What’s exciting from the start of Kissling’s book is that her topic, menstruation, brings together women’s and cultural studies. Both disciplines have something smart and useful to contribute. Kissling takes advantage of the feminist cultural critique that has sprung up on the web and in print magazines over the past decade. It is shame that Kissling does not situate her work against the growing field of consumer and ad theorists—in part because her consumer studies critique is right on the mark. Regardless, her wide-ranging work is a good introduction to the troubled collision between women and the medicalized, capitalist world.

Menstruation, Kissling says, “is both a biological event and a cultural event; the biology cannot be separated from the culture, and neither is a predetermined category with consistent impact on individual women’s lives…Indeed,” she goes on, “how a society deals with menstruation may reveal a great deal about how that society views women.” She focuses in this book on menstruation culture in the US, pointing out that “in our postmodern era, a woman’s relationship to her menstrual cycle is mediated through consumerism… menstruation provides an opportunity for participation in consumer culture.” Her main concern is three cultural aspects of menstruation: its portrayal in advertising and television, the medicalization (and subsequent marketing) of the menstruating body, and countercultural menstrual products and depictions.

Kissling’s analysis of the social significance of menstruation is rooted in the philosophy of Simone de Beauvoir, with its combination of feminism and materialism, and its tolerance for ambiguity. One of the first thinkers to consider menstruation, Beauvoir believed that women’s condition had its roots in humans’ lack of a fixed nature and thus in their constant self-creation: “one is not born, but rather becomes a woman,” as she famously said. Explains Kissling, “Much of The Second Sex is concerned with delineating the process by which individuals internalize and adopt cultural norms they did not create.” Women absorb these cultural norms through media, such as television, film and marketing. Beauvoir is Kissling’s jumping-off point, providing the reason for critically examining the market that developed around menstruation: “Discourses of menstruation in media and popular culture more than fifty years after Beauvoir … continue to reflect and reinforce women’s alterity” says Kissling. This, for better or worse, is the main role of Beauvoir in Kisslings’ book—her thinking provides a reason for the analysis, but it does not offer much, nor does Kissling ask it to, in the way of a framework through which to analyze the patterns of consumerism at hand.

Kissling begins by examining the trickiness of marketing a product most people will not acknowledge in polite conversation. Feminine hygiene products, as they are euphemistically called, were first sold commercially in the late 1800s, with tampons arriving on the market in the 1930s. At first, Kissling notes, sellers placed “a collection box near a display of “discreetly wrapped boxes of Kotex, so women could just put money in the container and take the pads without having to ask for them.”

Under capitalism, nothing is taboo so long as it turns a profit. Now, since nearly all US women use commercially produced supplies, companies must attract them at as early an age as possible—studies show that consumers are highly loyal to the products they first use as teenagers. Thus, the “femcare” industry produced a bevy of films, informational brochures, and free samples directed at young women and the teachers and mothers in charge of their education. This educational approach has subtly pernicious side effects, as advertisers begin “to interpret culture for consumers,” says Kissling. They portray menstruation as “a hygiene crisis that one must clean up, in secret, so that one’s public projection of ideal femininity is not damaged or polluted.” There have been occasional moves away from this idea—notably in the 1970s, when the “freedom” of tampons was briefly linked to women’s social and political gains—but “fresh, clean and hidden” has remained the industry’s dominant message.

In addition to advertising, Kissling considers the rare occasions when menstruation is addressed in film and television. Menarche onscreen, she says, is generally a marker, “a powerful reminder or signifier to these women that no matter what they do or say, or how they live their lives, they are still female and Other.” Television, more than film, has dared to depart from this standard narrative. Shows from Everwood to 7^th Heaven have included menarche storylines. Notably, two beloved shows of the late 1980s and early 90s, The Cosby Show and Roseanne, offered storylines in which menarche became an occasion for celebration and rebuttal of traditional notions of femininity. When Roseanne’s daughter Darlene, the tomboy of the family, gets her period, she begins throwing away all her sports equipment. Roseanne stops her and explains to her daughter that her bats and balls “are a woman’s things—as long as a woman uses them.” Such positive portrayals of menstruation onscreen are a hopeful sign, says Kissling. “Perhaps one day, menstruation will become a fact of life for everyone, onscreen and off, rather than each woman’s paradoxical secret shame and pride.”

Kissling then turns to the medicalization of menstruation, looking first at premenstrual “syndrome.” She chronicles the heated fight over including some form of menstrual mood disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Although PMS was first suggested as a diagnosis by a male doctor in 1931, the backlash against the codifying of female biology as a medical problem began in earnest in the late 1970s. Many prominent feminist writers, including Emily Martin, Barbara Ehrenreich, and Deirdre English, criticized the way “uniquely female biological processes, most notably childbirth, [had] come to be treated as diseases as the modern medical profession evolved.” The DSM eventually recognized “premenstrual dysphoric disorder”—treatable by Eli Lilly’s antidepression drug Prozac, remarketed as Sarafem. The two drugs are identical, save that Sarafem is coated pink instead of green. Kissling’s examination here is part of a growing movement of writers and activists that views pharmaceutical companies not as kind benefactors intent on saving lives but as companies like any others, which look only to the bottom line.

