So, why did you become an anthropologist? (Part 3 of 3)

This is the third and final part of the series “So, why did you become an anthropologist?” based on the AAPA plenary talk I gave in 2010 alongside many other wonderful and interesting anthropologists (Parts 1 and 2). The question that frames this final part is, How did you get a freaking job?

How did you get a freaking job?

How I survived graduate school
For most of my time in graduate school, I was a union organizer for the Graduate Employees and Students Organization at Yale University. Most semesters the hours I put in were equivalent to a full-time job, sometimes more. My last semester of graduate school I worked full time as expository writing faculty at Harvard. Yet I finished in six years, which was shorter than average in my department. How did I do this?

Well, first, I was lucky enough that my family was able to supply extra funding (like a car and car insurance) that my small stipend couldn’t cover, so I didn’t need to work. I didn’t have any dependents like I do now, unless you count my needy cat. I was and am able-bodied, so the university and surrounding area was set up well for me. And because I didn’t mind the occasional cockroach (well, I minded, but I was willing to tolerate them and several health and safety violations because my apartment was so airy and pretty), I was able to afford living less than a mile from campus.

Then, two things helped me be successful: I worked my ass off, and I had a community of people who were able to contradict the oppression and isolation of graduate school.

I’ll explain the easy part first. There has to be some tiny part of you that is crazily passionate about the work you do in order to be successful in graduate school. If not, you will not put in the necessary hours, you will not feel compelled to go to the library on a Saturday morning, you will not go back into lab in the evening after three hours of house visits and an intense two-hour staff meeting.
But really, that’s the easy part. Because if you’re considering graduate school, you are or shortly will become intensely interested in your discipline, you will think about it all the time, you will read about it just to learn more. Being an academic doesn’t require that this be constant; if anything, I think the more sane and more successful academics I know get periodically exhausted by their jobs and know when to put a project or manuscript down for a while. But you probably do need that occasionally manic buzzing in your ear that makes you spend three extra hours reading up and teaching yourself about inflammosomes when you could be watching an NCIS marathon.

The harder part is finding a way to contradict isolation and oppression. I think we need to be honest with ourselves that graduate school is incredibly oppressive, not necessarily by individuals, but certainly as a system. I don’t think I need to explain myself here, but if you are not in academia, as one example, find a graduate student and talk to her before and after her qualifying exams. Her feelings of isolation, stupidity, confusion, anger, self-blame will be incredibly high in your first interview compared to your second! And this is independent of the bread-and-butter issues that also promote stress during graduate school, like pay and benefits.

Being in GESO made me part of a collective of women and men that were able to identify the source of their oppression as external – the system of higher education – rather than internal. Not blaming yourself for feeling crazy all the time goes a long way towards feeling better during graduate school. Being a union organizer also meant I was creating social change on a daily basis. I got people to join the union, sometimes after months of conversations, and many of these people became lifelong friends. I helped write reports that showed the university’s true commitments to gender equality and other issues. I was arrested in civil disobedience and I went on strike, two times each. These were personally meaningful moments just as much as they contributed positively to the climate at Yale.

To me, being part of a movement to change the system of higher education is a necessary component of graduate school. This isn’t just selfishly to find friends to help you through graduate school and it’s not playing at union organizing. It is serious, it is real, and it is how we start our stewardship of higher education. If you are going to be an academic, you need to understand the workings and failings of academia, and you need to have experience working to improve it. Otherwise, the feelings of powerlessness that one can feel over qualifying exams, grantwriting, dissertation research, mentor relationships and the job market can overwhelm.

Myths and meritocracies
Academia is not a meritocracy. There, I said it! Many of the best scholars and intellectuals I have known quit graduate school, or left academia after getting a PhD. Many other excellent academics took years to find the magical tenure-track job. Still others are still looking. I think that many excellent scholars do tend to eventually find a home in academia, but I am also saying that while sitting comfortably in a tenure-track position at an R1 institution.

