The Body as a Tool
May 24, 2008
In a conversation I had with Nina, we were discussing the role estrogen and testosterone play in female sexuality. She made the point that it is surprising how many women don’t understand how their bodies work. Sadly, I have to agree. And, while it is a shame that everyday women don’t understand it, when you use your body as one of the tools to do your job, as is the case with those of us who work in the sex industry, it is especially troubling. I encountered a situation yesterday that stands as a marked tribute to this.
I was a member of a forum that escorts and other sex workers use to discuss things like personal safety, how to deal with finances, marketing, and a wide range of other topics that pertain to the business we’re in. One of the threads in the Health Forum had to do with menstruation. One woman wanted to know how the others of us dealt with that time of the month when it came to work. I made the point that I had just switched to Lybrel to prevent my monthly visit from even being an issue with work. Lybrel is the hormonal birth control pill that you take for a full year uninterrupted; you don’t experience a period for a full year (or ever if you start the next cycle immediately. It was approved by the FDA in 2006, and has undergone a huge series of clinical testing to ensure its safety, like all other hormonal birth control (hormonal BC is the single most studied class of medications in history, btw).
The board’s administrator posted a reply that said, “Your body has periods regularly to get rid of the waste each month, and it is harmful to interfere with that.”
I responded with an explanation that, when you’re on hormonal birth control, you don’t have any “waste” to get rid of. The bleeding you experience when you’re on BC is a faux period - one caused by the withdrawal of the hormones in your BC pill (or patch, ring, whatever mechanism you use).
Many people don’t realize this, in fact, but the period you experience when you’re using hormonal methods of contraception isn’t a true period. It helps to understand how the normal menstrual cycle works, so some background is in order.
When you ovulate each month, this triggers a number of different processes in your body, all in anticipation of getting pregnant and carrying a child. Among these is a substantial increase in the endometrium (inner lining) of the uterus. This takes places so that when the fertilized egg makes it to the uterus, it has a nice cushy uterine lining to embed in. The blood rich lining provides nourishment to the developing blastocyst until the amniotic sac develops and so forth. When there is no fertilized egg to implant, your body has to get rid of that excess tissue in your uterus, and that is what the process of menstrual flow (discharge) is all about. That chunky material that comes out is bits and pieces of what lined your uterus.
Now, obviously, if you suppress ovulation, these processes don’t occur. And that is exactly what hormonal birth control does - it prevents you from ovulating each month. No ovulation, no build up in the uterine wall, no “waste” to discharge. Seems like a simple concept, but I completely understand how many people who’ve not taken the time to study how BC works might not realize that. The period you experience on monthly BC was specifically designed to mimic the “natural cycle” of the female menstrual process and was designed for absolutely no other purpose, so to the average person, it still appears to be a “normal” period, though lighter (appearing lighter because, again, those chunks from your uterine lining aren’t coming out).
This case was different, though. The woman who originally replied with the “waste” post did so again thusly: “Alexa, I am an escort of 11 years, and a Registered Nurse. The body produces the waste every month that has to be eliminated.”
I was stunned! This woman claims to be a nurse and is apparently completely oblivious as to the basic principles regarding how contraception works. Perhaps she missed the lecture on the basics of contraception? I’m not sure.
Now, in many other forums I would’ve bitch slapped her and pointed out that she was deluded. However, I was new here, and not wanting to come off as an ass, I thought it’d be best if I pointed her to some confirmation of what I was saying. So I pointed her to this article on MedicineNet, and quoted the relevant section thusly:
Eliminating Menstrual Cycles While Lybrel is the first oral contraceptive designed to completely stop menstruation, Steve Goldstein, MD, says that’s not as dramatic as it sounds. Understanding how the menstrual cycle works helps to understand why. Normally, says Goldstein, a rise in hormones linked to ovulation causes the lining of the uterus to thicken in anticipation of a fertilized egg. If fertilization does not occur, hormone levels drop and the lining is shed in the form of menstrual blood. Oral contraceptives, however, change that activity. “The pill shuts down your normal hormone production and replaces it with a very tiny amount, so there is no buildup of the uterine lining,” says Goldstein, a professor at NYU Medical Center in New York City. Without a lining, there is no shedding, so the bleeding that occurs when you stop the pill is a “withdrawal bleed caused by a drop in hormones,” explains Goldstein. Goldstein tells WebMD that the monthly bleeding that occurs during pill use is unnecessary, so avoiding it — the way you can with Lybrel — should have no impact on health. Moreover, Goldstein says the menstrual cycle and fertility should return soon after stopping this pill, much the way it does with other oral contraceptives.
That mimics almost word for word what I had posted, no?
Now, upon reading this, the logical reaction would perhaps be to say, you know, I was wrong. Damn. You learn something new every day, and get on with bi’ness.
But, apparently, logic is not this woman’s forte. Her reaction was to delete my post a few minutes after I made it. I PM’ed her and suggested that deleting my post was a rather immature reaction. She replied to me that she “…didn’t need some 20 something year old la [sic] drama queen telling her how to run her forum.” And then deleted my account. Just like that. Gone. Banned. For trying to ensure people had accurate information.
