…

Guest Posts

21st Century Woman: A 20-something’s Ascent into Feminist Ethics

April 2, 2018

By Maria Prudente

On the night of the presidential election, a breakup of mine coincided with Trump’s victory. I couldn’t help but notice the symmetry of two completely annoying things happening simultaneously: a win for a man known for objectifying women and a breakup initiated by a guy who had spent several months objectifying me. One event was meaningful to me so, sorry to the dude who promptly unfollowed me on Instagram but our breakup was small potatoes. I spent the rest of the year dedicating myself to things that were more important: my career, education, health. Men were left off that list. Continue Reading…

Grief, Guest Posts, healing

Hidden Love

March 30, 2018

By Jamie Della

She was a mystery, a ghost as close as my skin. I discovered her love through the scent of old photographs and White Shoulders perfume. And there she was: Della Ruiz Martinez, my nana.

I bought a bottle of White Shoulders when I discovered it was her favorite perfume. I was 19. The first whiff of bergamot is astringent and sharp, like her acerbic tongue. They say she could cut you to pieces with her words. She was a Scorpio woman: born on November 12, 1920 and died November 14, 1967 – 39 days before I was born. They say she happily anticipated the birth of her first grandchild. But liver disease prevented her from holding me in her loving arms. She became two-dimensional and flat: a framed image of young Della at four-years-old, a brown-skinned cherub with a crown of baby’s breath at an altar. They gave me her name as my middle name: an angel and a legacy. It was nearly twenty years before I saw another picture of her. Continue Reading…

Guest Posts, No Bullshit Motherhood

Unbasic Bitch

March 28, 2018
imperfect

By Sarah Huffer

Fitting in is the most miserable decision of my life.

I’m clumsy and mostly awkward. Weirdly happy and bright. Somewhere in life, I decided I needed to blend. Like ya’ll blend eyeshadow. I smudged my personality until I became one watered down fragment of a soul without any defining characteristics.

I agreed with the crowd. I contoured my face(I still suck at this). I worshipped fall. I pinned Pinterest projects. Should I buy a salt rock lamp or eat kale? I was powerless to Target.

Even more, I highlighted the best parts of my life to portray my life. In reality, I couldn’t keep up with the dishes. I burn bread. My kids were feeding their healthy desserts to the dogs. My youngest daughter is, literally, pissed off all the time. She only smiles when you are hurting yourself. Continue Reading…

Friendship, Guest Posts

The Sisterhood of the Jade Fountain

March 14, 2018
jade

By Barbara Krasner

On the night before Passover in the spring of 1972, my mother pointed to our front door and said, “Out! All of you, out!” She wanted us out of the house so she and our longtime housekeeper, Clara, could change the dishes for the holiday. Changing the dishes was a Passover rite of passage and meant changing pots and pans, all silverware, tablecloths, even re-lining the cabinets.

My mother handed my eldest sister, Eileen, a wad of money.  Eileen, twenty-two, in turn, ushered us— my middle sister, Evelyn, eighteen, and my twin, Andrea and me, fourteen—to her red 1966 Ford Falcon. My mother’s mission was clear: Have dinner out at the Jade Fountain. It was situated in the next town, North Arlington, where our father had grown up and where he owned two supermarkets, a Jewish-owned business in a town governed by the Roman Catholic Church, specifically Queen of Peace, which stood across the street from our flagship store.

We passed Krasner’s Market on our way, that part of Ridge Road that intersects with Sunset Avenue, where my immigrant grandparents settled and set up their mom-and-pop shop in 1920. Farther north on Ridge Road, Eileen pulled into an alley which led to a parking lot behind the restaurant. Kitchen workers on break stood by the back door and the garbage cans. Already we could smell the fried grease mixed with sesame oil. Continue Reading…

Guest Posts, Self Image

Pale Pink Robe

April 16, 2017

By Anonymous

I have a pale pink silk robe hanging in my closet.  Every time I open the door, it makes me feel delicate and artful and foreign and adventurous. In life, I am better off in a gray zippered sweatshirt because of the coffee I dribble, the olive oil spatters that zap me when stir-frying onions, the mascara wiped on my sleeves from the night before. Once a week I put the silk on, feel chilly, and go back to the sweatshirt.

But, god, I love that robe.

I bought it at the Casbah on Sunset. The Casbah was my favorite place to write ten years ago. Everything was beautiful and curated and sheer and perfect and the coffee was strong and there was the sense that the owner didn’t treat the staff like garbage. It was a good place to be. A good place to write and get hopped up on caffeine and candied apricots and look at huaraches and baby T-shirts and Turkish towels I could not afford.

