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This article is undergoing a featured article review. A featured article should exemplify Misplaced Pages's very best work, and is therefore expected to meet the criteria. Please feel free to leave comments or be bold and improve the article directly. If the article has been moved from its initial review period to the Featured Article Removal Candidate (FARC) section, you may support or contest its removal.

This is the talk page for discussing improvements to the Menstrual cycle article. This is not a forum for general discussion of the article's subject.

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	Menstrual cycle is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Misplaced Pages community. Even so, if you can update or improve it, please do so.
	This article appeared on Misplaced Pages's Main Page as Today's featured article on August 30, 2005.
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This is the talk page for discussing improvements to the Menstrual cycle article. This is not a forum for general discussion of the article's subject.

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Featured article review needed

This is a Featured article that was promoted in 2004 and last reviewed in 2008 that has not been maintained to WP:WIAFA standards. At the time of its last review, it was 3,200 words of readable prose, but is now at 6,000 words, so a good deal of the text in the article has not been vetted in a content review process. There is considerable uncited text, and sourcing that does not comply with WP:MEDDATE. There are maintenance and citation problems evident throughout: sample, in the "Mate choice" section, the same dated book is cited multiple times (repeated) with page ranges that are too broad for verification. In fact, that same book is used extensively throughout the article, again, with page ranges too broad for verification and raising concern about UNDUE. There are short stubby sections. Some of the content does not stay tightly focused (sample, birth control). Acronyms are defined multiple times throughout the article, but then not used. Why is the "Other interventions" section hanging out there alone? "Other" relative to what? The society and culture section could be a tighter summary of the main article. Sample problems are found throughout, suggesting a top-to-bottom review and rewrite is needed, sample: Studies investigating effects of the menstrual cycle on alcohol consumption have found mixed evidence. However, some evidence suggests that individuals consume more alcohol during the luteal stage, especially if these individuals are heavy drinkers or have a family history of alcohol abuse. The first sentence can be tightened and the second is cited to a 2010 theory. A Featured article review to re-assess this article should be initiated. SandyGeorgia (Talk) 17:40, 24 January 2021 (UTC)

Readability issues

Often readers don't go past the first few paragraphs. I'd like to see improvements to the first few paragraphs to appeal to the average reader. Hopefully, the answer to the question "What is a menstrual cycle?" is presented right away in a clear and concise manner. I see a "readability" problem and so ran the lead through the Hemingway App. The readability report was "post-graduate," meaning one needs more than a college education to be able to understand the information. Of the 16 sentences, 11 were categorized as "very hard to read." Two were categorized as "hard to read." That means only 3 of the sentences were written for the average reader. A "readability" edit could improve the whole article. What about starting with just the lead? Then the authors could see if they agree that a readability edit would help. The goal is to improve clarity and conciseness without sacrificing accuracy.PlanetCare (talk) 02:45, 22 February 2021 (UTC)

Thanks. I am a bit confused how the featured article review process work. Should any comments about the article be posted there rather than here for now? @User:SandyGeorgia, please advise? EMsmile (talk) 03:13, 22 February 2021 (UTC)

Generally, once a Featured article review is open, anything relating to the criteria at WP:WIAFA should go there to be addressed. That said, I don’t think it helpful for this comment to go there. That this lead is dreadful is one thing; but none of those canned programs that assess readability are worth the paper they are printed on. We’ve had many discussions about this at WT:MED, but I’m sorry to say I don’t know how to point you to that information. At any rate, the readability of this lead is not anywhere near the main issue at the FAR; unless this article is seriously upgraded, it is not anywhere near FA level (and never really has been). The amount of work to be done here is in the body of the article— fixing the lead is usually best left ‘til last. Regards, SandyGeorgia (Talk) 03:16, 22 February 2021 (UTC)

the discussion that you had in mind is probably this one here, found it in the archive of the WikiProject Medicine talk pages. It was a discussion that I had started. See here. I agree with you that the lead won't be the main problem of this article but I agree with PlanetCare that she points out a flaw. If she decides to look at the lead first, this is perfectly valid. I think leads are often left to last for improvement and often are not improved in the end - which is ironic because it's the first thing the readers read (and often the only thing). But yes, the featured article review looks at other things first, I understand that. Anyhow, if there are people watching this page who want to work on the readability of this article (or just the lead), I would welcome that. If they want to use tools to identify which sentences most likely need improvement then that's up to them. If the tools are used with the right amount of brainpower and own thinking they can be useful. If they are used blindly, they are not (of course). EMsmile (talk) 10:37, 22 February 2021 (UTC)

I understand the point that maybe the lead isn't part off the current review. I "write to be read" and believe that it doesn't matter how good the rest of the article is if the reader doesn't get that far. I will happily work on other articles if the concensus is that there shouldn't be any work done on the lead.PlanetCare (talk) 14:05, 22 February 2021 (UTC)

The lead needs work, and if that’s what you want to work on, please do ! I was only pointing out that the readability tools aren’t very useful, and that the problems in this article are apparent at any rate, and go beyond the lead. That is, re-writing the lead isn’t sufficient to save the bronze star (although it may help our readers), and when rewriting the lead, if not keeping it in sync with the body, the article actually moves further from featured status. I didn’t mean to discourage you— just to answer the question EMSmile asked about the FAR process. Any improvement during a FAR is a good thing! SandyGeorgia (Talk) 14:29, 22 February 2021 (UTC)

The overlap/distinction between this article and menstruation needs to be sorted. Similar to menstruation, the flow in this article is all wrong, as they both approach menstruation/menstrual cycle as a pathology rather than a normal part of being a woman, and they each have disorders before discussion of the basics. I have tried to repair the leads, but the problem is throughout and I can’t do a lot from an iPad while my computer is in repair. I note that ejaculation is not written as a disorder. SandyGeorgia (Talk) 16:02, 22 February 2021 (UTC)

I can hardly say how good it is to have some women working on this article. I've had it on my list for years because I didn't like it one bit when I read it--though I just couldn't put my finger on just why... Now that it's been pointed out to me I understand that it is treating it like a disease. I never edited the article since all of these problems that women seem to be having were so foreign to me (even though I am a woman). All the jokes about women going completely off their rocker and how they could never be president because of their "monthlies" and such. Or saying she was "on the rag" (that's a really old one) if she acted in a perfectly normal assertive sort of way. You know, acted like a man is expected to act. OK, now to whether or not the first few paragraphs are too technical to understand. I don't like the idea of dumbing our articles down too much nor do I like the idea of catering our articles to those that have only enough interest to take them beyond less than a minute of time. Here for example of an excellent piece of information written for teens:

"A period happens because of changes in hormones in the body. Hormones are chemical messengers. The ovaries release the female hormones estrogen and progesterone . These hormones cause the lining of the uterus (or womb) to build up. The built-up lining is ready for a fertilized egg to attach to and start developing. If there is no fertilized egg, the lining breaks down and bleeds. Then the same process happens all over again."

For teens and many older adults this is. But I think that we have to keep in mind that we are an encyclopedia which IMO is here to stretch peoples knowledge a tad...or a lot. Unlike most informative articles we are able to link the more technical terms which makes the more difficult wording easily understandable. And if it is only for those willing to learn something, so be it. Gandydancer (talk) 17:16, 22 February 2021 (UTC)

Sheesh, the article reads like a disease. I can’t do much, and am making even more typos than usual because my computer is in repair (seems it did not want the full cup of coffee, cream and sugar I fed it), and I am iPad typing. I have tried to clear up some of the terminology by adding extra words here in there, but my editing is ineffective and more can be done. bst, SandyGeorgia (Talk) 17:34, 22 February 2021 (UTC)

I am not talking about "dumbing down" anything when I suggest we improve readability. Dumbing down implies your reader is dumber than you are. I don't believe that. I believe, instead, that Misplaced Pages readers have come for the truth, the whole truth, and nothing but the truth. They aren't as well read on the topic as authors are, but they want to be educated. I see it as our job to write so they can understand complex concepts. It's possible. I once helped a bunch of astrophysicists revise a grant so that someone who was not an astrophysicist could understand the proposal. I asked questions like "what did you mean by this sentence?" When they explained it to me, I wrote down an alternative sentence (using their exact words) and said "Is this what you meant?" Their problem was they were writing as if their audience was a bunch of astrophysicists. They DID know how to explain complex concepts to me. Eventually, they were open to questions like, "Is this relevant to the main point you want to make?" Often that was a "Yes, I just went off on a tangent there." The whole thing was shorter not because it was dumbed down, but because it was focused.PlanetCare (talk)

PlanetCare, copyediting is welcome, but it should be done in consultation with the sources. Re this edit, have you read the source? Why did you change “many” to “some”? I believe your edits have altered the source-to-text integrity where although and only are intended and reflect what the source says. This edit summary suggests you didn’t actually read the source to understand the distinction between the many and the few relative to severity. At any rate, this article overall is so dated and has so failed to reflect recent research and has so much undue content that I think we may just be shuffling the chairs on the Titanic. It might be more productive, rather than tweaking individual sentences, to go find some high quality recent secondary sources first. Again, in an article this bad and this dated, I hesitate to get into back-and-forth (like this) on individual wording based on dated sources anyway ... the article hasn’t even been edited to reflect DSM5 yet ! Copyediting an accurate updated article for readability would be more effective than tweaking up dated wording. SandyGeorgia (Talk) 18:50, 23 February 2021 (UTC)

Very good point. You are right. I didn't check the source. If you think "many" is more accurate, do revert. However, there might need to be more stats offered than just the 2-28% stat so that there isn't a contradiction between "many" and 2-28%. I found another source that studied "pain" in general. Not severe pain. It says that 84.1% of women do experience some pain. (That's closer to "many" than "some" but it's pain, no severe pain) Quoting: Menstrual pain was reported by 84.1% of women, with 43.1% reporting that pain occurred during every period, and 41% reporting that pain occurred during some periods.PlanetCare (talk) 19:40, 23 February 2021 (UTC)

It's most women, last time I checked. I've made comments below that differ from the medicalization assertions. LearnerB (talk) 16:57, 25 February 2021 (UTC)

Health effects

This section needs renaming, re-ordering and moving towards the bottom of the article. Menstruation is a normal biological function and this should not read as a medical article first and foremost. It is a biology article. I would cull as many of the "unhealthy" aspects of menstruation as we can, especially those that lack decent citations and are rare. Why isn't the importance of menstruation to women's health stressed? Quite a lot of this article reads like it was written by Queen Victoria's gynaecologist. Graham Beards (talk) 18:56, 22 February 2021 (UTC)

Yep :). I remain unconvinced that this article can retain featured status, as the problems are enormous and a top-to-bottom rewrite is needed— this article has been neglected for over a decade. And the boundary/overlap between menstruation and menstrual cycle needs to be defined. It requires more work than I can take on. SandyGeorgia (Talk) 19:01, 22 February 2021 (UTC)

I agree. Graham Beards (talk) 19:18, 22 February 2021 (UTC)

Could someone who has a working computer (not me) move the Cycles and phases section above Health effects, so we define the thing before we start talking about dysfunction? That will mean a lit of wikilinking repair. SandyGeorgia (Talk) 19:48, 22 February 2021 (UTC)

• This is what the structure of the article looked like when it was last vetted at a content review process; relative to now, it appears that a TON of content has been chunked in here that actually belongs at menstruation. 23:10, 22 February 2021 (UTC)

I have done the swap to put cycles first and then health effects (which I have now renamed as "impacts"), but we actually have a really similar section on health effects also in menstruation. How can we separate the two articles more clearly? Perhaps a solution is to actually merge the two articles?? Or to move everything on health effects across to menstruation? EMsmile (talk) 00:21, 23 February 2021 (UTC)

I haven’t formed an opinion yet because the content is so bad it’s hard to know where to start ... I guess it will become more clear as/if the content is cleaned up. Regards, SandyGeorgia (Talk) 00:41, 23 February 2021 (UTC)

Hi all, I have a different take on the medicalization thing. See my comments below. LearnerB (talk) 20:41, 24 February 2021 (UTC)

Society and culture content (and other content) moved

I have just culled the content that was under "society and culture" and moved it to menstruation. This article here should be purely about the biological/physiological aspects, right? And the rest should be in menstruation, or? EMsmile (talk) 00:24, 23 February 2021 (UTC)

That sounds right to me, but I defer to others like Graham Beards on biology versus medicine division. SandyGeorgia (Talk) 00:42, 23 February 2021 (UTC)

I think all of "impacts" and "Society and culture" does not belong here and should be covered in Menstruation, which is already linked as the main article. I see no need for anything here that cannot be sourced from a decent physiology or biology textbook.Graham Beards (talk) 19:54, 23 February 2021 (UTC)

This sounds reasonable to me. I have been searching PubMed for recent reviews, and I think the focus of this article is completely wrong, as it became “medicalized” over five years ago, converting a biological concept to a pathological one, and yet those very medical portions are outdated and don’t even reflect DSM5. I see little hope that this article can retain featured status unless someone with a textbook takes on a complete rewrite, but getting the biology separated from the medical would be a good start. That is, the route to fixing this article is to take a huge pair of scissors to it. Then we are only left with the mess at menstruation, which is as bad as this mess. (This is partly why I see little utility in spending time copyediting the mess that is currently here, although I do appreciate PlanetCare’s concerns.) SandyGeorgia (Talk) 20:01, 23 February 2021 (UTC)

@User:SandyGeorgia I agree with you and was bold today and basically cut out the whole section on "ovulation suppression". I have moved it for now to menstruation but it needs further work there now because there is repetition there. And probably far too much detail, given that there are good sub-articles on hormonal birth control etc. The paragraph on breastfeeding was duplicated exactly the same in both articles as well. I think this article on menstrual cycle should probably solely focus on the biological aspects of menstrual cycle and then everything else should be moved to menstruation. I would advocate for moving all that content about cramps, mood swings etc. to menstruation. Basically just leaving the content about the cycle itself here, plus short links to the other relevant articles (like I have done now for ovulation suppression). I even wonder if both articles should perhaps be merged to avoid this problem of overlaps. But would take it a bit too far? EMsmile (talk) 02:27, 24 February 2021 (UTC)

