Why can't we talk about periods? | Jen Gunter

翻译人员: Jiasi Hao

当我处于青春期的时候， 月经让我深受折磨。

When I was a teen, I had terrible periods.

I had crippling cramps,

我痛经很严重，

I leaked blood onto my clothes and onto my bed sheets,

衣服和床单上总是 不小心沾上漏出的血，

and I had period diarrhea.

我也会有经期腹泻。

And I had to miss school one to two days a month,

因此在学校，我每个月 总要缺勤那么一两天，

and I remember sitting on the couch with my heating pads, thinking,

我也记得抱着热水袋 坐在沙发上的日子，心想：

"What's up with this?"

这怎么回事？

When I ate food, I didn't leak saliva from my salivary glands.

当我吃东西的时候， 口水可从不会从唾液腺漏出。

When I went for a walk,

当我走路的时候，

I didn't leak fluid from my knees, "joint fluid."

我的关节液也不会 从膝盖处漏出“关节液”。

Why was menstruation so different?

为什么月经那么不一样？

I wanted answers to these questions

我想要知道这些问题的答案，

but there was no one for me to ask.

但没有人回答我。

My mother knew nothing about menstruation

我的母亲对月经一无所知，

except that it was dirty and shameful and I shouldn't talk about it.

除了“这是一个肮脏且羞耻的话题， 我不应该谈论它。”

我问过我的女性朋友，

I asked girlfriends

and everybody spoke in euphemisms.

然而她们每个人说得都很委婉。

And finally, when I got the courage to go to the doctor

最终，当我鼓起勇气去看医生

and talk about my heavy periods,

并谈论我月经过多的问题时，

I was told to eat liver.

我被告知要多吃动物肝脏。

(Laughter)

（笑声）

And when I went to the drug store to buy my menstrual products,

当我去药店买经期用品，

my 48-pack of super maxi pads,

48 包装的超长加大卫生巾，

back in the day when they were the size of a tissue box, each pad --

那时候每片卫生巾的大小 就宛如一个纸巾盒——

（笑声）

(Laughter)

你们知道我在说什么——

You know what I'm talking about.

You have no idea how far absorbent technology has come.

根本无法想象 吸收技术至今进步了多少。

(Laughter)

（笑声）

I used to have to buy my menstrual products

我曾经需要在女性卫生区的货架上

in the feminine hygiene aisle.

寻找我要买的经期用品。

And I remember standing there, thinking,

我也记得我站在那里，想着：

"Well, why don't I buy toilet paper in the anal hygiene aisle?"

为什么我不用 在肛门卫生区的货架上买手纸？

(Laughter)

（笑声）

究竟是为什么呢？

Like, what's up with that?

Why can't we talk about periods?

为什么我们不能谈论月经？

And it's not about the blood, as Freud would have you say,

正如弗洛伊德所说的那样， 这和血液无关，

because if it were,

因为如果有关的话，

there would be an ear, nose and throat surgeon up here right now,

现在这里就会有 一群耳鼻喉外科医师

谈论着流鼻血的禁忌，对吧？

talking about the taboos of nose bleeds, right?

这甚至也和月经无关，

And it's not even about periods,

because otherwise, when we got rid of our toxic, shameful periods

不然在我们摆脱 有害且令人羞耻的月经后，

when we became menopausal,

也就是我们绝经后，

we'd be elevated to a higher social status.

我们的社会地位会被抬高。

(Laughter)

（笑声）

（掌声）

(Applause)

It's just a patriarchal society is invested in oppressing women,

这依旧只是一个 压迫女性的男权社会，

and at different points in our lives, different things are used.

在我们生活的不同阶段， 会有不同的东西被用来压迫我们。

And menstruation is used

月经就是其中一个，

during what we in medicine call the reproductive years.

