An activist scientist for women’s health

15/02/2011

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When I was a college undergraduate, I took a class in human behavioral biology team-taught by two male professors. Most of what I learned really bothered me – it seemed reductionist to claim that males behaved one way and females another based entirely on reproductive goals. The tongue in cheek style, the ease with which other animals were compared to humans, agitated my righteous feminist mind.

Then on the very last day, one of the two professors gave a stirring lecture on the intersection of human biology and politics. The two sentiments I will never forget were that the glass ceiling is reinforced with concrete in academia — and that we have a sexualized culture that takes affront at a woman publicly breastfeeding her child. It was the first time I realized you could be an activist scientist.

My work looks at the natural variation in women’s reproductive physiology. Specifically, I study endometrial functioning – this is the lining of the uterus – and how its thickness varies through the cycle based on a woman’s lifestyle, environment and population. Endometrial thickness can be an important predictor of fertility when measured through the implantation window, which is six to twelve days after ovulation. I have found that there is population variation in how the endometrium is maintained through the implantation window that seems to map onto how much energetic constraint the population has (Clancy et al. 2009), and that endometrial thickness varies based on the length of one’s luteal phase (that is, the second half of the cycle) and progesterone concentrations (Clancy et al. 2010). We are just starting to look at certain biomarkers that will help us understand energy availability, so we may soon be able to say more about lifestyle variation and the endometrium.

The reason it’s so important to me that I be that activist scientist – someone whose work is informed by an understanding of the biases inherent in the process of science, and who promotes a deeper understanding of science to the general public – is that women’s health is something that many non-experts opine about, providing sometimes dangerous disinformation. I’ll give you just three examples.

Reproductive choice. For a while, the US media was making a big deal of a “post-abortion trauma syndrome” that demonstrated the ill effects of having abortions. However, the incidence of mental disorders before and after an abortion are no different, whereas the incidence of mental disorders is higher post-partum than before delivery (Munk-Olsen et al. 2011). This study came out in January, yet those of us who study women’s health already knew that the post-partum period is when women are most at risk for depression. This recent study needs to be widely circulated in order to provide scientific evidence for those people who are trying to think about and make decisions on reproductive choice.

In vitro fertilization. A lot of feelings surface around in vitro fertilization, which I have written about before. Yet few people understand how the process works, why it is done, and under what conditions it is needed for some women. For instance, a broad survey in France found that one third of infertility cases are of female origin, one fifth of male origin, and the rest shared female-male origin (Thonneau et al. 1991). Yet we tend to assume all, or the vast majority, of infertility cases are caused by women. Again, good information from scientists on IVF is good for the general public who would like to understand these issues better.

Normality. Young girls are taught that a normal cycle is 28 days long and deviation from this norm reflects abnormality; however, a 28-day cycle is at the extreme end of the global variation in women’s reproductive functioning, and this is especially true for girls in the first years after menarche (Ellison 1990; Ellison 2001; Vihko and Apter 1984). What’s worse, young girls often perceive themselves as abnormal even if they fall within the normal range of variation for this reason (Beausang and Razor 2000; Brooks-Gunn and Ruble 1982).The societal impacts of disseminating information regarding normal variation in women’s reproductive function cannot be overstated. Were young girls and women to understand that the variability they experience in their menstrual cycles is adaptive and normal, it would help to redefine their understanding of being female (Martin 1980).

Sharing this information and contrasting it with popular knowledge about the menstrual cycle is of vital importance in a country where hormonal methods are the main form of contraception: when women and men learn about the normality of variation in menstrual cycle length and how the ‘normal’ 28-day cycle is in fact on the extreme end of the spectrum, it permanently changes the way they think about the female body and the medical system.

At the end of the day, scientists are passionate about their science, and the public would benefit immensely from having access to that passion and that information. In this Internet age where you can search for just about anything, you cannot always filter out the noise and pseudoscience. When more scientists consider themselves activist scientists, and understand their duty to communicate the work that they do, we will have a better-informed and more appreciative public. That’s good for women’s health, and good for my science.

About the Author: Kate Clancy is an Assistant Professor of Anthropology at the University of Illinois, Urbana Champaign. Her work is on evolutionary medicine, and the intersection of endometrial functioning, stress and inflammation. Kate blogs at Context and Variation and her Twitter handle is @KateClancy. She has a daughter, two cats, and has been promised a dog.

References

Beausang CC, and Razor AG. 2000. Young western women’s experiences of menarche and menstruation. Health Care For Women International 21:517-528.

Brooks-Gunn J, and Ruble DN. 1982. The Development of Menstrual-Related Beliefs and Behaviors during Early Adolescence. Child Development 53(6):1567-1577.

Clancy KB, Baerwald AR, and Pierson RA. 2010. Ovarian, energetic and inflammatory variables are associated with serial endometrial thickness measurements in a sample of Canadian women (abstract). American Journal of Human Biology 22(2):251.

Clancy KBH, Ellison PT, Jasienska G, and Bribiescas RG. 2009. Endometrial thickness is not independent of luteal phase day in a rural Polish population. Anthro Sci.

Ellison PT. 1990. Human ovarian function and reproductive ecology: new hypotheses. American Anthropologist 92(4):933-952.

Ellison PT. 2001. On Fertile Ground. Cambridge, MA: Harvard University Press.

Martin E. 1980. The woman in the body.

Munk-Olsen T, Laursen TM, Pedersen CB, Lidegaard Ø, and Mortensen PB. 2011. Induced First-Trimester Abortion and Risk of Mental Disorder. New England Journal of Medicine 364(4):332-339.

Thonneau P, Marchand S, Tallec A, Ferial M-L, Ducot B, Lansac J, Lopes P, Tabaste J-M, and Spira A. 1991. Incidence and main causes of infertility in a resident population (1 850 000) of three French regions (1988–1989)*. Human Reproduction 6(6):811-816.

Vihko R, and Apter D. 1984. Endocrine characteristics of adolescent menstrual cycles: impact of early menarche. J Steroid Biochem 20(1):231-236.

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Comments

terriaminute - daylily hybridizer, mom 16/02/2011

I am so glad to learn that women’s health is being so specifically researched! This is important stuff!!! I will spread the word. I’ve already sent a tweet, now off to LiveJournal! THANK YOU.
Poppa Doc - Activity (optional) 19/02/2011

My anthropological view of humanity and our respective common humanesses in spite of our genders and sexual ideas with all the distortions of same are deeply shared with you. My career started before IVF, and when humans “had” 48 chromosomes. I have engaged many of the conflicts your work has taken you. Though there has been a great change in our insider information about all this, the insider understanding and applications of these variations in reproductive successes, failures and preferences has not been well taught in medical education. As you point out, it is unfortunate also that the general dissemination and acceptance of these data regarding the public at large has been so neglected. Keep up the good work. Want to talk?