What actually changed, and what did not

Where it leaves us

The modern era of this history is short. Menstrual bleeding was given standardised international terminology only in 2011, revised in 2018 — before that, "menorrhagia" meant whatever the clinician using it meant. The menstrual cycle was formally described as a vital sign, to be asked about at every visit, in 2015. Both of those are more recent than the mobile phone.

And the older patterns have not finished. Diagnostic delay in endometriosis is still measured in years, and the dominant contributor is normalisation of pain by patients, families and clinicians alike — which is the Aristotelian and Levitical inheritance still operating, in a consulting room, in the present tense. The definition of heavy menstrual bleeding still has no agreement between the research threshold, the quality-of-life definition, and the public-health criteria. We are better than Pliny. We are not finished.

Which is the reason this site keeps returning to one sentence: a period is progesterone withdrawal following an ovulation. That was not obvious. It was not knowable by observation. It took from de Graaf to Corner and Allen — two hundred and fifty-seven years — and everything believed before it was an attempt to explain a visible effect without access to its invisible cause.

Continue: the mechanism itself · every abnormality, named · the first period.