IS MENSTRUATION OBSOLETE?

Women have evolved past the need for menstruation, goes this questionable argument, and now should be relieved of the problem of an unnecessary monthly loss of blood. Coutinho (Gynecology, Obstetrics and Human Reproduction/Federal University of Bahia School of Medicine in Brazil) first advanced this startling opinion in a 1996 Portuguese edition of this work. Here he teams up with Segal (Distinguished Scientist at the Population Council in New York) to make the case that “recurrent menstruation is unnecessary and can be harmful to women. It is a needless loss of blood.” Biologically, the authors contend, women were designed to live shorter lives and to spend most of their reproductive lives pregnant or lactating, and so not ovulating. Longer human life spans and many fewer children mean more menstrual cycles, more cycle-related illnesses, an increased risk of such dangerous diseases as ovarian and endometrial cancers, and a serious worldwide problem of female anemia. “The attitude that menstruation is a ‘natural event’ and therefore beneficial to women has no basis in scientific fact,” conclude Coutinho and Segal, who therefore advise using long-acting contraceptives or continuously using oral contraceptives (with no monthly break to allow pointless bleeding) to achieve “freedom from menstruation.” “Under proper medical supervision,” they further suggest, “it can also be attained through natural means such as a conscientious regimen of rigorous exercise.” It’s difficult to imagine a world in which women would have the time for an exercise regimen of the level required to stop menstruation (literally hours each day), more difficult still to imagine this entire argument holding much appeal or even interest for readers of either sex.