Academia is not a meritocracy. Racism, sexism and classism, to name just a few, still run rampant. A lot of this is built into the institution: for instance, many places are improving their recruitment of people of color, but are still poor at retention. On-site childcare that is nonexistent or has too few slots is a disincentive for people with dependents or those who shoulder a greater proportion of childcare; these tend to be women. Departmental culture can discourage people from varying backgrounds to express themselves, or even survive in that world: I know male faculty who feel they can’t express themselves as parents in their departments because the other fathers work all the time and never see their children. I know a woman who quit graduate school in the physical sciences because of objectionable images of women plastered in the halls to advertise social events in her department; her work to have the images taken down ended in a meeting with a Dean who told her she was ruining her career by speaking up.

Academia is not a meritocracy. I am a spousal hire. I know that some people view spousal hires as second class citizens (I also know that those people don’t happen to reside in my department). I think this view originates in the fact that we want to believe academia is a meritocracy and that only the best get in, and that somehow dual hires get around that. There are two problems with this: first, spousal hires do not get around meritocracy, because they are as rigorously evaluated as other hires and are rejected as often as accepted (at least at R1s; I do know occasionally this happens differently at other types of institutions). The other dual hires I know on this campus are inspiring, intelligent, and major players in their departments. Second, since the idea of a meritocracy is a myth anyway, it is silly to pick on one group of people when we are all struggling to find work in the discipline we love.

The idea that academia is a meritocracy is a myth that keeps people who have not been successful in finishing their degrees/finding jobs/getting tenure/etc from speaking up about larger inequalities and issues in higher education. It’s time we discarded this in favor of an honest appraisal of what is wonderful and problematic about academia.

What now?
I finished my degree, then spent a year as a faculty preceptor at Harvard University teaching expository writing (that is a grueling job to cut your teaching chops, but has good pay, benefits and job security). Then I had a baby and a semester of maternity leave (sort of, but we’ll leave FMLA gripes for another day), then in the fall of 2008 moved to Illinois to begin my position here with a five month old in tow and only twenty hours a week of childcare because it was so hard to come by. We wouldn’t get to full time childcare until the beginning of my second year. This meant even less sleep than usual for young parents, as my husband and I had to work nights and weekends to make up for the childcare deficit.

In my work, I take a holistic approach to ecology and women’s reproductive functioning. While my dissertation was on the endometrium and that is still a major interest, some of the mechanisms for variation in endometrial functioning, and a little navel gazing from my experience of pregnancy and a recent diagnosis of gluten intolerance, led me towards immune health and inflammation. I have a few projects nearing completion (if you were at the AAPAs/HBAs and saw my talks you heard about one of them on ovarian follicular waves) and a few others in the mix (a departure from my human snobbery to work with mice?!).

All criticism of the system of higher education aside, and all paperwork and bureaucracy and grading and meetings aside, this is the most stimulating, interesting and fun job I could have ever hoped to have. I get to spend my day using my mind, interrogating ideas, and learning new things. If I have an idea for a project, it’s on me to do the legwork and on me if it fails… but how cool is it that I get to go after the idea in the first place? I love that if I get excited about something, I can explore it further. I can do a literature review, or write a grant, or find a collaborator in another discipline. One of my most interesting collaborations so far came from emailing the authors of an article I found interesting out of the blue.

I can teach women that what they learned about their bodies was reductive, that they aren’t diseased simply by being female. I can mentor undergraduates and graduates, make them critical thinkers, and help them get grants and get jobs and get into graduate school. I can work with non-science majors and make them less afraid of science. I can promote different kinds of pedagogy and increase access to education using online learning technologies.

Folks, I have drunk the kool-aid. This is a great job. But I don’t want to keep it to myself; I want more people to have access to academia and secure jobs and to just having a more intellectual life. That is why the institution and culture of higher education needs to change, and why I become an academic anthropologist. I like to think about women, I like to think about biology and medicine, but I also like to share my excitement. I hope you’ll join me in working towards positive change so that anthropology can continue to grow and have a positive influence on society.

So, why did you become an anthropologist? (Part 2 of 3)

This is the second post in a three-part series on why I became an anthropologist. I was invited to answer this question in the Plenary Session of the 2010 American Association of Physical Anthropology Meetings in Albuquerque this past April. You can find part 1 of the series here.

As I mentioned in the first post, I feel like this question has several parts. The first, answered already, is Why did I fall in love with anthropology? The one I'll answer today is Why did I pursue academia? And the last part of the series will answer How did I get a freaking job?

Why did I pursue academia?