I suggest our division is found right here: “The uterine cycle has three phases: menses, proliferative, secretory”. Menstrual cycle is about the *full* cycle, while menstruation covers menses— they are separate articles. We use summary style for whichever parts of menses need to be mentioned here, but that’s not much. SandyGeorgia (Talk) 02:42, 24 February 2021 (UTC)

Furthermore, I wonder if this article should make it clear that it is about all female mammals (with an emphasis on humans) or that it is only about female humans? This doesn't come out clearly. The first paragraph of the lead is still general, but then it focuses only on humans. I noticed also that the sections "onset and frequency" is again duplicated across both articles. I suggest we move the content from here to menstruation and only leave a very short summary here, making it clear to the readers that more information is to be found in the other article. - I have just moved the section on "evolution" to here as it struck me as a "biological" content section, and also included some information about other mammals. EMsmile (talk) 02:46, 24 February 2021 (UTC)

I suggest the older vetted version here is the best guide we’ve got— maybe not perfect, but somewhere along the line, this article lost that focus and became not tightly focused on its subject. Perhaps spend some time studying the old version to help decide what goes where ? WhatamIdoing we need you in here. SandyGeorgia (Talk) 02:51, 24 February 2021 (UTC)

The more I look, the more I find the same content duplicated in both articles. For example this one about the supposed synchronisation: "Among women living closely together, it was once thought that the onsets of menstruation tend to synchronize. This effect was first described in 1971, and possibly explained by the action of pheromones in 1998. Subsequent research has called this hypothesis into question.". Again the question: does it belong here or in the other article? Surely not in both articles. Which article is a reader expecting to find this sort of information? In my opinion, it belongs only into the menstruation article, not here. But this kind of duplication is EVERYWHERE with these two articles... And I don't think it's so easy to say that "menstruation" is only about the bleeding phase. Some women might have cramps just a few days before their periods start (or around the time of ovulation). So strictly speaking not during the bleeding phase. Nevertheless they would look for this kind of information as part of an article on "menstruation". Could we remodel it so that "menstrual cycle" focuses on those aspects that related to all female mammals, whereas "menstruation" focuses on humans only? Perhaps that would work. EMsmile (talk) 03:04, 24 February 2021 (UTC)

And I don't think the older version from 2008 will help us much. I see the same problems there with overlapping content to menstruation as we have now. EMsmile (talk) 03:04, 24 February 2021 (UTC)

Sorry, now I just realised that in other mammals it is called estrous cycle! Didn't know that. So this article should only be about humans then.EMsmile (talk) 03:07, 24 February 2021 (UTC)

and there is an article called menstruation (mammal). Have added it in the hatnote now. I think such a clarification is useful. EMsmile (talk) 03:15, 24 February 2021 (UTC)

I think some non-human animals – all of the great apes (maybe most primates?) and a few other species – menstruate; most mammals have estrous cycles. I think your suggested division between biology here and everything-else-in-humans over there is a workable one.

@Gandydancer, do you have an interest in this article? (I still miss @Lyrl.) WhatamIdoing (talk) 06:02, 24 February 2021 (UTC)

Thanks for the ping. I've been following the brilliant work here on the talk page. It is so good to see the great collaboration going on here behind the scenes. Gandydancer (talk) 12:01, 24 February 2021 (UTC)

I agree that we shouldn't over-pathologize menstruation, but, at the same time, a lot of that comes from the literature. I just looked at the more recent sources on the topic. As expected, it's still is very medicalized, with many sources commenting on the causes of menstrual symptoms and treatments for them. I know that there was an objection here and here to using "symptoms" on the menstrual cycle and menstruation pages (and so "problems" and "issues" were used in its place), but look at the literature here and here. "Symptoms" is what is overwhelmingly used. Others sources say "signs" or "effects", and fewer sources say "impacts." Even when I Googled "menstrual health effects", the word "symptoms" was used in sources. That said, I also saw the terminology "period problems" when I Googled that.

I know how our Misplaced Pages article defines "symptoms", but I don't think of using "symptoms" for the effects of menstruation negatively. I think of it as just a matter of fact. I think substituting "problems" and "issues" in place of it is worse and is vague.

While menstruation is a natural, biological thing, it's also often a painful, and sometimes debilitating, process. This is why menstrual leave is a topic. Experiencing a period is often not a breeze. For example, when looking at this source from the article, I think it's safe to say that most women experience menstrual cramps (which some take medicine to deal with, while others don't or don't have access to it). Many women have been open about periods in the negative sense. This occurs a lot more often than framing it as positive. So we can't just pretend that menstruation doesn't come with various negative effects and that these effects aren't tackled as things needing treatment. Even rare disorders, especially those with a Misplaced Pages article, should be mentioned. Women come to these articles to read about those things too. The definition of "rare" can also vary. For the "health effects" heading, we could have used "clinical significance", but "impacts" works. As for any positive effects of menstruation, if we have good sources for it, we should include those too. LearnerB (talk) 20:41, 24 February 2021 (UTC)

This article is about the cycle. The rest belongs in Menstruation. Graham Beards (talk) 20:54, 24 February 2021 (UTC)

Yeah, and you removed information about the cycle. LearnerB (talk) 16:57, 25 February 2021 (UTC)

Evolution section moved

I disagree with the move of the evolution section. Menstrual cycle is about the cyclical aspects of it. I would not go looking for evolution of menstruation in the menstrual cycle article, it feels more natural for it to be in "menstruation", IMO. Dividing these two articles into "biology" and "not biology" feels artificial. Mvolz (talk) 12:44, 24 February 2021 (UTC)

It hasn't been moved.Graham Beards (talk) 12:56, 24 February 2021 (UTC)

Err- what do you call this diff, then? https://en.wikipedia.org/search/?title=Menstruation&type=revision&diff=1008592204&oldid=1008591757&diffmode=source Mvolz (talk) 13:05, 24 February 2021 (UTC)

Err -you should discuss this at Menstruation. Graham Beards (talk) 13:07, 24 February 2021 (UTC)

This is the most relevant discussion. Mvolz (talk) 13:13, 24 February 2021 (UTC)

Both articles are a mess, that I think we can agree on. With regard to evolution, menstruation is a part of the menstrual cycle. I don't agree with dividing the articles into biology and "non-biology", but I disagree with treating the cycle or the related menses as an illness. Graham Beards (talk) 13:24, 24 February 2021 (UTC)

In the category of non-biology, I'm thinking about things like Menstrual taboos and Menstrual products, which might merit a namecheck here, but which I don't think need to be covered in any sort of detail in an article about the cycle. WhatamIdoing (talk) 16:21, 24 February 2021 (UTC)

I have a different take on the medicalization thing.

The "Impacts" material was removed, with some explanation that it doesn't belong, but look at it. Those references are about the cycle. Why clutter up the menstruation page with information about the cycle when we have an article right here about the cycle?

How can you separate the biology from the medical when the biology brings about the medical in several cases? Most women get cramps and other negative symptoms during menstruation, and some of these correlate with certain times of the cycle.

Men have a habit of acting like menstruation isn't a big deal. So, for topics like these, they say how it's just a natural part of biology and women should suck it up, shouldn't get menstrual leave, etc. Sorry, but for many women, menstruation is no walk in the park. LearnerB (talk 20:44, 24 February 2021 (UTC)

This article is about the cycle. The rest belongs in Menstruation. Graham Beards (talk) 20:50, 24 February 2021 (UTC)

I don't think it's as easy as you make it seem, Graham Beards. I do share the concern that the anonymous editor raised before you did. I think having the two articles merged into one might actually be the best solution. But if not, then we have to make sure people can find what they are looking for. So if they're looking for stuff in "menstrual cycle" and it's not there then we need to point them across to the correct place. Over time, I think the article menstruation would actually become the main article, and menstrual cycle becomes its sub-article. Previously, it was the other way around or the two articles existed side by side. EMsmile (talk) 23:58, 24 February 2021 (UTC)

Wikilinks and hatnotes do point to the other relevant articles. I think menstruation by definition is a subset of the overall topic, and we use WP:SS to summarize sub-articles to the main topic. SandyGeorgia (Talk) 00:08, 25 February 2021 (UTC)

I think it's the other way around: menstrual cycle is a sub-article to menstruation (in practical terms, not in theory; yes, "in theory" menstruation is one part of the menstrual cycle). Maybe it's an academic question but I think in practical life interests, people will be going to the article on menstruation to find out what they need to know (how to manage it, what side effects there are, when it starts and stops, how women in developing countries have additional issues to grapple with, menstrual taboos and so forth). The article on menstrual cycle will be more for "nerds" who want to find out which hormone kicks in exactly when, and things like that. So over time, I think the article menstruation will become the bigger, more important one. This will also be reflected in the page views. I think we are on the right track now, having trimmed "menstrual cycle" right down to the bare minimum regarding the biology of things. EMsmile (talk) 00:30, 25 February 2021 (UTC)

Excuse me, but User:Graham Beards, I did talk about the cycle. You removed information with this edit, claiming that it doesn't belong in this article when the information and its sources are mostly about the menstrual cycle. It's correct to say that some negative symptoms correlate with certain times of the cycle. Sources talk about this. So it makes sense to talk about that in the article about the cycle. It makes sense to include information about menstrual cycle disorders in this article. How do you figure that information about menstrual cycle disorders belongs at the menstruation page instead of this one?

The effort to split hairs between the cycle and menstruation as far as symptoms go is completely artificial. So I agree with User:Mvolz, who, judging by their user page, is exactly the type of editor we want working on this article. It's my understanding, from seeing User:Clayoquot around, that User:Clayoquot is another who can help at pages like this one.

If someone is going to insist on putting information and sources about the cycle in the menstruation article when that material and those sources are specifically about the cycle, then I suggest the pages be merged. I believe that User:EMsmile is on to something when suggesting a merge. That's preferable to keeping menstrual cycle information that's medical out of this article because it's medical.

It seems that there is a little opposition to reporting on the fact that menstruation is commonly a medical problem and that this correlates with phases of the cycle in different cases. But we need to accept that it is and does, as illuminated by sources, and do what is best for this article. LearnerB (talk) 16:57, 25 February 2021 (UTC)

Menstruation is what people are most likely to put in the search bar. I agree with some others who call for a complete merge. Really, do we need to make a distinction between menstruation and menstrual cycle? One and the same, in my view. If the first paragraph of every Heading and Subheading is a reasonable summary of that whole section, the scientists among us can go wild with detail in subsequent paragraphs, if they want to. Another way of thinking is that the whole purpose of footnotes is so that interested readers can go to the source themselves, for more detail. I think what we're looking for here is the right balance between "enough information" and TMI.PlanetCare (talk) 20:07, 25 February 2021 (UTC)

They are not the same according to sources and this is explained in the article. I have lost count of the number of times I have said this: menstruation is only a part of the cycle. Graham Beards (talk) 20:16, 25 February 2021 (UTC)

Menstruation is only part of the cycle (and I know you keep making that point) but I do still think that the rationale for keeping the two completely separate is just not as strong as the rational for keeping them both together in the same article. You can make the distinction between the two in one article.PlanetCare (talk) 20:27, 25 February 2021 (UTC)

I have already said (at least twice) that I have no objections to a merge at all, but we need to clean up both articles first. This one was a right mess and I gather menstruation is worse. I have updated and improved several citations, replaced a figure with one that can be better understood and copyedited the text. I haven't finished working on the article; there are still WP:MEDRS non-compliant citations to fix. In my fourteen years editing Misplaced Pages, I have never had so much flak from so few editors. I even had complaints about my gender Graham Beards (talk) 20:41, 25 February 2021 (UTC)

Thanks for the scholarly work, Graham; this is beginning to take shape. Over at menstruation, there’s a lot to be done, but the structure is the real problem now. It needs more WP:MEDMOS and WP:MEDRS-knowledgeable editors to address what goes where, in addition to cleaning up text and sourcing, so will be a much harder cleanup. SandyGeorgia (Talk) 22:03, 25 February 2021 (UTC)

Thanks for thinking of me but I have too much on my plate these days. Best wishes,  :) Clayoquot (talk | contribs) 21:56, 25 February 2021 (UTC)

Where did all the content go?

