Mothers Movement Online, July 2004.
A Season to Bleed

 

Chemically altering women’s bodies and mentally altering perceptions of “normal”

by Lizbeth Finn-Arnold

I’ll be the first one to admit that getting my monthly period is a veritable pain in the you-know-what. It always seems to come at the least convenient time, and brings with it unwelcome cramps, headaches, fatigue, bloating, and the blues. As busy women, competing in a man’s world, with no time to slow down, our periods are generally unwanted intrusions. As distracted moms, our periods are just one more inconvenience. Face it, there is no good time to bleed.

So you would think that I would be ecstatic to learn that in September 2003, the Food and Drug Administration approved a drug that for all intents and purposes, may abolish monthly bleeding from our lives. But I’m not. In fact, I find it appalling that U.S. pharmaceutical companies can brazenly promote the chemical alteration of our female bodies for profit, with very little opposition or public discussion. Instead, they promise a pill that will “liberate us”; yet completely ignore the way this magical pill can negatively impact our cultural perceptions of what is normal, natural, and acceptable for women’s bodies.

Produced by Barr Laboratories, Inc., in Woodcliff, New Jersey, “Seasonale®” is being marketed as the first “extended-cycle birth control pill.” According to a company press release, “The Seasonale regimen is designed to reduce the number of periods from 13 to 4 per year. Seasonale is a 91 day regimen taken daily as 84 active tablets of 0.15 mg of levonorgestrel/0.03 mg of ethinyl estradiol, followed by 7 inactive tablets.” As a result, women will no longer have lunar cycles; but find themselves with four “seasonal cycles” of bleeding.

According to WebMD Medical News, Dr. Paul Norris, a professor of obstetrics/gynecology at the University of Miami School of Medicine stated that “This probably is the first step of a progression towards yearly ....periods, maybe longer.”

Seasonale® is touted as being especially beneficial to women who suffer from severe premenstrual symptoms. “It’s definitely not for everyone,” Norris continued. “But for women who have cyclic problems, who are anemic, have symptomatic fibroids, and for women who are very active and just don’t want to be bothered by periods, it’s good news.”

And good news for Barr Laboratories, a company that stands to make billions of dollars if they can convince women that their periods are an inconvenience that they can live without. Seasonale® is Barr’s first internally developed New Drug Application (NDA) product to gain FDA approval and therefore is incredibly important to the company that “currently ranks as the third largest manufacturer and marketer of oral contraceptive products in the U.S. marketplace.”

Lara Owen, author of Honoring Menstruation: A Time of Self Renewal (Crossing Press 1998) has serious reservations about Seasonale®. She states, “While this drug may perhaps prove useful for some women with serious menstrual pathology, for healthy women it sounds potentially disastrous. Monthly menstruation has a variety of positive effects on the body/mind: it is a crucial element in the continuous ebb and flow of hormones central to overall health in women up till the time of menopause. It is also part of a concurrent emotional cycle in which a woman gains in maturity and self-knowledge through staying current with her feelings. To suppress this cycle puts at risk both physical health and psychological well being.”

The National Women’s Health Network, a network that serves as a watchdog over the regulation of drugs and devices that are marketed, prescribed and sold to women, also has reservations. While supporting the availability of Seasonale® as a contraceptive option, the network conveys concern about the methods in which the drug is already being discussed in the medical community. Their statement reads: “If menstrual suppression is presented as the preferred option, it will stigmatize menstruation and may raise unsupported and inaccurate worries about their periods among women who prefer the monthly cycle.” The network warns that the medical community should “avoid exaggerating the medical need or overstating the health benefits.”

Barr indicates that it plans to market Seasonale® directly to physicians and healthcare professionals, rather than consumers. But it appears as if Barr is already preparing a receptive marketplace for its product. Barr provides a “Know Your Period” educational website, which is described as being “sponsored by leading female women’s health experts,” and “designed to educate and inform women about important health and lifestyle issues related to menstrual periods.” The site, while informative with many links to various women’s health sites, is in fact solely sponsored by Barr Laboratories. However, the Barr company logo and name only appear on the “About Us” page.

The site, though, is not completely without an agenda. While it never openly mentions or directly promotes Seasonale® , the site sets the “groundwork” for its marketing campaign. On the “Menstrual Myth & Facts” page, the first “fact” declares that “Monthly periods are normal, but not necessarily necessary,” and continues to say that “there is no medical reason to maintaining the monthly period associated with oral contraceptives.”

But some, like Sheryl Paul, M.A., wholeheartedly disagree with Barr and the belief that monthly periods are not necessary. Ms. Paul, a counselor in California, and the author of The Conscious Bride (New Harbinger Publications, Inc. 2000) has closely studied rites of passage. She says, “There is often great wisdom and important information in the symptoms that emerge during each phase of woman’s cycle—from ovulation to the premenstrual phase to bleeding itself. These symptoms are one of the ways our bodies are attempting to communicate with us, and when we learn to decode the messages we are often rewarded with the boons of creativity, insight, and compassion. A woman’s menstrual cycle is her wisdom. It’s her gateway into womanhood. It’s her direct connection to the mystery of life, death, and rebirth.”

“The alteration of women’s bodies 
has become big pharmaceutical business.”

Barr argues that millions of women have already suppressed their menstrual cycles with years of oral contraceptive use. The “Know Your Period” site eagerly repeats that the monthly bleeding women on the Pill experience is “not a real ‘menstrual period,’ but actually a ‘withdrawal bleed’ induced by the withdrawal of hormones during the pill-free or placebo week.”

