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The Curse: The Last Unmentionable Taboo, by Karen Houppert

Review by Kathleen O'Grady, in the Globe and Mail newspaper, Toronto, Canada, 26 June 1999

The cover of The Curse tells its story nicely: A plain white dust jacket hides the real goods underneath, like the secretive film that disguises the true purpose of a sanitary pad. The jacket conceals a picture that is printed directly onto the hardcover of the book -- the lower torso of a naked young woman in side profile with one leg slightly raised. This in itself is not controversial. After all, one can hardly look through a magazine or at a billboard advertisement without seeing eroticized nudity used to sell every conceivable product. What makes this picture different from the others is a tiny white string, no more than two inches long, that dangles from between the woman's legs.

This photo accompanied a 1995 feature article by Karen Houppert on the tampon industry for New York's The Village Voice, where Houppert is a resident reporter. Readers were outraged and quick to complain about the offensive image; the controversy even spilled onto the pages of Glamour and The New York Times, where reporters questioned the aim and agenda of such pictorial shamelessness. Yet Houppert's goal in this early article, which sparked her book-length study on the topic, was clear from the start: to challenge head-on "the culture of concealment" that surrounds menstruation.

The Curse is a clearly written summary of the depth of shame and secrecy that surrounds a wholly ordinary and natural process. She is not so much interested in the origins and foundations of the menstrual taboo, or in the cultural construction of women's bodies that has defined menstruation in negative terms -- a weakness of her study -- but focuses instead on the way in which the silence that surrounds this physiological process has had a profound impact on women's health.

So while it might seem natural to link Houppert's book with the excellent array of recent books on the social history of women's sexuality -- Rachel P. Maines's The Technology of Orgasm,Marilyn Yalom's A History of the Breast and Natalie Angier's Woman: An Intimate Geography, to name just a few -- it is clear that Houppert is no academic or feminist philosopher interested in gender construction. Her voice is that of an activist with a visible target.

Houppert volleys a formidable attack on the giants that make up the "feminine protection industry." She demonstrates how manufacturers of menstrual products perpetuate the secrecy and shame of menstruation for their direct profit. Advertisements focus on confidentiality and concealment -- pads that fit in the palm of your hand, scented products, camouflaged flower packaging -- and emphasize that the "daintiness" of a woman is contingent upon the use of their product. Her "femininity" will be "protected" from that which makes her most "unwomanly," her menstrual bleeding.

Houppert unravels the complex genealogy of dozens of pad and tampon brands and finds that only a handful of companies control the whopping $8-billion (U.S.) menstruation market. (A recent merger between Tambrands, which controls 36 per cent of pad sales, and Procter & Gamble, which has more than 50 per cent of the tampon market, has further reduced this number, giving the industry almost unparallelled clout in a free-market economy.)

Houppert suggests that this kind of domination by a few goliaths goes a long way to explain the continued rise in prices for menstrual products. Too, the culture of "menstrual silence" prevents any consumer outcry against the increased cost. Such a significant rise in the price of other staples -- paper, milk, diapers -- would surely have met some resistance, but tampon and pad-wearers remain mute and continue to buy.

This same veil of secrecy, Houppert argues, prevents women from raising their voice against the continued taxation of menstrual products, in both Canada and the United States, where they are classified by the governments as "non-essential" items.

Yet a much more troubling side effect of menstrual secrecy is the reluctance of government bodies to involve themselves with menstrual product safety. While tongue depressors are classified "medical" and must be regulated as such, menstrual products are considered "cosmetic," and regular testing and research is largely left to the companies that produce them.

This remains the case even after the "toxic shock syndrome" (TSS) deaths of the 1980s, which were related to tampon use. While the synthetics found responsible for breeding the deadly bacterium -- staphyloccoccus aureus -- have been banned from tampon manufacturing, governments continue to allow tampon manufacturers to do their own testing. Houppert's research indicates that TSS continues to be a serious health problem for women, causing thousands of nonfatal illnesses each year.

The unfashionable nature of menstruation also means that medical foundations and university and government studies deal with other health concerns, and rarely with menstrual health. Further, the insider testing of the menstrual-product industries does not have to be made available to the public. This makes it difficult, if not impossible, to come to an independent assessment of the health risks of tampon or pad use.

Houppert indicates that the dioxin levels found in pads and tampons may be the next major menstrual concern. The few independent studies undertaken indicate that even trace amounts of dioxins affect the reproductive and immune system in humans, and is linked to infertility and endometriosis in women. But without further testing and without the accountability of the industries who profit from menstrual products, we cannot be certain.

Any woman reading Houppert's book will bristle with anger at almost every page, but the intellectual rigour and vivacity that mark The Curse throughout come with a good dose of humour. The inside cover is an assemblage of all the "secret" names for a women's menstruation, bespeaking a cultural history in itself. Houppert also signs her book with a flourish; on the unadorned white dust jacket, her surname is listed in black and white letters, containing a single vibrant and very red "O."

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