I am a bit confused about the editing work that you, User:Graham Beards have done here yesterday. I agree that you have cut down the article menstrual cycle but I was expecting that the removed material would make its way to menstruation or that you would at least copy it to the talk page for discussion. Is the entire text that you removed worthless, is that what you are saying? (it's possible, I can't judge yet) I am normally hesitant to completely delete stuff with a few strokes. I fully agree with moving stuff but deleting? Unless you have assessed it and it's rubbish - like the part about mating behaviour might have been rubbish, I am not sure. EMsmile (talk) 23:56, 24 February 2021 (UTC)

EMsmile you can see the reasoning behind each deletion Graham made by stepping back through the diffs, starting here, and reading the edit summaries; he deleted a lot of marginally sourced, undue material. Both articles need to be rewritten from MEDRS sources, and because this article is featured, those need to be high quality and recent. Separately, at some point, a goal here has to be established. If this article is to retain featured status, someone needs to get their hands on a textbook and start writing about this topic; with my computer out for repair, that is not going to be me, and even if I had my computer, I don’t feel I could rewrite the biology. SandyGeorgia (Talk) 00:06, 25 February 2021 (UTC)

SandyGeorgia I looked at all the edit summaries by User:Graham Beards and a few times he wrote "does not belong here, belongs to menstruation". So I would expect that he moved the text blocks to there but he didn't. He completely deleted them? Or expected someone else to rescue and re-insert them? I am not talking about the section on mating behaviour, that was probably pure speculation. But I am talking about the section on cramps and other health aspects. I thought that was meant to be moved & merged (and duplication removed). No? (regarding the featured article status we can worry about that later; let's get both articles into good shape first. They probably would not retain their featured article status - but to me that is a secondary consideration) EMsmile (talk) 00:21, 25 February 2021 (UTC)

I haven’t looked closely per iPad typing, computer in repair, but my recollection was that all the sourcing was so bad there was little salveageable. If you find anything that is correctly sourced, you can copy it over from the diff, but then you have to sort out the duplication, since most of that is already covered over there. Sometimes the fastest way forward with crap articles like this is to start over; but I haven’t looked closely, as I am more concerned about salvaging this article than trying to repair that one, which is even worse. At least this article was once in good shape ... SandyGeorgia (Talk) 00:27, 25 February 2021 (UTC)

Ok, makes sense. I might just wait another day or so to see if User:Graham Beards replies again. Perhaps he has looked at it all carefully and decided deletion is the best way, rather than move & merge. I had the feeling there might have been some salvageable information on cramps and pain management but will wait a bit before trying to salvage anything. EMsmile (talk) 00:33, 25 February 2021 (UTC)

Remember, nothing is ever lost on Misplaced Pages; it’s in a diff :). But we really need to focus on the bigger picture here, with a top-to-bottom rewrite, which will generate faster and better results than trying to repair old, poorly sourced, UNDUE and off-topic text. It’s pretty clear that we had some students plopping pet theories in here, and there doesn’t seem to have been anyone maintaining the article who understood the standards required for Misplaced Pages’s top content. As a former WP:FAC coordinator, a practicing professional, and the author of multiple Featured articles, Graham does ! Bst, SandyGeorgia (Talk) 00:38, 25 February 2021 (UTC)

Blimey - one ping would have been enough! Please remember that we live on different continents and hemispheres and I am not going to immediately respond to pings sent in the middle of the night :-) Much of the text I removed was either already covered in Menstruation, or, and more frequently, was too poorly sourced and written to be of value. If anyone disagrees, content can be salvaged from the article history. I don't think this article is going to retain its FA status, but at least we can clear up some of the mess. We have an article on menstruation, which is about menstruation and this article which is about "an essential life rhythm governed by interacting levels of progesterone, estradiol, follicular stimulating, and luteinising hormones". (Draper et al. Nature Scientific Reports 2018). I am happy to work on this article using this definition, but I don't have the time or motivation to repair both articles. If you don't agree with my approach, no problem. I have loads of other stuff to be getting on with. Graham Beards (talk) 09:49, 25 February 2021 (UTC)

No worries, I won't ping you anymore, Graham Beards. :-) (a ping for me doesn't mean I would expect an immediate response; I never expect immediate responses on talk pages; I know we are all just volunteers here with all sorts of other work pressures). I just want to be sure about two of the major sweeps (deletions) that you made. This one, where you wrote in the edit summary: "that belongs in menstruation". Which makes it sound like we should move it there, or did I misunderstand? And this one where the edit summary said: "this does not belong here - see Talk Page". So in both cases you didn't say "this is rubbish/unsourced, needs to be deleted" but I read it as saying "move this to elsewhere". Did I misunderstand? I would be happy to do the moving and merging but don't want to waste my time in case you have assessed it as rubbish / low quality and then someone else deletes it straight away from the menstruation article. - Also, personally, I am not planning to go back to text books and work on the featured article criteria at this stage. My focus is on improving what's there and making it readable, accurate and understandable for people who are looking for information. A lot of them are probably women, perhaps younger women, who are wondering what's going on in their bodies. As we are working here as a team, it's great if others can dig into the text books and pull information from there. I am just saying, we all have different roles to play in Misplaced Pages editing; different things that we enjoy doing. I enjoy improving and restructuring articles, working with existing content, removing duplication and making content understandable for lay persons. Others enjoy digging into the text books and writing new content. That's great. Let's collaborate and not insist on what has to be done first and what second etc. That's just my two cents worth. EMsmile (talk) 10:09, 25 February 2021 (UTC)

WRT the two examples you give. The first belongs in Menstruation because it is about delaying/preventing menses by hormonal drugs. The second "Impacts" should be covered in Menstruation but not necessarily copied directly across because of poor sourcing or prose or both. I have sources available - well in front of me - that I can use for this article; the one you say is for nerds. I don't intend to add or alter anything in Menstruation (at the moment). I am not even watching that article. You suggested somewhere above that a merger might be a solution and this is worth considering, but we don't want to merge two bad articles. For now we can use hatnotes to direct readers to the information they are seeking.Graham Beards (talk) 10:26, 25 February 2021 (UTC)

OK, thanks for the clarification. I have gone through that culled content now and incorporated some stuff in menstruation. There was also quite a lot that I felt was too detailed and with primary sources only - that content I have put up for discussion on the talk page of menstruation to see if anyone sees anything valuable here (or maybe move it to some other article). If anyone is watching the menstruation article in parallel to this one: do take a look, I think it's starting to take better shape and its structure is slowly improving as well. EMsmile (talk) 13:28, 25 February 2021 (UTC)

Did you see my suggestion below? Graham Beards (talk) 13:44, 25 February 2021 (UTC)

You removed information that is specifically about the cycle. I disagree with removing content that is about the cycle and artificially splitting content. I think we need female editors working on these two pages all the way around. Preferably those who know what's out there on the topic or who are willing to learn about it all as they go, and won't obscure just how troublesome menstruation and its cycle often are. LearnerB (talk) 17:04, 25 February 2021 (UTC)

Thank you for registering an account LearnerB. Generally, Misplaced Pages articles are based on what sources say, and not what one’s gender is or one’s opinions are, and we judge contributions based on how they hew to sources, not whether they were written by a male or female. The damage to this suite of articles was done equally by both, so please refrain from generalizing about editor contributions based on their gender. More to the point, sources specifically say that disruption to daily activities occurs in a minority, so I am concerned that there may be some WP:ADVOCACY in wanting to represent a normal biological reproductive cycle as a disease. The sources state clearly that most women do not experience interruption in daily activities from menstruation, and in those that do, that would be covered in one section of the medical article at menstruation (which right now is a mess because it has no structure to separate the normal from the complications, and that article could be served by having editors consult with WP:MEDMOS for a better organization, but that is there not here). SandyGeorgia (Talk) 17:14, 25 February 2021 (UTC)

Hi. I've seen comments about a need for for female editors at articles like these. One editor I've seen say so is User:Gandydancer. I also saw gendered comments at #Health effects and here (after I looked around to see how effort to improve this page came along). You said, "this is the most clear example of male editing a female topic I have ever encountered on Misplaced Pages) to make it sound like most women have problematic periods (holy hysterics !)." I didn't mean to imply that only men had damaged the article. Sorry about that.

Yeah, menstruation disrupting daily activities occurs in a minority, but cramps and sometimes other symptoms occur in the majority. I'm saying that women are typically not without any problems because of menstruation. I'm also saying that when the sources are specifically about the cycle and the focus is not just on menstruation, I don't think that belongs in the menstruation page only. LearnerB (talk) 17:28, 25 February 2021 (UTC)

LearnerB, excellent comments. About my remark about how good it is to see women's comments here I did not mean that women are more able to work on womanly articles. In fact, when it comes to the subject of male abuse of women I've found that the men are closer to my position than the women--I think...since I haven't made a close study of it. But the thing is, I like to work with women. In general we are more able to "chat" is the best way that I know how to put it. But men are every bit as able as women to produce good unbiased articles since we all must use good reliably sourced information. Gandydancer (talk) 00:42, 26 February 2021 (UTC)

Hi, User:Gandydancer. I can't say I lean toward the male perspective with regards to male violence against women or domestic violence specifically. I know what the sources say on that. So. That's a different topic, though, of course. My intention with part of my comment was to highlight the Misplaced Pages gender gap and the importance of the female perspective that even Misplaced Pages recognizes. It's just like EMsmile said below in the section about moving the page. I was going to point to that with my next replies, but she beat me to it. LearnerB (talk) 20:07, 27 February 2021 (UTC)

How to deal with repetition regarding onset and duration

The content on onset and duration is duplicated in this article and the menstruation article. Proposed solution: We move the content from the section "onset and duration" from menstruation to here, remove repetition and then leave just a link from the other article to here so that people know where to find this information in one central spot. I think that would be fair since onset and duration are purely "biological" aspects, aren't they (with very practical implications). EMsmile (talk) 00:24, 25 February 2021 (UTC)

IN my mind, onset and duration are about menses and belong over there. At any rate, we should be working from sources. The first step should be to get a high quality recent text book and start building from there ... worrying about which content is where is premature, when both articles need to be entirely rebuilt. SandyGeorgia (Talk) 00:30, 25 February 2021 (UTC)

One could equally argue that onset and duration is about menarche and menopause, i.e. the start of the menstrual cycle in a women's life and the end. And also the information about 28 days as a typical length of a menstrual cycle. In that case, it would belong into the menstrual cycle article, right? Once again, this shows that our planned delineation of the two articles has flaws. - But OK, I then suggest to move the section "onset and duration" to menstruation and leave just a link from here to here. I don't mind either way, I would just be against having it in both articles with the same level of detail and content. EMsmile (talk) 10:13, 25 February 2021 (UTC)

Again, I was bold and have cut down the section about "onset and duration" (and also renamed it). I hope you like it. My approach was to leave only the bare minimum and important key terms, like menarche, menopause, but to shift all the additional details to menstruation. I think the article is starting to take shape: only focusing on all the stuff that goes on with the hormones, follicles, eggs, tubes etc.EMsmile (talk) 12:22, 25 February 2021 (UTC)

I think you handled that in an okay way. I would have asked: How can we remove information about the onset of menstruation from the menstruation page? It belongs there. It is not a good idea at all to not have that information covered there. It's one of the main things people will be looking for when wanting information on menstruation. We can't get rid of all duplication, and Misplaced Pages:Content forking#Related articles says we can expect that for related articles. LearnerB (talk) 17:06, 25 February 2021 (UTC)

I think that basic information about timing (both menarche/menopause and typical cycle duration) belongs in both articles. WhatamIdoing (talk) 00:12, 26 February 2021 (UTC)

Yes, then it should be fine as it is now, as the information on timing does appear in both articles now. It's just that it's more detailed in one article ("Menstruation") and less detailed in the other ("menstrual cycle") and it points the reader from the less detailed one to the more detailed one. I just think it would be silly to make it equally detailed in both because then one would have to keep updating and maintaining a chunk of text in both articles. And I agree that it'll be one of the first things that many you women and their parents would look for when reading up about menstruation. Do we broadly agree that it's fine the way it is now (just double checking)? EMsmile (talk) 02:16, 26 February 2021 (UTC)

What if we first focus on cleaning up content and proper sourcing, and worry later about what goes where? In other words, why prioritize where it is when our readers are reading ... bad info regardless? There seems to have been some WP:ADVOCACY editing complicated by student editing affecting the entire suite of articles, worsened by structural changes that converted menstruation to a disease state. One thing at a time. SandyGeorgia (Talk) 02:24, 26 February 2021 (UTC)

Which entire suite of articles do you mean? So far I have only looked at "menstrual cycle" and "menstruation" this week. I think the "what goes where" discussion is important (and can be done in parallel to other discussions) as it determines what we think this article should be about. I think the article is starting to look quite good now, thanks to the massive cutting/moving efforts by Graham a few days ago. So glad that he has time (and expertise) to work on this in detail - we are lucky. EMsmile (talk) 12:54, 26 February 2021 (UTC)

The entire area of women’s health. Endometrial cancer is good, although in need of a tune up as it was featured six years ago, and outside of that, menstruation is quite typical of the level of quality one finds anywhere. Osteoporosis is another example of an important but neglected topic. Of course, prostate cancer is just as bad, so ... we are equal opportunity when it comes to C-class quality. SandyGeorgia (Talk) 18:30, 28 February 2021 (UTC)

Get rid of bibliography section?

The bibliography section only contains two books now. I suggest we merge them into the references section and use the page number template instead: {{rp|5}}. If nobody has any objections, I could make that change. EMsmile (talk) 12:15, 26 February 2021 (UTC)

Not yet, I haven't finished citing them. Graham Beards (talk) 12:27, 26 February 2021 (UTC)

My question was more about the type of referencing we want to adopt: I prefer the type where all the references are listed under "references" but I know other articles split it into two: references/notes and sources. Just wondering if people if the people in this group have a preference for one over the other? I know e.g. climate change uses the other style (references, notes and sources). But e.g. menstruation uses the style that I would prefer. This is just a minor question, don't feel under pressure to answer me now, it can wait. It's just a question, I am not trying to interfere with your editing process. EMsmile (talk) 12:48, 26 February 2021 (UTC)

That's the least of our problems at the moment :-) Graham Beards (talk) 12:56, 26 February 2021 (UTC)

I (and most editors, based on how infrequently it is used) strongly dislike the rp template referencing system; it is disruptive and ugly to the reader. The article will look different when it is fully cited and Graham finishes. I invite you to peruse our most recent (or most recently updated) medical FAs at Buruli ulcer, complete blood count, dementia with Lewy bodies, immune system, introduction to viruses, and virus. A comparison to menstruation is apples and oranges for multiple reasons. It does not use high quality sources, including books, and it does not correctly cite page ranges or sections. If it did cite textbooks and page ranges and page numbers on those journal articles where the range now is too broad for verification by the reader, like this, that would yield a mess using the awkward rp method. Climate change is another good example of a recently vetted FA, mostly written by an editor well familiar with Misplaced Pages’s top content. On a fully cited article, imagine popping something like this in to the text: repeatedly and throughout. SandyGeorgia (Talk) 15:27, 26 February 2021 (UTC)

Personally, I don't like the sfn template family, and since they're used on less than 1% of articles, I assume that most editors don't, either. But I agree that this question could be handled later.

