The best books on Menstruation

Before we get to the books, could you explain how you approach menstruation as an anthropologist?

I’m a biological anthropologist, which means the foundation I’m coming from is human evolutionary biology. That is the lens through which we seek to understand people. Over the years, bioanth has really moved away from just straight up studying human evolution and questions like ‘Why did we evolve big brains?’ There’s definitely a whole line of paleoanthropology that does that. But there are now a significant number of us within bioanth whose research questions focus on trying to understand the wide range of human biological variation.

Studying variation helps us understand how the environment leads to bodies developing adaptations, and how that creates change over time. So what I love about a biological anthropology approach to periods, for instance, is that we don’t start from a clinical perspective of asking questions around ‘What counts as healthy?’ ‘What counts as diseased?’ Instead, we ask, ‘What’s the full variation of what it means to experience or have a period? And how does that help us inform and understand evolutionary biology?’

I gather from your book that menstruation is something you wanted to know more about for a long time. That resonated with me because it’s a topic that I never heard anything about in an educational setting. Could you tell me how you got interested in it?

There were a couple of reasons. One is that even 13-year-old me, when I started bleeding, was struck by the fact that the first thing my nurse practitioner told me was that there was now something wrong with me, while I remember thinking to myself, ‘Isn’t this a very special thing that happens because you’re becoming a woman?’ Just the idea that a natural process that will occur 400 times in my life, that my mother had been experiencing for years, was somehow a problem just felt weird.

Then, in my sophomore year in college, I was double majoring in biological anthropology and women’s studies. Instead of large lectures, I had to take some small group seminars and there was one called ‘reproductive ecology.’ I didn’t know what that was, but the class turned out to be about hormones and menstrual cycles and it was with Susan Lipson. It was this realization that I could actually make this thing—that people had said was gross or weird but felt special to me—my life’s work. I could study it in a scholarly way. That was pretty cool.

Let’s turn to the books you’ve chosen. How did you set about selecting them?

I could just have picked five books about periods. Instead, I picked five books where I really admire the approach. Two of them are about periods and the other three are not.

I teach a general education course called ‘humanizing science.’ It’s a social science course designed for science majors. For the last class of the semester, I assigned two readings that were trying to expose students to a justice-minded way of thinking about the world, to ethics, to understanding the history of science and medicine and the incentive structures and problems of science so they can go and produce a different way of doing science. That’s my big dream.

“ We are as deserving of care and conservation as the rest of the planet”

I assigned them the first chapter of both Hope in the Dark by Rebecca Solnit and Viral Justice by Ruha Benjamin. One of my students said, ‘I started the readings you assigned, and neither of them is about science. Why did you assign them?’ I replied, ‘It’s because they give you a roadmap towards how you could live a different life as a scientist. Hope in the Dark is all about learning from history, realizing that you can have principled optimism and produce change and make a different future for yourself and that pessimism is lazy. Viral Justice shows that small changes in your local community can have big effects in the world, and that you shouldn’t believe that pulling on one little thread isn’t going to do something big. And since your final paper is on imagining futures, those are the things I want you to be thinking about as you’re writing it.’ Similarly, when I was thinking about what books to choose for you, I thought, ‘What were the approaches that really changed my thinking as I was writing my book?’

As it goes beyond menstruation to changing the world, what was the message you were trying to get across in your book?

I think the message in my book, and in a lot of these books too, is that all bodies matter. Material bodies matter. What’s on my mind lately—as we’re obsessing over AI and going to Mars—is that we have to take care of bodies. In this climate crisis, in this pandemic, we have completely forgotten that people have material bodies that are worth caring for. People have changes from day to day in their health and in how they feel, in their disability status and more, and it matters to take care of them. It is an act of justice and of care for our whole world when we put time into thinking about how to care for actual human bodies.

