The Twentieth Century - From Silence to Science

Author's Note: Menstruation Health Week Starts TODAY!! Check out the full calendar for all of our events, donate period products at a drop-off in Bemidji, and help us repackage those products this Thursday from 2-6pm! We hope to see you tonight at Pints, Pours, and Periods!!

The 1900s brought dramatic changes in our understanding of menstruation, from hormone discovery to the birth control pill. But the medical establishment's dismissal of menstrual pain remained stubbornly persistent.

The Ortho Pharmaceutical Corporation of Raritan, New Jersey, produced this oral contraceptive during the 1970s. A monthly prescription of 21 pink tablets is contained in Ortho’s trademarked DialPak dispenser. The DialPak, introduced in 1963, was the first oral contraceptive package to incorporate a “memory aid” and Ortho advertised it as “the package that remembers for her.” The center wheel of the DialPak reveals the day of the week and aligns with a pill on the outer ring. When the user turned the dial to dispense the next pill, the wheel in the center advanced a day, allowing the user to see if she had taken her pill -- from the Smithsonian National Museum of American History.

Breakthrough Decades: 1900-1940

The early 1900s saw significant scientific advances. Edgar Allen and Edward Doisy discovered estrogen in 1923, revolutionizing the understanding of the menstrual cycle. By the 1930s, researchers had mapped the basic hormonal patterns that govern menstruation.

This hormone research finally provided scientific explanations for menopause. The 1930s brought the first recognition that menopause involved declining estrogen levels, not just the cessation of periods. However, this knowledge was slow to translate into better treatment. Many doctors still viewed hot flashes as psychological rather than physiological, and women were often institutionalized for "menopausal insanity."

Yet despite these scientific breakthroughs, women's menstrual pain continued to be minimized. Medical textbooks acknowledged the pain existed but offered little beyond "rest" and "patience" as treatments. The same dismissive attitude extended to menopausal symptoms – women were told to simply "endure" this natural phase of life.

The famous Lysol douching ads of the 1920s-1940s targeted women's fears of being "unclean," with consequences ranging from chemical burns to death. These ads often played on menstrual anxiety, suggesting that periods made women inherently undesirable.

The War Years and Workplace Realities

World War II brought women into factory work in unprecedented numbers. With labor shortages, employers finally had to acknowledge that menstrual pain affected productivity. Some factories began offering basic pain relief or rest periods, but these accommodations were considered temporary wartime necessities.

The post-war era of the 1950s saw a renewed emphasis on domestic femininity. Period shame was institutionalized through "hygiene" films in schools that emphasized secrecy above health. Young women were taught that menstrual pain was something to hide and endure, not treat.

The Sexual Revolution and Birth Control

The 1960s birth control pill revolutionized women's lives – but initially, severe menstrual pain wasn't considered sufficient reason for prescription. Some women discovered pain relief as a side effect, but accessing the pill required considerable privilege and persistence.

The pill also inadvertently led to the first serious study of perimenopause and menopause. As more women used hormonal contraception, researchers noticed that stopping the pill in older women often triggered severe menopausal symptoms. This observation led to early hormone replacement therapy experiments in the 1960s, though these treatments wouldn't become widely available for another decade.

Dr. Robert Wilson's 1966 book "Feminine Forever" controversially promoted hormone replacement therapy (HRT) as a way to keep women "feminine" through menopause. While problematic in its medicalization of a natural process, the book did bring menopausal symptoms into public discourse for the first time.

Tampon use increased dramatically, leading to concerns about toxic shock syndrome (TSS) in the 1970s. The Rely tampon was pulled from shelves in 1980 after being linked to TSS cases, including several deaths. This crisis revealed how inadequately women's products were tested.

The Women's Liberation Movement

The women's liberation movement of the 1960s-70s finally began challenging medical dismissal of menstrual pain. Gloria Steinem's essay "If Men Could Menstruate" highlighted the double standard: "Street guys will brag ('I'm a three-pad man') or answer praise from a buddy ('Man, you lookin' good!') by giving fives and saying, 'Yeah, man, I'm on the rag!'"

Books like "Our Bodies, Ourselves" provided frank information about managing period pain and validated women's experiences. For the first time, many women realized their suffering wasn't inevitable.

Medical Recognition (Finally)

The 1970s brought crucial breakthroughs in understanding period pain. Researchers finally recognized dysmenorrhea as a legitimate medical condition, not just "women's troubles." Scientists discovered that prostaglandins caused cramping, leading to the development of NSAIDs specifically for period pain. Research into endometriosis began, though it was still frequently dismissed as "imagination."

The 1970s also marked a turning point for understanding menopause. The first comprehensive studies of menopausal symptoms began, finally documenting the physiological reality of hot flashes, sleep disruption, and mood changes. The Women's Health Initiative wouldn't begin until the 1990s, but preliminary research started challenging the notion that menopause was purely psychological.

Dr. Susan Love and other feminist physicians began advocating for better research into all aspects of women's reproductive health. They pointed out that while Viagra was developed based on studies of thousands of men, hormone replacement therapy was prescribed to millions of women based on very limited research.

Lingering Dismissal

Despite these advances, many doctors continued to dismiss severe menstrual pain. Women were told to "take Tylenol" for conditions that we now know could indicate endometriosis, adenomyosis, or other serious disorders. The "hysteria" narrative persisted, just with updated language.

As Abigail Norman powerfully states in "Ask Me About My Uterus": "In other words, we really don't know how many people have endometriosis, and why we don't has far less to do with a lack of scientific research and advancement than with our antiquated belief systems and power structures. But it's not even that we don't understand endometriosis on a population level: we can't even seem to get it right with just one patient."

This diagnostic failure wasn't due to lack of medical knowledge – the science was there. It was the persistence of gendered assumptions about women's pain that kept conditions like endometriosis in the shadows, affecting millions while being consistently underdiagnosed and undertreated.

Tomorrow: "The Digital Age: Periods Go Public"