Public school kids are intelligent too
As I finished my senior year in college, I considered my options. I could become a consultant, like many of my friends. I could become an investment banker, another popular option. I was strongly considering becoming a massage therapist or yoga instructor, or getting an MFA in creative writing to become a fiction writer (no, I'm not joking). I had looked into programs for all three of these options, because I felt adrift when I tried to sit down and consider what I wanted to do for a career. Consulting and investment banking just seemed like more of the same Harvard competitiveness, rather than a career I'd want to do for my whole life, where my other ideas had at least some appeal. I didn't know if I was smart enough for much else, quite frankly, which speaks to the hard time I had being a kid from a poor public school (actually, I think fiction writing may take a lot more intelligence than I have, but I told myself I could be a Starbucks barista as my day job).

Part of this can be blamed on a higher education system that doesn't support or think about the preparation of its variable students before arrival on campus -- that is, the culture of elite institutions like Harvard are not inclusive of people like me whose high school calculus teacher didn't actually know calculus, or even show up to teach most of class that year. I often received really good training and advice from people that I could not absorb because of my different background or lack of preparation. But if people like me either didn't know how to ask the right questions, or couldn't understand what was offered, then it's not really good advice, is it?

At the same time, part of what happened can be blamed on the lens through which I was seeing everything, which was tinted by resentfulness and frustration due to sexism and classism -- that is, even when I was given good advice or good training in a way that should have been accessible to me, I was too mad (or sometimes immature) to do anything with it. I did not take or understand criticism well, and now realize how much good raw material and real help I messed up for this reason.

All of that said, at some point I finally realized that public school kids are not dumb. I could keep being mad about being underprepared, I could lament my lack of boarding school experience, or I could suck it up and figure out how to do my work. This really didn't happen until I wrote my senior thesis, and if you are ever unfortunate enough to read the thesis you will see that it was too little, too late. But as I mentioned in part 1, even though my knowledge, skill set and writing bloomed late and incompletely, this allowed me to begin to love learning anthropology for its own sake, to learn to ask good questions and design good projects, and continue to bloom into graduate school.

Somebody has to believe in you
Please allow me to briefly wax cheesy. I think at least one of the major factors that made it possible for me to realize that I was not dumb involved dating my boyfriend, now husband. He too was a public school kid, albeit from a rich Boston suburb. What amazed me from the first day I met him was how committed he was to working hard to solve problems and do his academic work. He was curious and intellectual, yes, but he also knew that you had to put in a lot of time and that the qualities necessary to become a scholar were not something you already had (or didn't have) going into college. You had to work for it.

Inspired by him, I finally started to work hard. I had avoided working hard – doing all the readings, studying for exams – throughout college so that I could avoid feeling bad when I didn't perform well. I could always tell myself if I got a B (or worse, as I did spectacularly fail one test in a course by my own thesis advisor) on something that it was because I didn't study. I didn't work hard on everything, only on what I cared about, but that work became all-consuming. I spent entire days in the Currier House dining hall near a power outlet with my laptop (my first ever! and it didn't have internet at first!), writing and writing away on my thesis. I spent hours most nights there, drinking far too many cups of hot chocolate. It was exhilarating to put so much attention on one thing.

I discovered two things: first, that I was smarter than I thought, and second, that when you work hard on something you care about, it only leads you to care even more. Working hard on my senior thesis led me to fall in love with anthropology all over again, and re-commit myself to the beauty of the physiology, as well as the political nature of women's reproductive health. After that, I couldn't imagine being happy teaching sun salutations or massaging someone's wonky shoulder because what I really loved was learning about the way environmental variation impacts reproductive functioning, and how our incorrect medical understanding of that variation led to overpathologizing an entire gender.

So, why did you become an anthropologist? The white female early career parent weighs in (Part 1 of 3)

For the American Association of Physical Anthropology meetings this year in Albuquerque, six anthropologists were asked to answer the question: "So, why did YOU become an anthropologist?" in the AAPA Plenary Session. The other participants, who had some amazing and wonderful stories to share, were Kaye Reed, Karen Strier, Mark Zlojutro, Alan Swedlund and Jim Calcagno. Lorena Madrigal organized and chaired the session. I decided to turn my talk into a three-part series for the blog, because I think it's fun to hear the backgrounds of academics, and important to hear where things were hard for us. So here is part one.