被用于我们在医学上 称之为生殖年龄的阶段。

It's been around since pretty much the beginning of time,

在很早之前，其实已经就是这样了。

在很多文化中普遍认为 女性会破坏庄稼，

many cultures thought that women could spoil crops

或是牛奶，或是使花朵凋零。

or milk, or wilt flowers.

And then when religion came along,

后来随着宗教信仰的出现，

purity myths only made that worse.

圣洁的神话只是让情况变得更糟了。

医学也没什么实际帮助。

And medicine wasn't any help.

In the 1920s and '30s

在 1920 年代至 30 年代，

there was the idea that women elaborated something called a menotoxin.

有一种说法把女性描述为 某种叫月经毒素的东西。

We could wilt flowers just by walking by.

我们就算只是路过花朵旁， 也能使之凋零。

(Laughter)

（笑声）

And that's what happens when there's no diversity, right.

这是在多样化缺失时 会发生的事，对吧？

因为那时没有女性 举起手，走上前并说

Because there was no woman to put her hand up and go,

"Well, actually, that doesn't happen."

“你看，实际上，这并没有发生。”

当你无法谈论 你的身体正在发生什么的时候，

And when you can't talk about what's happening to your body,

你如何打破这些迷思？

how do you break these myths?

你甚至不需要成为一名医生

Because you don't even need to be a doctor

to say that periods aren't toxic.

来表明“月经不是有毒的”。

如果月经是有毒的，为什么胚胎 会扎根于这样一个有毒的环境？

If they were, why would an embryo implant in a toxic swill?

And if we all had this secret menotoxin,

如果我们所有女性 都携有这种秘密毒素，

we could be laying waste to crops and spoiling milk.

我们可能会毒害庄稼， 让牛奶变质。

(Laughter)

（笑声）

Why would we have not used our X-Women powers to get the vote sooner?

我们为什么还没用自己 X 女战警的能力更快地获得更多选票？

(Laughter)

（笑声）

(Applause)

（掌声）

Even now,

甚至直至今日，

when I tweet about period diarrhea,

和别人一样，当我发送关于

as one does,

经期腹泻的推文时，

(Laughter)

（笑声）

我也会提及， 这影响着 28% 的女性。

I mention that it affects 28 percent of women.

然而每一次， 都有人跑过来和我说，

And every single time, someone approaches me and says,

"I thought I was the only one."

“我以为我是唯一的一个。”

That's how effective that culture of shame is,

我们的羞耻文化就是那么的有效，

that women can't even share their experiences.

以至于女性们 甚至无法分享她们的经历。

So I began to think,

所以我开始思考，

"Well, what if everybody knew about periods like a gynecologist?

“好吧，如果每个人都能 像妇科医生一样对月经有所了解

Wouldn't that be great?"

不是很棒吗？”

Then you would all know what I know,

之后你就会知道所有 我知道的东西，

you'd know that menstruation

你会知道月经

是哺乳动物中相当特别的现象。

is a pretty unique phenomenon among mammals.

Most mammals have estrus.

大多数哺乳动物有发情期。

Humans, some primates,

人，有些灵长类动物，

some bats,

一些蝙蝠，

the elephant shrew and the spiny mouse menstruate.

象鼩，还有非洲刺毛鼠 都有经期。

And with menstruation what happens is the brain triggers the ovary

这意味着在月经期间， 大脑会触发卵巢

to start producing an egg.

开始产生卵子。

Estrogen is released

雌性激素也因此被释放，

and it starts to build up the lining of the uterus,

开始形成子宫内膜， 一层又一层地堆积卵子细胞，

cell upon cell, like bricks.

宛如砖块那样。

And what happens if you build a brick wall too high without mortar?

但如果你的砖墙建得太高 却没有足够的水泥，会发生什么？

Well, it's unstable.

它会不太稳固。

So what happens when you ovulate?

当你排卵的时候，

You release a hormone called progesterone,

你体内会释放 一种叫黄体酮的荷尔蒙，

which is progestational, it gets the uterus ready.

