The science of the ovarian “biological clock” and other reproductive health metaphors is wrong

Scientists still don’t know much about the female reproductive system. They don’t know how to treat the most common vaginal infection, bacterial vaginosis. They don’t have good solutions for many people who suffer from endometriosis, a common and sometimes incredibly painful condition in which tissue-like tissue grows inside the uterus elsewhere in the body. They still have many questions about how menopause affects the body.

A few years ago, reproductive health science reporter Rachel Gross set out to write a book about the mysteries of the female reproductive system. But as she got into the research, she began to wonder about the phrase she used — the term “female reproductive system.”

First, not all of the bodies he studied were female. He talked to non-binary people, intersex people, trans people; This anatomy is relevant and close to all people.

Also, the idea that these organs – the clitoris, the vagina, even the ovaries – only play a role in reproduction is beginning to feel reductive. Of course, these organs are involved in childbirth, but, she says, “I’ve found that they’re not just sexual, they’re huge and often overlooked, but they’re involved in immunity and defense. regeneration”.

on inexplicable — A Vox podcast exploring big mysteries, unanswered questions, and everything we learn from diving into the unknown — Gross speaks of one of these organs: the ovaries. He tells us a familiar story: the ovaries are “biological clocks” that only lose eggs, never again. But then, she walks us through new research that calls this idea into question, suggesting that the ovaries can create new eggs using stem cells.

And, Gross explains, this new way of understanding and imaging the ovaries could lead to new fertility treatments, but also new ways to treat menopause-related health effects, such as bone loss.

In his book, The Unknown Vagina: An Anatomical Journey, Gross finds many examples of metaphors such as the “ticking clock” of motherhood. even all the stories about the various organs of the pelvis, which hindered science and perhaps left scientists unable to solve some of the big questions about these organs.

“When you study the human body, even though the human body doesn’t change, you really see what you expect … and you just blur the rest,” he says.

I asked Gross to review some more examples from his book. Our interview below has been edited for clarity and length.

Byrd Pinkerton

What is an example of an agency that tells us the wrong story and how it has misled science?

Rachel Gross

So, a great example is the clitoris. For hundreds and hundreds of years it has been called a small phallus or an underdeveloped penis or a small testicle. And science has reduced it in various ways, from literally leaving it in anatomy textbooks to ignoring 90 percent of it.

A female urologist says, “Wait, there are far fewer studies on the female side than on the male side. “We haven’t looked at all the nerves and erectile organs.”

He found out that the clitoris has these veins and these bulbs that actually hug the vagina and swell with blood and become erectile like a penis. So you have the exact same erectile tissue, you have the head – or clitoral head – which is the part that you can see and touch. But then you have the shaft going back into the body and you have the bulbs and the arms flowing back into the hips. And all of these consist of erectile tissue like the penis.

These are very important for women operating in this area who do not want to have their nerves cut.

If you look [the clitoris] as a homologous organ [to the penis]you will come to a different conclusion than a small phallus or a little nub that is hard to find.


This video covers another misconception that scientists have been telling for decades—the role of sperm and egg in fertilization.

Byrd Pinkerton

[At the beginning of her book, Rachel Gross describes a personal experience. She got a persistent vaginal infection, and her gynecologist recommended that she put boric acid in her vagina. The poison would kill a lot of the organisms in her vagina, including, hopefully, the one causing her problems.

Boric acid is also used as a rat poison, however, so the harshness of the treatment surprised Gross. And as she dived into the research, she realized that a new way of imagining the vagina might lead to more effective, less poisonous treatments.]

You mentioned putting this boric acid in your sheath. Is this treatment based on an outdated story or a metaphor that people around the scabbard are revising?

Rachel Gross

So I think there’s a strict attitude towards the vagina… it has to be clean, it has to be clean, it has to be sterile. And that’s where you get all the vaginal cleaning products. What blew my mind was looking at the microbiome of the vagina, and instead it’s a full protective ecosystem.

Byrd Pinkerton

What is the vaginal microbiome?

Rachel Gross

So you’ve heard about the gut microbiome, the special bacteria that help maintain the digestive system.

Byrd Pinkerton

Yes.

Rachel Gross

Your vagina also has a microbiome that is truly unique to humans. It is a mildly acidic environment created mostly by bacteria called lactobacilli, as well as other bacteria, some viruses, and fungi. And they all live in harmony and protect you from invaders and keep this limited space healthy, not with you. Tampons, seeds, birth control, jade eggs, whatever else you put in… your vagina seems to be responding, protecting you, and reaching a new balance.

Byrd Pinkerton

Interesting So if you think of that space as a garden to protect against invaders, it seems like a reimagining of putting rat poison in the middle of your garden.

Rachel Gross

For sure. If you think of it as a garden, and it’s good to have weeds and different species in the garden, this rat poison isn’t going to destroy it. It’s about growing the right mix. This has led to innovations in vaginal microbiome transplants, or probiotics that can terraform the vagina. All of these different ideas aren’t sure if they’ll all work, but there are plenty of clever and imaginative ways to think about having a healthy vagina.

Byrd Pinkerton

So we know nothing about our body? Or is it just the stories we tell ourselves that shape the directions we take?

Rachel Gross

I think we know a lot about bodies and use that knowledge in a very practical way in medicine to heal and improve them. But language has the object of simply guiding the questions we ask and the questions we find interesting and valuable. So, could you hang this lens a little to the left, on the part where everything is blurry, and focus on that? And what would you see?

Byrd Pinkerton

How can you change the lens of what we know about the reproductive system?

Rachel Gross

By introducing new people with new knowledge to science, asking them questions and getting them interested in what they are interested in. And we’ve had very similar lenses for a long time.

You had people who represented the male body as something and viewed the female body as an afterthought or reproductive thing. This is basically an interesting difference between body types. Well, once my whole book gets new voices and people in science, the whole lens changes in really interesting ways.

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