When I was a teen, I had terrible periods. I had crippling cramps, I leaked blood onto my clothes and onto my bed sheets, and I had period diarrhea. And I had to miss school one to two days a month, and I remember sitting on the couch with my heating pads, thinking, "What's up with this?" When I ate food, I didn't leak saliva from my salivary glands. When I went for a walk, I didn't leak fluid from my knees, "joint fluid." Why was menstruation so different?
Semasa remaja, saya mengalami datang bulan yang teruk. Senggugut terlalu sakit Darah haid habis terkena pakaian dan cadar dan saya mengalami cirit-birit ketika datang bulan. Saya terpaksa ponteng sekolah satu atau dua hari sebulan dan saya ingat saya terpaksa duduk di sofa dengan pad pemanas sambil berfikir "Apa kena semua ini" Bila saya makan, tiada pula air liur meleleh Apabila saya berjalan tiada pula cecair sendi meleleh keluar dari lutut. Kenapa datang bulan ni, ia sangat berlainan?
I wanted answers to these questions but there was no one for me to ask. My mother knew nothing about menstruation except that it was dirty and shameful and I shouldn't talk about it. I asked girlfriends and everybody spoke in euphemisms. And finally, when I got the courage to go to the doctor and talk about my heavy periods, I was told to eat liver.
Saya menginginkan jawapan untuk kesemua soalan ini tapi saya tiada sesiapa untuk bertanya Ibu saya tidak mengetahui apa-apa mengenai datang bulan kecuali yang ia kotor dan memalukan dan saya tidak patut bercakap tentangnya. Saya ada bertanya kepada kawan-kawan perempuan tapi semua orang berkias tentangnya Akhirnya, apabila saya berani untuk berjumpa dengan doktor dan beritahu dia tentang aliran haid yang banyak, saya disuruh untuk makan hati
(Laughter)
(Ketawa)
And when I went to the drug store to buy my menstrual products, my 48-pack of super maxi pads, back in the day when they were the size of a tissue box, each pad --
Dan apabila saya ke farmasi untuk membeli barangan datang bulan, Tuala wanita super maxi bersaiz 48 inci, yang dulu saiznya seperti kotak tisu bagi setiap satu--
(Laughter)
(Ketawa)
You know what I'm talking about. You have no idea how far absorbent technology has come.
Anda tahu apa saya maksudkan. Bayangkan betapa canggihnya teknologi penyerapan pada masa ini.
(Laughter)
(Ketawa)
I used to have to buy my menstrual products in the feminine hygiene aisle. And I remember standing there, thinking, "Well, why don't I buy toilet paper in the anal hygiene aisle?"
Saya biasanya beli barangan datang bulan di lorong bahagian penjagaan wanita. dan saya masih ingat yang saya berdiri di situ sambil berfikir, "Kenapa tidak pula saya membeli tisu tandas di lorong penjagaan dubur? "
(Laughter)
(Ketawa)
Like, what's up with that? Why can't we talk about periods? And it's not about the blood, as Freud would have you say, because if it were, there would be an ear, nose and throat surgeon up here right now, talking about the taboos of nose bleeds, right? And it's not even about periods, because otherwise, when we got rid of our toxic, shameful periods when we became menopausal, we'd be elevated to a higher social status.
Macam, apa kena semua ini? Kenapa tidak boleh kita bercakap tentang datang bulan? dan ianya bukan sekadar darah seperti yang dikatakan Freud kerana jika ianya begitu, akan ada doktor bedah telinga, hidung dan tekak muncul di sini bercakap tentang pantang larang hidung berdarah, betul? Ia juga bukan sekadar tentang datang bulan, kerana jika tidak, apabila haid yang memalukan itu sudah tiada atau apabila kita putus haid, sudah pasti status sosial kita akan meningkat
(Laughter)
(Ketawa)
(Applause)
(Tepukan)
It's just a patriarchal society is invested in oppressing women, and at different points in our lives, different things are used. And menstruation is used during what we in medicine call the reproductive years. It's been around since pretty much the beginning of time, many cultures thought that women could spoil crops or milk, or wilt flowers. And then when religion came along, purity myths only made that worse. And medicine wasn't any help. In the 1920s and '30s there was the idea that women elaborated something called a menotoxin. We could wilt flowers just by walking by.
