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

Translator: H.L. Au Reviewer: Thomas Tam

When I was a teen, I had terrible periods.

當我仲係少女嗰陣 啲月經嚇死人

I had crippling cramps,

經痛非常厲害

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

嗰啲經血漏到落衫同床單度

and I had period diarrhea.

同時行經期間有肚瀉

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

每月都有一兩日返唔到學

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

我仲記得拎住個暖墊，坐喺沙發到諗

"What's up with this?"

「咩事啫？」

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

我食嘢，口水腺都唔會流出啲口水

When I went for a walk,

去散步

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

膝頭唔會漏啲關節液出嚟

Why was menstruation so different?

點解啲月經就咁衰漏曬出嚟？

I wanted answers to these questions

我想知點解

but there was no one for me to ask.

但係冇人問到答案

My mother knew nothing about menstruation

我媽咪乜都唔知

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

仲叫我唔好同人哋提起月經 呢啲污糟邋遢、又唔見得人嘅嘢

I asked girlfriends

我問過啲女仔朋友

and everybody spoke in euphemisms.

個個都講得好婉轉

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

最後，我提起勇氣去搵醫生

and talk about my heavy periods,

講畀佢聽我啲月經流得好犀利

I was told to eat liver.

醫生就話叫我去食啲肝

(Laughter)

（笑聲）

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

當我去藥房買月經用品

my 48-pack of super maxi pads,

我用嘅 48 包、超特大護墊——

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

嗰時每塊仲係紙巾盒咁大

(Laughter)

（笑聲）

You know what I'm talking about.

你明我講咩啦

You have no idea how far absorbent technology has come.

你諗唔到啲吸水能力進步咗咁多

(Laughter)

（笑聲）

I used to have to buy my menstrual products

我以前買啲月經用品

in the feminine hygiene aisle.

要去女性衛生嗰行

And I remember standing there, thinking,

我記得當時企咗係到諗

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

「點解我唔係喺 肛門衛生嗰行買廁紙呢？」

(Laughter)

（笑聲）

Like, what's up with that?

做乜啫？

Why can't we talk about periods?

點解唔講得月經啫？

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

正如弗洛伊德所講咁，唔關啲血事

because if it were,

因為如果係

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

依家就會喺耳鼻喉醫生面前企喺到

talking about the taboos of nose bleeds, right?

講起流鼻血嘅禁忌，係咪？

And it's not even about periods,

甚至係唔關月經事

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

如果係咁，當我哋到咗更年期

when we became menopausal,

擺脫咗又毒又可恥嘅月經

we'd be elevated to a higher social status.

我哋應該就可以升到更高嘅社會階層

(Laughter)

（笑聲）

(Applause)

（掌聲）

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

只因為係父權社會

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

喺女性唔同生命嘅階段 利用不同手段壓榨佢哋

And menstruation is used

利用月經係一種手段

during what we in medicine call the reproductive years.

醫學上，女性出現月經 係喺生殖年齡

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

自古以嚟已經係咁

many cultures thought that women could spoil crops

好多文化都認為 女性會破壞啲農作物

or milk, or wilt flowers.

牛奶、或者令啲花枯萎

And then when religion came along,

加埋宗教

purity myths only made that worse.

純真嘅傳說，就令情況更壞

And medicine wasn't any help.

呢種情況，啲藥物完全冇幫助

In the 1920s and '30s

喺 1920 同 1930 年間

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

仲有種想法 女人會喺月經度產生一種毒素

We could wilt flowers just by walking by.

行過就會令啲花枯萎

(Laughter)

（笑聲）

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

咁就係缺乏多樣性社會會發生嘅事

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

因為當時冇女人會企出嚟話

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

「其實，冇咁嘅事發生過。」

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

當你講唔出身體正在發生緊咩嘢事

how do you break these myths?

又點能夠打破呢啲無稽嘅傳說呢？

Because you don't even need to be a doctor

本來就唔需要醫生話你知

to say that periods aren't toxic.