这是一种孕激素， 让你的子宫做好准备。

它的作用就像水泥一样， 把那些砖块牢固地黏在一起。

It acts like a mortar and it holds those bricks together.

It also causes some changes

它也会改变子宫内膜的环境，

to make the lining more hospitable for implantation.

使之更适宜于受精卵的植入。

If there's no pregnancy,

如果没有怀孕，

(Whoosh)

（轻呼）

lining comes out,

那层膜会被排出体内，

there's bleeding from the blood vessels and that's the period.

同时血管也会流血， 这也就是月经的形成。

我总是觉得这个很有趣。

And I always find this point really interesting.

Because with estrus,

因为在发情期，

the final signaling to get the lining of the uterus ready

让子宫内膜做好 受孕准备的最终信号

实际上是来自胚胎。

actually comes from the embryo.

But with menstruation,

但对于月经，

that choice comes from the ovary.

是否来月经取决于卵巢。

It's as if choice is coded in to our reproductive tracts.

这个决策过程好像是被编码在 我们的生殖系统中一样。

（喝彩与掌声）

(Cheering and applause)

OK, so now we know why the blood is there.

好了，所以我们现在了解了 为什么会出血，

而且还是相对大量的血，

And it's a pretty significant amount.

30 - 90 毫升的血量，

It's 30 to 90 milliliters of blood,

which is one to three ounces,

约为 1 - 3 盎司，

and it can be more,

还可能更多。

and I know it seems like it's more a lot of the times.

我知道很多时候实际看起来更多。

我知道。

I know.

所以我们为什么排出那么多血？

So why do we have so much blood?

And why doesn't it just stay there till the next cycle, right?

为什么这些东西不呆在原地 等着下一个生理周期，对吧？

Like, you didn't get pregnant, so why can't it hang around?

如果你没有怀孕，为什么那些东西 不可以在我们体内随意逗留？

那么，想象每个月那层膜 都变厚一点，再厚一点——

Well imagine if each month it got thicker and thicker and thicker, right,

like, imagine what tsunami period that would be.

想象一下那种血崩 会是什么感觉。

(Laughter)

（笑声）

We can't reabsorb it, because it's too much.

我们无法重新吸收那些东西， 因为量太大了。

And it's too much because we need a thick uterine lining

量大是因为 我们对厚子宫内膜的需求

for a very specific reason.

是出于一个非常特定的原因。

Pregnancy exerts a significant biological toll on our bodies.

怀孕对我们的身体 会造成一个巨大的生物伤害。

There is maternal mortality,

这包括产妇死亡，

there is the toll of breastfeeding

母乳喂养的伤亡，

and there is the toll of raising a child until it is independent.

抚养孩子直至他们成年 其中获得的伤害，

And evolution --

还有进化——

(Laughter)

（笑声）

That goes on longer for some of us than others.

对于我们有的人 持续时间还更长。

(Laughter)

（笑声）

But evolution knows about risk-benefit ratio.

但进化是基于风险效益比率的。

进化的目的是最大化 有益结果出现的可能性。

And so evolution wants to maximize the chance of a beneficial outcome.

And how do you maximize the chance of a beneficial outcome?

那你怎么最大化这一可能性呢？

You try to get the highest quality embryos.

你尝试保留最高质量的那个胚胎。

And how do you get the highest quality embryos?

那你如何尝试保留 最高质量的胚胎呢？

你让它们为此奋斗。

You make them work for it.

You give them an obstacle course.

你给它们一个需要通过的障碍。

So over the millennia that we have evolved,

所以经过上千年的进化，

it's been a little bit like an arms race in the uterus,

子宫内的竞争 宛如一场军备竞赛，

the lining getting thicker and thicker and thicker,

内膜变得越来越厚，

and the embryo getting more invasive

胚胎也更具侵入性，

until we reach this détente

直至与子宫内膜的关系

with the lining of the uterus that we have.

