Why can't we talk about periods?
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0:01 - 0:04When I was a teen, I had terrible periods.
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0:05 - 0:06I had crippling cramps,
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0:06 - 0:10I leaked blood onto my clothes
and onto my bed sheets, -
0:10 - 0:12and I had period diarrhea.
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0:13 - 0:16And I had to miss school
one to two days a month, -
0:16 - 0:20and I remember sitting on the couch
with my heating pads, thinking, -
0:20 - 0:23"What's up with this?"
-
0:23 - 0:27When I ate food, I didn't leak saliva
from my salivary glands. -
0:27 - 0:29When I went for a walk,
-
0:29 - 0:32I didn't leak fluid from my knees,
"joint fluid." -
0:32 - 0:36Why was menstruation so different?
-
0:36 - 0:38I wanted answers to these questions
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0:38 - 0:40but there was no one for me to ask.
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0:40 - 0:42My mother knew nothing about menstruation
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0:42 - 0:46except that it was dirty and shameful
and I shouldn't talk about it. -
0:46 - 0:48I asked girlfriends
-
0:48 - 0:51and everybody spoke in euphemisms.
-
0:51 - 0:54And finally, when I got the courage
to go to the doctor -
0:54 - 0:56and talk about my heavy periods,
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0:56 - 0:58I was told to eat liver.
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0:58 - 1:00(Laughter)
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1:00 - 1:05And when I went to the drug store
to buy my menstrual products, -
1:05 - 1:09my 48-pack of super maxi pads,
-
1:09 - 1:12back in the day when they were the size
of a tissue box, each pad -- -
1:12 - 1:13(Laughter)
-
1:13 - 1:15You know what I'm talking about.
-
1:15 - 1:17You have no idea how far
absorbent technology has come. -
1:17 - 1:20(Laughter)
-
1:20 - 1:22I used to have to buy
my menstrual products -
1:22 - 1:26in the feminine hygiene aisle.
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1:26 - 1:28And I remember standing there, thinking,
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1:28 - 1:31"Well, why don't I buy toilet paper
in the anal hygiene aisle?" -
1:31 - 1:32(Laughter)
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1:32 - 1:33Like, what's up with that?
-
1:33 - 1:36Why can't we talk about periods?
-
1:36 - 1:41And it's not about the blood,
as Freud would have you say, -
1:41 - 1:42because if it were,
-
1:42 - 1:45there would be an ear, nose
and throat surgeon up here right now, -
1:45 - 1:48talking about the taboos
of nose bleeds, right? -
1:48 - 1:50And it's not even about periods,
-
1:50 - 1:54because otherwise, when we got rid
of our toxic, shameful periods -
1:54 - 1:55when we became menopausal,
-
1:55 - 1:58we'd be elevated
to a higher social status. -
1:58 - 2:00(Laughter)
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2:00 - 2:05(Applause)
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2:05 - 2:09It's just a patriarchal society is
invested in oppressing women, -
2:09 - 2:12and at different points in our lives,
different things are used. -
2:12 - 2:13And menstruation is used
-
2:13 - 2:16during what we in medicine call
the reproductive years. -
2:16 - 2:19It's been around since
pretty much the beginning of time, -
2:19 - 2:22many cultures thought
that women could spoil crops -
2:22 - 2:25or milk, or wilt flowers.
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2:25 - 2:27And then when religion came along,
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2:27 - 2:29purity myths only made that worse.
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2:29 - 2:31And medicine wasn't any help.
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2:32 - 2:33In the 1920s and '30s
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2:33 - 2:38there was the idea that women elaborated
something called a menotoxin. -
2:38 - 2:40We could wilt flowers just by walking by.
-
2:40 - 2:41(Laughter)
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2:41 - 2:44And that's what happens
when there's no diversity, right. -
2:44 - 2:47Because there was no woman
to put her hand up and go, -
2:47 - 2:49"Well, actually, that doesn't happen."
-
2:50 - 2:53And when you can't talk
about what's happening to your body, -
2:53 - 2:55how do you break these myths?
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2:55 - 2:57Because you don't even need to be a doctor
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2:57 - 2:59to say that periods aren't toxic.