月經係冇毒嘅

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

如果係有 點解仲將啲胚胎植入餿水度？

And if we all had this secret menotoxin,

如果我哋都有呢種神秘嘅月經毒素

we could be laying waste to crops and spoiling milk.

我哋就可以糟蹋莊稼同破壞牛奶啦

(Laughter)

（笑聲）

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

點解唔早啲用女性嘅超能力去拎選票

(Laughter)

（笑聲）

(Applause)

（掌聲）

Even now,

就算係依家

when I tweet about period diarrhea,

當我喺推特到講起經期有肚瀉

as one does,

呢樣嘢

(Laughter)

（笑聲）

I mention that it affects 28 percent of women.

我提到佢會影響 28% 嘅女性

And every single time, someone approaches me and says,

每次，都會有人同我講

"I thought I was the only one."

「我以為得自己係咁。」

That's how effective that culture of shame is,

呢啲令女性羞恥嘅文化，就係有效到

that women can't even share their experiences.

令女性都唔可以分享自己嘅經歷

So I began to think,

所以我開始諗

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

「如果每個人都好似婦科醫生 咁了解月經嘅話會點？

Wouldn't that be great?"

唔係會好好咩？」

Then you would all know what I know,

然後你哋就會知我知嘅嘢

you'd know that menstruation

你就會知到月經

is a pretty unique phenomenon among mammals.

係哺乳類動物中非常獨特嘅現象

Most mammals have estrus.

大部分哺乳類動物都有發情期

Humans, some primates,

人類、部分靈長類動物

some bats,

部分蝙蝠

the elephant shrew and the spiny mouse menstruate.

象鼩、刺鼠都會有月經

And with menstruation what happens is the brain triggers the ovary

而且月經就係大腦刺激卵巢

to start producing an egg.

去產生卵子

Estrogen is released

釋放出嚟嘅雌激素

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

令到開始建立子宮內膜

cell upon cell, like bricks.

一層一層，好似磚頭咁

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

當起咗太高嘅磚牆 又冇足夠嘅水泥會點？

Well, it's unstable.

咁就唔穩陣啦

So what happens when you ovulate?

但妳排卵時會發生咩事呢？

You release a hormone called progesterone,

一種妊娠激素會釋放出嚟

which is progestational, it gets the uterus ready.

令子宮準備好受孕

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

作用同水泥一樣，令啲磚頭黐實

It also causes some changes

轉變係

to make the lining more hospitable for implantation.

令到內膜更適合被植入受孕嘅卵子

If there's no pregnancy,

如果未有懷孕

(Whoosh)

（嗖一聲）

lining comes out,

內膜就會出咗嚟

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

血管會出血，嗰啲就係月經啦

And I always find this point really interesting.

我成日都覺得呢點好有趣

Because with estrus,

因為發情期

the final signaling to get the lining of the uterus ready

令子宮裡層準備好嘅最後信號

actually comes from the embryo.

實際上嚟自胚胎

But with menstruation,

但行經

that choice comes from the ovary.

呢啲決定就嚟自子宮

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

就好似程式咁 注入咗我哋嘅生殖器嗰度

(Cheering and applause)

（歡呼聲、掌聲）

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

好啦，依家我哋知道點解嗰到會出血

And it's a pretty significant amount.

都幾多血

It's 30 to 90 milliliters of blood,

係 30 到 90 毫升嘅血液

which is one to three ounces,

即係一到三盎司咁多

and it can be more,

而且仲可以更多啲

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

好多時都係會更多

I know.

係咁

So why do we have so much blood?

點解我哋會有咁多血？

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

點解佢唔留喺到，等到下個週期？

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

即係，我都冇懷孕，點解佢唔留低？

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

每個月令到子宮內膜越嚟越厚

like, imagine what tsunami period that would be.

咁你想像下 月經就會像海嘯咁樣排出嚟

(Laughter)

（笑聲）

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

實在有太多，唔可以再吸收返啲月經

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

我哋需要個厚嘅子宮內膜

for a very specific reason.