When I look at the robe in my closet now, I think of the day I got it. I was with two friends. I had stared at it during previous visits. The perfect, barely blushing pin-up, nippley shade of pink with a muted, red, woodblock pattern, a simple cut, sheer-ish, a belt. Continue Reading…

Guest Posts, The Body

Mythical Beasts

March 28, 2017
hair

By Beth Cartino

“Don’t you secretly want to be fuckable?”

We were in my small kitchen and I was cutting her bangs when she asked me this.  I had just finished dying her hair to cover the course white wires that were sprouting and multiplying on her scalp. I froze for an instant comb and shears halted in midair and then…

“No,” I said the word with conviction. Her brown eyes peered up at me through her thick dark brown hair, I could feel her assessing my answer trying to decide if it was the truth, and I looked way from her focusing instead on making sure her bangs weren’t crooked.  We were both silent for a while and I moved around to the side and began to cut in long layers to frame her oval face (the perfect face shape according to every fashion magazine ever).  Into the silence and safely unable to make eye contact with me she says, “I always want guys to want me, you know? I’m single and I’m almost fifty.”

I hear the unasked question in the slight tremble that enters her voice and the way it raises in pitch at the end.

What if no one ever wants me again?

What if this is it?

What if I die alone? Continue Reading…

depression, Eating Disorders/Healing, Guest Posts, Writing & The Body

A Tale of 19 Wet Towels or How I Failed to Shed My Skin

March 23, 2017
towel

By Ella Wilson.

1. Birth

Every time in my life that I have had the opportunity – that is to say I have been in the presence of a huge coming or going or leaving or starting, a massive adding on or taking away – every time I have had the chance to step out, to leave behind, to shed, to transform, to butterfly, to snake – every time I could have showered off the detritus of some time in my life that lay heavy on my skin. Every time I could have grown, instead I wet-toweled.

2. Starting school

Here is how you wet-towel. You take the thing you might have stepped out of, a skin, a time, a loss, a tiny pair of pants, a hit in the face. You take that thing and you wrap yourself in it.

3. Suicide attempt age 12

You shiver at first because the wet towel makes you cold. The weight of it makes you slow. After a few days you start to smell old and nothing seems like a very good idea.

4. Puberty

Shame is sticky and the antidote to transformation.

5. Losing my virginity

Shame tells you to hide, unfortunately the tools it gives you for hiding promote shame on shame. Shameless self promotion.

6. Leaving school

When you would rather not be seen it is preferable to hide in anything you can find.

7. Leaving home

8. Getting a job

9. My father dying

When my father died I did not notice. This is not because I was not paying attention exactly, in fact I paid so much attention, maybe too much. Nursing him from when I was 13 to 22. But something can become normal, like someone being ill, like thinking someone won’t really die. So I slept on his hospital floor for months. I swabbed his throat with little pink sponges. I knew the nurses names. He died. I wanted to stay on the floor. I wasn’t ready not to have a father. I wore his clothes. I didn’t cry. I did not become fatherless. I just became personless.

10. Moving to America

11. Being hospitalized for anorexia

12. Getting married Continue Reading…

Guest Posts, Sexual Assault/Rape, Vulnerability

Sexual Vulnerabilities: An Education

January 8, 2017
sex

CW: This essay discusses sexual assault.

By Beatrice M. Hogg

After hearing all of the recent media reports of sexual assault and improprieties, I wanted to think, “Glad that never happened to me.” But, like most women in this country, I couldn’t do it. In one way or another, it has happened to all of us. I have friends who have been raped and assaulted; amazing women who at some point barely escaped with their lives from domestic abuse. Some still have physical scars and many others still harbor emotional scars. When I started to think about my own life, I was surprised at all of the incidents that rushed to mind, some that I hadn’t thought about in years.

In my tiny coal-mining hometown, there was a small grocery store, owned by a husband and wife. When I was eleven or twelve in the late sixties, I would walk up there alone with a list of things to get for my mother. I always dreaded when the list included a meat item. That meant that I had to go to the back of the store, where the husband worked behind the meat counter. Almost every time I would go back there, he would come out from behind the counter to give me a big hug. His hugs always included a squeeze or a grope of my burgeoning breasts. I never told anyone. Would my father have believed me? In a town were everyone was armed, would he have gone up there with a shotgun? Would he have accused me of lying? Who was more credible, a shy little black girl or the friendly white grocer who everyone in town loved? As I took my meat purchases to the front of the store for the wife to ring out, I used to wonder – did he do that every girl? Did she know? I was overjoyed when the store went out of business. Continue Reading…