Dr. Jen Gunter’s book, “Blood: The Science, Medicine and Mythology of Menstruation,” discusses the complicated and often misunderstood nature of menstruation.
The doctor who taught me about human reproduction in medical school was a veterinarian. He stated that there is more information available about the reproductive cycles of sheep than those of women. This was mentioned during our first tutorial, possibly because ewes are a profitable animal. I was disappointed by this comparison. Menstruation and pregnancy should not be discussed in the same way as they would for any other animal. These are not just biological processes, but personal experiences influenced by memories and expectations. What about the days in school when girls, as young as eight, silently change their maxi pads in the bathroom, experiencing unpredictable and painful periods? Menstruation is a confusing burden: it brings both shame and relief on a monthly basis.
If the younger generation lacks knowledge about their bodies, then the previous generations were severely lacking. However, there has been a recent increase in media coverage addressing this silence, such as Emma Barnett’s book Period and the BBC Radio 4 series 28ish Days Later. Dr. Jen Gunter’s book Blood takes a scientific approach to understanding the menstrual cycle, aimed at anyone who wants to demystify it and learn about medical options for assistance. Gunter’s dedication to breaking the stigma around women’s health may have stemmed from her upbringing in Canada, where her mother believed tampons were “evil”. As a gynecologist in San Francisco with 30 years of experience, Gunter gained recognition for debunking pseudoscientific claims on Gwyneth Paltrow’s wellness site Goop in 2018. She has continued to fight against misinformation through her Substack newsletter, the Vajenda, and her bestselling books The Vagina Bible and The Menopause Manifesto. Gunter proudly supports professional expertise, informed consent, and reproductive justice without any bias or sponsorship.
In straightforward terms, the menstrual cycle serves as a means of managing resources to ensure a healthy pregnancy, but at the cost of the individual who menstruates, according to Gunter. Among mammals, primates are one of the few species (2%) that regularly sheds the lining of their uterus, a trait we share with bats, elephant shrews, and spiny mice. This process occurs every 24 to 38 days in humans and likely evolved as a defense mechanism against invasive placentas and early pregnancies with genetic abnormalities. Just like ongoing debates in the media about whether menopause is a blessing, a neutral event, or the worst phase of a woman’s life, menstruation is not a universal experience that unites half of the population. The significant variations in flow, pain, and accompanying symptoms highlight the need for rigorous studies rather than relying on personal accounts when making decisions about women’s healthcare.
The author discusses various hormonal changes, gynaecological conditions, and menstruation-related concerns, including endometriosis, adenomyosis, menstrual diarrhea, and premenstrual dysphoric disorder. The book also covers the different contraceptive options available today. To cater to different levels of interest, each section ends with a helpful summary in bullet points. The author also addresses exaggerated fears, such as toxic shock syndrome, and reminds readers that it is a rare infection. The book highlights the tendency to sensationalize scary stories about the vagina for the sake of attention.
The book’s impressive ability to effectively communicate complex scientific concepts is matched by its success in exposing the dangerous spread of false medical information. In her book, Gunter assists readers in differentiating between claims that may sound convincing, but lack evidence, and those that are actually supported by facts. While stories of menstrual blood causing milk to sour, crops to fail, and flowers to wilt may seem like outdated misogynistic tales, similar myths continue to circulate online today. Gunter expresses concern that we are at a critical point where it is becoming increasingly difficult to discern truth from fiction, especially with the proliferation of buzzwords like “natural” and “ancient” that often sway people’s beliefs. Social media platforms like TikTok and Instagram are promoting practices such as vaginal steaming and using menstrual blood as a facial mask for acne treatment, along with questionable products like boric acid elixirs for genital odor and CBD-infused tampons. There are even handmade tampons being sold on Etsy by a shop called “Gyno.”
Gunter frequently receives criticism for being closed-minded towards alternative practices and overly confident in her beliefs. She argues that evidence-based medicine is not a matter of opinion, regardless of personal preferences. She supports individuals’ right to make their own choices, and her criticism is aimed at those who exploit women’s discomfort and fears for profit under the guise of feminism. She believes that doctors are unfairly portrayed as pawns of the pharmaceutical industry, while influencers promote untested and unregulated supplements for their own gain. In the US, anyone can call themselves a doctor, and the use of symbols like white coats and stethoscopes on naturopathic and wellness websites is a warning for the UK to maintain clear distinctions between medically trained professionals and others. Gunter is concerned that alternative approaches not only cause harm, but also miss out on potential benefits. For example, pain relief and hormonal contraception can also act as “disease modifying drugs” by reducing inflammation and preventing pain sensitization. With the increasing availability of treatment options, the need for safe, effective, affordable, and timely gynecological care is more pressing than ever before.
The spread of false information is particularly prevalent when it comes to abortion. Gunter’s justified anger towards the harmful effects of purity culture and “rightwing politicians who claim to be experts on women’s health” reaches a climax in the final section of her book. Maternal mortality rates and the physical and mental toll of pregnancy and childbirth are shockingly high in the US, especially for black women (which is also true in the UK). Gunter argues that “pregnancy should come with a black box warning” due to these dangers. Contrary to popular fearmongering, terminating a pregnancy in the first or second trimester is actually safer than going through with a full-term pregnancy and giving birth. Gunter’s warning to her US readers about using period-tracking apps and location data is unsettling, as these tools have been used to incriminate women seeking abortions. She even has to advise against taking the abortion-inducing medication misoprostol vaginally, as it can leave white residue that may be seen during a later examination, whereas taking it orally produces the same result as a natural miscarriage without any distinguishable physical signs or complications.
The power of science to effectively communicate with clarity, relatability, and wit is evident in its ability to fulfill our desire for belonging and care. Unfortunately, the wellness industry has sometimes taken advantage of this by manipulating our needs. However, through the transparency of scientific research, Gunter demonstrates that our bodies become even more fascinating. She acknowledges the harm that doctors have caused women by not believing them, disregarding their priorities, excluding them from studies, using them as test subjects without consent, making decisions about their health without their input, and treating them poorly. Instead of rejecting science entirely, it is important for activists, researchers, clinicians, and patients to push back against this “medical disenfranchisement” by utilizing resources like Gunter’s book Blood and presenting evidence about their own bodies.
Kate Womersley is a psychiatrist and academic who specializes in studying sex and gender equality in biomedical research at Imperial College London.