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i recently made the decision to start taking the pill. at 23, i am probably quite old in comparison to some young girls in the uk who begin to take hormonal contraceptives at age 16 and onwards. when i begin, this will be the first time i have used something other than condoms alone as contraception.
a lot of this is to do with a rather old-fashioned notion of purity -- i didn't want 'artificial' hormones to be affecting the 'natural' cycle of my periods. i am aware, this view seems to conflict remarkably with my feminist politics -- the idea of a 'pure' womanhood which will be disrupted by hormonal control seems to be a profoundly sexist one. after all, i'm sure (although i own up to not having done sufficient historical research, sorry guys) that the idea the pill disrupts the purity of one's womanhood was used by conservatives to argue against it. god forbid that a couple, and more specifically a woman, enjoy sex, and have sex for its own sake, rather than good old-fashioned reproduction. furthermore, the pill gave women control over conception, contraception gave women their education & employment (as they could choose when - or if - they had children), and the social & cultural impact of the pill is widely documented and acknowledged.

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so why then, this internal resistance of mine to the idea of hormonal contraception? the notion of female 'hysteria' is one of a gender-specific madness, which has very ancient origins. there was the idea that hysteria was caused by a 'wandering' uterus, looking for its rightful place within a woman's body. the 'symptoms' of hysteria were wide-ranging, and hysteria was generally ascribed to any woman who was unwell, for reasons unknown, or who was un-well in behaving sufficiently 'womanly'. (wikipedia cites maines, who notes that 'a tendency to cause trouble' is one such symtom of hysteria; i should probably note that facts are lifted here and there from that great internet resources in this blogpost, and indeed, throughout this blog').
hysteria was sometimes treated by 'pelvic massage' in order to bring about hysterical paroxysm, or, in other words, an orgasm. hysteria, (i first came across this concept when i was quite young, through the film the road to wellville). in other words, was the pathologisation of a woman's sexuality, and indeed, of womanhood more generally.
to me, hormonal contraception (illogically & irrationally perhaps) can seem like a way of 'pathologising' the female. i suppose this is partly because, although i do have difficult periods, i view them as something kind of cool (note that i find rashes & most bodily functions cool too, so...), and maybe even worth celebrating. i remember eagerly anticipating my period whilst going through puberty: after all, it meant that i was finally a 'woman'! periods, in other words, are closely tied up to my idea of 'what it means to be a woman', even though this biological definition isn't something that i mentally ascribe to, emotionally it holds a lot of weight for me still, having grown up with difficulty negotiating gender norms. (i knew i was never going to be 'womanly' enough, because in postcolonial hong kong, this - to my mind - also included being white; but i still desperately wanted to be, aware that i was of the social rewards and acceptance this would grant me). and so, hysteria is particularly relevant to my case now.
this is because it's not even quite for reasons of contraception that i am considering this. i started taking antidepressants for depression & anxiety after the assault. i am taking sertraline, and the drug leaflets that came with one particular brand of box (american, i think; the brand i take differs depending on whatever the pharmacy has in stock, which varies according to availability, i imagine -- once there was a 'shortage' due to manufacturing issues, apparently) stated that it was sometimes used to treat something called premenstrual dysphoric disorder, abbreviated to pmdd.
further investigation led me to this rather useful website, which describes pmdd as "a condition associated with severe emotional and physical problems that are linked closely to the menstrual cycle". it comes and goes (and i'm sure there are other contributing factors) but at its worst, i get very depressed, cry for no reason, have difficulty sleeping, feel a very specific type of tired (heaviness) that i only ever get when i have my period, and, the most contentious thing perhaps - . at its worst, i have possibly all if not ten out of the eleven listed symptoms on the aforementioned website.
the website suggests that the contraceptive pill is also sometimes used to treat pmdd. and, after months of debating, i've decided to try it out -- my reasoning being that even if it doesn't help (i'm not sure the sertraline has), i will at least be able to regulate my periods & therefore anticipate moodswings etc. with better ease.All of the symptoms need not be present and they may vary from month to month. At least 5 are required to make the diagnosis, including at least one of the first four.*
- Very depressed mood, feeling hopeless
- Marked anxiety, tension, edginess
- Sudden mood shifts (crying easily, extreme sensitivity)
- Persistent, marked irritability, anger, increased conflicts
- Loss of interest in usual activities work, school, socializing
- Difficulty concentrating and staying focused
- Fatigue, tiredness, loss of energy
- Marked appetite change, overeating, food cravings
- Insomnia (difficulty sleeping) or sleeping too much
- Feeling out of control or overwhelmed
- Physical symptoms such as weight gain, bloating, breast tenderness or swelling, headache, and muscle or joint aches and pains

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so, in the end, like hysteria, there are links with here mental health too.
i am not even entirely sure i emotionally believe in pmdd (which i have described to my friends as extreme pms). or at least, i don't believe in pmdd in relation to me. if a friend told me they had it, i would not doubt them, but with respect to myself... i find it difficult to imagine where the line between pms and pmdd is. is it a matter of not taking myself & my health seriously enough? certainly, the symptoms match up to mine, and more than one close friend has agreed with me that it seems possible. (my doctor's lack of interest, on the other hand, put me off somewhat). i suppose, at the end of the day, the extent to which the symptoms affect how one lives one's life, to what extent it is a disruption
this is also how one can consider mental health issues. often, the characteristics of mental health issues seem to be to characteristics in mentally 'healthy' people, but are taken to an extreme, and an extreme where these behaviours become disruptive to their lives. for example, we all get down from time to time, and people commonly use the term 'depressed' but looking back now at my deeper depression, i can recall a time when the effort of getting out of bed, and even taking my own medication, seem to be a significant amount of effort which i didn't bother to make. this is what makes it seemingly difficult for people to understand as mental health an important issue.
and, certainly, it is only after having taken antidepressants for a considerable amount of time that i have been open to taking the pill for this reason, partly.i do, to an extent, value aspects of my possible pmdd -- to be able to feel things that deeply, and strongly, even pain is something that i consider valuable. and again, i have that is another common trope of that those with mental health issues express. some people who are bipolar, for example, often refuse to medicate they value their 'manic' episodes. (i should point out my observations are merely anecdotal).
having said all that, someone close to me had an ovarian cyst in the past couple years; it was large enough to make her look pregnant. it, along with an ovary, had to be surgically removed. said someone started taking the pill, because the pill apparently can helps with preventing cysts.
so, perhaps my problem is that i am all too much separating my body and mind? i'm not sure. when i was asking a close friend of mine about his mental health, he spoke of it as predominantly genetic. mental illness was extremely common in his family; and in mine too, i undoubtedly have a predisposition.
i'll have to think (and bleed!) on it more, and perhaps wait for my heart to catch up with my head? (that old separation again...)
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