Written Evidence submitted by Dr Sally King (Founder/ESRC Postdoctoral Fellow at Menstrual Matters King’s College London) [WRH0040]

Dear colleagues,

I’m a Medical Sociologist and the founder of Menstrual Matters, an evidence-based info hub on menstrual health and associated rights issues. My work combines physiological, epidemiological, and sociological data, to identify research biases within women’s health.

I am currently writing an academic book about the influence of gender and racial myths in biomedical and lay discourses regarding PMS (Premenstrual Syndrome) – based on the findings of my doctoral research on this topic. In short, the way in which mood changes and emotional distress are prioritised over more common experiences of pain and discomfort- contrary to the available epidemiological evidence- and how this perpetuates stereotypical beliefs about (racialised) women.

During my studies, I also found that school, general medical, and even gynaecological textbooks reduce menstrual physiology to its hormonal coordination, only. This has obscured healthy menstrual physiological changes beyond hormones, the purpose of menstruation, the likely cause(s) of typical cyclical changes/ symptoms (inflammation/ iron deficiency), and, therefore, how best to manage them (anti-inflammatory methods). It means that general medical doctors, & even gynaecologists who do not go on to specialise in infertility or menstrual health issues, are not adequately taught about healthy menstrual physiology. What is more, ‘hormonal’ accounts of the menstrual cycle reproduced in biomedical and lay discourses, perpetuate gender myths regarding the hormonal/hysterical female, who is prone to invent, imagine, or exaggerate symptoms by virtue of her reproductive body (first the womb, now the hormones).

A peer-reviewed book chapter is due to be published on my analysis of 17 of the top UK medical textbooks in November 2023. I hope to launch an online campaign to include more comprehensive menstrual physiology in school textbooks around this time. This will serve as a prequel to my book, due to be published by Bristol Policy Press in June 2024.

I have also developed evidence-based materials and resources regarding ‘What’s normal?’ in terms of cycle length, blood loss, pain, mood change, and other cyclic changes. Interestingly, not all clinical researchers and GPS/ gynaecologists are aware of these parameters. Plus, some resources regarding the purpose and physiology of the cycle beyond ‘hormonal changes’- again, most people are unaware of these things (outside of fertility clinical research circles).

My website is very popular- attracting over 60K visitors per month- and a crowd science project regarding cyclical symptoms now has the data from over 1500 anonymised participants. I am happy to share this data with other researchers.

It is hard for me to summarise a whole book for this contribution! My research findings are extremely relevant to this enquiry and I have identified several practical recommendations and common pitfalls to avoid for those working in women’s health- both researchers, and clinicians. I also have a background in evaluating qual/ quant research projects and interventions regarding gender equality. As a result, I can spot the (typically unintentional) reproduction of gender/ race myths in medical writing and research questions. I suggest that your project keeps an eye out or these!

I am still in the process of publishing from my thesis so am unable to share much at this point. I just thought you should be aware of my work- to avoid accidentally reproducing gender/ race myths yet again within women’s health discourses. I am happy to be contacted for further discussions etc.

Many thanks, it’s great to see that this topic is finally being taken seriously!

September 2023