There’s this way that especially in Western science and culture, we think of humans as separate from nature, instead of understanding that there is interconnection. We are as deserving of care and conservation as the rest of the planet. What I hope is that by putting attention on the material body, we start to notice once again that our bodies are just as worthy of conservation. If we’re not taking care of ourselves, I don’t understand the point of taking care of everything else.

And is studying or writing a book about periods a good way of setting about that?

Yes. That’s part of the reason I put Bodyminds Reimagined on my list. Periods are a tricky thing to talk about because a lot of second-wave feminism—and even third-wave feminism that persists today—offers the idea that menstruation is something that doesn’t hold you back. We can be in the workplace just like men, and we can do all the things men can do.

Those things are absolutely true. It’s also true that bodies need to rest sometimes and all bodies have moments when they’re not feeling great. There are some people who actually can’t function during their periods. They have endometriosis or adenomyosis or just unbelievable fibroids that make them bleed through their clothes continuously. I have friends who have periods that are that bad.

Periods do not quite fit into the disability justice space, but they are a function that we hide. They’re a phenomenon that we experience 25% of the time and yet we act like it’s not an experience we’re having. There’s something about that masking, that invisibility, that stigma, as well as the variety of experience, that I think is worth paying more attention to.

Let’s go through the books you’ve chosen. The first one is The Managed Body: Developing Girls and Menstrual Health in the Global South. Tell me about this book and why you like it.

Chris Bobel is a professor of gender and women’s studies at the University of Massachusetts, Boston. I’m a huge fan (as I am of everybody on this list!). Bobel has written many books about periods and has long had a really interesting scholarly approach to them. In this particular book, she does what she calls an invested critique of the menstrual hygiene management movement. In particular, the international movement where it’s mostly white Westerners, white women, going into other countries with their imperial feminist thoughts and saying, ‘We know what’s best for you. It’s more period products or more attention to sanitation conditions (or whatever).’

Some of those things may actually be true. The problem is—and this is not a new argument, I was just reading a paper from the 90s, by Antoinette Burton about this—that the project of imperial feminism, of white women going in and imposing their ideas on others, is one that’s been around for over 100 years, if not far more. It deserves being interrogated, because all people can speak for themselves. And when adult women from one culture decide that they know what’s best for the adult women or people of another culture, that’s concerning. They’re not even right all the time.

For me, this book was really powerful. I cite and talk about it quite a bit in one chapter of my book. I thought her critique was so skillful. In the vein of what I was talking about with Rebecca Solnit’s book, I think critique is actually optimistic. It offers a path forward toward a better future and demands more of others. That’s what I admire about this book. It isn’t saying, ‘Therefore, you should all do nothing, go leave now.’ Instead, she’s saying, ‘I expect better of all of us. Let’s figure out a path forward.’

Taking a step back, she’s writing about this in the context of the menstrual hygiene management (MHM) movement. In the mid-2000s, there was a big push towards talking more about menstruation and making it less of a taboo. Broadly, MHM was a good thing, but she’s pointing out some limitations?

Yes. The other piece of her critique—that I don’t talk about as much in my book, but I think is important—is, ‘Why is the solution a capitalist one? Why is it about getting more products to people?’ There are probably some fundamental issues that precede, ‘Here’s a pad.’ Especially considering you need a lot of products to span the entire lifetime of a person who’s bleeding. Instead of a capitalist solution—like ‘Let’s get donations for lots of menstrual cups’ or ‘Let’s teach people how to make pads and then sell them’—what would it look like to think instead about underlying issues? There are different types of interventions other than a capitalist model. Why don’t we address the extraction and genocide that probably characterize why it is that folks are in poverty in the countries that we’re identifying to begin with?

Let’s go on to the next book, which is called Blood Magic (1988). It’s a collection of articles, looking at menstruation around the world, edited by Alma Gottlieb and Thomas Buckley. Tell me about this book and why you chose it.

Alma Gottlieb is an emeritus professor from my university and my office at work is her old office. She gave me a copy of this book just as I was about to start writing. It’s a cultural anthropology of menstruation. It’s one of the first books that said, ‘Instead of universalizing the idea that all humans have menstrual stigma, let’s actually take a closer look at all of these different groups.’

