by Kelly Jensen
Poetic? It depends on what time of the month you ask me.
Dangerous? Not yet.
Detrimental when it comes to menstrual pain? Disastrously.
When the doctor says there is nothing truly wrong with me—not yet—her voice is so reassuring that I cannot bring myself to tell her that something is wrong. Two to three days a month are wrong. Two to three days when I feel like my uterus has been put in my mother’s old-fashioned citrus press, which I now can’t look at without thinking of my own body, my blood like the acid and pulp of a crushed lemon.
After more nights lost to screaming and the hottest baths I can stand, I work up the nerve to go back. This time, the doctor writes me an order for a prescription-strength dose of an over-the-counter painkiller, which I know will accomplish exactly nothing except letting me take one pill instead of three. But I do not mention that the equivalent dose barely touches that wringing pain. This is after working myself up in the waiting room, promising myself I will tell her I need help, that I cannot walk out of here with more recommendations for hot-water bottles and anti-inflammatories.
And yet I hear myself being silent.
I see my hand taking the prescription.
I feel myself nodding.
I am seldom more cowardly that I am in the face of doctors. It was true when I was fifteen, and mostly, it still is. I walk in ready to make demands, to insist the way I would for my husband or mother or best friend, and I walk out sure that I simply haven’t been as open-minded about naproxen as I should be. After hearing the same recommendations from so many physicians, I tire and buckle and convince myself that if I work out more or wear red lipstick or listen to my mother more often that this thing I hate about myself will simply tire and buckle along with me.
The medication one doctor eventually puts me on, meant to regulate my cycles, gives me mood swings so fast and so severe that friends see my demeanor shift in the length of a single conversation, like the shadows of clouds moving overhead. In the span of a couple of minutes, I can go from burying my face in a neighbor’s dinner-plate dahlias that bow over the sidewalk to sitting on the curb, clutching my ankles, because I am sure the grip of my hands is the only thing stopping my body from flying apart.
Against doctors’ advice, I stop taking the medication.
It takes years of a plant-based diet and curanderismo-based remedios to repair the apparent damage done to my hair, skin, and brain chemistry.
When I am chosen for a random search of my suitcase, the TSA agent looks alarmed to see the impressive stock of pads and tampons taking up more space than my shoes (the statistically improbable frequency with which this random search happens likely has something to do with a profile I fit—Latina, small, young-looking, often clad in jeans and a sweatshirt, generally nervous around law enforcement). The four disposable heating pads I travel with at all times (the number I will need to cover the duration of my cramps) are more often than not flagged as suspicious on an X-ray, soliciting an explosives-residue test. When they’re done, I thank the officers who have just shown the terminal my bras and toothbrush, and take with me what they must assume is some kind of pharmacy I’ve assembled in my carry-on.
A friend tries to teach me to use a menstrual cup, but a history of sexual assault makes me so tense about the prospect of shoving anything bigger than a super tampon into my vagina, I can’t even relax enough to insert it.
When I shower, clots the size of walnuts and the color of plums fall out of me and break apart on the tile floor. When I’m not showering, I feel them dropping down and instantly soaking whatever tampon I’ve just put in.
When my body is being wrung out so hard that I’m sure something is ripping open, I genuinely consider what I might bang my head against hard enough to knock myself out. (Intense pain has a way of making such things seem like a logical idea.)
My abuela makes the sign of the cross on my forehead and tells me I will be healed. When the cramps come again to wring me out the next month, and the month after, and the month after, I do not tell her. My abuela’s faith burns so hot, and I have seen so many of her prayers heal so many suffering bodies in her church, that I cannot help thinking the fault is purely mine.
I learn that society should raise men not to run at the thought of periods, that we must teach our brothers and sons and nephews to view our cycles as natural and even beautiful. But who knows when the hell that’s going to happen, so instead I marry a trans guy who gets it because he’s endured having one of his own. When we’re moving into our first apartment, I make an offhand remark about my pad folding over while I’m wearing it, the adhesive sticking to half my pubic hair, how it feels like getting a bikini wax with masking tape. He does not recoil. He does not exhibit the same horror my ex-boyfriends displayed at this part of me they considered crafted from blood and brujería. My husband just gives me a look of pained commiseration and says, “I hate that.”
I accept the small mercies of friends who exist in that wringing-out space alongside me. They offer suggestions of spearmint tea and what to put in a bath. They offer them in a way that quietly makes clear that should my body not respond, there is no blame to assign. I look back at the nights I have curled up on the bathroom tile, blood on my hands because I cannot get up from the floor, cannot move the small distance to the cabinet that has the pads and tampons. And I realize that the doctors, as well as some of them may have meant, were taught medicine designed mostly with white, straight, cis, able bodies in mind, because our world has, for so long, been meant for white, straight, cis, able bodies. And I begin to believe that maybe, maybe, the fault is not with my body. Maybe it is not even with the blood-filled locket between my hips.