* * * * *
I am an Assistant Professor in biological anthropology at the University of Illinois in Urbana-Champaign. I am in my second year there, but took a tenure rollback because of the birth of my child, so really it’s like I’m repeating my freshman year. I wanted to tell the story of not only how I became an anthropologist, but why I persist in being one today.

For me, this breaks down into three questions: 1) Why did I fall in love with anthropology? 2) Why did I pursue academia? And 3) How did I get a freaking job? And of course, I really lied, because there is also a fourth question in the mix here: What am I doing now?

Why did I fall in love with anthropology?

When I was a freshman at Harvard University, I spent a lot of time being angry. I was angry at large lectures, at being an underprepared public school student, at sexism, at feeling like I didn’t particularly belong. I took Science B-29: Human Behavioral Biology to meet a core requirement, but also because it fulfilled a bio requirement I would need if I ended up going into biology like I had been planning when I first got there. My abysmal performance in math and chemistry – prereqs for the bio courses I wanted to take – and my abysmal performance in Expository Writing – which was not easy to swallow since I thought I also wanted to be a writer – had me feeling pretty horrible going into my second semester of college. Then this one class that I thought sounded interesting had 500 students in it and was nicknamed “Sex.” I took B-29 despite my growing concerns about my placement at that university and my ability to do science.

The course was okay. It would have been exceptional to me if I was into behavior, because Professors Marc Hauser and Irven Devore are engaging, interesting and thoughtful speakers. But for most of the class, I only became more convinced that I wasn’t biology material. I didn’t like learning about mating strategies in lizards and felt like my fellow students were making pretty problematic conclusions based off what we were learning. It seemed like I was getting into the kind of problematic, reductionist material that only triggered my righteous sexist anger. If it isn’t obvious already, I do want to be clear that my perceptions of that class were tinted by my experiences as a kid from a poor public school who was having a pretty crappy time in an elite college that didn’t acknowledge her different experience of high school and lack of preparation, and that I was going to be angry about that class even if they had handed us all copies of the Feminine Mystique along with Sex, Evolution and Behavior.

Then, on the last day of class, Irv Devore gave a rousing speech that, to me, was on cultural sexism and its incompatibility with biology. I will never forget how angry he looked when he talked about academic science: the glass ceiling for female academic scientists, he said, is reinforced with concrete. He continued, It is a sad day when a man who has written three books but spent little time with his children is given tenure over an equally talented woman who has produced two but been involved in her family’s life, especially given the nature of the imbalance of physiological investment in parenting. Devore also spoke eloquently about the ridiculousness of laws that prevent women from breastfeeding publicly, when she is only feeding her child, and the wellbeing of her child should not be threatened because we have decided to sexualize breasts.

I don’t know that I can really describe what it was like to have an older man stand in front of five hundred college students and speak so strongly as an ally to women against sexism. I was also amazed and excited by the idea that science could be political, that I could work to eliminate sexism as an anthropologist. I had been invalidated in my anger for so many years, that all I could do in response to this lecture was cry. So cry I did, all the way back to my dorm room, where I proceeded to write the dorkiest letter of my life to Devore, praising his talk, admitting my tears, and proclaiming that I would become a joint Biological Anthropology and Women’s Studies major.

Soon after sending the email – just a day or two later if I remember correctly – Professor Devore called me up on the phone. Mind you, this means he had to look me up in the directory and dial a number to talk to the weepy, dorky girl who had changed her major based on a fifty minute lecture. I nearly fell on the floor when my roommate handed me the phone! He said he appreciated my email, and thought Biological Anthropology was a good major, but that I should skip the Women’s Studies thing because I could just take Women’s Studies classes as electives.

So of course I became a joint major in Biological Anthropology and Women’s Studies.

I took some lovely courses in both majors, and having feminist theory on one side, and bio anthro on the other, provided me with the necessary foundation to think well about the meaning behind my work. While an undergrad, despite good training, I was not good at articulating all of this, and yet over the years I have realized that this coursework was essential in my personal and professional development, and I draw from this training every day in my job as an academic. In particular, I had a tutorial in Women’s Studies led by Lauren Korfine (the one wearing her baby in the picture) that provided me with the support I needed to write my honors thesis. My work as an undergrad was probably pretty unremarkable, and my thesis isn’t something I pass around for kicks, but sometimes it’s less about the work you produce and more about the way to learn to think and the relationships you build. It is because of my peers and mentors in both majors that I love anthropology as much as I do today.

