The Menstrual Cycle is NOT a Detox

Don't learn about the menstrual cycle from a chiropractor.

I decided to write a book about menstruation in large part because social media and alternative medicine providers have breathed new life into a lot of menstrual mythology. Hence the book’s title, Blood: The Science, Medicine, and Mythology of Menstruation. Menstrual myths are problematic because they misinform people about their bodies, can lead people to bad medical care, and they almost always perpetuate awful patriarchal tropes about women. When you know the science and the medicine, it’s much easier to spot the mythology!

Today, we’re going to talk about the original sin of menstrual myths–that menstrual blood contains toxins. Why? I was sent an Instagram clip from a podcast featuring Mindy Pelz, a chiropractor, and unfortunately, it appeared on an account with three million followers. 

Here is an excerpt from the clip: 

Pelz: So this is what women need to know, your cycle is a detox, you are shedding the inner lining of your uterus, and you are getting rid of what is not serving you, so it’s not just a troublesome situation you have to deal with, your body is getting rid of hormones, it’s getting rid of toxins. It’s how we detox. It takes a couple of years for the pattern of the brain and the ovaries to get to know each other, so if we come in with birth control a year after a woman started her period, there’s never an internal innate sense of the body, and then we keep women on birth control until menopause and now she has a serious hormonal issue that because she never learned that pattern. 

Wow, so much wrong to unpack there, and that was just a single paragraph. 

(I’m not going to link to the post because sending traffic will boost the algorithm, and then more people will potentially be exposed).

The Problem with Toxins and Detox

Toxins are the Emmanuel Goldstein of so-called alternative medicine, never-seen (and rarely even described) terrifying villains capable of mounting untold harm. In the real world, toxins are harmful substances made by animals, plants, and bacteria. Think snake venom and botulinum toxin. Humans don’t make toxins.

Now, it is true that we humans do sometimes eat or manufacture harmful substances; for example, when we metabolize alcohol, we produce acetaldehyde, which is a carcinogen, but then acetaldehyde is converted into another, safer, substance called acetate, which is then is broken down into water and carbon dioxide, which are easily removed. The liver and the kidneys do the bulk of this work. Or if we don’t have a way to remove the substance, we get sick and need medical care. For example, if bacteria in the vagina produce the toxin that causes toxic shock syndrome or if we eat food contaminated with a toxin that produces food poisoning. 

Claiming humans need a detox for toxins makes as much sense as saying airplanes are powered by elves riding bicycles. It is nonsense because that’s not how it works. The real purpose of the word “toxins” in alternative medicine seems to be to sell a detox, which is useless because A) you can’t remove imaginary substances and B) your liver and kidneys do not need help (and can’t be helped) by special supplements, intermittent fasting, or whatever nonsense is being sold under the guise of a “detox,” and C) If you are actually sick from a real toxin, you need science-based medicine (often intensive care), not a chiropractor and a detox. 

Whenever you see toxins discussed as a threat to the normal functioning of your body and detox as the answer, that is a big red flag that you are not getting science-based content. 

Menstrual Blood is Not a Waste Waste-Removal System

Toxins and menstruation is an old canard, and it’s as misogynistic as it is wrong. The Ancient Greeks believed men were in perfect balance and women were not. The proof of this was menstruation, which was the inferior female's (insert eye roll) way of getting rid of excess moisture and harmful humors and whatnot. Many cultures have believed the myth that menstrual fluid is harmful or filled with pollutants, and some dude even coined the term menotoxins. The idea that menstrual fluid is a polluting swill has been used to oppress women for thousands of years. This is why many ancient physicians focused on menstruation, and there were many ancient recipes to attempt to bring on menstruation; otherwise, the build-up of fluid and dangerous substances would cause severe sickness. This is one reason why, historically, menopause was viewed as a harmful state because it was believed that poor, unfortunate women could no longer dump their toxins that their ineffective, shoddy bodies couldn’t handle the right way, i.e., like men. Thank goodness it’s 2023, not 1023.