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2:59 - 3:04If they were, why would an embryo
implant in a toxic swill? -
3:05 - 3:08And if we all had this secret menotoxin,
-
3:08 - 3:12we could be laying waste
to crops and spoiling milk. -
3:12 - 3:13(Laughter)
-
3:13 - 3:17Why would we have not used
our X-Women powers to get the vote sooner? -
3:17 - 3:19(Laughter)
-
3:19 - 3:23(Applause)
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3:23 - 3:25Even now,
-
3:25 - 3:27when I tweet about period diarrhea,
-
3:27 - 3:28as one does,
-
3:28 - 3:30(Laughter)
-
3:30 - 3:34I mention that it affects
28 percent of women. -
3:34 - 3:38And every single time,
someone approaches me and says, -
3:38 - 3:41"I thought I was the only one."
-
3:41 - 3:44That's how effective
that culture of shame is, -
3:44 - 3:47that women can't even share
their experiences. -
3:47 - 3:49So I began to think,
-
3:49 - 3:52"Well, what if everybody knew
about periods like a gynecologist? -
3:52 - 3:54Wouldn't that be great?"
-
3:54 - 3:56Then you would all know what I know,
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3:56 - 3:57you'd know that menstruation
-
3:57 - 3:59is a pretty unique
phenomenon among mammals. -
4:00 - 4:01Most mammals have estrus.
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4:02 - 4:04Humans, some primates,
-
4:04 - 4:06some bats,
-
4:06 - 4:09the elephant shrew
and the spiny mouse menstruate. -
4:09 - 4:12And with menstruation what happens is
the brain triggers the ovary -
4:12 - 4:14to start producing an egg.
-
4:14 - 4:16Estrogen is released
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4:16 - 4:18and it starts to build up
the lining of the uterus, -
4:18 - 4:20cell upon cell, like bricks.
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4:20 - 4:24And what happens if you build
a brick wall too high without mortar? -
4:24 - 4:25Well, it's unstable.
-
4:25 - 4:27So what happens when you ovulate?
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4:27 - 4:29You release a hormone called progesterone,
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4:29 - 4:33which is progestational,
it gets the uterus ready. -
4:33 - 4:36It acts like a mortar
and it holds those bricks together. -
4:36 - 4:39It also causes some changes
-
4:39 - 4:42to make the lining more hospitable
for implantation. -
4:42 - 4:44If there's no pregnancy,
-
4:44 - 4:45(Whoosh)
-
4:45 - 4:46lining comes out,
-
4:46 - 4:49there's bleeding from the blood vessels
and that's the period. -
4:49 - 4:51And I always find this point
really interesting. -
4:51 - 4:53Because with estrus,
-
4:53 - 4:56the final signaling to get
the lining of the uterus ready -
4:56 - 4:59actually comes from the embryo.
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4:59 - 5:01But with menstruation,
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5:01 - 5:03that choice comes from the ovary.
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5:03 - 5:07It's as if choice is coded in
to our reproductive tracts. -
5:07 - 5:14(Cheering and applause)
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5:16 - 5:18OK, so now we know why the blood is there.
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5:18 - 5:20And it's a pretty significant amount.
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5:20 - 5:22It's 30 to 90 milliliters of blood,
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5:22 - 5:24which is one to three ounces,
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5:24 - 5:25and it can be more,
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5:25 - 5:28and I know it seems like it's more
a lot of the times. -
5:28 - 5:29I know.
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5:29 - 5:31So why do we have so much blood?
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5:31 - 5:34And why doesn't it just stay there
till the next cycle, right? -
5:34 - 5:37Like, you didn't get pregnant,
so why can't it hang around? -
5:37 - 5:41Well imagine if each month it got thicker
and thicker and thicker, right, -
5:41 - 5:44like, imagine what tsunami
period that would be. -
5:44 - 5:45(Laughter)
-
5:45 - 5:48We can't reabsorb it,
because it's too much. -
5:48 - 5:51And it's too much because we need
a thick uterine lining -
5:51 - 5:54for a very specific reason.
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5:54 - 5:59Pregnancy exerts a significant
biological toll on our bodies. -
5:59 - 6:01There is maternal mortality,
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6:01 - 6:02there is the toll of breastfeeding
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6:02 - 6:07and there is the toll of raising a child
until it is independent. -
6:07 - 6:08And evolution --
-
6:08 - 6:11(Laughter)
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6:11 - 6:13That goes on longer
for some of us than others. -
6:13 - 6:16(Laughter)
-
6:16 - 6:19But evolution knows
about risk-benefit ratio. -
6:19 - 6:24And so evolution wants to maximize
the chance of a beneficial outcome. -
6:24 - 6:27And how do you maximize the chance
of a beneficial outcome? -
6:27 - 6:29You try to get the highest
quality embryos. -
6:29 - 6:31And how do you get
the highest quality embryos? -
6:31 - 6:33You make them work for it.
