Reproductive Health and Rights News
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The New Menstruation
August 2024
Menstruation is a critical indicator of health because it can reflect potential risks for, such as but not limited to: various diseases and conditions of the reproductive system, cardiovascular disease, cancer, and premature death. To measure the health of the population, researchers from the National Institutes of Health and Harvard T.H. Chan School of Public Health analyzed the menstrual cycle of more than 71,000 women using data collected from the Apple Women’s Health Study. The study found that girls in the United States have been getting their first period earlier and earlier throughout the last 55 years. Comparing data from 1950 to 1969 and 2000 to 2005, the average age of menarche–the age of the first period–has decreased from 12.5 to 11.9 years old. Researchers also learned that the percentage of people who experienced early menarche (before the age of 11) increased from 8.6% to 15.5%, and the percentage of those who experienced very early menarche (before the age of 9) more than doubled from 0.6% to 1.4%. In addition, it is now clear that it takes longer for periods to become regular in girls. The results of this study alarmingly point towards a worsening of overall reproductive and population health.
Because the determinants of menarche are multifactorial, it is difficult to pinpoint why the experience of menstruation is changing at the rate it is. The changes can be associated with factors related to body composition, diet, physical activity, stress, environmental exposure to endocrine-disrupting chemicals, and air pollutants.
Since menstrual health and women’s health is understudied and underfunded, large-scale data such as that provided from the Apple Women’s Health Study offer the opportunity to study and understand factors that are impacting menstrual and fertility trends. This opportunity also allows for systemic interventions that are necessary to halt or possibly even reverse these trends.
To read more about endocrine-disrupting chemicals, also known as EDCs, and environmental justice, click here.
Reference: Merelli, Annalisa (2024). “The new menstruation: Girls are getting their periods earlier and less regularly.” STAT News. https://www.statnews.com/2024/05/29/early-menarche-jama-study-average-age-first-period/?utm_campaign=later-linkinbio-blkwomenshealth&utm_content=later-43380644&utm_medium=social&utm_source=linkin.bio
Possible Tie Between Hypertension and Uterine Fibroids
July 2024
In a 2024 JAMA-published study, researchers found that participants with untreated and new-onset hypertension, also known as high blood pressure, had an increased risk of newly self-reported fibroids, whereas those who were taking antihypertensive treatment had a lower risk. The study suggests that treating hypertension could play a role in preventing fibroids.
While previous research has focused on the link between fibroid growth and estrogen, a hormone that plays an important role in regulating menstrual cycles, this study found a connection between lower risk of fibroids and antihypertensive medication. The connection points towards the idea that blood pressure control may be worth exploring to learn more about the growth of fibroids.
A possible tie between hypertension and uterine fibroids can suggest potential mechanisms that may control fibroid growth. To obtain a greater understanding of these mechanisms can encourage new approaches to prevention and treatment of a common gynecological condition; so common, that it is estimated that 70% to 80% of Black women will develop it by the age of 50. This is especially important for Black women since uterine fibroids occur more often in Black women than in any other ethnic group.
To read more about uterine fibroids, click here.
To read more about the study, how it was conducted and its results, click here.
Reference: Tomiyoshi, Tricia (2024). “Research suggests tie between hypertension and uterine fibroids.” UC Davis Health. https://health.ucdavis.edu/news/headlines/research-suggests-tie-between-hypertension-and-uterine-fibroids/2024/04#:~:text=Research%20suggests%20tie%20between%20hypertension%20and%20uterine%20...,there%20is%20no%20preventive%20treatment.
Why New York Has Faltered in Making Childbirth Safer for Black Mothers
June 2024
Black women are nine times more likely to die from pregnancy or childbirth complications in New York City, a disparity larger than the national average. Despite (1) new legislation and programs supporting more government funding for doulas, (2) a state board examining every maternal death, (3) surveys for new mothers about their childbirth experiences, and (4) Gov. Kathy Hochul’s proposal of a plan to address the disparity, the state’s Black maternal health crisis is worsening.
In March 2024, the New York State Department of Health reported that from 2018 to 2020 a total of 121 pregnancy-related deaths were recorded. Out of the 121 deaths, 73.6% had at least some chance of being prevented. Furthermore, it was found that Black women had a pregnancy-related mortality rate five times higher than that of their white counterparts. Additionally, a 2023 report from the New York State Maternal Mortality and Morbidity Advisory Council found that during 2018, “discrimination was a probable or definite circumstance surrounding 46% of pregnancy-related deaths” in the state. Black mothers often face racism in the form of unconscious bias, denied medication, or verbal abuse which can ultimately impact the child-birthing experience.
