Another big T: Tampons, perimenopause, and learning to question everything
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The big, scary news this week was about tampons. Organic, not organic – it doesn’t matter.
According to a study published in the August issue of Environment International, millions of women using tampons around the world may be exposed to heavy metals from the agricultural or manufacturing process, even if in small amounts. They measured 16 metals in 30 tampons from 14 brands, and found “measurable” concentrations of all of them. (Lead was higher in non-organic brands, arsenic was higher in organic).
One of the most reasonable takes came from board-certified naturopathic endocrinologist Jolene Brighton on Instagram. She points out a bunch of important things – including that its crazy we are in 2024 and only now have the first, small clinical study on a topic that impacts all of us.
Brighton points out we’ve been asking for these studies for a long time. That there are big problems in women’s health, including in the industries that serve them, not being prioritized in research. And that the likely response from critics will be ‘we don’t have enough research, keep using your tampons’.
“The pattern of medicine apologizing in retrospect instead of being proactively cautious from the jump has caused harm to women,” she writes.
America’s Doctor Menopause Guru Jen Gunter posted about this three days ago on her The Vagenda Substack, and guess what she said? “Don’t Panic about Lead in Tampons”.
“As if on cue, self-styled alternative medicine doctors, naturopaths, and menstrual influencers are claiming this is proof that women should stuff moss in their vaginas instead (I am only half joking here),” she writes. “The massive irony is that many push unregulated supplements.”
Part of Dr Gunter’s argument is that the study is small, exploratory and there are too many confounding elements to do anything base on it. (Question: Isn’t this how a body of scientific evidence is built?)
But her big one? Somehow tampons became a conversation about supplements. I think you call this a straw man fallacy, which is what happens when you use another, unrelated argument to knock down the original point. Straw man (or in this case, straw woman) arguments are super effective if you don’t know about them, and then they become not obvious and silly, but obstructive, as they undermine discourse and hinder debate. (Dr Gunter is a great champion for midlife women and she’s also really, really good at them.)
My point! Tampons are essential and we’ve not only been told they are safe, safe, safe, we’ve been ridiculed for suggesting otherwise.
As my wise and very successful former colleague Danae Mercer (a good follow if you are struggling with body image or self-love) points out on Instagram, Johnson & Johnson is still settling billions in lawsuits over the talc in its baby powder, and the demonstrated association with ovarian cancer.
As far as I know, baby powder just goes on the outside. So excuse us, Dr Gunter, if we rethink this a little. (One thing Dr Gunter is not so good at? When she stitched Danae’s video to ‘debunk’ it, the audio didn’t come through. Awks.)
The rise of menstrual cups and their less-intrusive counterpart, period underwear, are an obvious sign that women have been waking up to this for a long time. Having a study so late, so small, but so unnerving demonstrates that in so many ways we live in a ruptured reality.
I write all this knowing millions of women don’t have access to any of these products. And acknowledging that the companies who make them are for profit, not what’s best for us – or the rest of the world. (One example: Kenya’s depressing ‘burning pads’ saga.)
But that aside, I get it: if you question tampons? Don’t you have to question everything?
I’m sorry and happy to say yes you do. This is something that happens all the time in perimenopause, and it’s part of the reason why the transition can leave a person so discombobulated. We are just getting more information than ever before.
I’d reckon a lot of women abandon tampons in their 40s, for a variety of reasons. The down-there symptoms of genitourinary syndrome of menopause can make them suddenly, wildly uncomfortable. Maybe, just maybe, some of us get an inner knowing that it might be time to just go with the flow. And unlike all the times before, we pay attention to it.
Free thinking and waking up to narratives? That’s an essential part of the menopause transition too, if you let it be.
The testosterone debate rages on, with a big piece (paywall) in The Telegraph that calls testosterone a ‘wonder drug’ for men and women over 50. I’m starting to wonder if there aren’t three parts to this hormone therapy conversation: symptom treatment, which is the most clear-cut, risk prevention, not-so-much, and then biohacking-style optimization. A different beast altogether. Don’t forget: All things going well, I’ll have clinician researcher Susan Davis on The Hotflash inc podcast Thursday. She is an expert in hormones across a woman’s lifespan out of Monash University in Melbourne, and we are going to dive into the research on testosterone. If you get this soon and have a question you’d like me to ask, hit reply.
Hot tip: Insulin resistance reverser
So many people think of midlife as a time of loss, when they have to cut out all the things they love. And we hear that over and over (alcohol, carbs, fruit) when it comes to metabolic dysfunction, the dreaded insulin resistance and pre-diabetes, which is not only the precursor of most disease, but can really throw our systems right out of whack. It might encourage you to hear Canadian naturopathic doctor, registered dietitian and intuitive eating coach Jenn Salib-Huber, telling me on The Hotflash inc podcast that she is all about one add-in:
“What I tell people about insulin resistance is that the problem isn't the fuel. So you don't need to cut out carbs,” she says. “You don't need to cut out all sugar….The best thing that you can do is to increase the demand for energy and that in usually means movement of some kind. Regular movement: walking, strengthening your muscles, doing anything that is going to increase the demand for energy from your cells will help to improve insulin resistance.”
