Birth control pills and menstruation - a few questions

The report: Who invented tampons?

I dunno about your mom and grandma, but there has been a documented, significant change in bones. Part of the discipline of forensic anthropology involves determining sex of an individual from leftover bones. (This discipline was developed prior to the development of the ability to use DNA on bones, and is still relevant for bones too old for DNA to be recovered from them.)

It is easy to determine the sex of an individual from the pelvis - even I can do it. (I’m not a forensic anthropologist; I just hang with them.) However, often a fragmented skeleton is recovered, or only parts of it. A great number of measurements have been standardized which can tell you if that’s a male or a female femur you’re holding. I once deeply embarrassed a forensic anthropologist by bursting into the giggles when she held up a humerus and announced, “The humerus is good for sex!”

Naturally she meant good for determining gender. She was the kind of scientist who would never ever think of the alternate meaning…

The point of this post is that you used to be able to tell males from females based on a caliper measurement of the width of the ball of bone at the top of the humerus. I don’t recall the exact measurements, but they were something like, forty to forty-five mm, female; forty-nine to fifty-seven mm, male. It was assumed by everyone that these measurements were testosterone related and therefore immutable.

Imagine their surprise to find that female Americans in the last fifty years were starting to come in at forty-six mm. Then forty-seven. The scientists said there must be a grey zone. Guess what. Well fed females, if fed much protein and fat from birth, can reach fifty mm. Testosterone not required. And so the humerus is no longer good for sex, except in ancient populations.

When we were discussing this shocking (to the forensic anthropology world) news a few years ago, older scientists started remembering some cultural memes from childhood. If there was only enough meat at breakfast to feed one child, the boy got it. The girls ate oatmeal. If there was a limited supply of meat at dinner, the boys got more of it, or all of it. This turned out to be true in the memories of white Americans, black Americans, and visiting Chinese scientists.

America nowadays has so much fat and protein available even to the poor (and so little cultural reward for scrimping on girl diets) that we have actually changed the bones.

I’m not saying it’s not possible, but it doesn’t make sense with my experience. I started menstrating at 10, and I was a skinny underfed thing who could not eat dairy as a kid. My mom started menstrating at 15, and we only have a 19 year age gap. I gew up eating most meals at my grandparent’s house, and I’m pretty sure the food has been the same there for decades. I may be an anomaly or something, but “better nutrition” doesn’t seem to explain it all.

even sven, it’s also true that statistics have absolutely nothing to do with the individual experience.

I have a question: since a woman on birth control pills is having withdrawal bleeding rather than a real period, is it possible for her to have PMS?

PMS is supposedly* triggered by the fall in hormones around menstruation. As the “week off” the pill leads to a similar decline in hormone levels, the pill can indeed trigger PMS in some women.

Tri-phasic preparation mimic the body’s hormones most closely- for some women they make PMS worse, for some, better. Monophasic pills have the same dose in hormones in every pill, and some women find that this keeps them on a more “even keel” and decreases PMS, some find that the sudden loss of hormones makes their PMS worse.

Yet again, it’s all about the individual. If you have bad PMS off the pill, you might find it decreases on it, but with only certain perparations, you might find it the same, you might find it worse.

There’s no hard and fast rule, so if you do have PMS, the pill is probably worth a shot, just to see what happens (and try at least 3 different types of pill before you decide it’s definitely not going to help).

*PMS is a bit of a mystery- the vast majorty of women report some sort of symptoms, but it’s unclear exactly how many reported symptoms are actually PMS and how many are just co-incidental. In one survey a typical PMS questionaire was given to men (although they didn’t know what it was), and many of them reported positive findings! For some women there is no doubt that PMS makes their lives a misery, and although lots of things have been tried (vitamin B, evening primrose oil, various hormone therapies) nothing has been shown conclusively to work in everyone.

What is “natural”–what was normal during most of our evolution–was near-constant pregnancy or breastfeeding, both of which supress periods (and it is my understanding that your periods stop for far longer if you are breastfeeding while border-line malnourished, which would have been more common in the past). What is “natural” is to have years and years where you would have very few, if any, periods–my mother and grandmother both got pregnant more than once on the inital ovulation after a birth/breastfeeding cycle, which means they went from one pregnancy to the next without ever having a period. That’s natural.

But it still isn’t natural. It still isn’t what the body is used to dealing with, or evolved to deal with. Provided you are going to be on the pill either way, supressing menstration comes closer to imitating a “natural” state than allowing it does.