Jerilynn C. Prior BA, MD, FRCPC
Dr. Elizabeth Comen, Breast Cancer Oncologist at Sloan Kettering in New York, in her 2024 book, All in Her Head, wrote that women in medical history are ‘mute bodies’. She highlighted that not only are women’s voices not heard, women learn to react with shame to physiological changes that are part of being a female human.
Women make up more than half of most University of British Columbia medical school classes and have since the 1970s. The Faculty of Medicine strongly endorses anti-discrimination, having created the Office of Respectful Environments, Equity, Diversity & Inclusion—women are still not heard.
- Still in 2025, only 7% of Canadian Institutes of Health Research (CIHR) funding is awarded for women’s health research—according to Dr. Angela Kaida, head of the Institute for Gender and Health.
- Still, heart disease in young women is increasing while it is decreasing in same-aged and older men1.
- And when grading the scientific credibility of an applicant for a CIHR grant, women were judged less capable than men.2
Women’s Voices—One Experience at a Time
We at the Centre for Menstrual Cycle and Ovulation Research are seeking to overcome the silencing of women. From the start we have considered women’s day-to-day menstrual cycle and life experiences to be important. In the 1980s, we recruited a healthy community cohort of normally menstruating and ovulating women and asked them to record their lives—their exercise, diet and daily perceptions. As part of that study, 53 women3 carefully recorded daily experiences in the Menstrual Cycle Diary©4 over 1-year in the Prospective Ovulation Cohort (not different from the whole study’s 66 women5).
In these healthy young women aged 20-41 we also know the approximate amount of progesterone produced and whether egg release (ovulation) occurred in each cycle. Normal progesterone production is in a luteal phase length of 10 or more days6 that we calculate using our validated Quantitative Basal Temperature© tool. We documented the luteal phase length—the time from ovulation until the start of flow in the next period. Most cycles were of the expected 21-36 days in length and only 18, of about 700 menstrual cycles, were without ovulation.
Does Interest in Sex Peak at Ovulation?
Despite publishing scientific studies of fluid retention7, negative moods8, interest in sex9, breast tenderness10, and feelings of self-worth from these Prospective Ovulation Cohort data, this new information seems to have had no influence on what doctors know and what they teach their patients. I recall in particular our study of women’s interest in sex. A bright young woman, who had just finished a Masters in Sex Education, volunteered to do an analysis and wrote a paper. It was repeatedly rejected by women’s health and psychology journals with the reasoning that ‘interest in sex’ was not a validated tool, why didn’t we use this or that questionnaire? Everyone knows that women are sexy before ovulation.
The problem was that ideas of primal behaviour were firmly entrenched as being what women experience. Instead, we found no change in interest in sex across all ovulatory cycles! However, interest in sex was associated with feelings of energy and of self worth11. By the time that our “interest in sex” paper was finally published9, our volunteer was married and had two children!
Do Major Medical Journals Publish Innovative Menstrual Cycle Information?
We discovered two new and important things in randomly sampled population-based studies and submitted both manuscripts to all the major medical journals (you know, the ones you hear about—New England Journal of Medicine, The Lancet etc.). Both were rejected by ALL. And, without peer review (meaning that an editor decided). Let me tell you about each study:
The first was in adolescent women in the Canadian Multicentre Osteoporosis Study (CaMOS)—a population-based, CIHR-funded investigation of bone health in women and men in nine centres across Canada. We learned that these teen women (aged 16-19) who were taking the Pill (combined hormonal contraception, CHC) tended to gain less bone than same-aged women (who reported not taking it) adjusted for important things like weight, calcium, and physical activity12. We subsequently found five other groups around the world who had made the same comparison—the meta-analysis clearly showed negative bone change in teens on the Pill13, something that could increase later-life risks for fracture.