I live with a boy whose relationship with his own body is even more complicated than mine. He forgives me when he tries to bring me a cup of tea and I bite his hand, because something about the wrenching inside me makes me feral, and the fact that he knows this makes me too tired to hide it. He regards the sheer volume of blood my body crafts each month in a way that seems more awed than horrified, as though I have just pulled off a spell or a magic trick, and sometimes, sometimes, when the wringing has dulled enough to let me sleep, I believe him.
I learn to love certain things about my body—the beech-bark color of my hips, how my eyes are a dark enough brown to hide my pupils, the way my hair inexplicably gets more sun highlights on the bottom layer than the top. I learn to love these things even as I feel my body turning on me every three weeks, even as I hate the fact that my own biology can’t even give me the courtesy of a twenty-eight-day-or-more cycle.
I adapt, as well as I can, to the fact that the particular hand biology dealt me will exact the price of between two and six days every calendar month, depending on how and where my cycle falls. Accounting for age and family history, chances are it will continue to do so for more than two decades to come. And because something inside me still bucks against that many days over that many years, I fight back, even if only in small stretches. I give speeches, win Irish dance medals, and smile at friends’ weddings all while in the deepest moments of that pain, because there are some things worth pushing my body for, no matter what price it will demand for it in the days after. I accept the help of those around me who notice the signs of what happens to me because it happens to them too. (The first time I meet an author I’ve admired for years, she catches me wincing before a panel and quietly gives me an extra heating pad because I have burned through the entire set the TSA picked through days before.)
I learn, very slowly, to accept the help others offer.
I take small pieces of myself back.
I lose a little less of my life each month.
This is what I’ve learned from the weight of my own body dragging me to the floor two or three days out of every twenty-one:
You do the work of your own life, even if the truth of the world and your own body have worn you down so com
pletely that you live some of that life on the floor.
If you cannot get up, you do the work anyway.
If you cannot get up, you work from the floor.
What are some normal side effects of menstruation?
Every person who menstruates experiences different side effects. Some may not experience anything at all, aside from discharge. Others may feel headaches, nausea, body pains (particularly breast tenderness or lower-back pain), cramps in the belly, and/or exhaustion. Some may experience appetite changes, desiring more or less food than normal. Sleep may change, as may skin, as it’s more prone to acne. Many people may also become bloated.
There are many emotional side effects of menstruation as well: frustration, mood swings, sadness, low-grade depression, anxiety, and more.
It’s possible for those who menstruate to not see menses every twenty-eight to thirty days. This can be normal and healthy, particularly for adolescents. It’s common for runners, gymnasts, and other high-endurance athletes to experience athletic amenorrhea, which happens because of a shift in hormones in the body. If periods are irregular for more than three or four months, it’s worth talking with a medical professional.
Another common phenomenon for those who menstruate is mittelschmerz, also known as ovulation pain or “middle pain.” This sharp pain happens on one side of the abdomen, about two weeks before the start of one’s period. It can be a jarring experience, but it’s simply the body releasing an egg from an ovary. It can change from month to month in degrees of pain, and some people never feel it at all.
Although these are common menstrual experiences, any symptoms that disrupt one’s daily activities are worth a trip to the doctor. A period can be annoying as much as it can be empowering and exciting, but it shouldn’t derail your life completely.
Five Things People Want to Know about Their Junk (and Are Afraid to Ask)
by I. W. Gregorio
1. I think my penis looks funny. Am I going to be OK?
The short answer is this: almost certainly! If there’s anything I’ve discovered after more than a decade of being a urologist, it’s that there is a very wide definition of normal when it comes to human anatomy. Everyone’s body looks different and behaves differently, and penises are no exception.
The most common and obvious way one penis can look different from another, of course, is whether it’s circumcised or not. Basically, when a boy is born, he usually has a turtleneck-like cylinder of skin that covers the glans, or head, of the penis. For millennia, due to various cultural and religious reasons, some people have had their foreskin removed either in infancy or later in life. For an equally long time, circumcision has been controversial. The Greeks, for instance, considered it an aesthetic affront, preferring to “leave their genitals in their natural state,” as per Herodotus. Nowadays, though about half the boys in America get circumcised just after birth, many parents choose not to circumcise, pointing out the risks of circumcision (including bleeding, possible loss of sexual sensation, and narrowing of the meatus—a.k.a. pee hole).
Some people can benefit from circumcision, however. In urology residency, we learn to perform circumcisions when boys and men need it for medical reasons, like prevention of UTIs, treatment of phimosis (inflammation of the foreskin that prevents a guy from pulling the foreskin back behind the glans), and removal of penile cancers, which are more common in uncircumcised men. There is data to suggest that circumcision can prevent STDs as well. Right now, no major medical society has come out clearly for or against circumcision, leaving the decision up to parents.
Other natural variations in penile anatomy exist, though they’re rarely talked about. This can be a problem for the one in every three hundred boys who is born with hypospadias, a genital difference in which the urethral meatus isn’t quite at the tip of the penis. Most of the time, the meatus is only a few millimeters away from where it’s supposed to be, but sometimes it can be inches away—even underneath the scrotum. Often, hypospadias can come hand in hand with a condition called chordee, in which the penis can be twisted or curved. Usually this is painless, though the curvature may cause some discomfort during sex.