I know that one FAC regular has repeatedly claimed that some journal articles are too big to cite in the standard fashion (which is used by all external style guides). However, there does not appear to be consensus for that POV, and the boldy-created templates that once claimed a two-page maximum have been revised to eliminate those claims after discussion. Also, since almost everyone reads journal articles online, editors normally can't give the page numbers even if they wanted to. WhatamIdoing (talk) 16:15, 26 February 2021 (UTC)

Which is why section names are used, and are easier on verification. Again, on apples and oranges, since most Misplaced Pages articles are very poorly cited, they do not offer a good comparison. In content vetted at the top level, WP:V is met by narrowing page ranges to verifiable chunks, and the rp system is rarely used. I once hated sfn myself; once I used it, I saw how much simpler it was, both for editor and reader. Perhaps we medical editors were stuck in a rut, but we were not doing readers any favors by giving them 30 pages of an article and expecting them to be able to verify well paraphrased text, where the search function would not produce what we paraphrased.SandyGeorgia (Talk) 16:22, 26 February 2021 (UTC)

For a journal article, my first question is whether you're misusing the source if you're able to reduce the page range to a single page. WhatamIdoing (talk) 17:45, 26 February 2021 (UTC)

As with anything, it depends on what fact the sources is used to support. Graham Beards (talk) 20:01, 26 February 2021 (UTC)

WAID, I think your point helps make my point about the rp referencing system, which sticks a page number in a superscript in the middle of the text. When appropriate page ranges are listed out in detail (as opposed to one page), or full section names, that is incredibly disruptive to the reader. Separately, what often occurs in medical articles is that, as we have to go back and upgrade sources to conform with MEDDATE by adding newer sources, one specific page number gets stuck in there, when actually, the entire body of literature often supports the statement. So, again, if the articles were correctly cited to begin with (using full sections or more encompassing page ranges), we would be less likely to end up with this “single page” problem as citations are retrofitted to text to conform with MEDDATE. SandyGeorgia (Talk) 13:55, 27 February 2021 (UTC)

Wayward section

Graham, I don’t want to get in the way while you are still working, as too many cooks spoil the broth, and things are starting to smell very good in the kitchen! But the “Onset and end” section is causing multiple issues ... perhaps you will get to that as work progresses?

1. It should be part of the next section (“Cycles and phases”)
2. It contains considerable content that is introduced elsewhere in the article. The flow is all off.
3. It introduces topics out of order; eg, talks about precocious puberty without ever having defined puberty, and we have an issue with when/where and in what order we define the word “menses”.
4. The first sentence is problematic; it defines cycle as ... cycle ... and needs rewording.

I’d be willing to work on all of this, but suggest that one editor at a time is a better approach when there are so many moving pieces, and hope you are getting to that part :). Bst, SandyGeorgia (Talk) 14:02, 27 February 2021 (UTC)

Yes, it has been bothering me too. Do you want to have a bash? I'm taking a few hour's off. I have spent a lot of my time on the article. Graham Beards (talk) 14:12, 27 February 2021 (UTC)

PS. It needs a fresh pair of eyes. ;-) Graham Beards (talk) 14:15, 27 February 2021 (UTC)

OK, if you are off for a bit, I will work on it ... keep in mind, though, that I am editing from an iPad, so it will take me several steps (and multiple typos!) to get things in the right place. I will start after breakfast. SandyGeorgia (Talk) 14:17, 27 February 2021 (UTC)

I'd send you a PC, but I'm even further away than Texas. Graham Beards (talk) 14:31, 27 February 2021 (UTC)

Three cheers for FedEx; twelve days after mailing, my computer tracks this morning (finally) to a FedEx warehouse in Texas. They need to decentralize their operations away from over-reliance on one hub (Memphis). Starting in on article now, but I will put the article inuse while I work, because iPad editing is a challenge. SandyGeorgia (Talk) 15:03, 27 February 2021 (UTC)

Did what I could, but that was very slow going. SandyGeorgia (Talk) 16:11, 27 February 2021 (UTC)

Thanks Sandy. Graham Beards (talk) 17:29, 27 February 2021 (UTC)

I would prefer it if that section about onset, duration and end still had a section heading (i.e. Level 2 now instead of Level 1 that it had before), so that it can be found from the table of content. Also, I liked that we gave readers the link across to the correct section in the menstruation article where more about the usual times for menarche and menopause in a woman's life can be found. Why was that cross-link deleted? As a reader, I find it useful when articles point me to other articles for more detail. Or is that a big no-no for featured articles? EMsmile (talk) 13:00, 28 February 2021 (UTC)

How would we have a separate section when the pieces of content are in multiple sections? Do you want to repeat every piece of data about onset, duration and timing in one section, even though the concepts haven’t been introduced yet? That would render the article very hard to read. Could we please remember that this article is about much more than menstruation? SandyGeorgia (Talk) 18:24, 28 February 2021 (UTC)

To clarify what I meant, I am proposing this change. This way, people can find it from the table of contents. And yes, I do remember that this article is about "much more than menstruation". But menarche is the start of the menstrual cycle times in a woman's life, whereas menopause marks the end. For that reason, they are both worth mentioning in the article, aren't they? Which is why the article rightly says " Beginning at puberty (as a child's body begins to mature into an adult body capable of sexual reproduction), the first period (called the menarche) occurs at around 12 to 13 years of age. The cessation of menstrual cycles at the end of a woman's reproductive period is termed menopause, which commonly occurs between the ages of 45 and 55." All I am trying to do is to give this information a suitable sub-heading so that it can be found more easily. The sub-heading used to be there (for years) and I think it was useful to have it. EMsmile (talk) 00:49, 1 March 2021 (UTC)

Society and culture

This section needs to actually talk about the full cycle, rather than things like products for menstruation. Graham, do you have better sources for this? SandyGeorgia (Talk) 16:11, 27 February 2021 (UTC)

I don't have any sources on this but do we need them? The moon has no influence at all on human reproductive hormones.Graham Beards (talk) 17:37, 27 February 2021 (UTC)

Because the misperception exists, I feel like it is OK to include that here ... want to hear what others think, but believe the rest belongs at menstruation. SandyGeorgia (Talk) 17:42, 27 February 2021 (UTC)

Also, could we please take greater care when importing text from other articles into a featured article? Citations should be complete, and sources need to actually verify the text. When copying text from another article, please try to make sure it is verified. Separately, I am unconvinced we should even be talking about sanitary products in this article, versus at menstruation. SandyGeorgia (Talk) 17:19, 27 February 2021 (UTC)

I don't think the inclusion of this section is warranted and I suggest we delete it.Graham Beards (talk) 17:33, 27 February 2021 (UTC)

Hi. The section isn't much of anything right now. Maybe we don't need it here and we can just leave it at the menstruation page. But if there is good sourcing for the mating stuff (which was about the cycle rather than menstruation) that was removed, some of that could be added as a part of a society and culture section or put elsewhere on the page if there's not a decent amount of material on other things for a society and culture section here. LearnerB (talk) 20:15, 27 February 2021 (UTC)

LearnerB perhaps you could mine The Palgrave Handbook of Critical Menstruation Studies for whether there is anything scholarly; that source is freely available, and quite lengthy, and I am seriously impeded by iPad typing, not able to process my usual volume. You can find it in Pubmed. It is alarming how many laypress sources are used at menstruation when scholarly sources are so widely available. Meanwhile, does anyone think we need to leave feminine hygiene products in this article, since they relate strictly to menses ? SandyGeorgia (Talk) 20:27, 27 February 2021 (UTC)

Sure, give me a few days to look that source over. I'm having offline/personal issues I'm simultaneously tackling. I think the feminine hygiene products stuff should be at the menstruation page. LearnerB (talk) 20:32, 27 February 2021 (UTC)

I looked through Palgrave and didn’t find anything. The mating material was removed because most of it was from one group that published in predatory journals (not a good sign). Here is what I have found so far, explaining again why that material isn’t worthy: . Perhaps someone can turn up something else. SandyGeorgia (Talk) 14:29, 28 February 2021 (UTC)

Gosh, it's getting confusing to know what to discuss where... I have left a comment about the "society and culture" question, and my opinion about it, on the FA review page: https://en.wikipedia.org/Wikipedia:Featured_article_review/Menstrual_cycle/archive2#Menstrual_cycle . Discuss it here or there? EMsmile (talk) 13:14, 28 February 2021 (UTC)

I recommend discussing it here, as you don’t seem clear on how Featured articles are written or vetted; perhaps clarification can be better offered here. A good deal of what you put on the FAR page needed correction, and it would be good to clear up that type of confusion here on talk, rather than on the FAR page. The FAR page is used to let others know when they can review relative to WIAFA— not for hashing out confusion or interim steps. SandyGeorgia (Talk) 13:36, 28 February 2021 (UTC)

I have eliminated the section by moving the two remaining sentences elsewhere in the article. I am not committed to keeping either of the sentences in this article, but I decided we didn't really need a whole section for those two. WhatamIdoing (talk) 19:21, 28 February 2021 (UTC)

I scanned the Palgrave source, and most of the taboos still seem related to menstruation, rather than the overall (ovarian and uterine) cycles, so I’m not convinced we need that one sentence, but your solution is a good one regardless, because at least it’s not out of place now. Because WP:MEDMOS suggests a Society and culture section does not mean we must have one, and you worked those two sentences in to logical places that do not disrupt the flow, whereas the Society and culture section was standing out like a sore thumb. SandyGeorgia (Talk) 19:56, 28 February 2021 (UTC)

Raven, Johnson, Biology book

Everything cited to this source needs to be checked or replaced with a new source because a) it is 2001, and b) the cited source indicated different authors than the ones pointed to in the citation. Would anyone else working here have time to make sure everything cited to this source can be verified by the links to pages given in archives?

• Raven PH, Johnson GB (2001). Biology. New York: McGraw-Hill. ISBN 978-0-07-303120-0.

The citation was originally written like this:

• Losos JB, Raven PH, Johnson GB, Singer SR (2002). Biology. New York: McGraw-Hill. pp. 1207–09. ISBN 978-0-07-303120-0.

Those links point to pages of a book that does *not* include Losos as an author. It could be a different version, so we need to make sure the version pointed at in the citations verifies the text (unless Graham is planning to upgrade to a newer source anyway). SandyGeorgia (Talk) 17:10, 27 February 2021 (UTC)

Thanks Sandy, yes I will replace the citations of that source. Graham Beards (talk) 17:28, 27 February 2021 (UTC)

 Done, go, Graham! No more Raven, Johnson, SandyGeorgia (Talk) 18:21, 28 February 2021 (UTC)

Waiting for sources

The libraries are closed where I live, so I am relying on book purchases to provide sources to update the article. I think I will need about another week to finish restoring the article to something near FA. Graham Beards (talk) 21:51, 27 February 2021 (UTC). Graham Beards (talk) 21:51, 27 February 2021 (UTC)

Thanks for being willing to spend your own money to help out this article, Graham; your efforts are most appreciated! I hope these new books will come in handy for many other articles! As you know, there is no time pressure at FAR as long as we indicate work is ongoing. SandyGeorgia (Talk) 13:53, 28 February 2021 (UTC)

Explaining the FAR process

With apologies again for my miserable piecemeal typing (my computer is still in a warehouse in Texas, waiting for the SquareTrade warranty repair shop to reopen after the February 13–17, 2021 North American winter storm), I will attempt to answer the queries about how the WP:FAR process works.

When a Featured article has fallen out of standard (meaning no longer complies with Misplaced Pages:Featured article criteria), it is re-evaluated at Misplaced Pages:Featured article review (FAR) against the criteria. FAR has multiple outcomes which include de-featuring the article with no improvements, defeaturing the article even if it improved, or improving the article to the point that it retains its featured status. Because the goal is NOT to strip the bronze star, FAR is a very deliberative process; time is allowed in any phase of the process if progress is being made, and articles are not delisted if there is still the possibility of improvement. Articles have been listed at FAR for many months, although most are processed in about a month. Those that are processed quickly are typically when no editors engage to improve the article (probably 3/4 of the FARs), and it is commendable when editors do engage and the article is improved. Typically FAs that have deteriorated are because the original writers are no longer editing and no one is watching the article— or no one watching the article is familiar with FA standards.

The first step required by the FAR instructions is to give notice explaining the deficiencies on the article talk page. As seen in the notice from January 24 at the top of this section, no one cared to address the deficiencies until the FAR was opened a month later.

In the first phase of the FAR (review), a wider net of notifications is cast with the goal of finding editors who might engage. If no one engages, after about two weeks, the nomination passes to the FARC (Featured article removal candidate) phase. If editors do engage, then improvements can be worked out on talk, but the FAR Coordinators are kept apprised on the FAR page that work is still underway. When work is judged to be nearing completion (relative to WIAFA), other (independent) editors at FAR are asked to have a look. The outcome at that point can be “Close without FARC”, or proceed to FARC for !voting to Keep or Delist, in cases when the outcome is less clear.

In the third (removal) phase, improvements may still occur, but to close the FARC, !voting happens. If improvements are not ongoing, after about another two weeks, the FARC can close with a delist if !voters so opine. But if work continues, the FARC can still remain open for quite a long time.

So, when someone is willing to take on improvements, it is always an exciting thing at FAR (compared to the number of articles that no one cares about any longer, as the original authors have usually moved on), and working towards the goal of a restored Featured article becomes a fun thing. We are at the stage where work is ongoing, and we just have to keep the FAR page apprised, more or less weekly, that work is still underway, and the Coords will look in here to verify that progress is being made.