Ia hanya cuma budaya masyarakat patriarki yang menindas kaum wanita. Pada sesuatu tahap dalam kehidupan, berbagai-bagai pekara dijadikan alasan. dan datang bulan digunakan semasa kami panggil tahun akil baligh dalam istilah perubatan. Ianya sudah lama wujud, Menurut kebanyakan budaya, wanita boleh merosakkan hasil tuaian susu atau melayukan bunga Dan apabila datangnya agama, mitos kesucian hanya memburukkan keadaan. dan perubatan juga tidak terkecuali. Pada 1920-an dan 30-an, ada pendapat mengatakan wanita menghasilkan menotoksin. Kita boleh melayukan bunga hanya dengan melintasinya.
(Laughter)
(Ketawa)
And that's what happens when there's no diversity, right. Because there was no woman to put her hand up and go, "Well, actually, that doesn't happen." And when you can't talk about what's happening to your body, how do you break these myths? Because you don't even need to be a doctor to say that periods aren't toxic. If they were, why would an embryo implant in a toxic swill? And if we all had this secret menotoxin, we could be laying waste to crops and spoiling milk.
Dan apabila terjadinya tiada kepelbagaian, betul? kerana tiada wanita yang berani angkat tangan dan berkata, "Sebenarnya, bukan itu yang terjadi" Apabila anda tidak boleh bercakap tentang apa yang berlaku kepada badan anda, bagaimana mitos ini akan hilang? Anda tidak perlu menjadi sorang doktor untuk mengatakan yang haid itu tidak berbahaya Jika bahaya, bagaimana janin dapat tersemai dalam keadaan bertoksik? dan jika kita semua mempunyai racun menotoksin rahsia ini, tentu kita dapat merosakkan hasil tuaian dan susu
(Laughter)
(Ketawa)
Why would we have not used our X-Women powers to get the vote sooner?
Kenapa kita tidak gunakan kuasa Wanita-X untuk mendapatkan undian dengan cepat?
(Laughter)
(Ketawa)
(Applause)
(Tepukan)
Even now, when I tweet about period diarrhea, as one does,
Sehingga kini, apabila saya menciap tentang cirit-birit ketika haid seperti selalu,
(Laughter)
(Ketawa)
I mention that it affects 28 percent of women. And every single time, someone approaches me and says, "I thought I was the only one." That's how effective that culture of shame is, that women can't even share their experiences.
Saya akan sebut yang ia mempengaruhi 28 peratus daripada wanita. Setiap kali seseorang mendekati saya mereka berkata, "Saya ingatkan cuma saya seorang sahaja" Begitulah betapa berkesannya budaya malu sehingga wanita tidak boleh berkongsi pengalaman mereka.
So I began to think, "Well, what if everybody knew about periods like a gynecologist? Wouldn't that be great?" Then you would all know what I know, you'd know that menstruation is a pretty unique phenomenon among mammals. Most mammals have estrus. Humans, some primates, some bats, the elephant shrew and the spiny mouse menstruate. And with menstruation what happens is the brain triggers the ovary to start producing an egg. Estrogen is released and it starts to build up the lining of the uterus, cell upon cell, like bricks. And what happens if you build a brick wall too high without mortar? Well, it's unstable.
Jadi, saya mula berfikir "Apa kata semua orang tahu tentang haid seperti pakar sakit puan?" "Bukankah itu hebat?" Anda semua tahu apa yang saya tahu Anda tahu yang haid itu fenomena yang unik bagi mamalia Hampir semua mamalia adalah estrus (yang datang bulan) Manusia, sesetengah haiwan primata, sesetengah kelawar, tikus gajah dan tikus berduri juga mengalami haid Apa yang terjadi ketika haid adalah otak akan merangsang ovari untuk penghasilan telur. Hormon estrogen akan dirembes dan mula membentuk lapisan dinding rahim sel-bersel seperti bata dan apa terjadi jika dinding bata dibina terlalu tinggi tanpa dilepa? Sudah tentu ia tidak stabil.