Ironically, for years health care providers and pharmaceuticals have glossed over the fact of suppressed menstruation. I’m sure millions of women, including myself, never fully understood how the Pill worked or how it altered our body chemistry. We were generally just happy to have a reproductive choice. But now, when the truth can be used as a competitive marketing tool, Barr has decided to dispel the myths about the Pill. Surprise ladies, you’ve already tinkered with your “real periods” for decades. Now it’s time to go a step farther, and stop that unnecessary monthly bleeding once and for all—you silly girls!

While Seasonale® is being promoted as a “breakthrough in women’s health,” in actuality it represents a “breakthrough in pharmaceutical marketing.” After all, as even Barr will point out, Seasonale® is not a new drug. In fact, it is the same old oral contraceptive being promoted and packaged in a brand new way, in order to gain a considerable edge in an already crowded marketplace of competing oral contraceptives. According to Barr Labs, the market is ready and willing. The company cites a study indicating that “given the choice, nearly two-thirds of women would be interested in reducing the number of periods to four times a year.”

Let me just say that I completely advocate the use of birth control, as long as it is personal choice a woman makes with full knowledge of the health risks involved. I am, however, a bit wary of Seasonale®, because it has the potential to seriously obliterate ovulation and menstruation—two otherwise healthy, normal, and natural bodily functions in women. The National Women’s Health Network also mentions special concern for teens, stating: “Introducing menstruation to pre-adolescents and newly menstruating girls as a negative experience to be avoided may affect the girls’ body image and relationship to their bodies in negative and lasting ways.”

Ms. Paul considers the marketing of Seasonale® as problematic. She states, “What kind of message are we sending to young girls, women, and men about the menstrual cycle when we continually push products that support its eventual eradication? There is no doubt that many women struggle with various degrees of physical and emotional discomfort around her period, and these issues need the attention that they deserve. But slowly erasing the menstrual cycle does nothing toward addressing the roots of these issues.”

Already the Biotech Rumor Mill website has posted an anonymous rumor that there is a concept for advertising Seasonale® which includes TV spots combining Vivaldi’s “Four Seasons” with images of spring, summer, fall, and winter. It sounds beautiful—this chemical alteration of women’s bodies—doesn’t it? And so much for Barr's intention to market Seasonale directly to doctors and not to consumers. I've already seen the distinctive day-glow pink two-page ads for Seasonale popping up in many of the magazines that I read. And in a quick perusal of national magazines at my local drugstore just this morning I found Seasonale's ads in the following: Marie Claire (Gwyneth Paltrow on the cover), Lucky (Hilary Duff cover),InStyle (Charlize Theron cover), Parents (June 2004), and of course,Cosmo (Angelina Jolie cover).

Disturbingly, the alteration of women’s bodies has become big pharmaceutical business. And rather than investing in costly research and development, it appears that marketing old drugs for new purposes has become the new specialty of pharmaceutical companies. According to AC Nielsen, the world's leading marketing information company, “Since 1997, when the Food & Drug Administration relaxed advertising guidelines, pharmaceutical manufacturers have spent billions of dollars encouraging people to ask their doctors about specific Rx brands.”

Ms. Owen says, “The Seasonale® marketing campaign looks like a cynical attempt to manipulate women into thinking they need medication to circumvent the natural process of menstruation, just as they have been manipulated into avoidance of menopause through hormone replacement, the long term effects of which are only just becoming evident.”

My greatest fear, is that quietly and rather quickly Seasonale® ads will become as commonplace in our magazines as those already pushing Botox, Prozac, and Adderall. I fear that Madison Avenue will package and sell “lack of menstruation” as if it were the must-have beauty product of the new millennium. I fear that advertisers will imply that menstruation is messy, inconvenient, disgusting, and uncivilized. I fear that monthly bleeding eventually will be seen as something only for hippies, indigents, the uneducated, and third world occupants. I fear that as women, living in a high-tech, sophisticated world that devalues women and our bodies, we are way too willing to deface, demean, and diminish our natural feminine attributes. And after personally enjoying the liberation brought to me courtesy of the Pill, I fear that it sounds anti-feminist for me to ask for scientific and technological restraint.

Because I admit that even I initially found the idea of menstrual suppression immensely attractive and inviting. But positioning normal menstruation as “something that isn’t really necessary” trivializes our female bodies and overlooks the importance of our natural functions.

Ms. Owen believes, “We simply don't know enough about the subtleties of the menstrual cycle to mess about with women’s bodies like this. We do know that our evolution coincided with a shift to monthly ovulation occurring at a separate time from monthly bleeding, that the evolution of the human being is intricately wrapped up with the evolution of the monthly menstrual cycle. And that this cycle has always mirrored the orbit of the Moon around the Earth, the monthly flux of time and tide that affects all of the creatures on this planet. Who are we to imagine we know better than this fundamental rhythm of life?”

Perhaps it is time for us to start considering the cultural implications, and not just the scientific applications of all drug approvals. Perhaps, as a society, we need to rethink our attitudes towards taking pills to “cure our ills.” At some point, we need to stand up—as educated and informed women—and tell pharmaceutical companies that we don’t want or need to “be cured” of our feminine attributes. As feminists, we should proudly fight for our bodies, rather than automatically succumb to societal pressure to change them. As mothers, we should set examples for our own daughters, who will someday soon be the target of glossy pharmaceutical advertisements that promise to make their female lives perfect and complete, as long as they ignore the fine print and the long list of medical complications involved.

Some people (probably pharmaceutical reps) have called Seasonale “liberating.” Liberating from what? I didn't know we were prisoners to our female bodies. Besides, no drug can truly liberate us as women, until we liberate ourselves and stop hating our own bodies.

This piece appeared first at the Mothers Movement Online.  It is reprinted here with the permission of the author, Lizbeth Finn-Arnold, who owns the rights to the piece.