If you don't want to meet brilliant young biological anthropologists, you can ignore this post

Which is exactly why you are reading. Who wouldn't want to meet the coolest cohort in the AAPAs?

Plenty of us young biological anthropology folk are struggling in isolation at an important point in our careers: we may be writing up our dissertations, defending, starting our first postdoc, contingent faculty or tenure-line faculty gig, or we may be otherwise looking at the established folk and thinking, "How in heck did they get there, and will I ever get there too?"

Enter BANDIT, the brainchild of brilliant and eminently likable Assistant Professor Julienne Rutherford of the University of Illinois, Chicago (full disclosure: I am completely biased because we are collaborators and friends). BANDIT, or Biological ANthropology Developing Investigators Troop, is a loose collective of young anthropologists sharing information, insight, and support. Check it out, contribute, and appreciate the early career anthropologist in your life by supporting this site. Go to http://aapabandit.blogspot.com for more information, and check back in as it grows.

Premenstrual syndrome: understanding origin and variation

If you are female and post-menarcheal (that is, you’ve had your first period), you have probably had at least one person tell you that you are PMSing – either jokingly, or with an unpleasant edge. You may have expressed anger or irritability; you may have simply stood up for yourself. Or, you may have no idea what prompted the statement.

Maybe you were angered further by this comment, because you have never experienced any shifts in mood in your premenstrual phase (the several days leading up to your period). Maybe you were embarrassed because, whether or not the comment was at the time accurate, you do feel different right before your period. There is a lot of variation in the emotional experience of the premenstrual phase, from no changes, to dysphoria (that’s mild depression) or anger and irritability, increased creativity, well-being and happiness, to a whole host of other feelings. Part of this variation is a small minority of women who do experience negative symptoms strong enough to interfere with their daily lives, often called premenstrual syndrome. A syndrome refers to the association of symptoms and/or signs that often occur together, but that does not mean the etiology, or origin, of this syndrome is the same for everybody, and that does not mean everyone has the same disease if they have the same set of symptoms. This distinction is important because there are several syndromes out there relevant to women’s health (polycystic ovary syndrome and chronic fatigue syndrome come to mind), yet it is a classification that says, to me, “hey, we don’t know what causes this and in fact it may be a whole bunch of different things going on for different people, but this is what we have so far.”

Despite the fact that the experience of the premenstrual phase is varied, and the negative symptoms some number of women experience are categorized by a syndrome which does nothing to explain its etiology, there appear to be only two games in town in treating PMS: hormonal contraceptives (HCs) and selective serotonin reuptake inhibitors (SSRIs). And the most studied potential origin of PMS is progesterone withdrawal.

Now, a twenty-eight day, ovulatory menstrual cycle looks like this:

Notice the estradiol (that’s a kind of estrogen) peak just before ovulation, and the swell of progesterone (pro-gest, so supporting gestation should you conceive) in the second half of the cycle. Progesterone is secreted by the corpus luteum, which is left behind by the follicle that erupts from your ovary when you ovulate. If that egg is not fertilized, to wend its way through the fallopian tube and invasively implant its way through your endometrium, then that corpus luteum and progesterone doesn’t have much of a purpose. Without a signal that pregnancy has occurred, the corpus luteum degrades, progesterone concentrations decline, and your nicely primed endometrium sloughs off to be able to make another plush surface for the next attempt.

Allow me to briefly wax anthropological before moving on in my discussion of these premenstrual symptoms. This twenty eight day cycle with its nice estradiol peak and progesterone swell and ovulation smack dab in the middle? It’s pretty much a farce.












Those are real luteal progesterone concentrations from healthy, normal, reproductively-aged women from past studies of mine in one population of women in rural Poland (the follicular phase is the first half of your cycle, luteal phase the second). And the next image is from a whole bunch of other studies showing population variation in progesterone. Regular menstrual cycles, and yet luteal phases that range from 9-17 days. Mid-luteal progesterone concentrations varying by several orders of magnitude. You are looking at data ONLY of healthy women, in a homogenous rural environment, and ONLY cycles where they ovulated. And yet, look at all that variation.