Experts say the reasons for the racial disparities are complex and varied, but a few of the factors that have been associated with the lack of proper care of patients stem from the impact of COVID-19. The pandemic decreased the overall health of many and greatly contributed to the growing staffing deficit among doctors and nurses. Because of the unbalanced patient-provider ratio, understaffing on some labor and delivery floors may have played a role in physician “burnout” and infant deaths or severe injuries. Another factor is the lack of available appointments for pregnant women. In the Bronx, under 60% of those in their first trimester receive prenatal care. Additionally, an overall decrease in adequate prenatal care has also been seen in Brooklyn.
In September 2022, New York Mayor Eric Adams signed seven bills that promised more education and doulas as a way to address disparities in maternal mortality. Although these bills are a good start, the complexities of the problems call for more action.
References:
Goldstein, Joseph (2024). “Why New York Has Faltered in Making Childbirth Safer for Black Mothers”. The New York Times. https://www.nytimes.com/2024/01/07/nyregion/childbirth-maternal-mortality-black-women.html
New York Department of Health (2023). New York State Maternal Mortality and Morbidity Advisory Council Report, 2023. https://www.health.ny.gov/community/adults/women/maternal_mortality/docs/2023_mmm_council_report.pdf
New York State Department of Health (2024). New York State Health Department Releases Maternal Mortality Reports Detailing Stark Racial, Ethnic Disparities. https://www.health.ny.gov/press/releases/2024/2024-03-14_maternal_mortality.htm#:~:text=The%20 overall%20 pregnancy%2Drelated%20 mortality,deaths%20per%20100%2C000%20live%20births).
New Study from Silent Spring Institute
April 2024
As breast cancer remains the most commonly diagnosed cancer in the United States, recent studies have found an increased incidence among young women. Given that this trend could not be explained by genetics, Dr. Jennifer Kay and her colleagues at the Silent Spring Institute conducted a study to identify environmental exposures that could be contributing to this trend.
During their study, Silent Spring utilized a report from the Environmental Health Perspectives to investigate a total of 921 chemicals that could promote the development of breast cancer. The researchers found that 90% of these chemicals are commonly exposed to people through consumer products, food and drinks, pesticides, medications, and workplaces.
At the conclusion of their study, Dr. Kay and her team used this information to design a research-based roadmap to help develop prevention strategies and reduce the burden of the disease. This roadmap was created to help regulators and manufacturers quickly flag chemicals that may contribute to breast cancer. These chemicals are identified by their characteristics of altering the body’s hormones in a way that could promote the disease. The goal of the strategic plan is to prevent the use of these chemicals in consumer products and to find safer alternatives.
To learn more about endocrine disrupting chemicals (EDCs), click here.
Reference: Silent Spring (2024). “More than 900 chemicals, many found in consumer products and the environment, display breast-cancer causing traits” https://silentspring.org/news/more-900-chemicals-many-found-consumer-products-and-environment-display-breast-cancer-causing
Toxic Free Kids in the State House News
March 2024
In late January of 2024, State House News featured a story by reporter Colin A. Young about An Act relative to toxic-free kids (S.2564)—a bill that would ban manufacturers, wholesalers, and retailers from knowingly selling or distributing any children’s products with regulated PFAS chemicals and require companies to report the toxic chemicals used in any children’s products in Massachusetts. The Joint Committee on Consumer Protection and Professional Licensure reported the bill favorably and referred it to the Senate Ways and Means Committee for voting. In both June and November of 2023, Clean Water Action, the Resilient Sisterhood Project, and several other stakeholders testified in support of this bill because of its potential positive implications for children in Massachusetts.
In the article, Young quotes Laura Sparks, Director of Environmental Health at Clean Water Action as saying, "We know that rates of cancer and neurodevelopmental disease are on the rise. We know that chemicals that cause these illnesses are in things that children use every day. Tiny exposures during infancy and early childhood can alter the course of a person's life. That's why there is no excuse for toxic chemicals in children's products."
Reference: Young, Colin. A. (2024). “Committee Favors Bill Safeguarding Children's Products”. State House News.
Supreme Court: Mifepristone Case
March 2024
Mifepristone, approved by the Food and Drug Administration (FDA) in 2000, is part of a two-dose regimen for medication abortion. Since its approval, the drug has been established as safe and effective for abortion. In addition, mifepristone, as well as misoprostol, is often prescribed as a treatment for miscarriages by potentially warding off weeks of waiting, worrying, and bleeding for a pregnant person. Currently, easy access to this medication is at risk.
