OB-GYN and author Dr Jen Gunter discusses the biology of menstruation, common misconceptions, and the social and political forces shaping how menstrual health is understood. She argues there is no single ‘standard’ 28-day cycle and describes normal variability in cycle length, as well as why only a small number of mammals menstruate. Gunter explains hormonal phases of the cycle, including decidualisation and why shedding the uterine lining occurs, and outlines how prostaglandins contribute to cramps and menstrual diarrhoea.
She distinguishes PMS from PMDD and urges people with pain affecting daily life to seek medical care, noting NSAIDs as a first-line, evidence-based approach for many. On self-tracking, she supports short-term cycle diaries for clinical problem-solving but criticises the ‘quantified self’ approach and says many tracking apps are not transparent about their algorithms. She warns that menstrual data stored on phones could be subpoenaed and used against people in places where abortion is illegal.
The second half focuses on menopause: its timing, the menopause transition, and symptom range. Gunter says menopause is not a disease and sets out evidence-based uses for menopausal hormone therapy, while cautioning against compounded hormones and marketing terms such as ‘bioidentical’. She also argues most supplements lack strong evidence and may be adulterated, recommending third-party verification where supplementation is medically indicated.
Dr Jen Gunter argues menopausal hormone therapy should use regulated pharmaceutical preparations rather than compounded products, citing uncertainties about absorption and dosing. She says compounded hormones are not batch-tested like licensed products and may lack comparable warning labels, which she claims can mislead patients about safety.
Read this moment →Dr Jen Gunter says menstrual tracking app data could be subpoenaed by prosecutors and used in investigations where abortion is illegal. She advises people in those jurisdictions to be careful about what cycle data their phones and apps collect and store.
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