So what happens when you ovulate? You release a hormone called progesterone, which is progestational, it gets the uterus ready. It acts like a mortar and it holds those bricks together. It also causes some changes to make the lining more hospitable for implantation. If there's no pregnancy, (Whoosh) lining comes out, there's bleeding from the blood vessels and that's the period. And I always find this point really interesting. Because with estrus, the final signaling to get the lining of the uterus ready actually comes from the embryo. But with menstruation, that choice comes from the ovary. It's as if choice is coded in to our reproductive tracts.
Jadi, apa yang terjadi ketika fasa ovulasi? Hormon yang dipanggil progestron akan dirembeskan, yang bersifat progestasional untuk menyediakan rahim. Ia bertindak seperti lepa yang melekatkan batu-bata. Ia juga menyebabkan beberapa perubahan supaya lapisan rahim lebih sesuai untuk pengimplanan. Jika tiada kehamilan, (Whoosh) lapisan dinding rahim akan luruh. Pendarahan berlaku di saluran darah dan berlakulah haid. Saya selalu merasakan poin ini sangat menarik Disebabkan dengan estrus, isyarat terakhir untuk mempersiapkan rahim, sebenarnya datang daripada embrio Tapi dengan haid, pilihan itu datang dari ovari. Seolah-olah pilihan sudah diprogram dalam sistem reproduktif kita.
(Cheering and applause)
(Sorakan dan tepukan)
OK, so now we know why the blood is there. And it's a pretty significant amount. It's 30 to 90 milliliters of blood, which is one to three ounces, and it can be more, and I know it seems like it's more a lot of the times. I know. So why do we have so much blood? And why doesn't it just stay there till the next cycle, right? Like, you didn't get pregnant, so why can't it hang around? Well imagine if each month it got thicker and thicker and thicker, right, like, imagine what tsunami period that would be.
Baik, sekarang kita sudah tahu kenapa adanya pendarahan. Dan jumlahnya agak signifikan. 30 ke 90 mililiter darah, dalam 1-3oz, dan ia boleh jadi lebih banyak, dan saya tahu ianya sering lebih banyak Saya tahu Jadi, kenapa kita ada banyak sangat darah? dan kenapa ia tidak kekal di situ sehingga kitaran seterusnya, betul? Anda tidak mengandung, jadi kenapa tidak dibiarkan sahaja? Bayangkan jika setiap bulan ia menebal dan semakin menebal, betul, haid anda tentu menjadi tsunami
(Laughter)
(Ketawa)
We can't reabsorb it, because it's too much. And it's too much because we need a thick uterine lining for a very specific reason. Pregnancy exerts a significant biological toll on our bodies. There is maternal mortality, there is the toll of breastfeeding and there is the toll of raising a child until it is independent. And evolution --
Kita tidak boleh menyerap semula kerana ia terlampau banyak. Dan ia terlalu banyak kerana kita perlukan lapisan rahim yang tebal untuk sebab yang sangat spesifik. Kehamilan mendedahkan diri kita kepada tanggungjawab dan risiko biologi. Terdapat kadar kematian ibu, jumlah ibu menyusu dan membesarkan anak sehingga mereka boleh berdikari Dan evolusi--
(Laughter)
(Ketawa)
That goes on longer for some of us than others.
Sesetengah orang ambil masa lama untuk faham
(Laughter)
(Ketawa)
But evolution knows about risk-benefit ratio. And so evolution wants to maximize the chance of a beneficial outcome. And how do you maximize the chance of a beneficial outcome? You try to get the highest quality embryos. And how do you get the highest quality embryos? You make them work for it. You give them an obstacle course. So over the millennia that we have evolved, it's been a little bit like an arms race in the uterus, the lining getting thicker and thicker and thicker, and the embryo getting more invasive until we reach this détente with the lining of the uterus that we have.
Tapi evolusi tahu tentang nisbah risiko dan manfaat. Maka, evolusi ingin memaksimakan peluang hasil yang bermanfaat dan bagaimana anda memaksimakan peluang itu? Anda cuba dapatkan embrio dengan kualiti terbaik dan bagaimana cara untuk dapatkannya? Anda membuatkan ia berusaha. Anda memberinya cabaran. Setelah berevolusi untuk beberapa tahun, ianya seperti perlumbaan senjata di dalam rahim lapisan dinding rahim semakin menebal malah embrio pula semakin membesar sehingga ia menjadi satu dengan lapisan dinding rahim kepunyaan kita
So we have this thick uterine lining and now it's got to come out, and how do you stop bleeding? Well, you stop a nose bleed by pinching it, if you cut your leg, you put pressure on it. We stop bleeding with pressure. When we menstruate, the lining of the uterus releases substances that are made into chemicals called prostaglandins and other inflammatory mediators. And they make the uterus cramp down, they make it squeeze on those blood vessels to stop the bleeding. They might also change blood flow to the uterus and also cause inflammation and that makes pain worse.