係有個特別原因嘅

Pregnancy exerts a significant biological toll on our bodies.

因為懷孕對我哋身體 會造成嚴重嘅生物損害

There is maternal mortality,

所以會有孕產婦死亡率

there is the toll of breastfeeding

喂母乳對母親係有傷害

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

同時將個細路湊大嘅代價都好大

And evolution --

呢個係人類進化過程

(Laughter)

（笑聲）

That goes on longer for some of us than others.

有啲人仲要等耐啲

(Laughter)

（笑聲）

But evolution knows about risk-benefit ratio.

但演化過程好清楚風險同利益嘅比例

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

所以想提升得到最好結果嘅機會

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

咁點樣可以做到呢？

You try to get the highest quality embryos.

就係嘗試得到最高質素嘅胚胎

And how do you get the highest quality embryos?

咁點先得到最高質素嘅胚胎？

You make them work for it.

就係要佢哋努力去爭取

You give them an obstacle course.

畀個障礙賽佢哋玩

So over the millennia that we have evolved,

經過咗幾千年嘅進化

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

子宮嘅變化，好似軍備競賽咁

the lining getting thicker and thicker and thicker,

內膜變厚啲，又厚啲，再厚啲

and the embryo getting more invasive

胚胎亦變得更具攻擊性

until we reach this détente

要中和呢個情況

with the lining of the uterus that we have.

就需要個厚嘅子宫内膜包圍著胚胎

So we have this thick uterine lining

因此形成厚嘅子宮厚內膜

and now it's got to come out,

同埋佢點可以脫落

and how do you stop bleeding?

咁你點樣止血呢？

Well, you stop a nose bleed by pinching it,

止鼻血，你會捻住個鼻

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

如果隻腳整損咗，你會壓住個傷口

We stop bleeding with pressure.

用壓力去阻止出血

When we menstruate,

當我哋嚟經期

the lining of the uterus releases substances

子宮內膜會釋放出一種物質

that are made into chemicals called prostaglandins

叫做前列腺素嘅化學物質

and other inflammatory mediators.

同其他發炎症介質

And they make the uterus cramp down,

佢哋會令到子宮抽筋

they make it squeeze on those blood vessels

佢哋會擠壓血管止血

to stop the bleeding.

They might also change blood flow to the uterus

改變咗子宮嘅血流狀況

and also cause inflammation and that makes pain worse.

會引起發炎，加劇咗啲痛楚

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

你就會問︰「咁又會有幾大壓力呢？」

And from studies where some incredible women

有啲研究得到啲好勇敢嘅女性肯犧牲

have volunteered to have pressure catheters

喺自己個子宮度

put in their uterus

放入壓力導管

that they wear their whole menstrual cycle --

放足一個月經週期——

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

主保佑佢哋，所以我哋先可以知道

and it's very important knowledge,

呢啲咁重要嘅知識

because the pressure that's generated in the uterus

因為喺月經期間

during menstruation

子宮所產生嘅壓力

is 120 millimeters of mercury.

係 120 毫米水銀

"Well what's that," you say.

你就會問「係咩嚟嘅？」

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

呢個數字其實就等同

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

你第二階段分娩 身體內所產生嘅壓力

(Audience gasps)

（觀眾喘氣）

Right.

係嘛

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

對於你哋嗰啲人，未試過自然分娩

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

噉咪當血壓袖帶

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

比原先無咁緊

but it's still pretty tight,

但都係好緊

你都好想佢放鬆

and you wish it would stop.

So that kind of makes it different, right?

咁都會令件事好唔同，係咪

If you start thinking about the pain of menstruation,

如果你開始諗經期嘅痛楚

we wouldn't say if someone needed to miss school

我哋唔能夠話人冇去上堂

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

就會經歷第二階段分娩嘅痛楚

we wouldn't call them weak.