The FAR for this article is not about any other article, and FAR is not dispute resolution: the purpose of FAR is to evaluate this article against the criteria. The quality/assessment/issues at menstruation have no bearing on the FAR for this article, which is a broader topic covering more than the menses phase. Hope this helps, please ask any questions if not clear and you can put up with my typos. SandyGeorgia (Talk) 19:46, 28 February 2021 (UTC)

Prose

As User:Tony1 would say, this snake needs chopping, but I’m not sure where to split. The cycles are driven by naturally occurring hormones and the cyclical rise and fall of the hormone estrogen prompts the production and growth of oocytes (immature egg cells) and with the hormone progesterone, the thickening of the lining of the uterus to prepare for pregnancy.. SandyGeorgia (Talk) 23:26, 28 February 2021 (UTC)

How about: The cycles are driven by naturally occurring hormones and the cyclical rise and fall of the hormone estrogen prompts the production and growth of oocytes (immature egg cells). The hormone progesterone stimulates the thickening of the lining of the uterus to prepare for pregnancy. Graham Beards (talk) 23:31, 28 February 2021 (UTC)

Better. But I’d like better a stronger split: The cycles are driven by naturally occurring hormones. The cyclical rise and fall of the hormone estrogen prompts the production and growth of oocytes (immature egg cells). The hormone progesterone stimulates the thickening of the lining of the uterus to prepare for pregnancy. Don’t want to get too short and choppy, but the first two together were confusing ... SandyGeorgia (Talk) 23:45, 28 February 2021 (UTC)

 Done improved below per Tony1. SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

I was starting to check wikilinking but then realized you might not be done writing, so will hold off. SandyGeorgia (Talk) 23:47, 28 February 2021 (UTC)

I'm done for today. Graham Beards (talk) 23:49, 28 February 2021 (UTC)

Antral follicle could benefit from a parenthetical, and I don’t know what that is. The thickness of the endometrium continues to increase in response to mounting levels of estrogen released by the antral follicle into the blood circulation. SandyGeorgia (Talk) 01:12, 1 March 2021 (UTC)

Graham Beards can you find any way to put a short parenthetical for “antral follicle”? From the article, I cannot deduce what to say ... SandyGeorgia (Talk) 13:54, 1 March 2021 (UTC)

Do you mean like this . Graham Beards (talk) 14:11, 1 March 2021 (UTC)

Good,  Done. SandyGeorgia (Talk) 14:12, 1 March 2021 (UTC)

Peak levels ... of estrogen or of the thickness of the uterine lining? Peak levels are reached at around day thirteen and coincides with ovulation.. SandyGeorgia (Talk) 01:14, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

I don’t know what is intended with “dominated by”, and suggest this sentence could be split or use a semi-colon. The follicular phase is the first part of the ovarian cycle and is dominated by maturing follicles, and during this phase, the ovarian follicles mature and get ready to release an egg.. SandyGeorgia (Talk) 01:20, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

This hasn’t been defined/discussed yet ... can this sentence be moved to there? The latter part of this phase overlaps with the proliferative phase of the uterine cycle. SandyGeorgia (Talk) 01:23, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

This is the first time we encounter the word “ovum”: The follicle that reaches maturity is called a tertiary or antral follicle, and it contains the ovum. SandyGeorgia (Talk) 01:25, 1 March 2021 (UTC)

Found it linked later, fixed. SandyGeorgia (Talk) 01:42, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

The first two years after menarche???? Ovulation only occurs in around 10% of cycles during the first two years,. SandyGeorgia (Talk) 01:29, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

This whole paragraph needs attention, such that I suspect it Was Not Written by Graham :)

These hormones are regulated by gonadotropin-releasing hormone (GnRH), and a surge of GnRH has been shown to precede the LH surge, suggesting that estrogen's main effect is on the hypothalamus region of the brain, which controls GnRH secretion. This can be enabled by the presence of two different estrogen receptors in the hypothalamus: estrogen receptor alpha, which is responsible for the negative feedback estradiol-LH loop, and estrogen receptor beta, which is responsible for the positive estradiol-LH relationship. High levels of estradiol can provoke 32 increases in LH in humans, even when GnRH levels and pulse frequencies are held constant, suggesting that estrogen acts directly on the pituitary to provoke the LH surge.

We’ve talked about a lot of hormones at this point: which of them is “these”? All of them? Besides that, I have no idea what this paragraph is saying or why it matters: help the lay reader? SandyGeorgia (Talk) 01:36, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

Secondary oocyte links to oocyte, and secondary is never mentioned in that article. The release of LH matures the egg and weakens the wall of the follicle in the ovary, causing the fully developed follicle to release its secondary oocyte. SandyGeorgia (Talk) 01:38, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

Stopping there (just before Luteal phase) for Graham to catch up. Will continue later, SandyGeorgia (Talk) 01:48, 1 March 2021 (UTC)

I think I have caught up. Graham Beards (talk) 13:38, 1 March 2021 (UTC)

I received notification from Sandy's use of my name above. I looked at the opening sentence only:

"The menstrual cycle is a series of natural changes that occur in the human female reproductive system (specifically the uterus and ovaries) that makes pregnancy possible."

Is it the female reproductive system that makes pregnancy possible? Surely yes, but I don't think that's the intended meaning. The reader shouldn't have to guess what is making pregnancy possible. And don't other animals have menstrual cycles? Why human? I'll have a go:

"The menstrual cycle is a series of natural changes in the the uterus and ovaries of the female reproductive system that make pregnancy possible."

I still may not have the right wording, though. Is the rest of the article more clearly written? Tony (talk) 06:09, 1 March 2021 (UTC)

Thanks, Tony1 ! Great to see you doing what you do, SandyGeorgia (Talk) 13:52, 1 March 2021 (UTC)

Subject-verb agreement??? The thickened lining of the uterus and its blood supply provides nutrients to an embryo if it successfully implants. A and B provide? Or A, along with B, provides ? Or, The blood supply from the thickened lining of the uterus provides ... ??? SandyGeorgia (Talk) 14:15, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 15:32, 1 March 2021 (UTC)

Two weeks, fourteen days ... what distinction is being made ? From the time of ovulation until progesterone withdrawal has caused menstruation to begin, the process typically takes about two weeks, with 14 days considered normal SandyGeorgia (Talk) 14:20, 1 March 2021 (UTC)

 Done. SandyGeorgia (Talk) 15:32, 1 March 2021 (UTC)

I don't know if this is quite as done as you'd like. What that sentence meant to say is that the process typically takes approximately two weeks, and that exactly 14 days was the most common number. I haven't looked, but if memory serves, I believe that anything in the range of 10–15 days is officially normal/healthy (i.e., quite a bit shorter or a little longer; it's not evenly distributed). WhatamIdoing (talk) 22:54, 1 March 2021 (UTC)

 Not done per WAID still needs attention. SandyGeorgia (Talk) 23:49, 1 March 2021 (UTC)

I think we can leave it as it is. From my sources, Reed says "This phase is usually 14 days long in most women", and Ugwunadu says, "about 14 days after ovulation". I don't think we need a discussion on a skewed distribution. Graham Beards (talk) 09:26, 2 March 2021 (UTC)

I recognize the need to vary wording, but thinking of the layreader, why do we switch from “average” to “median”? @Colin and WhatamIdoing: this is part of your mathy-concern thingie and how we talk about numbers. The average age is generally later in the developing world and earlier in developed world, and the median cycle length can vary from 28 to 36 days. SandyGeorgia (Talk) 14:37, 1 March 2021 (UTC)

Because the they are different. The simple average is the mean. The median covers 50% of the population. The mode is the most frequent.Graham Beards (talk) 14:48, 1 March 2021 (UTC)

Yes, we know that, but they layreader does not ... these kinds of issues are things that Colin and WAID like to toy with :). SandyGeorgia (Talk) 15:12, 1 March 2021 (UTC)

The lay reader has a better chance of discovering these wonderful concepts if we use the correct terms. We can link them to provide greater clarity. WhatamIdoing (talk) 22:56, 1 March 2021 (UTC)

I agree. These are standard school concepts, even if people get a bit rusty on them with lack of use. I think people will probably guess "median" is something to do with a middling value, even if they can't remember the formal definition. However, I do find this paragraph confusing. The sentence Sandy quotes starts off commenting on "average age" (which the previous sentence explains is the menarche) and ends commenting on cycle length. I think that is too confusing. Can we discuss menarche and cycle length separately, in separate paragraphs even? I'm also confused about "median cycle length can vary from 28 to 36 days". What is that the median of, because median is a single number drawn from a sample. So is this the median of each woman's own cycle length measured over a year, say, that varies among all women from 28 to 36 days? Or are we still talking about developing/developed nations, and this is the median within different economic/national groups that vary from country to country from 28 to 36 days? Or something else? -- Colin° 10:36, 2 March 2021 (UTC)

Saying there's a median of 28 to 36 is just wrong. WhatamIdoing (talk) 01:51, 8 March 2021 (UTC)

Reading some more of the article, I think it may be useful to say something about expected variation within an individual woman, and variation within the population.

Btw, I see earlier we comment on the relationship between the lunar cycle and the ovarian cycle and say "in modern humans there is no relation between the two". What do we mean by "modern humans"? Are we suggesting we know the cycles of prehistoric humans? Or is this a comment about us living in a world that is lit by lamps at night rather than by the moon. Or is "modern" irrelevant. I see Lunar effect links back here but the link no longer works as "The Moon" section doesn't exist. -- Colin° 10:46, 2 March 2021 (UTC)

Thanks Colin. I'll add something on average (mean, median or mode depending on sources) cycle lengths in different settings. I have deleted "modern humans" - I don't know where that came from. Similarly, I don't think we need "median cycle length can vary from 28 to 36 days", here. Graham Beards (talk) 12:18, 2 March 2021 (UTC)

I think that the "modern humans" was meant to express uncertainty about the relationship in the past (whether pre-industrial or pre-historic). I agree with removing it. WhatamIdoing (talk) 01:49, 8 March 2021 (UTC)

It is not at all apparent why we are introducing delayed puberty (this is content that Graham inherited). This needs a better transition to explain why it’s here or provide context. Delayed puberty is the absence of secondary breast development by the age of thirteen years.. SandyGeorgia (Talk) 14:39, 1 March 2021 (UTC)

Removed,  Done. SandyGeorgia (Talk) 15:33, 1 March 2021 (UTC)

It is not entirely clear what is meant by “corresponds with”: Menses occurs on average once a month from menarche to menopause, which corresponds with a woman's fertility. SandyGeorgia (Talk) 14:41, 1 March 2021 (UTC)

I meant "fertile years".14:55, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 15:39, 1 March 2021 (UTC)

This sentence is oddly tacked on to a paragraph about other stuff. It is unclear why it is here. Does it need a better transition, or does it belong over at menstruation, not here ? ] An enzyme called plasmin breaks up the blood clots in the menstrual fluid.. SandyGeorgia (Talk) 14:44, 1 March 2021 (UTC)

Without this important enzyme, menses would not occur. The blood and discarded lining would say in the uterus and decompose. Graham Beards (talk) 15:08, 1 March 2021 (UTC)

Could you work this in? SandyGeorgia (Talk) 16:56, 1 March 2021 (UTC)

Yes. I'll try to make it sound less stomach-turning. Graham Beards (talk) 17:07, 1 March 2021 (UTC)

 Done SandyGeorgia (Talk) 23:49, 1 March 2021 (UTC)

Multiple issues: The estrogens initiate the formation of a new layer of endometrium in the uterus, histologically identified as the proliferative endometrium. The estrogen also stimulates crypts in the cervix to produce cervical mucus, which causes vaginal discharge regardless of arousal, and can be tracked by women practicing fertility awareness.

Do we need to introduce the “histology” jargon, or can we just say “anatomically”?

We don’t really explain what is “tracked”, why or how ... that is, the amount of vaginal discharge in this part of the cycle can help women who are tracking fertility ... the construct is not very clear. See next point (below). SandyGeorgia (Talk) 14:57, 1 March 2021 (UTC)

Snake for chopping: During the secretory phase, the corpus luteum produces progesterone, which plays a vital role in making the endometrium receptive to implantation of the blastocyst and supportive of the early pregnancy, by increasing blood flow and uterine secretions and reducing the contractility of the smooth muscle in the uterus; it also has the side effect of raising the woman's basal body temperature.

And should we be introducing here that basal body temperature is also part of tracking fertility (per above), or should we separate both of those sentences into one sentence about fertility tracking ?? SandyGeorgia (Talk) 15:00, 1 March 2021 (UTC)

In fact, the “Ovulation suppression and interventions” section is short and choppy ... can it be expanded to move all of the fertility awareness tracking stuff into it ? Just an idea ... because by this point, we have now explained all the pieces. SandyGeorgia (Talk) 15:09, 1 March 2021 (UTC)

That’s all I’ve got; once this is done, perhaps we will get Ajpolino, Colin, Spicy and Tom (LT) to go through. SandyGeorgia (Talk) 15:10, 1 March 2021 (UTC)

Sourcing

Stat Pearls is used twice, for completely uncontroversial information, and WebMD is used for three non-controversial statements. Any objections? WhatamIdoing? SandyGeorgia (Talk) 02:00, 1 March 2021 (UTC)

I'm not concerned about sources for uncontroversial information. The value in a source is utilitarian. They need to help us get the article content right. If they do that, they're good enough. WhatamIdoing (talk) 23:23, 1 March 2021 (UTC)

I agree with SG. In my opinion based solely on the fact it is called 'stat pearls' and therefore is likely directed at learning or memorising content rather than intended as an up to date summary of a topic area, I don't think this should be used at all in our best articles. No objections in other areas but I think a featured article deserves an appropriately reliable source. --Tom (LT) (talk) 09:29, 2 March 2021 (UTC)

MOS issues

WP:LAYOUT says explicitly that the short description goes first, but someone changed it. Thoughts ? SandyGeorgia (Talk) 14:26, 1 March 2021 (UTC)

There is (caused by me) a WP:MOSNUM mess with respect to ages. Some paragraphs discuss only menarche (young girls) with ages like eight and twelve, so I switched them all to spelled out to agree. But then the same sections discuss menopause, with ages like 45 and 55, so digits are used. Does anyone think we should just use all digits for ages so that entire sections are consistent, or should we consistently spell out the lower numbers per MEDMOS even if sections are not consistent? SandyGeorgia (Talk) 14:26, 1 March 2021 (UTC)

This is an issue that User:Tony1 would be good at addressing :). How do I resolve this? Digits throughout, consistency within paras, consistency within sections? SandyGeorgia (Talk) 14:34, 1 March 2021 (UTC)

Have you considered the "10 and under" approach? That would mean "eight to 12" is okay (although we could stretch it to "eight to twelve") and that 45 and 55 must always be digits.