-
6:33 - 6:35You give them an obstacle course.
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6:35 - 6:39So over the millennia
that we have evolved, -
6:39 - 6:41it's been a little bit
like an arms race in the uterus, -
6:41 - 6:44the lining getting thicker
and thicker and thicker, -
6:44 - 6:46and the embryo getting more invasive
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6:46 - 6:47until we reach this détente
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6:47 - 6:50with the lining
of the uterus that we have. -
6:50 - 6:52So we have this thick uterine lining
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6:52 - 6:54and now it's got to come out,
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6:54 - 6:56and how do you stop bleeding?
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6:56 - 6:58Well, you stop a nose bleed
by pinching it, -
6:58 - 7:01if you cut your leg,
you put pressure on it. -
7:01 - 7:03We stop bleeding with pressure.
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7:03 - 7:04When we menstruate,
-
7:04 - 7:06the lining of the uterus
releases substances -
7:06 - 7:09that are made into chemicals
called prostaglandins -
7:10 - 7:12and other inflammatory mediators.
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7:12 - 7:14And they make the uterus cramp down,
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7:14 - 7:16they make it squeeze
on those blood vessels -
7:16 - 7:18to stop the bleeding.
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7:18 - 7:20They might also change
blood flow to the uterus -
7:20 - 7:23and also cause inflammation
and that makes pain worse. -
7:23 - 7:26And so you say, "OK,
how much pressure is generated?" -
7:26 - 7:29And from studies
where some incredible women -
7:29 - 7:31have volunteered
to have pressure catheters -
7:32 - 7:33put in their uterus
-
7:33 - 7:35that they wear
their whole menstrual cycle -- -
7:35 - 7:38God bless them, because
we wouldn't have this knowledge without, -
7:38 - 7:40and it's very important knowledge,
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7:40 - 7:43because the pressure
that's generated in the uterus -
7:43 - 7:44during menstruation
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7:44 - 7:46is 120 millimeters of mercury.
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7:46 - 7:48"Well what's that," you say.
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7:48 - 7:51Well, it's the amount of pressure
that's generated -
7:51 - 7:53during the second stage of labor
when you're pushing. -
7:53 - 7:54(Audience gasps)
-
7:54 - 7:56Right.
-
7:56 - 7:59Which, for those of you
who haven't had an unmedicated delivery, -
7:59 - 8:01that's what it's like
when the blood pressure cuff -
8:01 - 8:04is not quite as tight as it was
at the beginning, -
8:04 - 8:05but it's still pretty tight,
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8:05 - 8:06and you wish it would stop.
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8:06 - 8:09So that kind of makes it different, right?
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8:09 - 8:12If you start thinking
about the pain of menstruation, -
8:12 - 8:15we wouldn't say
if someone needed to miss school -
8:15 - 8:18because they were in the second stage
of labor and pushing, -
8:18 - 8:19we wouldn't call them weak.
-
8:19 - 8:22We'd be like, "Oh my God,
you made it that far," right? -
8:22 - 8:23(Laughter)
-
8:23 - 8:26And we wouldn't deny pain control
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8:26 - 8:29to women who have
typical pain of labor, right? -
8:29 - 8:33So it's important for us to call this pain
"typical" instead of "normal," -
8:33 - 8:36because when we say it's normal,
it's easier to dismiss. -
8:36 - 8:39As opposed to saying it's typical,
and we should address it. -
8:39 - 8:44And we do have some ways
to address menstrual pain. -
8:44 - 8:46One way is with something
called a TENS unit, -
8:46 - 8:47which you can wear under your clothes
-
8:48 - 8:51and it sends an electrical impulse
to the nerves and muscles -
8:51 - 8:52and no one really knows how it works,
-
8:52 - 8:55but we think it might be
the gate theory of pain, -
8:55 - 8:57which is counterirritation.