Following the Supreme Court overturn of Roe v. Wade in 2022, the Alliance for Hippocratic Medicine, an anti-abortion organization founded in 2022, sued the FDA, challenging its approval of mifepristone. Originally, the Alliance for Hippocratic Medicine argued that the FDA should not have approved mifepristone in 2000. Now, they are arguing that access to the drug should not have been made easier. FDA and Danco, the pharmaceutical company that manufactures mifepristone, hold the counterargument that the FDA followed standard procedure and used scientific evidence in making its decision to approve the drug.
The legal implications of the case may put the pharmaceutical industry, abortion access to oral medication such as the two-dose regimen of mifepristone and misoprostol, and reproductive health care at risk. A decision is expected in June of 2024.
Reference: Simmons-Duffin, Selena (2024). “What's at stake in the Supreme Court mifepristone case” NPR. https://www.npr.org/sections/health-shots/2024/03/25/1240282129/mifepristone-supreme-court-fda-medication-abortion-explainer
Brittany Watts
January 2024
Brittany Watts of Warren, Ohio, was 21 weeks and five days pregnant when she was admitted to St. Joseph Warren Hospital in Youngstown, Ohio, on September 19, 2023. She presented with cervix dilation, premature water break, vaginal bleeding, and a significantly elevated white blood cell count. During this initial visit, doctors notified Watts that her fetus was no longer viable and that she was experiencing a potentially fatal miscarriage. Watts waited for about eight hours before leaving without receiving help.
The delay of a potentially life-saving procedure was due to the hospital ethics panel’s deliberation to determine whether inducing Watt’s pregnancy could be done legally. According to Ohio law, the viability timeline of a fetus is 22 weeks. Since Watts was on the cusp of this timeline, it raised concern for possible legal action.
Watts returned to the hospital the following day, to be refused prompt medical assistance once again. Ultimately, on September 22, 2023, Watts passed the fetus at home, alone in her bathroom. With no clear direction on how to proceed, Watts disposed of what she believed to be the remains of the fetus in a bucket in her backyard.
While receiving treatment for her post-miscarriage treatment, Watts confided in her nurse. The nurse reported Watts to the police, resulting in the arrest of Watts on October 5, 2023, on the charge of abuse of a corpse. On January 11, 2024, an Ohio grand jury declined to indict Watts on the charges.
References:
Tumin, Remy (2024). “Ohio Woman Who Miscarried Faces Charge That She Abused Corpse.” The York Times. https://www.nytimes.com/2024/01/03/us/brittany-watts-ohio-miscarriage-abortion.html
Javaid, Maham (2023). “She miscarried in her bathroom. Now she’s charged with abuse of a corpse.” The Washington Post. https://www.washingtonpost.com/nation/2023/12/15/ohio-woman-miscarriage-abuse-of-corpse-grand-jury/
Bacterial Infection Linked to Endometriosis
December 2023
A 2023 study published in the Lancet Science Journal suggests that a bacterial infection might be a contributing factor for endometriosis. The study concluded that Fusobacterium nucleatum was significantly more present in endometrial and endometriosis tissue from patients with endometriosis in comparison with patients without endometriosis. Because endometriosis is not fully understood, few treatments are currently available. According to Dr. Dominique de Ziegler (Department of Obstetrics and Gynecology and Reproductive Medicine, Hospital Foch -Université de Paris Ouest UVSQ, Paris, France), the findings from this study suggest that an antibiotic treatment may be used in the future to treat some people with endometriosis.
Reference: Venkatesan, P. (2023). Bacterial infection linked to endometriosis. The Lancet Microbe, 4(10), e768. https://doi.org/10.1016/s2666-5247(23)00221-5
I AM Bill
November 2023
On Thursday, October 26th, 2023, the Massachusetts Senate unanimously passed Bill S.1381 (known as the “I AM Bill”) which makes disposable menstrual products available at no cost in prisons, homeless shelters, and public schools. The legislation requires these spaces to make menstrual products “available in a convenient manner that does not stigmatize the individual seeking such products.” The bill is sponsored by Senator Patricia Jehlen, a Somerville Democrat, along with the support of the Massachusetts Menstrual Equity Coalition. The next step will be to gain support in the House of Representatives.
Reference: Borkhetaria, Bhaamati (2023). “Senate passes menstrual period equity bill.” The CommonWealth Beacon. https://commonwealthbeacon.org/health-care/senate-passes-menstrual-period-equity-bill/