Actually, menstrual stigma is the exception, not the rule. All these practices that we’ve assumed were stigmatizing, like various types of menstrual seclusion practices, are actually more about ‘this is allowing us to concentrate our power’ or ‘this is giving us a break from domestic labor’ or ‘this is allowing us to go hang out with friends.’

Our Western narration told the wrong story, and this was the first collection that really pushed against that. It’s a really powerful book and it’s recognized as a classic among people who do critical menstrual studies. But outside of that, I think it’s an under-recognized collection. People don’t realize what a big deal it was that Buckley and Gottlieb had this thought, wrote an amazing introduction, and put together all these readings.

Let’s go on to Bodyminds Reimagined.

Bodyminds Reimagined is by disability studies scholar, Sami Schalk, who’s at the University of Wisconsin-Madison. I’ve admired her work for a long time and I’ve assigned a lot of her readings in classes that I’ve taught.

As we talked about before, the big picture meaning of my book is this idea that we should be imagining different futures. Black feminist speculative fiction is where we can get some of the best and most hopeful ideas for what our future could be. I’ve been a fan of the Parable of the Sower for a really long time and Octavia Butler is one of the main authors that Sami works on in this book. We should be paying more attention to reading and learning from and lifting up the voices of Black feminist speculative fiction writers and folks like Professor Schalk, who are so brilliant in their analysis of this work.

What’s so important about this is that it’s pushing back against the idea that we’re going to fix gender injustice or sexism by saying, ‘This group can now do everything this other group can do.’ What that often requires is making invisible what makes us different, or hiding or concealing things that might challenge us to exist in a world that wasn’t made for us. Schalk really insists that you can’t get rid of sexism by suppressing periods indefinitely and creating womb incubators. You can’t just take reproduction and put it away and that’s how you solve the problem.

The future is going to be messy. The future is going to include real bodies. How are we going to manage that? We can’t just all sit in a cubicle and sip Soylent all day, as much as some tech bro in Silicon Valley might want that.

What works of speculative fiction does she focus on in the book?

The main one is Kindred by Octavia Butler and then Stigmata by Phyllis Alesia Perry. She also does some work analyzing N.K. Jemisin, Shawntelle Madison and Nalo Hopkinson. I don’t know if you’ve ever read any N.K. Jemisin or Nalo Hopkinson but they’re amazing.

A lot of what she does is show that disability is going to exist in the future. You can’t disappear ableism by just saying, ‘We’re going to have a medicine for that one day.’ A lot of these works reckon with, ‘What will it be like when these bodies actually have to manage?’ In some ways, you could read the main character’s experiences in N.K. Jemisin’s Broken Earth trilogy that way. She has these powers, but she also has a disability associated with them. There’s a lot of mental strain associated with her powers. Certain children, if they’re very powerful when young, have a lot of mental strain that goes with it. She resists the idea that we can just fix things—that we can fix an oppressive system within our culture by erasing a difference. Which is a good segue to the next book.

Yes, tell me about Pollution is Colonialism by Max Liboiron.

The connection between Schalk and Liboiron’s work is this insistence that you can’t fix things by just moving them away. The desire we often have to fix pollution is, ‘Okay, here’s the recycling bin, and that will take our plastic away.’ Plastic never leaves. It never degrades. Every time we make plastic, we are committing to that plastic existing on our planet for the rest of time, effectively.

Max’s work really shows the naivete of how we think about pollution and how the first solutions that we so often come up with, especially in Western science narratives, are always, ‘Let’s get it out of our context and put it somewhere else.’ We don’t think about the fact that we moved the factory, so now it pollutes somebody else’s community, or that when we put the landfill over here, the waste leaks into the groundwater and affects this other community. We don’t pay factory workers enough, some of them commit suicide or die, or don’t have enough wages to feed their families. There is a real need for us to imagine greater interconnection, and to stop creating solutions that are all about assuming access to land that isn’t ours and extracting resources without a mind to the consequences of it.

