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c h a p t e r t h r e e The Modern Way to Behave while Menstruating Changing Health Beliefs and Practices Between the late nineteenth century and the middle of the twentieth century, medical and popular beliefs about the relationship between menstruation and general health shifted dramatically. By the 1990s, women and physicians in United States were remarkably unconcerned about menstruation as an indicator of general health or illness. Even more definitively, they stopped worrying about menstruation as a time of particular bodily vulnerability. Previously wide-ranging concerns about menstrual irregularity and pain were narrowed to a focus on relieving pain in order to continue normal work and play. Of course, menstruation did not completely cease to be an indicator of health or illness; too much disruption in a woman’s usual pattern of menstruation caused concerns about specific problems with reproductive organs. But these occasional concerns about reproductive health were completely overshadowed by the new way of thinking about menstruation in terms of managing blood and discomfort so that they did not interfere with everyday life. These changing ideas about health and menstruation allowed women and their employers, teachers, doctors, and sexual partners to construct a new set of expectations about which activities were appropriate during menstruation. The “modern” body they envisioned did not need any special attention or treatment during menstruation; women were expected to be able to play sports, work, and even have sex during their periods, and if these activities caused discomfort, they were supposed to call on their doctors to remedy the pain. These new expectations were not uncontroversial, and not all women felt obliged to meet all of them. Experts sometimes challenged them as well, concerned that the focus on maintaining women’s productivity all month might endanger their reproductivity . Nonetheless, the push for women to continue normal activities during menstruation grew stronger and stronger over the course of the century, feeding into the larger vision of the well-managed, constantly productive modern body. The Modern Way to Behave while Menstruating 75 Indications of initiation of major change came in the last quarter of the nineteenth century, when the movement of “new women” into colleges and into public life more generally sparked an extended, published discussion of menstruation in the medical and popular press. Fierce debate pitted the most conservative medical writers, who saw menstruation as particularly debilitating and menstruating girls and women as uniquely fragile, against women reformers who made radical claims about women’s capabilities in many areas. Although a few generations later, even those radical reformers would appear quaint and old-fashioned in their concern about protecting menstruating girls’ health, their protests against conservative medical views marked the beginning of a “modern” way to think about menstrual health. Conservative medical thinkers were led by Dr. Edward Clarke, a prominent faculty member at Harvard Medical School, who published an alarming book, Sex in Education; or, a Fair Chance for the Girls (1873). Clarke claimed that women who studied hard and competed with boys in preparatory school and college, ignoring their periods and their pubertal development, ruined their health and often were unable to have children. Clarke called upon a popular medical theory that the body had a limited supply of vital force. This vital force had to be carefully husbanded for maintenance of health. Men were often warned that masturbation and excessive coition would drain vital force from other necessary bodily activities and reduce mental abilities. Clarke applied the medical theory to girls at puberty, arguing that the vital force necessary to grow their reproductive organs and establish their functional regularity would be sucked up during intensive study, resulting in general and reproductive feebleness, debility, and even death. This damage could not be immediately detected; a girl might feel perfectly healthy during her studies, only finding later that she had damaged her reproductive system beyond repair. Or, a girl might suffer profoundly during her periods, a sign that she was damaging herself, but hide it from her teachers in her ambition to compete with the boys. He recommended that girls rest entirely during their periods and take an easy course of study during adolescence.1 Clarke made his recommendations, he said, both to benefit individual girls and to protect “the race.” Like many of his time, Clarke feared that white AngloSaxons were soon to be outnumbered by those he considered to be “racially” inferior , and he made eugenicist arguments promoting childbearing among white, middle-class, Anglo-Americans. Clarke’s...

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