达到一个缓和状态。

所以我们有了 这层厚厚的子宫内膜，

So we have this thick uterine lining

and now it's got to come out,

它现在需要被排出体外，

and how do you stop bleeding?

但是你是如何停止流血的？

通常流鼻血的话， 你会捏住鼻子止血，

Well, you stop a nose bleed by pinching it,

if you cut your leg, you put pressure on it.

如果你划到腿了， 你会加压止血。

We stop bleeding with pressure.

压力能够帮助止血。

When we menstruate,

当我们来月经的时候，

the lining of the uterus releases substances

子宫内膜会释放一种物质，

that are made into chemicals called prostaglandins

它能够生成一种 名为前列腺素的化学物质

and other inflammatory mediators.

以及其它炎症介质。

And they make the uterus cramp down,

它们会造成子宫向下筋挛，

they make it squeeze on those blood vessels

使子宫对血管造成压力

to stop the bleeding.

从而起到止血作用。

They might also change blood flow to the uterus

它们也可能会让血流向子宫，

and also cause inflammation and that makes pain worse.

同时引发炎症，并加剧疼痛感。

And so you say, "OK, how much pressure is generated?"

你会说：“好吧， 这里产生的压力有多大？”

And from studies where some incredible women

一些超赞的女性曾志愿

have volunteered to have pressure catheters

在她们的子宫内植入压力导管，

put in their uterus

让学者们进行研究，

that they wear their whole menstrual cycle --

她们在整个月经周期 都带着那个导管——

God bless them, because we wouldn't have this knowledge without,

感谢她们，因为没有她们， 我们不会了解这个知识，

and it's very important knowledge,

而这是一个很重要的知识。

because the pressure that's generated in the uterus

因为在月经期间

子宫内产生的压力

during menstruation

is 120 millimeters of mercury.

为 120 毫米汞柱。

"Well what's that," you say.

你会问：“这代表什么？”

Well, it's the amount of pressure that's generated

这相当于你分娩第二阶段用力时

during the second stage of labor when you're pushing.

所产生的压力。

（观众倒吸冷气）

(Audience gasps)

Right.

没错。

Which, for those of you who haven't had an unmedicated delivery,

对于在座没有进行过 非药物分娩的人，

that's what it's like when the blood pressure cuff

这就好比你戴着的血压袖套

不像一开始那样紧，

is not quite as tight as it was at the beginning,

但依旧蛮紧，

but it's still pretty tight,

而且你希望它会停止的 那种感觉。

and you wish it would stop.

So that kind of makes it different, right?

这情况就变得很不一样了，对吧？

If you start thinking about the pain of menstruation,

如果你开始回想经期疼痛，

we wouldn't say if someone needed to miss school

我们不会说—— 倘若一个人在学校旷课，

是因为她们处于分娩第二阶段， 并且用力在生孩子，

because they were in the second stage of labor and pushing,

we wouldn't call them weak.

我们不会说她们是弱者，

而会说，“我的天 ， 你竟然做到了！”对吧？

We'd be like, "Oh my God, you made it that far," right?

（笑声）

(Laughter)

And we wouldn't deny pain control

我们不会否认

那些承受典型分娩阵痛女性的 忍痛能力，对吧？

to women who have typical pain of labor, right?

用“典型”，而非“正常” 来形容这种疼痛很重要，

So it's important for us to call this pain "typical" instead of "normal,"

because when we say it's normal, it's easier to dismiss.

因为当我们说这很正常， 这说明疼痛很容易消失。

As opposed to saying it's typical, and we should address it.

然而说这很典型， 代表我们需要解决它。

我们确实有一些解决痛经的办法。

And we do have some ways to address menstrual pain.

One way is with something called a TENS unit,

一个方法就是使用 经皮神经电刺激（TENS）止痛仪，

which you can wear under your clothes

你可以把它贴在衣服里，

and it sends an electrical impulse to the nerves and muscles

它能将电流送往神经和肌肉，

and no one really knows how it works,

并且没人真正知道其中的原理，

but we think it might be the gate theory of pain,

但我们认为这个技术可能是 基于闸门理论，

即反刺激。

which is counterirritation.