Despite these very heavy messages, Max also manages to be very light. The footnotes are amazing in this book. They are a whole book unto themselves, sometimes, longer than the text itself on a given page. They are righteous and friendly and offer a different approach or are talking a little bit to a different audience. She knows most of her readers will be white, but she sometimes has footnotes that say, ‘This is for my fellow Indigenous peeps.’ The art of what she does with this, not to mention the thinking behind it, is why I try to put this book into the hands of pretty much everyone I know.

So you’ve chosen this book because you like the approach, rather than because it has a menstruation angle per se?

Except that in some ways there is. A chapter that we ended up pulling from the book, but I wrote as a feature for American Scientist last year, was about pollution and disposable products for menstruation. The way we tend to think is, ‘How can we manage periods to make them invisible so we can go exist in the world?’ We tend to prioritize, ‘What are the most effective products that sop up my period blood and keep it from being visible to other people?’ In doing so, we are producing more and more disposable products that are harmful to the planet.

Also, the people who are making these products are not thinking about our health and safety. These products contain VOCs, they contain phthalates: there was just that settled lawsuit showing that PFAS are present in Thinx underwear. We are exposing ourselves, on our thin genital skin, to plastics that then get absorbed into our bodies and live in us forever and have profound health consequences—all in the name of using the most absorbent thing that will keep periods from being seen. So, in a lot of ways, pollution is connected to menstrual justice, because the decisions we make about the products that we use do have those consequences.

At the same time, her systemic approach—and what I offer, I hope, in my book—is around not telling people this is what you personally should or shouldn’t do. As much as it’s important for all of us to try to make good choices, we need to turn our eyes upward and say, ‘What are the systems in play? What can we do to effect change in a capitalist system that is trying to extract money from us, and give us these products that may be super absorbent, but are not super safe, and have profound negative consequences for the environment as well as our health? And how can we be putting more thought into that and pressuring these companies to make different decisions?’

We have a history of that. With Toxic shock syndrome (TSS), it was feminist activists who were the ones who first noticed what was going on. That was a book I almost put on this list: Toxic Shock: A Social History by Sharra Vostral. It’s the whole history of the feminist activism that got us to recognize the problems with superabsorbent tampons and how that was leading to TSS.

Yes, I remember reading the warnings on the box as a teenager. I was shocked that a tampon could kill you.

Well, those warnings were because of Esther Rome and other feminist activists at the time, who made sure that we all knew there was a problem and changed how we categorize and standardize the absorbency of tampons.

I don’t know much of the history. One thing I always wondered growing up is what happened 100 years ago, before there were sanitary pads or tampons or in societies where you don’t have all those disposable products. What did people do?

So Sharra Vostral has another book, Under Wraps. It’s another book I almost put on this list. It looks at menstrual technologies. Blood Magic and Chris Bobel’s work also cover the reusable rags and absorbent fabrics that people used to use. They’re not as absorbent as a disposable pad, but if you swap them out often enough, you can make do.

One of the things that’s amazing about menstrual technologies—but again, has gotten us into the pickle we’re in—is that because they weren’t that good people really did remove themselves from modern life when they were menstruating. You would wear an absorbent fabric between your legs, then you’d wear rubber underwear over it, or a rubber apron that was supposed to protect your skirt from getting blood on it. That’s how you protected yourself and tried to keep from showing that you had menstrual blood. If you were a heavy bleeder, that was pretty much always insufficient.

That’s why I think we have to have a nuanced approach to thinking about menstrual technologies and why I would never tell somebody, ‘Listen, you just can’t use disposable pads anymore because they’re bad.’ Without them, many people couldn’t exist in public while menstruating. I couldn’t: I bleed way too much. So sure, I could sit in bed for the first three days, and just bleed on myself and use inferior products in terms of their absorbency. Or I could use ones that are worse for the environment and worse for me but allow me to be out in public. There isn’t really an in between right now. There are some reusable things like cups, but not everyone tolerates them very well.