So hormone concentrations, menstrual cycle lengths, experiences of the menstrual cycle and menses themselves, vary so much so that the idea that there is such a thing as one normal cycle for everyone is patently false. Women’s reproductive functioning only makes sense in the context of its environment, and if it is responding logically (high stress, low function, and vice versa), it’s pretty safe to say that woman is normal.

Okay, so back to PMS and progesterone withdrawal. You may have noticed something in the preceding images: progesterone concentrations decline in the days leading up to menses in all ovulatory cycles. In a physiological process with so much variation it’s hard to determine universals, this is one of them. So I suppose it makes sense, then, that researchers think progesterone withdrawal has something to do with premenstrual symptoms. Further, post-partum depression or the maternity blues occurs soon after parturition, when a mother goes from having huge quantities of progesterone (orders of magnitude higher than in a regular menstrual cycle) to zero, once that placenta that was making all that yummy progesterone is birthed.

At the same time, if these symptoms are not universal, if in fact some women have positive experiences of their premenstrual phase (and post-partum period), and to top it off progesterone withdrawal is a major feature of the menstrual cycle for most women… then perhaps the idea that progesterone withdrawal is the trigger only serves to further pathologize a population that is historically overpathologized and understudied. That is, does it make sense to consider a universal feature of the menstrual cycle the culprit for a set of symptoms that affect about five percent of the population?

Let’s unpack the data a bit more, then, and cut these folks some slack… at least to start. There are two kinds of work going on in the literature: the first is the identification of the mechanism of how progesterone withdrawal could be producing effects in the brain, and what most folks are focusing on is the fact that progesterone concentrations are tied to allopregnanalone (ALLO) concentrations in the brain (this makes sense, since ALLO is a kind of progestin and progesterone is its precursor). The second is to identify whether it is how rapidly progesterone declines that produces negative symptoms (this certainly does vary, if you look at how different women’s mid-luteal progesterone concentrations are), the overall concentration, or the estradiol to progesterone ratio.

Several studies indicate an association between decreased ALLO concentrations and premenstrual syndrome and post-partum depression [1-6]. Gracia et al [3] also note lower ALLO concentrations in those individuals suffering from PMS who are responsive to SSRI treatment, versus unresponsive individuals. So it does seem like those with lower concentrations of ALLO (and thus lower progesterone at that time as well) are perhaps more likely to have PMS. However, it also looks like reduced ALLO isn’t the only explanation for PMS: 1) only 63% saw improvement with SSRI treatment, and 2) the women in this study (n = 46) were grouped into tertiles by their ALLO concentrations, and the highest tertile (the women with the highest ALLO concentrations) did not show improvement. So it seems it is possible to have PMS without low ALLO relative to your population.

The second issue, that it may not be total levels of progesterone/ALLO triggering PMS symptoms but rather something about the rapidity of decline (an understandable hypothesis to start from given what we know of post-partum depression) is not as frequently studied. But I did find one study that examined this and managed to review a few articles I hadn’t yet found: Beckley and Finn [1] described work that suggested more rapid decline in progesterone concentrations was associated with depression-like behaviors in rodents, and themselves found similar results both when creating progesterone withdrawal conditions with supplementation, and when using finasteride (which inhibits progesterone metabolism; also known as Propecia).

I think the idea here and the results are tantalizing, but I am not yet confident in the mechanism. Part of the reason for this is that in human studies women were only sampled once per cycle in the luteal phase; often something like five plus or minus three days before menses. If you look at the graph above (this is the same as the second figure, just the mean and standard deviation instead of the concentrations of each individual), that six day spread (-8 to -2) shows a significant amount of time-dependent variation in progesterone concentrations. Further, progesterone is strongly influenced by age, energy balance, energy expenditure, and population (developmental conditions) [7-14], and I am unclear whether this variation has an impact on these results or can be controlled for in future work. One last point to consider is that social influences on perceptions of menstruation, as well as degree of social support, urban versus rural setting, and level of education, predict premenstrual syndrome and post-partum depression quite strongly [15-18]. We need to be careful when examining something that is a product of the interaction between biology and culture not to simply look at the concentration of a hormone to explain its etiology.