Other editors prefer all digits. All digits is easier for some people to read. I think it looks silly for one and two, but I have no objection to "8 to 12". WhatamIdoing (talk) 22:58, 1 March 2021 (UTC)

I am conflicted because a) “10 and under” doesn’t work when MOS also calls for consistency within lists, b) I hate to read all digits as I feel like they overwhelm the reader, but c) I hate mixing digits with spelled out. ‘Tis a dilemma! Can go with whatever everyone is comfortable with ... SandyGeorgia (Talk) 23:28, 1 March 2021 (UTC)

What criteria are being used for inclusion in See also?

• Menstruation (mammal) makes sense because this article is about the human cycle, and it tells the reader where to find other mammals.

  In fact, should this article not be linked in to the text in the “Evolution and other species” section SandyGeorgia (Talk) 15:54, 1 March 2021 (UTC)

Yes.Graham Beards (talk) 16:31, 1 March 2021 (UTC)

 Done. SandyGeorgia (Talk) 17:11, 1 March 2021 (UTC)

• Ovulatory shift hypothesis, unclear, does it have any traction? Is it necessary here?

No. Graham Beards (talk) 16:31, 1 March 2021 (UTC)

 Done (and that article is quite the mess of SYNTH and primary sources and out of date). SandyGeorgia (Talk) 03:14, 3 March 2021 (UTC)

• Menstrual hygiene management is part of menstruation; we need to establish how many of the sub-topics of menstruation are going to end up on See also here and what the logic is; I don‘t see the reason for this one link to be here. SandyGeorgia (Talk) 14:32, 1 March 2021 (UTC)

Neither do I. Graham Beards (talk) 16:31, 1 March 2021 (UTC)

If we remove the "See also" section altogether, that's alright. But would it be OK to include the term menstrual hygiene management somewhere in the text? If we have teenagers coming to this page (perhaps before they go to the more practicel menstruation page, perhaps we could say something about menstrual hygiene management, just half a sentence somewhere? Or do we feel that they would find it after clicking through to menstruation? — Preceding unsigned comment added by EMsmile (talk • contribs) 02:39, March 3, 2021 (UTC)

I’m not understanding the claim at all about teenagers coming to this page to understand menstruation. The very first thing they will encounter is a dab link at the top of the page that will send them to menstruation, if they typed in the wrong search term and that is what they are actually looking for. If the typed in period, that page is sending them straight to menstruation away. I can’t imagine why they would type in “menstrual cycle”. Nor am I seeing that the article menstrual hygiene management is aimed at these teenagers. SandyGeorgia (Talk) 03:05, 3 March 2021 (UTC)

Image review

Nikkimaria could you do an image policy check here? Thanks in advance, SandyGeorgia (Talk) 15:21, 1 March 2021 (UTC)

Licensing is appropriate. File:Illu_cervix.jpg is tagged as lacking author information and File:MenstrualCycle2_en.svg would benefit from more specific source information. All images should have alt text added. Nikkimaria (talk) 15:51, 1 March 2021 (UTC)

Thank you, Nikki ... I Don’t Speak Images and have never edited Commons; can someone fix these? SandyGeorgia (Talk) 16:52, 1 March 2021 (UTC)

Colin might you be able to address Nikki’s points? SandyGeorgia (Talk) 15:01, 2 March 2021 (UTC)

For the File:Illu_cervix.jpg author information, the source website does not explicitly give credit. Some images on that site are created by third-parties and have copyright, while some are created by NCI and are copyright-free. Per this advice I have emailed them to ask about this image. The file File:Basic Female Reproductive System (English).svg may be a suitable alternative: its sourcing is documented if complex, ending at this CDC diagram.

For File:MenstrualCycle2_en.svg, we are unlikely to learn what the sources were, since the author has not edited for more than 10 years. Google image search for "events of menstrual cycle" produces lots of similar images (and some that credit our image). To be honest, though, if the author had just said "Own work" we'd have been no wiser, and nobody would have raised a query. I suggest we AGF unless someone points out an older and visually identical image from some textbook or ancient website. -- Colin° 15:54, 2 March 2021 (UTC)

Accessibility

RexxS do you see any accessibility issues, and might you do alt text ? Thanks in advance, SandyGeorgia (Talk) 15:22, 1 March 2021 (UTC)

Age of menarche

I can’t decipher what is up with the IP changes of data, and I may have tagged the wrong version. Which source says what? SandyGeorgia (Talk) 15:29, 1 March 2021 (UTC)

Let's stick with "around 12 years", which most of the sources accept. Graham Beards (talk) 16:32, 1 March 2021 (UTC)

Some sources give a "normal" that encompasses a small group (e.g., the 50% in the middle) and others a "normal" that encompasses a large group (e.g., anything that isn't pathological). If we have sources, it might be useful to say something like "around 12 years is common, but anything between 8 and 16 can be healthy". WhatamIdoing (talk) 23:27, 1 March 2021 (UTC)

I am sorry I don't have a source here, but I feel like with the onset of menopause there is likely to be a large amount of both individual and geographical variation in this so I think it would be more appropriate to provide the range of normal rather than an average year. --Tom (LT) (talk) 09:30, 2 March 2021 (UTC)

There is so much geographical variation that it's proving nigh on impossible to find a WP:MEDRS source that gives a range that we can use. I can't do it with breaking WP:SYNTH, so the best I can offer is what we already have in the article "The average age of menopause in women is 52 years, and it typically occurs between 45 and 55 years of age.Towner MC, Nenko I, Walton SE (April 2016). "Why do women stop reproducing before menopause? A life-history approach to age at last birth". Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 371 (1692): 20150147. doi:10.1098/rstb.2015.0147. PMC 4822427. PMID 27022074." Graham Beards (talk) 11:41, 2 March 2021 (UTC)

'The menarche'

I am not acquainted with the description of menarche as "the menarche". To be sure that this wasn't just a regional variation I also checked Merriam-Webster here . I think it is more typical to refer to "menarche" without "the". --Tom (LT) (talk) 09:45, 2 March 2021 (UTC)

I think there was only one, which I have fixed. Graham Beards (talk) 10:37, 2 March 2021 (UTC)

Use of 'menses'

Within this article, the term 'menses' is variably used to refer to part of the uterine cycle ("The uterine cycle has three phases: menses, proliferative and secretory"), the first day of menstruation ("the first day of menstruation (menses) "), menstruation itself ("Menstruation (also called menstrual bleeding, menses, catamenia or a period) ") and menstrual fluid ("The flow of menses "). As a solution to this I propose unless absolutely necessary the word should be removed or substituted. --Tom (LT) (talk) 09:45, 2 March 2021 (UTC)

Thanks, I have culled them. Graham Beards (talk) 11:42, 2 March 2021 (UTC)

Jargon, readability and further prose checking

Medical editor Graham Beards is done with the bulk of the writing and source updating, and anatomy editor Tom (LT) has been through. I think I have gotten most of the MOS issues and am satisfied with the numbers vs digits as I now have them, where less than 10 and teens are spelled out (menarche) but menopause ages are digits.

PlanetCare, you indicated you would like to do a readability review, and now would be a good time. @Femkemilene: might you also review now? SandyGeorgia (Talk) 15:15, 2 March 2021 (UTC)

Clayoquot I recognize that you are swamped, but the article is to a readable place, should you find time to glance at it. Gandydancer ? SandyGeorgia (Talk) 15:22, 2 March 2021 (UTC)

SandyGeorgia, Alrighty, there have not been many times in my life when I've gotten two invitations to a place where some of the coolest people in town are already hanging out, so I will join the party! Clayoquot (talk | contribs) 06:45, 3 March 2021 (UTC)

Thanks for letting me know it was time to make a run at improving readability. I've done that with only the Lead. Shorter sentences, shorter words. No changes to meaning. In some cases, I switched the sequencing of the info in a sentence. For example, "During menstruation," at the beginning of the sentence rather than at the end helps the reader orient their mind to what's coming. I did read on to the rest of the article and can see there's a tendency to use "run-on" sentences. A period and a capital letter cures that, but many academic writers would rather keep parallel points in one long sentence. Maybe we should leave it to original authors to decide if they want to reword to use shorter sentences? I often just work on leads. What do others think? User:SandyGeorgia User:GrahamBeards User:EVSmile PlanetCare (talk) 18:51, 4 March 2021 (UTC)

People who want parallel points in one long sentence can use a semicolon. WhatamIdoing (talk) 03:18, 8 March 2021 (UTC)

Gandydancer

OK, for now just covering the lead: The wording says: Some women experience problems sufficient to disrupt daily functioning as a result of their menstrual cycle. These include acne, tender breasts, bloating, feeling tired, irritability and mood changes. About 20% of women have issues that interfere with daily lives and 3 to 8% experience more severe problems... This wording has always bothered me because it seems to support the suggestion that women are less than well- balanced (due to their hormonal cycles) than men and thus less capable than men who don't get periods. To read that tender breasts, bloating and acne disrupt ones life seems a bit extreme to me. Perhaps fatigue, irritability and mood changes could disrupt, but IMO only if they are severe. From my memory of my teenage years, it seems that the boys had as much acne as the girls, if not more, and I doubt that it is mentioned in our male articles. So then what we get is a president of the United States feeling perfectly correct when he suggests that a female journalist is showing how unable a woman is to carry on a rational conversation in a presidential debate because of her periods. On the other hand, when this information is coming from multiple RS, I don't know what we can do about it. Gandydancer (talk) 16:52, 2 March 2021 (UTC)

At one point, I thought I had rephrased to reflect the majority (80% of women do *not* have issues); by focusing on the 20% that do, are we not presenting the menstrual cycle as a disease state rather than a normal cycle? Can we fix this by reflecting the majority rather than the minority? The fix that I made (to the 80% rather than the 20%) seems to be over at menstruation ... SandyGeorgia (Talk) 17:11, 2 March 2021 (UTC)

That's why I switched it around. Graham Beards (talk) 18:44, 2 March 2021 (UTC)

Looking at the two sources we are using it seems to me that neither of them actually call PMS bad enough to affect daily living in those that don't have severe symptoms as we are presently saying: Some women experience problems sufficient to disrupt their lives as a result their menstrual cycle. These include acne, tender breasts, bloating, feeling tired, irritability and mood changes. Looking at the sources, one says PMS can be bad enough to affect daily living but may just be a "bother" for others. The other says, "The pooled prevalence of reproductive age women affected with PMS worldwide amounts to 47.8%. Among these, about 20% of women experience symptoms severe enough to disrupt their daily activities, and the remaining have mild to moderate symptoms." Gandydancer (talk) 21:03, 2 March 2021 (UTC)

I've read that some women experience bloating to the point that their clothes don't fit, which probably counts as disrupting everyday life. Presumably breast tenderness could reach a point at which hugging, carrying toddlers, etc. would be a problem. I share Gandydancer's trouble imagining how cyclical acne disrupts everyday life. Acne can be uncomfortable, but it doesn't seem disruptive, especially if it reliably clears up after a week or so. WhatamIdoing (talk) 03:24, 8 March 2021 (UTC)

In the Menstruation health section this wording: In some women, ovulation features a characteristic pain called mittelschmerz (a German term meaning middle pain). This occurs when an egg does not enter the fallopian tube but the pelvic cavity where it breaks up. The small amount of blood loss associated with the ruptured follicle is the cause of the pain. This is not correct. Pain at the time of ovulation is quite common and can occur monthly in a perfectly normal ovulation. Gandydancer (talk) 20:20, 2 March 2021 (UTC)

I was writing about "a characteristic pain" not just a pain. So it is correct. How can we make this clearer? Graham Beards (talk) 20:37, 2 March 2021 (UTC)

I suspect we need to do the following (meaning we need to find a source to do the following). The “characteristic” sharp pain is mittelschmerz. But, in women experiencing mid-cycle pain, we don’t want to leave the impression that all is well, this is normal, in the event they have something else going on which requires medical attention, like endometriosis or a cyst. Or God forbid a life-threatening ectopic pregnancy. Is that the concern, Gandydancer? If so, we must find a source ... SandyGeorgia (Talk) 21:53, 2 March 2021 (UTC)

Sandy, reading the Mittelschmerz article I don't find that "The “characteristic” sharp pain is mittelschmerz." For me and for the women I have talked with it is a minor pain just enough to make one think "Oh, I'm ovulating," and it is my impression that this is what the mittenschmerz article generally says. As for ovarian cyst, my daughter had a huge one and they correctly told her to just wait and see--it will most likely take care of itself. Our article says, Often they cause no symptoms. Occasionally they may produce bloating, lower abdominal pain, or lower back pain. The majority of cysts are harmless. If the cyst either breaks open or causes twisting of the ovary, it may cause severe pain. Re endometriosis, I wonder if we should mention it? Same for ectopic pregnancy since as you say it is life threatening. Do these conditions need a section of their own so that we can refer people to the other articles? Gandydancer (talk) 22:28, 2 March 2021 (UTC)

No, I don’t think we should go into detail on all of the menstruation or reproductive disorders in an article about the cycle, but mittleschmerz is here as a fairly natural part of ovulation, so we need to find a source to distinguish others lest we leave a misimpression. (I don’t consider what our other articles say to be very useful for this.). Per this google books source and others, mittleschmerz needs to be differentiated at least from ectopic pregnancy and ruptured ovarian cyst. We don’t need to go into all of those, but perhaps just mention that besides mittleschmerz other, more serious conditions can cause mid-cycle pain. SandyGeorgia (Talk) 22:49, 2 March 2021 (UTC)

Graham, what about something like this ... we now have:

• In some women, ovulation features a characteristic pain called mittelschmerz (a German term meaning middle pain).

We put a footnote after “characteristic pain”. We don’t need to introduce all the other stuff in to the text, but I am worried that we not leave the impression that mid-cycle pain is never to worry about. The footnote says something along the lines of: Other, more serious medical conditions can also cause mid-cycle pain. And cite that to the differential diagnosis literature that includes all the bad stuff like ruptured cysts, ovarion twisting, ectopic pregancy, etc. which are distinguished from mittelschmerz. SandyGeorgia (Talk) 15:08, 4 March 2021 (UTC)

I think a footnote would work well as along as we don't make it sound like advice of course. Graham Beards (talk) 15:23, 4 March 2021 (UTC)

I wonder whether it would be useful to differentiate between mid-cycle pain and pain that coincidentally happens to appear mid-cycle. A one-time pelvic pain that appears mid-cycle could be a UTI, STI, hernia, appendicitis, diverticulitis, kidney stone, etc.