Kini, kita ada lapisan dinding rahim yang tebal dan tiba masanya untuk luluh Bagaimana anda menghentikan pendarahan? Jika hidung berdarah, anda picit untuk hentikannya Jika kaki luka, anda menekannya Kita hentikan penderahan dengan tekanan Ketika datang bulan dinding rahim akan mengeluarkan bahan-bahan kimia yang dipanggil prostaglandin dan pengantara keradangan yang lain yang menyebabkan rahim kekejangan dan penguncupan pada salur darah untuk menghentikan pendarahan Ia juga boleh mengubah arah aliran darah ke rahim sehingga menyebabkan keradangan dan lebih menyakitkan
And so you say, "OK, how much pressure is generated?" And from studies where some incredible women have volunteered to have pressure catheters put in their uterus that they wear their whole menstrual cycle -- God bless them, because we wouldn't have this knowledge without, and it's very important knowledge, because the pressure that's generated in the uterus during menstruation is 120 millimeters of mercury. "Well what's that," you say. Well, it's the amount of pressure that's generated during the second stage of labor when you're pushing.
Anda mungkin bertanya "OK, berapa banyak tekanan dihasilkan?" Mengikut kajian di mana beberapa wanita hebat telah sukarela dipasangkan kateter pada rahim mereka untuk tempoh lengkap kitaran haid mereka Jika bukan kerana mereka, kita tidak akan mengetahuinya dan ianya ilmu yang sangat penting kerana tekanan yang dihasilkan di rahim ketika datang bulan adalah sebanyak 120 mililiter merkuri "Apa itu?", tanya anda. Ianya jumlah tekanan yang dihasilkan ketika fasa kedua kelahiran iaitu semasa anda meneran
(Audience gasps)
(Audiens merengus)
Right. Which, for those of you who haven't had an unmedicated delivery, that's what it's like when the blood pressure cuff is not quite as tight as it was at the beginning, but it's still pretty tight, and you wish it would stop. So that kind of makes it different, right? If you start thinking about the pain of menstruation, we wouldn't say if someone needed to miss school because they were in the second stage of labor and pushing, we wouldn't call them weak. We'd be like, "Oh my God, you made it that far," right?
Baik Bagi yang tidak pernah tidak dibius ketika melahirkan begitulah rasanya bila tekanan darah mencengkam ianya tidaklah sekuat awal-awal tapi tetap ketat dan anda berharap yang ia berhenti. Jadi, ia membuatkan menjadi berlainan, betul? Jika anda mula terfikir tentang senggugut kami tak akan cakap yang seseorang kena ponteng sekolah sebab mereka sedang melalui fasa kedua kelahiran dan meneran kami tidak akan panggil mereka lemah Reaksi kami hanya "Awak berjaya lakukannya", betul?
(Laughter)
(Ketawa)
And we wouldn't deny pain control to women who have typical pain of labor, right? So it's important for us to call this pain "typical" instead of "normal," because when we say it's normal, it's easier to dismiss. As opposed to saying it's typical, and we should address it.
Kita tidak akan menolak ubat tahan sakit untuk wanita mengalami sakit bersalin, betul? Jadi, ia penting untuk kita panggil sakit ini sebagai "khas" berbanding "biasa", sebab bila kita panggilnya biasa, ia senang diremehkan berlainan jika dipanggil "khas" dan kita patut panggilnya begitu
And we do have some ways to address menstrual pain. One way is with something called a TENS unit, which you can wear under your clothes and it sends an electrical impulse to the nerves and muscles and no one really knows how it works, but we think it might be the gate theory of pain, which is counterirritation. It's the same reason why, if you hurt yourself, you rub it. Vibration travels faster to your brain than pain does.