References
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2. Brinton RD, Thompson RF, Foy MR, Baudry M, Wang J, Finch CE, Morgan TE, Pike CJ, Mack WJ, Stanczyk FZ, & Nilsen J (2008). Progesterone receptors: form and function in brain. Frontiers in neuroendocrinology, 29 (2), 313-39 PMID: 18374402
3. Gracia CR, Freeman EW, Sammel MD, Lin H, Sheng L, & Frye C (2009). Allopregnanolone levels before and after selective serotonin reuptake inhibitor treatment of premenstrual symptoms. Journal of clinical psychopharmacology, 29 (4), 403-5 PMID: 19593190
4. Maguire, J., & Mody, I. (2008). GABAAR Plasticity during Pregnancy: Relevance to Postpartum Depression Neuron, 59 (2), 207-213 DOI: 10.1016/j.neuron.2008.06.019
5. Monteleone, P. (2000). Allopregnanolone concentrations and premenstrual syndrome European Journal of Endocrinology, 142 (3), 269-273 DOI: 10.1530/eje.0.1420269
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7. Chapman, J., McIntyre, M., Lipson, S., & Ellison, P. (2009). Weight change and ovarian steroid profiles in young women Fertility and Sterility, 91 (3), 858-861 DOI: 10.1016/j.fertnstert.2007.12.081
8. ELLISON, P. (1993). Population variation in ovarian function The Lancet, 342 (8868), 433-434 DOI: 10.1016/0140-6736(93)92845-K
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12. O'Rourke, M.T., S.F. Lipson, and P.T. Ellison, Ovarian function in the latter half of the reproductive lifespan. American Journal of Human Biology, 1996. 8(6): p. 751-759.
13. Panter-Brick C, & Ellison PT (1994). Seasonality of workloads and ovarian function in Nepali women. Annals of the New York Academy of Sciences, 709, 234-5 PMID: 8154716
14. Rosetta L, Harrison GA, & Read GF (1998). Ovarian impairments of female recreational distance runners during a season of training. Annals of human biology, 25 (4), 345-57 PMID: 9667360
15. Cénac A, Maikibi DK, & Develoux M (1987). Premenstrual syndrome in Sahelian Africa. A comparative study of 400 literate and illiterate women in Niger. Transactions of the Royal Society of Tropical Medicine and Hygiene, 81 (4), 544-7 PMID: 3445335
16. Chaturvedi SK, & Chandra PS (1991). Sociocultural aspects of menstrual attitudes and premenstrual experiences in India. Social science & medicine (1982), 32 (3), 349-51 PMID: 2024146
17. Marván ML, Díaz-Erosa M, & Montesinos A (1998). Premenstrual symptoms in Mexican women with different educational levels. The Journal of psychology, 132 (5), 517-26 PMID: 9729845
18. O'hara, M., & Swain, A. (1996). Rates and risk of postpartum depression—a meta-analysis International Review of Psychiatry, 8 (1), 37-54 DOI: 10.3109/09540269609037816

A new direction

One of the projects that is just getting off the ground in the Laboratory for Evolutionary Endocrinology is the study of hormonal contraception in young women. We will be exploring the science behind it -- when is it useful to young girls and women, when is it not, what future health implications does it have -- but also the relationships between health care providers and patients regarding this drug.

I am developing a hypothesis regarding when health care providers prescribe hormonal contraceptives. For now, and this is before I have delved into the literature on this, I would like to test the conditions under which it is prescribed for a health complaint, and the conditions under which the health complaint is further explored instead. My suspicion is that when a woman goes to her PCP with a reproductive health issue but is not currently interested in having children, she is often prescribed hormonal contraceptives. When a woman goes to her PCP with a reproductive health issue and is interested in having children, the possible health concern is explored.

I would like to test this hypothesis and others using an online survey in the coming months. As we work to put the survey together and obtain IRB approval, I would like to solicit your thinking. What kinds of questions should we ask? What population should we seek for answers? Should we survey doctors as well as patients? What hypotheses would you want to see tested?

Put your questions and comments in the comments section of this post. If I get a lot of clarification queries, I will post more information about what we're thinking to give you more ideas.