Next, Kissling turns to hormonal birth control. Seasonale, introduced by Barr Laboratories in 2003, shifts women from 30 to 90 day cycles—just four periods a year. This is not merely a birth control method—it is, in the words of the original Seasonale website, a “lifestyle choice.” Kissling fears that this twist plays into cultural beliefs that menstruation is an obstacle, an inconvenience that women must overcome:

Clearly, many of the menstruation-related health problems menstrual suppression purports to solve are not caused by menstruation, but by US society’s prescribed treatment of menstruation. As historians of women’s health have documented, the promotion of Seasonale isn’t the first time the pharmaceutical and healthcare industries have recommended hormonal adjustments for problems best remedied by attitude adjustments.

In the final section of the book she uses the debate over the toxicity of tampons as the launching point for an examination of the menstrual counterculture and alternatives to standard menstrual products. Toxic Shock Syndrome, which was linked to tampon use in the early 1980s, sparked a revolution among activists, who called companies to account for the ways in which feminine hygiene products are manufactured. “In a climate in which there is little other public communication about menstruation, concerns about tampon safety are difficult for many to address. They’re also unprofitable,” notes Kissling.

She then turns to the menstrual counterculture that has arisen to confront tampon safety concerns. Her examination of anti-tampon activists however, is limited to a largely third-wave feminist, online- and college campus-based crowd. This crop of menstrual activists, although vocal critiques of tampon safety, often provided incomplete information or used words such as “wimmin” or “yonis” that can alienate the non-initiated. Still, anti-tampon activists have helped make alternative products, such as the Keeper and other internal cups, as well as organic tampons and pads, more widely available, says Kissling.

Kissling surveys these products and their marketing, which she finds “strikingly different,” from that of mainstream products. Ecologically conscious manufacturing is usually the selling point—rather than the usual “fresh, absorbent, discreet.” Ads for alternative products often discuss menstruation and female anatomy in ways that Kissling finds positive. At the now-defunct Eco-Logique cloth pad website, women were encouraged to examine their external genitalia. Compare this to Kotex ads, in which women are encouraged to accept the “power of hormone surges over your emotions.” I found it odd that Kissling gives little more than a mention to Instead—a disposable menstrual cup that has been on the market since 2000, and the only such product that is widely available outside of alternative and mail-order sources. This type of oversight crops up throughout Kissling’s book—she explains that she selected products and advertisements on the basis of “easy availability rather than by systematic searching or random sampling,” but this choice frequently limits the strength of her conclusions.

Finally, Kissling considers several countercultural projects—activist Geneva Kachman’s “menstruMobile” and “Menstrual Monday” holiday; Harry Finley’s online “Museum of Menstruation and Women’s Health” (www.mum.org); and pop-culture venture capitalist Vinnie D’Angelo’s “Vinnie’s Tampon Cases.” The fact that these last two projects are run by “nonmenstruators” worries Kissling:

My hesitation in fully endorsing these projects is situated in the larger struggle this book wrestles with over who “owns” menstruation. I favor greater openness and less shame regarding menstruation for both women and men, and I don’t consider maleness or masculinity disqualifying characteristics for menstrual activists and educators. Yet I remain uneasy with a menstrual counterculture in which the most visible projects are created and promoted by nonmenstruators. It seems premature in a society in which so few of those who do menstruate are able to safely and freely claim that identity publicly.

I differ with Kissling on this point—I was in my late teens when D’Angelo introduced his rough canvas cases emblazoned with a 1950s-style truck driver cheerfully piloting a tampon van. My friends and I considered it a strange, funny victory to use menstrual products made by a man. Still, I appreciate Kissling’s concern about who has cultural permission to break menstrual taboos.

Overall, Kissling provides a needed overview of the pitfalls of cultural representations of menstruation in the United States. Her questions about who drives our cultural narratives about menstruation, and what this means for the health and well-being of women, is sure to make readers spend their next few weeks quite conscious of when and how they hear menstruation discussed. Kissling suggests that this type of awareness will bring change:

[I]f our cycles mandate participation in consumer culture, we can use our voices and our dollars to insist that advertisers promote menstrual products on the basis of the merits of the products, instead of cloaking menstruation with shame and secrecy.

Although Capitalizing on the Curse offers an opening salvo in a war against market-based narratives of menstruation, more work on redefining how we talk and think about this part of womanhood remains, and will require a more extensive analysis of the cultural narratives. After all, as Beauvoir concludes,

Woman is the victim of no mysterious fatality; the peculiarities that identify her as specifically woman get their importance from the significance placed upon them. They can be surmounted, in the future, when they are regarded in new perspectives.

Phoebe Connelly is acting managing editor of In These Times, a monthly, progressive political magazine. She writes on political culture, human rights, and feminism.