It's the same reason why, if you hurt yourself, you rub it.

同样这也是为什么如果 你伤到了自己，你会搓揉疼痛处。

Vibration travels faster to your brain than pain does.

振动，相比疼痛， 能够更快地被神经传导至大脑。

我们也有药物方法，

We also have medications

called nonsteroidal anti-inflammatory medications.

实用非甾体抗炎药物（NSAID）。

And what they do is they block the release of prostaglandins.

它们的主要作用是 抑制前列腺素的合成。

They can reduce menstrual pain for 80 percent of women.

该药物可为 80% 的女性 缓解痛经，

也可以减少 30% - 40% 的出血量，

They also reduce the volume of blood by 30 to 40 percent

and they can help with period diarrhea.

同时缓解经期腹泻情况。

And we also have hormonal contraception,

我们也有荷尔蒙避孕药，

which gives us a thinner lining of the uterus,

让我们的子宫内膜变薄，

so there's less prostaglandins produced

从而减少前列腺素的生成，

and with less blood, there's less need for cramping.

并缓解出血情况， 同时对痉挛的需求也变小。

Now, if those treatments fail you --

如果这些治疗方法 对你都没用——

and it's important to use that word choice,

这里的措辞很重要，

because we never fail the treatment,

因为我们从不会让治疗失败，

the treatment fails us.

而是治疗对我们没用。

If that treatment fails you,

如果那些治疗方法“辜负”了你，

you could be amongst the people

你可能属于

who have a resistance to nonsteroidal anti-inflammatories.

对 NSAID 具有抗药性的一批人。

We don't quite understand,

我们尚未完全理解，

but there are some complex mechanisms

为什么这些药物 就是对某些女性无效用，

why those medications just don't work for some women.

这其中包含着一些很复杂的机制。

也可能是因为， 导致你经期疼痛的原因

It's also possible that you could have

another reason for painful periods.

与上述情况都不同。

You could have a condition called endometriosis,

也可能是因为你 患有子宫内膜异位症，

where the lining of the uterus is growing in the pelvic cavity,

即，子宫内膜生成于盆腔中

causing inflammation and scar tissue and adhesions.

进而引起炎症， 疤痕组织以及黏附现象。

或许其中还有我们 尚未了解的机制存在，

And there may be other mechanisms we don't quite understand yet,

because it's a possibility that pain thresholds could be different

因为这会牵涉到 非常复杂的生物学机制，

due to very complex biological mechanisms.

疼痛阈值也可能会随之不同。

But we're only going to find that out by talking about it.

但我们只有通过不断谈论它， 才能发现更多。

It shouldn't be an act of feminism

了解你的身体如何运作

to know how your body works.

不应该是一种女权主义的行为。

It shouldn't --

这不应该——

(Applause)

（掌声）

It shouldn't be an act of feminism

在你身受月经折磨时寻求帮助，

to ask for help when you're suffering.

这不应该是一种女权主义的行为。

The era of menstrual taboos is over.

月经作为一种话题禁忌的时代 已经结束了。

(Cheers and applause)

（喝彩与掌声）

The only curse here

这里唯一的魔咒

is the ability to convince half the population

就是说服一半的人口，

那个让各个物种得以 在历史长河延续生命，

that the very biological machinery that perpetuates the species,

that gives everything that we have,

给予我们所拥有的一切的生物系统，

是肮脏的、有毒的。

is somehow dirty or toxic.

And I'm not going to stand for it.

我不会去支持这个观点。

(Applause)

（掌声）

And the way we break that curse?

如何打破这一魔咒？

It's knowledge.

用知识。

Thank you.

谢谢。

(Cheers and applause)

（喝彩与掌声）