The second was a population-based study of ovulation based on knowing each woman’s usual cycle length and measuring estrogen and progesterone on a random cycle day. Also funded by CIHR, this study was conducted with over 3,000 women from a whole Norwegian county. In cycles 21-35 days long and using a cycle-timed level of progesterone that is accepted as ovulatory, we found that about a third of women did not have normal ovulation in that cycle14. That has huge implications for fertility and debunks the concept that all normal-length, regular cycles are perfect.
What DO the Major Medical Journals Publish?
We decided we would find out what these international, highly ranked, prestigious journals were publishing! We examined the scientific studies in each of two journal issues after the rejection dates for each of our two papers. They were publishing articles about drugs and diseases in men15. The sole, women-only studies were about the Zika virus and birth defects in Brazilian women and breast cancers. Only 4% of articles were about natural changes in physiology—all in men15.
When CeMCOR Publishes, do Media Notice?
When we (finally) achieve publication, likely because they are in low-ranked journals, CeMCOR’s research receives very little media publicity. Despite major efforts, our successful randomized controlled trial of progesterone for perimenopausal night sweats16 (funded by CIHR) was only reported by a few Canadian news outlets and one or two international ones. It remains the only treatment proven effective for night sweats and sleep problems—the things that bother perimenopause most. Ironically, without the science to back it up (what FDA or Health Canada would approve a drug without a randomized controlled trial!) “menopausal” hormone therapy is STILL considered effective and safe for perimenopausal women by Canadian and all major influential, international menopause societies.
Increasing the Number of Women in the Mainstream News
Sixteen years ago, Shari Graydon started a small not-for-profit Canadian organization, Informed Perspectives. It is increasingly making a difference in improving the awareness of journalists about those speaking for and making science for women. When I asked her to comment, here’s what she wrote:
“Women’s bodies and lives are demonstrably different than men’s. So, the fact that we’re quoted less than a third of the time has implications for all of us — especially in the health arena. Journalists and the sources they rely on shape the stories they tell.
Informed Perspectives has been amplifying the voices of women and gender diverse experts to ensure that the insights we can offer add nuance and depth to public conversations. We deliver training to support experts across sectors, disciplines and diversities to become more comfortable and effective when engaging with the media, and we promote a free database of sources that makes it easier for our 1,200+ journalist subscribers to find them. Please consider joining; it only takes 10 minutes to sign up.”Shari Graydon
Women-focused Social Media is Making a Difference!
When I was contacted months ago by journalist Michelle Cyca writing an article for Chatelaine, I was delighted to talk with her. She wanted to understand the typical experiences of women before they become perimenopausal. I felt it was important to convey that regular cycles do not always mean normally ovulatory ones and the influences of daily life stresses on menstrual cycle experiences. Here is Michelle’s supportive, personal essay.
I was also interviewed by Kelly Pau for Betches— a popular female-founded and led media and entertainment brand—that I ended up doing solely through answering email questions. This younger audience, to my surprise was attributing all kinds of sexy and horny-ness to ovulation. I wondered what they meant by “ovulation” because only rarely can women have a twinge that we now know comes before the egg is released. They assumed that stretchy cervical mucus (as the fertility-focused information teaches) is ovulation. I needed to explain that the peak of estrogen (that can be felt, often as breast tenderness) occurs before ovulation, but doesn’t always predict that an egg is released. I told her about our interest-in-sex paper and its results—women’s interest was not changed across ovulatory cycles, but it WAS related to feelings of self-worth and energy. You can read Kelly’s article here.
Women’s questions and experiences are not being funded. But we at CeMCOR have archived important prospective data and analyzed it with the help of skilled volunteers and medical students in the FLEX program at the UBC School of Medicine.
The new social media world is asking questions and women-focused journals are filling the gap.
Gradually, women’s voices are being heard.
August Highlights
New Video from Reuters — When the cycle stops: the overlooked sign
Period loss, or amenorrhea, affects approximately 3% to 4% of women of reproductive age and, except for during pregnancy, it’s not normal. In more than a third of women with the condition, it’s the body’s response to an energy deficit. Reuters has produced a video story which explains how Hypothalamic Amenorrhea (HA) relates to Relative Energy Deficiency (REDs).