係件懦弱嘅事嚟

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

我哋會話「哇，你咁痛都忍得﹗」

(Laughter)

（笑聲）

And we wouldn't deny pain control

我哋唔會阻止有陣痛嘅媽媽

to women who have typical pain of labor, right?

去食止痛藥，係咪？

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

重要嘅係，我哋要將呢種痛楚 稱為「典型」而唔係「正常」

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

因為當叫佢正常 就會好容易忽略咗佢

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

唔講佢哋係咪典型 我哋都應該要處理佢

And we do have some ways to address menstrual pain.

我哋有啲方法應付經痛

One way is with something called a TENS unit,

其中一種使用經皮神經電刺激器

which you can wear under your clothes

你可以放喺衫入面用

and it sends an electrical impulse to the nerves and muscles

佢會向神經同肌肉發出電脈衝

and no one really knows how it works,

冇人知佢點可以止痛

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

但我哋覺得可能係閘門控制嘅影響

which is counterirritation.

即係反刺激

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

同你整親嗰陣會捽下自己一樣

Vibration travels faster to your brain than pain does.

震動比痛楚更快到達你嘅大腦

We also have medications

我哋亦都有藥物治療

called nonsteroidal anti-inflammatory medications.

叫非類固醇消炎止痛藥

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

功用係阻止釋放前列腺素

They can reduce menstrual pain for 80 percent of women.

可以減少八成女性經痛

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

亦會減少三到四成月經流量

and they can help with period diarrhea.

同時幫助到經期肚瀉

And we also have hormonal contraception,

仲有激素可以避孕

which gives us a thinner lining of the uterus,

令我哋有個薄啲嘅子宮內膜

so there's less prostaglandins produced

因此會少咗前列腺素

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

少咗血，咁就少咗抽筋啦

Now, if those treatments fail you --

如果呢啲療法對你都冇效——

and it's important to use that word choice,

其實用字好重要

because we never fail the treatment,

因為我哋唔會令療法無效

the treatment fails us.

只係療法對我哋無效

If that treatment fails you,

如果療法對你無效

you could be amongst the people

你可能就係其中一個

who have a resistance to nonsteroidal anti-inflammatories.

對非類固醇消炎止痛藥 有抗藥性嘅人

We don't quite understand,

我哋唔係好明白

but there are some complex mechanisms

但係有啲複雜嘅機制

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

解釋點解對部分女性無效

It's also possible that you could have

亦都可能有另外一個原因

another reason for painful periods.

引致你有經痛

You could have a condition called endometriosis,

你可能患有子宮內膜異位症

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

子宮內膜喺骨盆腔內生長

causing inflammation and scar tissue and adhesions.

引起炎症、疤痕組織同粘連

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

可能有其他我哋唔係好明嘅機制

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

由於非常複雜嘅生物學機制

due to very complex biological mechanisms.

忍受痛楚嘅程度可能因人而異

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

但我哋要靠講出嚟搵出原因

It shouldn't be an act of feminism

想要知道自己身體嘅運作

to know how your body works.

唔應該屬於係女權主義嘅行為

It shouldn't --

絶對唔係——

(Applause)

（掌聲）

It shouldn't be an act of feminism

因為痛楚而需要求助

to ask for help when you're suffering.

唔應該係女權主義嘅行為

The era of menstrual taboos is over.

月經係禁忌嘅時代已經結束咗

(Cheers and applause)

（歡呼、掌聲）

The only curse here

呢到唯一嘅詛咒

is the ability to convince half the population

就係過往說服咗一半人

that the very biological machinery that perpetuates the species,

天賦予我哋依家嘅生物機制

that gives everything that we have,

令到物種永存

is somehow dirty or toxic.

係污穢兼有毒嘅破壞物質

And I'm not going to stand for it.

咁我係唔會容忍

(Applause)

（掌聲）

And the way we break that curse?

我哋要打破詛咒嘅方式？

It's knowledge.

係知識

Thank you.

多謝

(Cheers and applause)

（歡呼、掌聲）