Generally, "characteristic pain" is a code word for being recognizable to the person experiencing it. That is, if you get this, it's a pain you get every cycle (or at least most cycles), and you can recognize it and differentiate it from other sensations. Maybe it'd be clearer to use a different word instead of "characteristic". WhatamIdoing (talk) 03:37, 8 March 2021 (UTC)

Femke

• the word womb/uturus is glossed on the second mention. Maybe it should be glossed in the first sentence

What do you mean by "glossed"? Graham Beards (talk) 18:33, 2 March 2021 (UTC)

It's made clear that the difficult word uterus is synonomous to the more common word womb by putting parentheses around it: lining of the womb (uterus)

• Still some redundancy in the last paragraph (Some women experience problems sufficient to disrupt daily functioning as a result of their menstrual cycle/About 20% of women have issues that interfere with daily lives
• I'm of the opinion the word comprises is above our typical reading level.

No. It's an everyday word surely. Graham Beards (talk) 18:32, 2 March 2021 (UTC)

We're talking about 10-14 year olds that read this page after just having had their first period. Of course, not everything needs to be understandable to them, but I do imagine a big chunk of our audience is teenage girls, and we should do everything we can do, without leaving out science, to reduce difficulty. FemkeMilene (talk) 18:48, 2 March 2021 (UTC)

It's an everyday word even for teenage girls where I live. But change it if you want. Graham Beards (talk) 19:11, 2 March 2021 (UTC)

I did some asking around, and my sample of 5 seemed to agree it's not the easiest word. Consists of may be repetitive however, so I'll have another think when I'm less tired. FemkeMilene (talk) 21:44, 2 March 2021 (UTC)

Encompasses ??? SandyGeorgia (Talk) 21:49, 2 March 2021 (UTC)

It is my impression that womb is as old fashioned word not used much any more. As for "uterus,", keep in mind that young girls get this knowledge in school in many cases and I'm willing to bet that they are very familiar with the word uterus. Gandydancer (talk) 22:46, 2 March 2021 (UTC)

Uterus is way more common than womb these days. Clayoquot (talk | contribs) 06:27, 5 March 2021 (UTC)

• Between menarche and menopause the human ovaries regularly alternate between the luteal and follicular phases -> To me, this reads like it happens maybe 30 times in a lifetime, but it's every cycle, right? If so, drop the 'Between menarche and menopause'. FemkeMilene (talk) 17:11, 2 March 2021 (UTC)

They don't do this before menarche or after menopause. Graham Beards (talk) 18:31, 2 March 2021 (UTC)

I know it's technically correct, but it throws the reader off by talking about a woman's life cycle, whereas this happens within the menstrual cycle. FemkeMilene (talk) 08:17, 3 March 2021 (UTC)

There is no mention of a "woman's life cycle".Graham Beards (talk) 09:23, 3 March 2021 (UTC)

I sometimes wish telekinesis was a thing to explain my brain on wiki. By emphasizing "menarche and menopause", two vital points of a woman's life cycle, you seem to begin talking about a different topic than the menstrual cycle. My default understanding is that luteal phase and follicular phase are part of the menstrual cycle, but by mentioning something some other cycle, I'm confused (and a separate sample of N=1) . Would Within the menstrual cycle, the human ovaries regularly alternate between the luteal and follicular phases work?

The previous section (called Times, still thinking of a better word there) already talk about the fact that the menstrual cycle doesn't take place before first period/after menopause. FemkeMilene (talk) 19:33, 3 March 2021 (UTC)

OK, first women don't really have life cycles but as a compromise I have changed it to: "Between menarche and menopause the human ovaries regularly alternate between the luteal and follicular phases during the monthly menstrual cycle." And has anyone checked the endocrinology? I'm still finding omissions. Graham Beards (talk) 21:20, 3 March 2021 (UTC)

Why do we even have the “Timings” subhead? It unnecessarily creates a one-paragraph section, when that content does fine in that section without the (awkward) subheading. SandyGeorgia (Talk) 14:11, 4 March 2021 (UTC)

I think it was useful to have a sub-heading called "timing" (or some other, better term) so that people can jump directly from the table of content to there. We have had a heading like that for years. It used to be called "onset and duration" which I don't think captured it well. Why are you so against having such a sub-heading, SandyGeorgia? Makes it easier for the reader to find information, doesn't it? EMsmile (talk) 00:57, 5 March 2021 (UTC)

I think you mean “Onset and frequency”? When you say we had it for “years”, I guess you mean since the article was changed to a “disease” state in 2015 (at a point when similar ‘’fait accompli’’ was happening across many medical articles) while I have a longer view, and relate more to my involvement with this article since 2007, when this normal biological process was not viewed as a disease article, and “onset and frequency” sounds disease-y to me. But more significantly, we don’t need a section for one paragraph, when the section it is in now is only two paragraphs. And I’m not all convinced that people are coming to this article specifically for that data, nor do we choose section headings around a Crystal Ball. And if they are coming here looking for that information, that is why the most important timing detail is already in the lead. One thing that happens with stubby section headings is that people start chunking in irrelevant information, primary sources, and advocacy content. A well structured article doesn’t lend itself to such. More importantly, we should be guided by sources. The secondary sources we use don’t divide the topic that way; they discuss phases, as we do. Graham could tell us whether any of the textbooks separate out ages/timing as you suggest. Featured articles strive for a professional presentation that reflects sources, which is very different than content areas that are related to policy advocacy, and we shouldn’t be guiding the reader to what we THINK they might want to read, or what we want them to think, rather reflecting sources. This biological process is not a disease state, and sources discuss the phases. SandyGeorgia (Talk) 01:32, 5 March 2021 (UTC)

Also, I suggest that a lot of what might be driving your concerns could be resolved by dealing with the abysmal state of the article at menstruation. That is an important article, that is an unmitigated wreck, and addressing that would go a long way towards giving our readers the information you believe they want. Bringing menstruation to Featured status would be awesome. Once an article becomes featured, it gets read more: User:SandyGeorgia/Achieving excellence through featured content. But the lead image right now makes it appear that it is striving more for advocacy than for medical accuracy or meeting Misplaced Pages policy and guidelines. SandyGeorgia (Talk) 01:43, 5 March 2021 (UTC)

Can we fix the redundancy about the 20% by mentioning instead the 80% that have no issues (see point above from Gandydancer). I introduced the word “comprise” only because I couldn’t find a better word, but agree it should be changed if someone can do better. SandyGeorgia (Talk) 17:14, 2 March 2021 (UTC)

I typically replace the word comprise with consist of.

Not sure what the source says (I can't find the 20%, 3% and 8% in the source given), but most of those 80% still have some issues, even if it doesn't interfere with daily life (easy-to-ignore pain f.i.). It's not clear from the text that the symptoms of acne and all are PMS symptoms. I think we should condense PMS, and add something about normal period pain to that paragraph, or the second paragraph of the lede. FemkeMilene (talk) 18:01, 2 March 2021 (UTC)

Whether acne is a PMS symptom depends upon both the acne and the definition of PMS being used. Not every case of period pimples is PMS, and women can get acne that has nothing to do with the menstrual cycle. WhatamIdoing (talk) 03:43, 8 March 2021 (UTC)

That is beside my point, but interesting. The point is that were using a source about PMS to make claims about the menstrual cycle in general. FemkeMilene (talk) 08:12, 8 March 2021 (UTC)

The full text of the salient paragraph is at the bottom of this page. Graham Beards (talk) 18:37, 2 March 2021 (UTC)

The placement of FN1 implies the numbers can be found there, instead of in FN11. Is FN1 needed in that sentence? FN11 is solely about PMS/PMDD, not about the menstual cycle in general. I imagine menstrual cramps are at least as likely to cause problems as PMS symptoms. That should be made clear in the lede. FemkeMilene (talk) 21:54, 2 March 2021 (UTC)

• Replace uterus, ovum, menarche by womb, egg and first period in as many locations as possible? FemkeMilene (talk) 22:00, 2 March 2021 (UTC)

I really like your approach here FemkeMilene, and generally agree with you. However, the word "womb" might indeed not be any easier than "uterus". Keeping in mind that people will also come to this page also when English is not their first language (like it is for me). As a teenager, one would be learning a few new words and whether I learn "womb" new or "uterus" makes no difference. Ovum replaced with egg - maybe although when I hear egg I automatically thing of a chicken's egg. "First period" I also find not ideal because after e.g. pregnancy there is a point when a woman has another "first period" (after a break of 2 years for example). I think those key technical terms are not so problematic but apart from that I am all for improving readability, e.g. shorter sentences, less passive voice, more active voice, as little jargon as possible but still be accurate. EMsmile (talk) 02:43, 3 March 2021 (UTC)

Per romance languages I have to agree that uterus and ovum are going to be the more familiar terms in the non-English languages I speak. I think we have this covered by having inserted parentheticals on the first occurrence. SandyGeorgia (Talk) 02:53, 3 March 2021 (UTC)

I really do not understand why we would not use the most common word, uterus, when womb is not commonly used and when it is it generally refers to a uterus with a baby in it. This article is part of our medical series and the correct Latin/medical word is uterus. You will not find a diagram showing the placement of the uterus, ovaries, etc., where it is called a womb. Speaking of this or that function, dysfunctions, etc., it is called a uterus, not a womb. Gandydancer (talk) 03:37, 3 March 2021 (UTC)

Deferring to native speakers on uterus of course :). For ovum, I'm not so sure that a single glossing will do. It's not superclose to huevo or oeuf for roman speakers, and I only knew what it means via ovo-vegetarianism. Even worse for menarche. FemkeMilene (talk) 08:03, 3 March 2021 (UTC)

I think we have to be careful here to balance our strengths and weaknesses as native/non-native readers/writers.

This article will be read by all ages, including women at the opposite end of their fertility. These women, who may have had children and taken pills and patches and had all sorts of procedures, may not appreciate being written to as though this was a "Your first period" leaflet for children.

One measure of whether to use technical vs lay or simplistic words, is whether those terms are important to an understanding of the subject area or not, and help the reader when they read other material on the topic, or when they visit professionals. Uterus, ovum and menarche all sound like words someone reading an encyclopaedia about the female reproductive system would expect to read and learn. Menarche may be rarely used everyday, and it is odd that the opposite, menopause, is an everyday word. I see the article explains menarche several times and/or uses it like "from menarche to menopause" in a way that helps the reader remember what it is. It is seeing these professional-level words used in-context and idiomatically that reinforces learning and I do think that is part of our mission. If we just replaced it with "first period" everywhere, and relegated use of menarche to its own article, we'd be neglecting a learning opportunity. -- Colin° 12:49, 4 March 2021 (UTC)

Nail —> head Colin. (Not to mention all these complaints about menstrual issues; the grass is always greener on the other side of the hill? Not. :) SandyGeorgia (Talk) 14:14, 4 March 2021 (UTC)

I'm not arguing that we should make this article understandable for 10 year olds. The main audience we should target for those students between the ages of 15 and 18 studying the mention cycle for school. I imagine that is a more substantial group of our readers than younger girls. The difficulty I would like to see is similar to the NHS: https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/.

The main thing we need to convey are the mechanisms / processes. Jargon distracts from that primary teaching goal, and jargon itself should in my opinion never be a teaching goal.

I think many sections of the article aren't far off from the level I would ideally see. I'm not gonna bludgeon discussion by insisting we should use egg / first period, but I do think I've got other suggestions to make the article fit for purpose. FemkeMilene (talk) 16:54, 4 March 2021 (UTC)

Teaching relatively common terms is an appropriate goal because that enables readers to understand the sources, and occasionally even their own medical records. Misplaced Pages has a really broad audience, and it's good to have something for everyone. WhatamIdoing (talk) 03:50, 8 March 2021 (UTC)

Introducing or using jargon gratuitously is unjustified. Some jargon is unnecessary even for professionals and simply exists to sound pompous or exclude people. However, professional terms can be difficult or obscure, but are widely used, have additional precision or allow necessary brevity. I do think it is our job to educate readers about topic-relevant terms that professionals use, and not doing that weakens our articles. People will see those terms when they read academic or professional writing about the subject, such as sources or medical notes as WAID says, and so need to know what they mean. I remember one article on a drug for high blood pressure that had been edited to avoid ever mentioning "hypertension". The NHS mentions hypertension immediately. It's a word many people won't know, but if you've got it enough to need pills for it, then it would be really odd to read an article about your drug that doesn't mention the condition your doctor diagnosed you with by the name the doctor used. -- Colin° 18:11, 8 March 2021 (UTC)

• Although the average length of the human menstrual cycle is similar to that of the lunar cycle, there is no causal relation between the two. -> Should this be in the uterine cycle, as it's a myth most commenly associated with menstruation? Or in the introduction, as it could technically be about either?
• The ovaries contain a finite number of eggs (oocytes) and granulosa cells, which surround and together they form primordial follicles. rm they for grammar. What are granulosa cells? Is follilicular cell easier, as that word implies they grow into a follicle? Or is it too uncommon?
• involute?

I have expanded the phrase. Graham Beards (talk) 12:00, 3 March 2021 (UTC)

• no left and right co-ordinating process is known I'm surprised by that fact. If there weren't any coordination, you would have no follicle a quarter of the time, and to follicles another quarter of the time, right? Is this supported by modern sources?
  • The process is not known. The ovaries don't seem to function completely independently (so the results aren't perfectly random), but nobody knows how it happens. WhatamIdoing (talk) 03:52, 8 March 2021 (UTC)
• combined oral contraceptives -> I had to click that link before knowing were simply talking about the pill

Clayoquot

1. I have a pretty strong grasp of mammalian evolution, but I'm having a lot of difficulty understanding the "Evolution and other species" section. What does it mean for the evolution of a trait to be driven by ovulation more than menstruation? How would menstruation be a driver of the evolution of the menstrual cycle? How does the fact that there are changes during the cycle increase fertility?
2. only...have a menstrual cycle - Does this mean that the species named in this sentence are the only other species that menstruate? Or is there a difference between being a species that has a menstrual cycle and being a species that menstruates? If the latter, what is the difference?
3. For comprehensiveness: Something should be said in this section about how the females of other species manage their periods.