This saddens me for a variety of reasons. First, I have to wonder if any other sex worker who has the audacity to question something this apparently infallible administrator says has been deleted (or would be)? Doing this deprives us access to information that is critical to our health and safety. So, in effect, this administrator is more concerned with saving her own face than the actual safety of those she insists she’s trying to help. Rather disingenuous in my opinion.
Second, the board is supposed to be (allegedly) about providing honest, legitimate information to the women in the sex industry. This “nurse” is providing obviously bogus information about menstruation and contraception. That could easily be a health risk to the women who don’t know any better and take her information as gospel.
Third, this woman makes her living with her body and she has no idea how hormonal contraception and menstruation work together. Her body is one of her most important tools she has (along with her personality, her looks, her intellect [such as it is]), and just as is the case with any other job, it is critical that you understand how the tools you have at your disposal work and how to use them. The functioning of your reproductive system must be seen as critical knowledge for women to begin with, but this is especially true of women who work in the sex industry in my opinion.
Fourth, and perhaps most troubling to me, this woman is a health care provider and she has no idea how hormonal contraception works and how it affects the body. Maybe she works in a position where that knowledge is not necessary, I don’t know. I do know that I don’t want to show up at her hospital for treatment any time soon! 
Anyway, as I have suggested in the past, female sexuality and all that it entails is incredibly complex and complicated. It pains me that so many women lack an understanding of even the basics of menstruation and how hormonal contraception works especially, since this is a fundamental part of being female. I know when my doctor originally prescribed BC for me, there was no mention whatsoever of how it did what it did. I believe that knowledge would help women use it more effectively, thereby empowering women. Knowledge is power. Application of that (correct) knowledge makes you powerful. Keeping yourself and others in the dark about it, especially when you’ve had the truth put before you is not only disempowering, it is irresponsible. I can only hope she’s not as clueless about how STIs are transmitted and how they affect the body - not just for her, but her clients as well.
Posted by Alexa | Filed Under Miscellaneous, Work
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6 Responses to “The Body as a Tool”
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Alexa,
I have several reactions here.
My most immediate is that you’re absolutely right to discuss the complexities of female sexuality — and in this case you were discussing something which is relevant to sexuality, but more to do with basic female biology.
Menstruating is a fact of life for all women. Why did I happen to hear “Only Women Bleed” today? lmao!
But — with Lybrel, women now have another option, and a good one too. I myself use the Mirena IUD and also don’t get periods the way I did when taking hormonal BC pills. So, we have good options now!
Tho what troubles me is that you were posting good information and included links — what the fuck does your age have to do with it???
Good lord — I’ve run into disputes and disagreements with people online (either in forums or on my own blog), but I’ve never censored anyone’s thoughts, especially when they disagree with my own. I’d always rather fight it out with someone, and if it turns out that one of us was wrong, even if that happens to be me, I’m the one who is going to be the big girl and say I’m sorry, I fucked up, I was wrong.
And then usually both of us have a greater respect for one another because we know that the relationship/friendship isn’t bullshit.
It’s really disappointing to know that this person ran you off like that because you showed her up. I mean, I think there are some situations when having some age and experience under your garter is beneficial — but not with something like this. No way. She was way out of line — and to think that this was a nurse too??
Some of my other thoughts are that women need to understand every aspect of their sexuality… and for sex workers, even more so. There’s a need to know about diseases, how they’re transmitted, what’s safe to do and what isn’t safe to do, what are the risks, when you might be pregnant, how to deal with that, how to treat common problems like knowing which lubes and condoms won’t fuck up the pH of your vagina, everything. If you make a living with your body, you have to know this stuff!
I think your suggestion of using Lybrel to eliminate a monthly visit probably pointed out to her that she might not be as well informed as she thinks she is. I mean, she can have the opinion that it isn’t a good choice for her — but who is she to censor the information from the rest of her readers? That’s bullshit.
I’m sorry that you got bounced, Alexa, but you were right. Keep doing what you do sweetheart.
xoxo,
nina
Thanks for sharing your thoughts, Nina. I have encountered situations on other forums where people have posted bogus information, and usually when you post something that refutes it along with evidence to back it up, that’s all it takes. Quite frankly, I was astounded that she bounced me as well, and it scares me that she’s the gatekeeper for such an important site. Who knows what else she’s censored?
Anyway, I think we should make you an honorary sex worker!
Anyway, I think we should make you an honorary sex worker!
ha! lmao! Yeah… or the sex worker’s mother hen! lol!
Mwah!
xoxo,
nina
That’s really fucked up. I wouldn’t argue with people like that at all. By the way, though I agree and understand all that you’ve written about BC, but I still want those faux period every month because I need to know that I am not pregnant even though the possibility of that is extremely low. Is that stupid? :)
I still want those faux period every month because I need to know that I am not pregnant even though the possibility of that is extremely low. Is that stupid?
Of course it’s not stupid. Once again, that is one of the primary reasons the cycle works like it does with monthly BC.
And welcome to the blog, Flynn.
Thanks. I am loving it here
Can’t wait to read when you actually start.