Kita ada beberapa cara untuk mengetahui sakit sengugut Salah satunya dengan alat TENS yang dipakai di bahagian dalam baju untuk menghantar impuls elektrik kepada saraf dan otot dan tiada siapa pun betul-betul tahu cara ia berfungsi Kami rasa ianya mungkin berdasarkan teori 'gate control' yang bersifat mengurangkan kesakitan Sebab yang sama juga kenapa bila sakit, kita gosok Getaran tersebar dengan lebih cepat ke otak berbanding sakit
We also have medications called nonsteroidal anti-inflammatory medications. And what they do is they block the release of prostaglandins. They can reduce menstrual pain for 80 percent of women. They also reduce the volume of blood by 30 to 40 percent and they can help with period diarrhea. And we also have hormonal contraception, which gives us a thinner lining of the uterus, so there's less prostaglandins produced and with less blood, there's less need for cramping.
Kami juga ada ubat-ubatan yang dipanggil ubat anti-radang bukan steroid (NSAID) yang berfungsi untuk menghalang penghasilan prostaglandin Ia dapat mengurangkan senggugut untuk 80 peratus daripada wanita dan mengurangkan isi padu darah kepada 30 ke 40 peratus juga membantu mengatasi cirit-birit ketika haid Kami juga ada pil hormon yang berfungsi untuk menipiskan lapisan dinding rahim supaya prostaglandin dihasilkan dengan sedikit Dengan kurangnya darah, maka akan kurangnya senggugut
Now, if those treatments fail you -- and it's important to use that word choice, because we never fail the treatment, the treatment fails us. If that treatment fails you, you could be amongst the people who have a resistance to nonsteroidal anti-inflammatories. We don't quite understand, but there are some complex mechanisms why those medications just don't work for some women. It's also possible that you could have another reason for painful periods. You could have a condition called endometriosis, where the lining of the uterus is growing in the pelvic cavity, causing inflammation and scar tissue and adhesions. And there may be other mechanisms we don't quite understand yet, because it's a possibility that pain thresholds could be different due to very complex biological mechanisms. But we're only going to find that out by talking about it.
Jika rawatan itu tidak berkesan kepada anda Wajib anda gunakan ayat itu kerana kita tidak akan pernah menggagalkan rawatan Sebaliknya, rawatan yang gagal untuk kita Jika rawatan gagal untuk anda, anda mungkin tergolong dalam kalangan yang mempunyai rintangan kepada ubat anti-keradangan bukan steroid Kita tidak begitu faham tapi sesetengah mekanisme adalah kompleks Kenapa ubatan itu tidak berkesan untuk sesetengah wanita Ia juga berkemungkinan yang anda mempunyai sebab lain yang menyebabkan haid yang menyakitkan Anda mungkin ada endometriosis iaitu lapisan dinding rahim tumbuh di rongga pelvis yang menyebabkan keradangan, parut dan lekatan Mungkin ada mekanisme lain yang kami belum cukup faham oleh sebab tahap kesakitan yang berbeza-beza disebabkan mekanisme biologi yang sangat kompleks Kita akan tahu hanya dengan berbicara tentangnya
It shouldn't be an act of feminism to know how your body works. It shouldn't --
Ia tidak sepatutnya menjadi perjuangan feminisme untuk mengetahui cara tubuh anda berfungsi. Tidak sepatutnya--
(Applause)
(Tepukan)
It shouldn't be an act of feminism to ask for help when you're suffering. The era of menstrual taboos is over.
Ia tidak sepatutnya menjadi perjuangan feminisme untuk meminta tolong ketika anda kesakitan Era pantang-larang haid sudahpun berakhir
(Cheers and applause)
(Sorakan dan tepukan)
The only curse here is the ability to convince half the population that the very biological machinery that perpetuates the species, that gives everything that we have, is somehow dirty or toxic. And I'm not going to stand for it.
Sumpahan yang kini tinggal hanyalah kebolehan untuk meyakinkan separuh daripada populasi yang ianya cuma mesin biologi untuk mengekalkan spesis yang memberikan semua apa yang kita ada Ia mungkin dianggap kotor atau toksik tapi saya tidak akan membiarkannya
(Applause)
(Tepukan)
And the way we break that curse? It's knowledge.
Dan cara untuk meleraikan sumpahan itu? Ia ialah ilmu.
Thank you.
Terima kasih.
(Cheers and applause)
(Sorakan dan tepukan)