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Clinical Crossroads: A 21-Year-Old Woman With Menstrual Irregularity

Colleen Fogarty, MD
JAMA. 1997;278(10):822. doi:10.1001/jama.1997.03550100048035.
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To the Editor.  —The Clinical Crossroads article1 discussing menstrual irregularity in a young woman displays some disturbing attitudes regarding menstruation. For example, Dr D, the physician who cared for the patient, used words like "anxious" and "big source of aggravation and inconvenience" to refer to the menses and reflect a negative perception of women's experience of menses.Indeed, one cultural value of the West views menstruation with "shame and disgust," an attitude that can be traced to the 19th century, when menstruation began to be viewed as a pathological process.2 Even in the modern era, medical research and discourse view menstruation and other aspects of women's physiology more commonly from a "deficit" or "problem" perspective, which reflects a patriarchal influence.3Many women view the menses as the defining element of womanhood.2 Equally important is the awareness that attitudes about the menses may vary depending on societal

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