Vagina

• When I ask my menstrual health workshop participants – including clinicians – there’s usually a lot of shrugging and shaking of heads.
• If given multiple choice options, most think that periods either “clean the womb” or somehow “help prepare for pregnancy”.
• Yes, the blood part can stain clothing, but there is nothing pathological, contaminating, or dangerous about periods.

So, why do we have periods?

• Periods likely evolved as a kind of preemptive abortion, to protect women from unviable or dangerous pregnancies.
• As a result, we have low rates of conception, high rates of miscarriage, and extremely high rates of maternal mortality in comparison to other mammals.
• The menstrual cycle is critical for facilitation of the initial steps of this raison d’être of the female reproductive system.
• The menstrual cycle is critical for facilitation of the initial steps of this raison d’être of the female reproductive system.

What else don’t we know?

• Perhaps with the fact that the second phase of the cycle from ovulation to menstruation is a series of highly inflammatory processes.
• This was only very briefly mentioned in three out of 16 textbooks.
• We really ought to be taught from puberty how to reduce period pain and blood loss – this is not difficult science.

Why aren’t we taught this stuff?

• My research shows that the exclusive focus on the female sex hormones in menstrual education is informed by societal influences, such as the myth of the hysterical or hormonal female.
• This gender myth is still alive and well, although now we tend to blame the (female sex) hormones.

• Again, there was no scientific reason for this change in focus, although it reflected existing societal beliefs about the inherently irrational behaviour of women.
• Unfortunately, menstrual health literacy has not yet recovered from this shift in physiological models.

So what?

• It also becomes much easier to differentiate premenstrual changes from underlying health conditions, since the latter will not be substantially alleviated by anti-inflammatory interventions alone.
• Teaching the reductive hormonal model of the menstrual cycle unintentionally provides pseudo-scientific evidence for the damaging hormonal or hysterical female gender myth.

Sally King is the founder of Menstrual Matters- the world's first evidence-based info hub on menstrual health and rights www.menstrual-matters.com. Her doctoral research and current research fellowship were funded by the ESRC (Economic and Social Research Council).

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• In this case, raising HPV awareness, getting timely vaccination and high-quality screening together contribute significantly to the prevention of HPV infection and related diseases.
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• Providing astronauts with the right diet is also paramount in supporting their mental and cognitive health, in a way unlike previous missions.
• That includes acknowledging the role of microbes in mental health and wellbeing, and providing astronauts with the right foods and conditions for a variety of these beneficial microbes to grow.
• Here’s why a healthy balance of microbes is important under such challenging conditions, and how we could put microbes on the menu.

Why are missions to Mars so challenging?

• Deep space missions will expose humans to immense physical and psychological challenges.
• These include prolonged isolation from loved ones, extreme space and resource constraints, and the difficulties of microgravity.

Why is diet important for mental health?

• We already know the quality of people’s diet not only influences their physical health, but also their mental and brain health.
• Diet quality is consistently and independently linked to the risk of depression or anxiety.

Diet can have such consequences by altering:
Diet can also influence the many ways microbes in the gut affect the brain, a link known as the microbiota gut-brain axis.

Read more:
Essays on health: microbes aren't the enemy, they're a big part of who we are

Not all foods make the grade

• Space foods need to appeal to a diverse crew and stay nutritious for an extremely long time (likely a three- to five-year mission).
• They also need to be lightweight and compact enough to fit on the spacecraft.

Why are microbes so important?

• We have co-evolved with, and are hosts to, trillions of different microbes that live on our skin and in all our niches and cavities.
• Gut microbes influence our mental health and behaviour, and these, in turn, influence our gut microbes.
• So ensuring all astronauts have the healthiest and most diverse of microbes for the whole of the mission is vital.

How could we encourage healthy microbes?

• We also need to think about how we grow the food if we are to support healthy microbiomes.
• Indeed, microbes play an essential role in the nutrient and phytochemical content of plants, and the microbes in soil, plants and humans are interconnected.

• Some types have a meat-like flavour and texture, and can provide all the amino acids humans need as well as useful byproducts from the microbes themselves.
• Fermentation itself creates thousands of different bioactive molecules, including some vitamins, that have diverse beneficial effects on health, including possible benefits to mental health.
• Probiotics are live microbes that have demonstrated health benefits and prebiotics are food for these healthy microbes.

Benefits on Earth too

We’re only at the start of learning how to optimise microbes to keep space crews healthy, which is crucial for long space flights and for possible settlement on other planets. However, this research could have many other applications. We can use what we learn to help create self-sustaining and sustainable food systems on Earth to improve the environment and human health.

• She is on the Scientific Advisory Board of the Dauten Family Centre for Bipolar Treatment Innovation and Zoe Limited.
• Dorit Donoviel is Executive Director, NASA-Funded Translational (moving products from lab-bench to practice) Research Institute for Space Health at Baylor College of Medicine.