In this episode of The Hotflash inc Podcast, I speak with iconic American 80s supermodel Kim Alexis. (I had a picture of her on the back of my bedroom door and the front of my binder) We talk about her career, navigating the quagmire of lifestyle information social media and online, and really starting over in midlife – moving, finding new love and making new friends. Kim also opens up about her menopause transition and choice to use hormone therapy – using the controversial delivery method of pellets. We also talk about the impact of environmental disruptors on health and, possibly, menopause; beauty and self-image in aging, and the importance of self-care, self-inquiry, adaptation and outreach in midlife. Listen on Apple (most of you do!), Spotify, or wherever you get your podcasts.
Science stuff: Menopause-adjacent
• That Med diet again: More evidence for olive oil’s role in reducing inflammation. Researchers at Temple University’s Lewis Katz School of Medicine in the US fed mice with extra virgin olive oil and found a reduction in a number of inflammation biomarkers, according to research published in June’s Journal of Alzheimer’s Disease.
• Moving and relaxing for the win: A regular tai chi practice reduces the risk of inflammatory disease and helps insomnia in survivors of breast cancer, according to a study out of the University of California, Los Angeles, Health Sciences published in the August issue of Brain, Behavior and Immunity. Researchers followed blood samples taken from a 2017 study comparing tai chi to cognitive behavioral therapy (CBT). They looked at 90 breast cancer survivors for 15 months and found tai chi had a more significant and sustained reduction in inflammation. The researchers said they need to test tai chi across different populations and acknowledged it’s an ongoing practice, which needs to be done several times a week to get the benefit.
• Feel it to heal it: Confronting trauma helps older veterans alleviate chronic pain, according to a study conducted by UCLA Health and the US Veterans Affairs Office and published in JAMA Network Open. The researchers compared a new kind of therapy, called emotional awareness and expression therapy (EAET), to CBT and found a clinically significant 30 percent reduction in pain. The 126 veterans studied were mostly men; 63 percent of the EAET group reported a clinically 30 percent reduction in pain, compared to 17 percent in the CBT group. The pain reduction was sustained by 41 percent of people in the EAET group, compared with 17 percent who did CBT. While CBT has long been the ‘gold standard’ in evidence-based therapy, by design it only helps you cope with emotions, pain and problems. EAET takes a more modern approach, focusing on experiencing, expressing and releasing them.
Click, watch, listen, read, learn
• American former TV presenter and podcaster Maria Menounos is a 46-year-old woman, so that means she is in the #perimenoposse. But she is also going through everything else too: pancreatic cancer, following up from a brain cancer, and an IVF baby. One thing she’s not worried about? Her age: “I get to be 46,” she tells the Flow Space. “That was maybe not going to happen.”
• The Tamsen Fadel-produced documentary The M Factor: Shredding the Silence on Menopause, will be released on the American channel PBS on World Menopause Day, October 18. Billed as the first menopause documentary, with Emmy Award-winning director Jacoba Atlas is at the helm, it follows women as they visit doctors across the US.
• Menopause at work: Bonafide’s fourth annual State of Menopause report surveyed 2,000 women ages 40-64. They found lingering stigma is impeding career growth and ambition; women are still perceived as less productive and emotionally unstable; three out of four are in workplaces without any accommodations and a bunch of other depressing things. Some good news? The word is getting out, with 70 percent of women learning about menopause online, up 10 percent from 2023.
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Three of me:
Watching
The Bear, season 3. Excruciating and delightful. The flashback episode where Tina loses her job? Heartbreaking. “I’m a 46-year-old woman” she says, exhausted by a job search that’s gone nowhere, as if it’s the end. You want to hug her and say ‘you will not believe what’s ahead of you gorgeous’.
Re-reading
1984. Wow.
Taking
Biotin. (Please don’t tell Dr Gunter I did not independently verify the ingredients). My nails were splitting. I thought it was my gut acting up. Or maybe my body is just recovering from the sudden loss of my dad almost five months ago. Whatever. They aren’t splitting anymore, and that is one less thing to worry about.
AMx
PS: Follow me on Instagram and hear what happened when I visited a dermatology clinic to ask about non-invasive treatments.
Disclaimer: This newsletter and all of Hotflash inc’s content is for educational purposes only. It is not intended as medical advice.
I'm 52. From the time I got my period my Mum told me not to use tampons because they were unsafe. Toxic shock syndrome was even a thing back then, it was something that popped up in women's and girl's magazines now and then over the years, enough for me to stick with pads. They blamed toxic shock on bacterial infections (but strangely enough only happened to someone using a tampon - and giving an underlying message the girl with TSS wasn't washing her hands before inserting or being hygienic enough. Girl shame again - her fault not the big company's fault). I am now on estrogen patches for peri-menopause and it shocks me to think how absorbent our skin is. If I can get my estrogen quota for three days through my skin from this small patch - what the hell are we absorbing from all the lotions and potions marketed to us with all sorts of chemicals in them? Our vagina lining is the most sensitive, I can't believe they have never tested tampons up to now!
Brilliantly written( as always💕)
I am becoming rather tired of Gunter’s polarised view of women’s health… as you say is questioning the “accepted “narrative not how we progress and move forward …
So glad to have you back on the keys Ann Marie🙏💕