The idea that the menstrual cycle gets rid of nonexistent toxins or hormones is ridiculous on the face of it. Will no one think of the men? How do they get rid of their toxins? Unless, of course, alternative medicine ascribes to the ancient belief that men are in perfect balance and women are uniquely toxic. How do people survive a hysterectomy if they no longer have this important toxin-removing organ? People die without a liver, so if you follow the “logic,” then without a uterus, you are basically doomed. And what about menopause? I guess I should be stewing in my own toxic swill instead of, you know, washing my hands well after food prep and enjoying my toxin-free life.   

Inquiring minds want to know! (Not really).

Here’s the deal. Menstrual blood is blood. It’s not special, magical blood. It’s not toxin-filled blood. It is not dirty or spoiled or polluted blood. It also does not assist the liver or kidneys. Blood flows to the uterus and ends up in tiny blood vessels in the endometrium called spiral arteries. Here is an illustration from my book, Blood. 

At the start of the cycle, you can see that the blood vessels are very small, and then the spiral arteries grow and become more coiled. The chemical cascade that triggers menstruation weakens these blood vessels, and they open and bleed, which helps to push off the outer layer of the endometrium (uterine lining). The blood picks up the endometrium that has now separated from the uterus and then heads down through the cervix to the vagina picking up cervical mucus and vaginal discharge along the way. What comes out of you is regular blood, the same blood I would get if I drew a sample from a vein in your arm, mixed with endometrial cells, and the flotsam and jetsam it picked up along the way.

As for menstrual blood being a way to get rid of hormones, that is false. First of all, if menstruation were an important system for removing hormones, just like with toxins, what would happen to all the women who have a hysterectomy but keep their ovaries? Wouldn’t their estrogen levels skyrocket without their uterus? The reason women don't get estrogen poisoning after a hysterectomy is that estrogen is removed from the body via the liver and kidneys. If you want to know more about that, I wrote about it previously here.

Now, it is true that the endometrium produces some hormones, for example, prolactin and relaxin. Obviously, those hormones will come out mixed with menstrual blood, but they originated in the uterus. And if you take the pill continuously and don’t get a period, these hormones don’t accumulate because they were never produced to begin with. 

An elegant study from 1989 actually looked at the hormone component of menstrual blood and compared that to the sample from a typical blood draw (the women collected their menstrual blood for the first three days of their cycle with a special menstrual cup that fit around the cervix, to limit vaginal secretions). The researchers found that prolactin levels were higher in menstrual blood than blood from the vein, which is unsurprising as the endometrium makes prolactin, but estradiol and progesterone levels were similar or slightly lower than that in the circulation (lower was probably a dilution effect). So, the levels of estradiol and progesterone in the menstrual blood reflected what was actually in the blood in the body. The bottom line is that there is no evidence to support the claim that the uterus removes hormones from the blood. 

What About How the Pill Affects the “Internal Innate Sense of the Body?” 

First of all, the phrase “internal innate sense of the body” sounds like a discarded line from a poorly written Victorian melodrama.

There is a tiny kernel of truth here, which always makes misinformation stickier because it sounds familiar. It can indeed take a year or two after the first menstrual period for ovulation to become regular, but no evidence suggests that stopping the menstrual cycle with the pill, or pregnancy for that matter, affects the menstrual cycle long term. Your brain and ovaries aren’t learning to talk, like cartoon characters in a show, any more than your heart learns to beat by talking with your brain.

What we do know is that when the pill is stopped, fertility returns within three menstrual cycles, and the age of the person doesn’t have an effect. Remember, the pill suppresses menstruation the same way that pregnancy does, with hormones (with the pill, it's primarily by the progestin, and with pregnancy, it is progesterone). Once that hormone is removed, the cycle can start up again. After pregnancy, without breastfeeding, the cycle takes about 6-12 weeks to start up again, basically like stopping the pill. The menstrual cycle evolved to be suppressed by hormones. I could twist this and then say it’s natural to be on the pill because it’s mimicking the cyclic suppression of pregnancy! Instead, what I do is explain the benefits and risks of the pill and how it works, as I do with every medication. In California, a chiropractor can't prescribe hormonal contraception, so it’s not surprising they may not know that much about these methods.