-
8:57 - 9:00It's the same reason why,
if you hurt yourself, you rub it. -
9:00 - 9:04Vibration travels faster
to your brain than pain does. -
9:04 - 9:06We also have medications
-
9:06 - 9:08called nonsteroidal
anti-inflammatory medications. -
9:08 - 9:12And what they do is they block
the release of prostaglandins. -
9:12 - 9:16They can reduce menstrual pain
for 80 percent of women. -
9:16 - 9:20They also reduce the volume of blood
by 30 to 40 percent -
9:20 - 9:22and they can help with period diarrhea.
-
9:22 - 9:25And we also have hormonal contraception,
-
9:25 - 9:27which gives us a thinner
lining of the uterus, -
9:27 - 9:29so there's less prostaglandins produced
-
9:30 - 9:33and with less blood,
there's less need for cramping. -
9:33 - 9:36Now, if those treatments fail you --
-
9:36 - 9:38and it's important to use
that word choice, -
9:38 - 9:40because we never fail the treatment,
-
9:40 - 9:43the treatment fails us.
-
9:43 - 9:45If that treatment fails you,
-
9:45 - 9:47you could be amongst the people
-
9:47 - 9:51who have a resistance
to nonsteroidal anti-inflammatories. -
9:51 - 9:52We don't quite understand,
-
9:52 - 9:54but there are some complex mechanisms
-
9:54 - 9:58why those medications
just don't work for some women. -
9:58 - 10:01It's also possible that you could have
-
10:01 - 10:04another reason for painful periods.
-
10:04 - 10:06You could have a condition
called endometriosis, -
10:06 - 10:10where the lining of the uterus
is growing in the pelvic cavity, -
10:10 - 10:13causing inflammation
and scar tissue and adhesions. -
10:13 - 10:17And there may be other mechanisms
we don't quite understand yet, -
10:17 - 10:20because it's a possibility
that pain thresholds could be different -
10:20 - 10:22due to very complex biological mechanisms.
-
10:22 - 10:26But we're only going to find that out
by talking about it. -
10:26 - 10:29It shouldn't be an act of feminism
-
10:29 - 10:31to know how your body works.
-
10:31 - 10:32It shouldn't --
-
10:32 - 10:38(Applause)
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10:38 - 10:41It shouldn't be an act of feminism
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10:41 - 10:44to ask for help when you're suffering.
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10:45 - 10:50The era of menstrual taboos is over.
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10:51 - 10:55(Cheers and applause)
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10:55 - 10:57The only curse here
-
10:58 - 11:01is the ability to convince
half the population -
11:01 - 11:06that the very biological machinery
that perpetuates the species, -
11:06 - 11:08that gives everything that we have,
-
11:08 - 11:11is somehow dirty or toxic.
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11:11 - 11:13And I'm not going to stand for it.
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11:13 - 11:19(Applause)
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11:19 - 11:21And the way we break that curse?
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11:21 - 11:23It's knowledge.
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11:23 - 11:24Thank you.
-
11:24 - 11:29(Cheers and applause)
- Title:
- Why can't we talk about periods?
- Speaker:
- Jen Gunter
- Description:
-
"It shouldn't be an act of feminism to know how your body works," says gynecologist and author Jen Gunter. In this revelatory talk, she explains how menstrual shame silences and represses -- and leads to the spread of harmful misinformation and the mismanagement of pain. Declaring the era of the menstrual taboos over, she delivers a clear, much-needed lesson on the once-mysterious mechanics of the uterus.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 11:42
Erin Gregory commented on English subtitles for Why can't we talk about periods? | ||
Erin Gregory edited English subtitles for Why can't we talk about periods? | ||
Brian Greene edited English subtitles for Why can't we talk about periods? | ||
Erin Gregory approved English subtitles for Why can't we talk about periods? | ||
Erin Gregory edited English subtitles for Why can't we talk about periods? | ||
Erin Gregory edited English subtitles for Why can't we talk about periods? | ||
Erin Gregory edited English subtitles for Why can't we talk about periods? | ||
Joanna Pietrulewicz accepted English subtitles for Why can't we talk about periods? |
Erin Gregory
The English transcript was updated on 2/11/20:
0:29 - 0:32
I didn't leak join fluid from my knees,
"joint fluid."
-->
I didn't leak fluid from my knees,
"joint fluid."
and,
10:22 - 10:26
But we're only going to find that out
by taking about it.
-->
But we're only going to find that out
by talking about it.