Now we’re at the last book you recommended, which is Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America by Leslie Reagan. Tell me about this book.

Leslie is also a professor here at the University of Illinois and a person I’m a super fan of. She’s a professor of history, and there are two books of hers I was trying to decide between. There’s this book and then there’s her other book, When Abortion Was a Crime, which is a history of abortion from the 1800s through to the 1970s here in the US (though she mentions some other Western countries).

Dangerous Pregnancies is the story of how people came to realize that rubella causes birth defects. It was actually mothers who noticed first. I feel a lot of time is spent talking about how mothers are over-worriers or obsessed with their children or their pregnancies. There are two reasons why it makes sense for them to be. One is that the medical system doesn’t actually care that much about them. In the US we have one of the highest rates of maternal mortality out there. We kill moms on the regular and we don’t seem to feel that bad about it. So there are ways in which it makes sense for pregnant people to really pay attention to their bodies. Also, children are deeply underserved. In the US, we are closing pediatric hospitals, pediatric units and NICUs all over the place because they aren’t profitable enough. So what happens when your child is really, really sick? We have a healthcare system that only cares about the most profitable parts of healthcare, not things that will prevent kids from dying.

It took a significant amount of time between moms noticing that if they had rubella while they were pregnant their child might be born blind or die, for people to pay attention. They said it enough times to enough people. The first person who really believed them seems to be a doctor in Australia, Norman Gregg.

This book is so powerful because it shows how important it is to respect people when they say, ‘No, something’s wrong. I don’t care what your tests say. I don’t care what your belief is about rubella being a minor disease. This is wrong.’ And it’s because of this that the rubella vaccine was able to be fast-tracked, and implemented as quickly as it was. In my book, I talk about our research on COVID vaccines and menstrual changes and my lab’s principles around the art of noticing. This book really shows, in so many ways, why it’s so important to pay attention to what a patient says.

So in this book, there’s no connection with menstruation?

No, but there is a connection to health, to medicine. What moves me about this book is the incredible detail, compassion and attention that Dr. Reagan puts on all these parents who said, ‘No, my kid deserves something better. And I deserve something better because I don’t want this to happen again.’ Mothers were saying, ‘Nobody is protecting me. I’m going to get rubella and my kid is going to die.’

For me, I also see a connection with our current pandemic. We’ve stopped caring about how many people we’re killing. If you look at the death rates, they’re still very high. If you look at the infection rates, they’re still very high. And yet people are acting like they don’t care. Every person who doesn’t care and goes indoors unmasked risks transmitting the disease to a pregnant person, or an immune-compromised person. It’s perpetuating a pandemic and incredible harm. And yet, we’ve all decided we’re okay with it. I still mask indoors everywhere; I still can’t wrap my mind around the fact that we’ve decided we don’t care about our fellow human beings.

We now know that COVID during pregnancy could cause microcephaly in babies. We now have two cases at the University of Miami showing that there is a link. We also know that getting COVID while you’re pregnant increases your risk of miscarriage, stillbirth, preeclampsia and intra-uterine growth restriction. We’re exposing pregnant people every day to a disease that causes harm to the parent and causes harm to the fetus. We’ve known about this since 2020 and nobody gives a shit. We’ve known for three years what we’re doing to pregnant people and we don’t care.

That’s why I’m curious when I look at this book, and how we actually cared. We fought to come up with a vaccine to stop transmission of rubella to protect pregnant people and fetuses and children. Today, we don’t have that for COVID. Most pregnant people don’t even know that every time they go out unmasked or the people around them don’t bother masking, they are exposing themselves to the risk of stillbirth, miscarriage, preeclampsia, intrauterine growth restriction and microcephaly.

So yes, my book is about periods. But it’s also about what it means to care about people. And that I think we should care about people more than we do.