New Center for Gynepathology Research

Linda Griffith, PhD, Professor of Biological and Mechanical Engineering at MIT, opens a new Center for Gynepathology Research today. She has paired with Padma Lakshmi of Top Chef fame to cast light on endometriosis, a condition that is said to affect 10% of women (and probably many more). You can go to the Center site here, and read the Boston Globe article about the Center here.

Dr. Griffith is doing women all over the world a service with the opening of this new Center. She is pairing up with scholars and clinicians at MIT, Vanderbilt, Harvard, Cornell and Tufts. I'm very excited by the fact that people who do basic science will be working with clinicians on a disease whose research has not advanced that much in recent years. We have a few hypotheses about why women get endometriosis -- some genetic causes, inflammatory variables, and flowback of copious menstruation -- but so far little of this research has yielded results that help prevent endometriosis, or help treat it. This Center is an important step forward.

We anthropologists and evolutionary medicine folks happen to like evidence from the angle of global and ecological variation in a condition in order to set a baseline and understand pathology better. So here are some additional questions that I think we should be asking about endometriosis:

• What is the global range of variation in the presence of endometriosis in different populations? I'm not talking just about the debilitating symptoms, but the presence of endometrial tissue outside the uterus. And what is the range of variation for amount of endometrial tissue outside the uterus?
  
• What ecological/lifestyle factors are most commonly associated with endometriosis? I'm thinking not just energetic stress, but immunological stress, psychosocial stress, diet composition, etc.
  
• Are there less invasive ways to test for endometriosis (i.e., ultrasound) that will allow us to examine this disease in non-western or non-industrialized environments?
  
• How do daily ovarian hormone concentrations vary with endometriosis incidence?
  
• When and under what conditions does endometriosis co-occur with other gynepathologies, such as polycystic ovarian syndrome?

Evolution of Diseases of Modern Environments: my report now up

Many of you know that I attended a conference in Berlin last month entitled "Evolution and Diseases of Modern Environments" that was convened by Randolph Nesse and dove-tailed with the 350th World Health Summit. Ben Campbell (University of Wisconsin, Milwaukee) and I were the rapporteurs for our group "Early Development and Reproductive Function." Our report is now online at The Evolution and Medicine Review and can be found here.

A highlight to get you over there:

The fertility group’s main conclusion was that we need to bring our particular approach to variability to medicine.... The main problem we note is that we are uncomfortable making strong recommendations to medicine regarding reproductive health because we do not yet have enough baseline data of the normal range of variation within and between women and within and between populations. The focus in funding mechanisms is on basic molecular science and disease-focused science, and our discipline falls between these two extremes. Thus we first propose a greater emphasis on research that assesses normal variation in the following ways: longitudinal, repetitive sampling, an assessment of lifestyle factors, documentation of ethnic and geographic variation, and a focus on the major lifestyle transitions as these can be periods of major variability.... Finally, we wanted to point out that the population that the majority of our data is western and economically developed, and that they represent the most extreme and highest concentrations of ovarian hormones (and likely other indicators of reproductive function).

Go!

Shameless self-promotion

My paper in the Yearbook of Physical Anthropology is now up. You should check it out!

Expect a more substantive post next week.

The latter half of the cycle and the endometrium

Because it's been a while since any of us has blogged, I thought I would post a quick teaser regarding our AAPA and HBA abstracts. Following up from a recent paper in Anthropological Science on rural Polish women, we have found in Canadian women that luteal phase length is correlated to endometrial thickness through the implantation window. The implantation window is six to twelve days after ovulation (the middle of the cycle), and the average luteal phase is twelve to sixteen days long (the second half of the menstrual cycle). Before menses endometrial thickness begins to decline, so as you might expect, those with shorter luteal phases have thinner endometria through the window of implantation.

For now this simply demonstrates variation in endometrial thickness through what has been demonstrated to be the period during which the vast majority of implantations occur. This also means that there is significant variation in luteal phase length, even in ovulatory cycles in well-fed, urban women, in a way that has the potential to be biologically meaningful. Are there factors that are producing variation in luteal phase length (timing of menstruation) that in turn impact endometrial thickness through the implantation window? Or is the endometrium breaking down early for some reason (not a timing so much as a maintenance issue), leading to the shorter luteal phase? How much of this variation is genetic?

This demonstrates that normal women are incredibly variable in their reproductive physiology. Thus, deviation from the "norm" is not immediately suggestive of pathology.