Anytime you hear that modern medicine somehow distorts the “natural order,” what you are being exposed to is a natural fallacy. The implication here with the wild claim about the pill affecting the “innate sense of the body” is not just fear-mongering; it’s a patriarchal take because the implication is you have spoiled your body or rendered it impure. This is purity culture. How often do you hear about medications that spoil a man’s innate sense of his body? The pill is a stand-in for the apple, and now that you have tasted technology, you are spoiled and doomed.

Your Menstrual Cycle Doesn't Teach You to Get Ready for Menopause

The idea that you need to learn the pattern of menstruation to learn how to be in menopause is so absurd; I’ve got nothing. I’ll add it to my growing collection of the worst or the worst menstrual mythology (aka bullshit). Being on hormonal contraception for years does not cause “serious hormonal issues.” What does that even mean? What diagnosis does it cause?

This isn't the first time I’ve seen a truly absurd claim from Pelz. It does make you wonder what they teach in chiropractic school. There is a video of her recommending a wand that will “bring your water back into coherency” so the water can enter your cells “more effortlessly” and give you “more hydration.” Apparently, she uses it when she travels, so the local tap water doesn’t “toxify” her. You can find a takedown of that product here by Abby Langer, a kick-ass science-based registered dietician (and she is definitely worth a follow on Instagram). 

Misinformation is Harmful

Studies tell us that just five exposures to what you might think of as a ridiculously false statement can start to move the needle on whether we might consider it to be true. How ridiculous? In the study that I’m referencing, the investigators repeated statements like “The Earth is a Perfect Square.” Now think about the misinformation we’ve just debunked: menstrual toxins, the uterus as a detoxifying organ, the menstrual cycle removing hormones, and your body needs to learn the menstrual cycle to prevent hormonal chaos in menopause. These sound truthy, so are far more likely to be believed than a statement like the earth is square. Now, think about how often you see harmful content on social media. Once you’ve watched something, that same content seems to pop up repeatedly. You get exposed over and over to these truthy pieces of misinformation, and gradually, you learn less about your body, and some of the science-free therapies and supplements (unstudied and unregulated pharmaceuticals) might start to seem attractive.

My advice for the safe use of social media involves a lot of blocking. This isn’t censorship; people don’t have an innate ownership of your precious time and attention and the right to stuff medical bullshit in your face. This is content curation. 

Please, can we let the misogynistic menstrual myths die already? Your body does not have toxins. Menstruation isn’t a detox or a way to excrete hormones. And your brain doesn’t need to study your menstrual cycle for a better menopause. 

And don’t get medical advice about the menstrual cycle from a chiropractor.

References

Zhou JP, Fraser IS, Caterson I, Grivas A, McCarron G, Norman T, Tan K. Reproductive hormones in menstrual blood. J Clin Endocrinol Metab. 1989 Aug;69(2):338-42. doi: 10.1210/jcem-69-2-338. PMID: 2753976.

Yland J J, Bresnick K A, Hatch E E, Wesselink A K, Mikkelsen E M, Rothman K J et al. Pregravid contraceptive use and fecundability: prospective cohort study BMJ 2020; 371 :m3966 doi:10.1136/bmj.m3966

Critchley HOD, Babayev E, Bulun SE, Clark S, Garcia-Grau I, Gregersen PK, Kilcoyne A, Kim JJ, Lavender M, Marsh EE, Matteson KA, Maybin JA, Metz CN, Moreno I, Silk K, Sommer M, Simon C, Tariyal R, Taylor HS, Wagner GP, Griffith LG. Menstruation: science and society. Am J Obstet Gynecol. 2020 Nov;223(5):624-664.

Todd N, Black A. Contraception for Adolescents. J Clin Res Pediatr Endocrinol. 2020 Feb 6;12(Suppl 1):28-40. doi: 10.4274/jcrpe.galenos.2019.2019.S0003. PMID: 32041390; PMCID: PMC7053440.

Lacassagne D, Béna J, Corneille O. Is Earth a perfect square? Repetition increases the perceived truth of highly implausible statements. Cognition 2022; 223,105052.

Rules and Regulations. California Board of Chiropractic Examiners. Revised November 2021 https://www.chiro.ca.gov/laws_regs/regulations.pdf

License search, California Board of Chiro[practice Examiners https://search.dca.ca.gov/results