Menstrual Health

We take a biocultural approach to understanding menstruation across ethnicities and race in cisgender women and transgender people because gendered norms necessarily influence the hormonal axes that regulate menstruation. They also impact how we study these axes and their correlation to various disease outcomes.

Our work with Mongolian women has demonstrated that breastfeeding duration and living a more nomadic lifestyle versus an urban one influences hormones across the menstrual cycle. Our work with people of trans experience has further highlighted that menstrual discourse is deeply gendered. Terms such as "feminine hygiene" and "women's health" make transmasculine and nonbinary people acutely aware that they fall outside the ideal of the default menstruator.  Our work with transgender women continues to explore the hormonal underpinnings of the cycle symptoms that transgender women experience while on gender affirming hormone therapy and what relationship those symptoms have with their cultural experience of menstruation.

Finally, we are working to overcome limitations imposed by gendered thinking about menstrual health research and its application to other health outcomes. Historically, this research has been dictated by dismissive notions that hormonal variation in females is unpredictable, noisy, and difficult to account for in experimental designs. For example, much of research and clinical tests with premenopausal women target hormone collection on day 21 of the menstrual cycle, ignoring how hormones during other phases of the cycle may be implicated in disease risk.

To undo these practices, we have worked with colleagues Jeff Goldsmith, PhD, Columbia University Mailman School of Public Health, and Julie Herbstman, MSc, PhD, Columbia University Mailman School of Public Health to develop a prediction tool that pinpoints menstrual cycle day within a 2-3 day window of accuracy. Such prediction can improve studies as well as refine current diagnostics for numerous outcomes that vary over the menstrual cycle such as breast cancer, cardiovascular risk, and mental health disorders. Our lab also collects  menstrual cycle data using menstrual tracking apps in longitudinal cohorts to understand variations and norms of menstruation and how these can be used as critical health indicators for chronic diseases