Neither chordee nor hypospadias are emergencies, with the main concerns being cosmetic appearance, the potential inability to pee straight, and in the case of really severe hypospadias, not being able to inseminate a partner through vaginal intercourse. Traditionally, pediatric urologists have offered parents early surgery on their children, due to concerns that any penile abnormality could cause emotional distress later on in life. A growing number of adults with hypospadias, however, argue that the risks of surgery are unacceptably severe for what is essentially a cosmetic procedure; this is supported by some medical research, which shows complication rates as high as 50 percent when the hypospadias is severe.
The bottom line is that variation in how things look down there is rarely life threatening. If something looks funny but doesn’t hurt, things are probably going to be fine. Don’t be afraid to seek out a urologist for reassurance if you’re worried, though, and definitely see a doc if it hurts to pee or to get an erection.
2. My balls hurt, but I’m too embarrassed to tell anyone about it. What should I do?
Please, please, please do not be ashamed. There is one instance where it can be devastating if you try to tough it out and avoid medical attention, and that’s something called testicular torsion, which is when the blood supply to the testicle gets cuts off when it twists around 720 degrees in your ball sack. It’s basically like a heart attack in your scrotum, and that pain you feel is a disturbance in the force, as if millions of sperm are suddenly crying out in terror.
If you get yourself to an emergency room to see a urologist right away (and I’m talking minutes, not hours), they can sometimes do a surgery to untwist things and hopefully save the testicle. But you can’t be afraid to say where the pain is. I’ve had one too many patients come into the emergency room complaining of belly pain, only to admit an hour or two into their stay that the pain was actually coming from their scrotum. Sometimes those two hours are just long enough that the testicle can’t be saved—after four to six hours, the rate of salvage goes down, waaaay down.
3. Is it OK for me to touch myself?
Abso-freaking-lutely! In my work as a urologist, hardly a day goes by when I don’t tell a young man to touch himself.
OK, so maybe my definition of touching yourself isn’t exactly the one you’re thinking about. What I encourage my young male patients to do is a testicular self-exam (TSE)—think of it as a guy’s version of a breast exam. It’s easy to do in the shower, and it’s one instance in which self-screening is by far the most effective tool we have to catch cancer early, when it can be successfully treated.
Testicular cancer is one of the few tumors that’s more common in young adults than it is in older people. It’s also one of the most curable, so go to your doctor right away if you notice a change in how things feel down there. The key thing is that you know your body better than any physician or ultrasound. The typical testicle is soft and oval shaped, with a small ridge on the back that represents the epididymis, where the sperm is stored. Don’t worry too much about lumps and bumps outside the testicle itself—99.9 percent of those are benign. Focus on the contours of the testicle; tumors are often irregular, more like the surface of a potato than that of a tomato. They’re also usually quite firm, with a consistency that almost feels like that of a rubber bouncy ball.
4. What’s the best thing I can do for, uh, performance?
This is going to sound super boring, but clean living is honestly the best prescription for any guy who’s looking to get it on.
These are the biggest causes of erectile dysfunction in youngish men:
• Smoking. Basically, cigarettes are the anti-Viagra. They screw up the blood vessels that lead to erection.
• Alcohol. The conventional wisdom is that a
lcohol, a depressant, can impact the brain signals that regulate sexual arousal, and it also shunts blood away from your nether regions. While some data shows that moderate drinking might not affect erectile function, sexual dysfunction is higher in men who abuse alcohol.
• Unhealthy diets and inactivity. Overeating and lack of exercise contribute to obesity (which can affect testosterone levels) and diabetes (which can affect both the blood vessels and the nerves that contribute to sexual function).
• Recreational drugs. Some studies have shown that marijuana, especially, can make it more difficult for men to get hard-ons, but the evidence isn’t 100 percent conclusive.
One of the most important—and overlooked—factors for young people when it comes to sexual function is mental health. People who are depressed can have a lower sex drive and are more likely to be on medications that can impair arousal, ejaculation, and orgasm.
The take-home message is that the best way to ensure good performance is to exercise, eat and drink well, and take care of both your body and your mind.
5. If size doesn’t really matter, then what does?
I’m so glad you asked! If you come out of reading this essay remembering one thing, I hope it’s this: you don’t need a penis to pleasure your partner.
In my practice, I see thousands of men a year. Some of them are eighty years old with heart problems and can barely walk. Some of them have had prostate surgery that damaged the nerves that lead to erection. Some of them have had penile cancer and needed to have their penises amputated. Some of them are veterans whose genitalia or spinal cords were damaged by IEDs. Some of them are transgender men who weren’t born with male anatomy.
All these people, though, have the potential to have meaningful sex lives. Though no one is denying that penises can be quite useful, they aren’t necessary to give others orgasms. There are lots of ways to get someone off, including oral or digital stimulation.