   If they "manage" them at all, this belongs in menstruation. Graham Beards (talk) 09:17, 3 March 2021 (UTC)

   Fair enough :) Clayoquot (talk | contribs) 07:52, 4 March 2021 (UTC)

4. The section doesn't seem to address some key questions: Why did humans evolve to menstruate? What are the evolutionary benefits of being a menstruating species?

Clayoquot (talk | contribs) 07:08, 3 March 2021 (UTC)

There are few sources on this, but I agree the section needs more work.Graham Beards (talk) 09:28, 3 March 2021 (UTC)

There are only a few sources on this but I have expanded the section.Graham Beards (talk) 10:49, 3 March 2021 (UTC)

Love it, interesting :). FemkeMilene (talk) 19:35, 3 March 2021 (UTC)

Thanks Graham for the rewrite! I am still looking it over and hope to have more comments tomorrow. Clayoquot (talk | contribs) 07:52, 4 March 2021 (UTC)

Question 4 assumes that there is an evolutionary benefit to menstruation, which is not a valid assumption. It's probably just an unfortunate side effect of humans having a hemochorial placenta. WhatamIdoing (talk) 04:09, 8 March 2021 (UTC)

Comments on the recent rewrite of the Evolution section

1. Regarding Theories on the evolution of the menstrual cycle focus on decidualization and the shedding of the endometrium when pregnancy does not occur, decidualization is specialized terminology and therefore should be defined. The sentence as a whole doesn't make sense to me because the shedding of the endometrium when pregnancy does not occur is by definition menstruation, right? So the sentence seems to be saying "Theories of the evolution of the menstrual cycle focus decidualization and menstruation." I don't get it.
2. The rest of the section, which lists hypotheses and the issues with each hypothesis, has a lot of specialized terminology: "spontaneous decidualization", "uterine pre-conditioning", " fully-formed and differentiated endothelium", "invasive placenta". I have no idea what these phrases mean. The whole discussion on hypotheses mostly goes over my head. I do have better luck following the description in Menstruation (mammal)#Evolution. Could that section be condensed into something succinct enough to use in Menstrual cycle? Clayoquot (talk | contribs) 06:05, 5 March 2021 (UTC)

   I have the opposite problem (can’t make any sense of the uncited text over at Menstruation (mammal)#Evolution, which seems to be overstating how much we really know). I prefer how this article makes it clear that all theories have issues. Anyway ... I have added this BBC laysummary of the paper to the citation in the article; it may help us in sorting out the language (if you overlook the hyperbole in the introduction, it does get to explaining the four). SandyGeorgia (Talk) 07:42, 5 March 2021 (UTC)

   I started trying to spell out each hypothesis, until I got messed up between 3 and 4, and ran out of time (Finn threw me off when reading the BBC lay summary).. Graham may decide to revert everything I did, but you can see the direction I was trying to head. (Off all day tomorrow for med app’ts, ending with .... ta da ... getting my COVID vaccine ... so please revert entirely if needed.). If (someone) wants to dig in to each source to get past not knowing which piece came from where in the uncited Menstruation (mammal) article, Clayoquot’s approach may be better than the four separate points approach. SandyGeorgia (Talk) 08:21, 5 March 2021 (UTC)

Our problem is that it is the (few) sources which are confused and we have to make them less so. As I understand it the salient theory does not focus on decidualization and menstruation, but just decidualization – the development of the endothelium, which involves cells of the immune system, the development of a blood supply, tissue differentiation and so on and so forth. In non-menstruating mammals this process is driven by the embryo, not the mother, hence it's relevance to evolution. I can see why you are not happy with the section, but sadly we are restricted by our sources and have to avoid WP:NOR and WP:SYNTH. I think Sandy's edits have helped and I will if I can make it clearer while still complying with our policies. Graham Beards (talk) 09:40, 5 March 2021 (UTC)

Graham, hotspot iphone editing, so it sounds like all of the uncited Evolution section at the other article comes from Emera (2012), but that article summarizes the theory with too much certainty? SandyGeorgia (Talk) 16:21, 5 March 2021 (UTC)

Yes. We say the same but we have included the caveats and I have added the papers that Emera cites. Graham Beards (talk) 16:33, 5 March 2021 (UTC)

Cervical mucus

1. I have some issues with this phrase: cervical mucus, which causes vaginal discharge regardless of arousal. It can be read as suggesting that vaginal discharge in the absence of arousal = cervical mucus. Most vaginal discharge is not arousal-related, so I would remove "regardless of arousal" here. Also, there are many types of cervical mucus and we should say that we mean a specific type called fertile cervical mucus, which is very distinctive (resembles egg whites, slippery, and elastic). For women who are trying to get pregnant - which is one of the main reasons people want to learn about the menstrual cycle - the presence of fertile cervical mucus is the most easily-observed sign that ovulation is imminent. So it's important to get these details right. Clayoquot (talk | contribs) 17:12, 4 March 2021 (UTC)

Do you want to make the edit? We will need a source for "fertile cervical mucus". Graham Beards (talk) 17:20, 4 March 2021 (UTC)

Graham Beards, Sure :) Clayoquot (talk | contribs) 17:34, 4 March 2021 (UTC)

I found a good new source. The article currently says, citing two sources:

"The estrogen also stimulates crypts in the cervix to produce cervical mucus, and the emergence of the small spiral arteries, which increase the blood supply. The increasing estrogen levels changes the viscosity and pH of the cervical mucus to make it more sperm-friendly."

Some issues here: The first sentence gives the impression that cervical mucus is produced only once a month; I don't see why the small spiral arteries are worth mentioning; if we say blood supply increases we need to say to where; and if we're going to say the viscosity changes we might as well say how. More broadly, the fact that fertility changes over the course of the cycle should not be just a footnote - it is one of the main reasons people study the menstrual cycle. If you do a Google search for, say, "luteal phase Reddit" the discussions you'll see (or what I see anyway) are overwhelmingly between women who are trying to conceive. Very few other people are curious about what a luteal phase is.

I'm going to rewrite this along the following lines:

"Under increasing estrogen levels, crypts in the cervix produce a type of cervical mucus that is more sperm-friendly, with higher alkalinity and a viscosity that is thinner than usual. This type of mucus can be detected as a vaginal discharge that is copious and resembles raw egg whites. For women who are practicing fertility awareness, the presence of this type of cervical mucus is a sign that ovulation is about to take place."

All of this except the higher alkalinity part and the crypts part can be sourced to Detection of ovulation, a review of currently available methods. Clayoquot (talk | contribs) 19:32, 7 March 2021 (UTC)

This is an improvement, thanks. I have a couple of points. Viscosity cannot be "thinner; this should say "more" or "less". More importantly, the spiral arterioles are an important part of the anatomy. Did you see above where I described their springing back when menstruation begins and this action reducing blood loss? They even have their own article, Spiral artery. It seems odd not to mention them here.Graham Beards (talk) 19:52, 7 March 2021 (UTC)

I did some cleanup, but where does the alkalinity come from then (source?), if we are going to use it needs to be linked and sourced, and what to do about the thinning ? We lost the link to Ph (along with some other helpful info). And I do wish we would bring back the springy spiral arteries, as that info was most helpful. I am sorry that my iPad editing is so miserable ... I am sure it is making all of you as miserable as it is making me :( :(. SandyGeorgia (Talk) 22:00, 7 March 2021 (UTC)

I made a few changes including bringing back the spiral arterioles. I'll see what can done about the loss of pH, which was a useful link. Graham Beards (talk) 22:24, 7 March 2021 (UTC)

Thanks. I'm fine with the new wording about spiral arterioles. "Higher alkalinity" (or lower acidity) is just another way of saying "higher pH". Since you feel the link was useful, I reworded it and restored the link to pH. Clayoquot (talk | contribs) 23:06, 7 March 2021 (UTC)

@SandyGeorgia: There have been many edits to this paragraph in the past few hours. Do you still have concerns about what statements in this paragraph are supported by what sources? The review from Hsiu et al. supports the thinning of the mucus. Clayoquot (talk | contribs) 23:10, 7 March 2021 (UTC)

@Clayoquot: I think we are good now, and it is hanging together well ... thanks for the push forward on that, and my apologies again for the difficulties I am causing with trying to work from my little bluetooth iPad keyboard (computer repaired last week, but still sitting in a FedEx warehouse waiting to ship), Best, SandyGeorgia (Talk) 00:36, 8 March 2021 (UTC)

Ovulation suppression and interventions

This section reads like an odd collection of snippets left over from previous versions, looking like an expanded “See also” section.

• Can the first sentence (breastfeeding) be moved to the “Ovulation” section?
• Can the second sentence (contraception) be moved to the top of the Cycles section where we discuss timing?
• Can the third sentence (induction) be moved to “Ovulation” section?

Another option is to bring everything to do with fertility awareness and tracking to this section and change the section name to something related to “Tracking and altering” (the cycle). Right now, it is just a short bunch of snippets that is jarring. SandyGeorgia (Talk) 14:58, 4 March 2021 (UTC)

Sandy, while you were writing this, I was expanding the section. Can you take another look? Graham Beards (talk) 15:26, 4 March 2021 (UTC)

Much better ... it no longer looks like a collection of afterthoughts. SandyGeorgia (Talk) 15:31, 4 March 2021 (UTC)

How can this be correct? These COCs are available in a variety of forms such as pills, patches, skin implants and intrauterine devices (IUDs). ... How can a patch, implant or IUD be “oral”? SandyGeorgia (Talk) 18:16, 4 March 2021 (UTC)

Fixed ? . SandyGeorgia (Talk) 18:34, 4 March 2021 (UTC)

LEAD

Thanks, PlanetCare. Per WP:LEAD, a six-paragraph lead won’t fly in a short article (would be rejected at FAR or FAR as stubby and overly segmented and breaching LEAD); are you able to better combine some of the info to end up at four paragraphs? Some of your rephrasing also triggers a MOS:ITALICS issue, MOS:WAW. When we refer to “terms” that becomes words as words, which requires italics, and I suggest that going back to the original wording on menopause and menarche would not only avoid that problem, but is more straightforward and avoids repetitive wording in the lead (Menarch is the term ... menopause is the term). SandyGeorgia (Talk) 18:45, 4 March 2021 (UTC)

I don’t want to get in the way while you are still working, but some of the sentences in the lead are shorter than need be, leading to a staccato stubby feel, so we might want to recombine some of those short thoughts to one sentence; it is especially important in the lead to vary the sentence structure to retain reader interest and so we don’t end up with “headache-inducing” prose. SandyGeorgia (Talk) 18:50, 4 March 2021 (UTC)

Thanks for this quick feedback User:SandyGeorgia. Easy enough to combine paragraphs so it's only four. I tend to go with short paragraphs as avidly as I go for short sentences and short words. The stubby feeling you refer to is a matter of taste. I do have a doctorate and do plenty of technical reading in my field, but I still prefer an easy read if I'm trying to educate myself on a somewhat new topic. You suggest the need to vary the sentence structure: I don't see it that way. I will completely and 100% defer to your opinion on this. If you would rather retain some of the longer sentences, go for it. On the point about italics and introducing terms: apologies! I didn't know about that. I hope you will go ahead and make the changes you want to make. Authors have rights, and I respect that.PlanetCare (talk) 19:00, 4 March 2021 (UTC)

Who added this nasty fused participle? "with each female cycle being " (See WP:PLUSING). And how long is the male one? Graham Beards (talk) 19:18, 4 March 2021 (UTC)

Sorry for barging ahead, but since I just asked other editors to review at FAR, I didn’t want them to encounter a choppy lead. Graham, am I misunderstanding the three to eight percent? I didn’t fix the plusing ... your turn :). SandyGeorgia (Talk) 19:19, 4 March 2021 (UTC)

I did.PlanetCare (talk) 19:53, 4 March 2021 (UTC)

In that case you are in good company. I hear them used on the BBC all the time! But I don't think they work in written English for all the reasons given in Tony's essay. Thank you for your help. Bouncing ideas back and forth is very productive at this stage.Graham Beards (talk) 20:07, 4 March 2021 (UTC)

PlanetCare, sorry again for the hurry; I noticed that you had not significantly edited since 28 Feb, and didn’t expect to hear from you, so had just mentioned on the FAR page that we were ready for independent review. FAR reviewers would wonder why I was asking them to look at a lead that is at odds with what is expected on a Featured article. Thanks for the good prose improvements and clarity you added! SandyGeorgia (Talk) 19:46, 4 March 2021 (UTC)

The request I saw was dated 2 March so I thought you were still looking for a readability edit. You (and others) have worked so hard to get this ready for review. Bravo on that. I won't tinker -- I see you got it to four paragraphs, which is good.PlanetCare (talk) 20:04, 4 March 2021 (UTC)

And I ran the article through one of those (discredited :) readability tools (that I found on the thread linked above by EMSmile), and it says we are at grade level 8, good for 13-year-olds, so hopefully we’re all happy now :). If this one passes FAR, Graham has himself (another) half WP:million award (which is painfully close to three-quarter million) Regards, SandyGeorgia (Talk) 20:11, 4 March 2021 (UTC)

Some thoughts on content

Some humble thoughts, along with possibly useful, non-primary sources (though I don't have access to the full text of some of them) - with apologies for contributing late in the review, bringing up issues already covered (the discussion is to long to read from start to finish), and not contributing actual article text, at least for now:

• A section on psychological aspects of menstrual cycle seems to be warranted, as they are not limited to menstruation. (Articles on menstruation and the rest of the phases of menstrual cycle mention little, if any).

1. Sundström-Poromaa I (2018). "The Menstrual Cycle Influences Emotion but Has Limited Effect on Cognitive Function". Vitam Horm. 107: 349–376. doi:10.1016/bs.vh.2018.01.016. PMID 29544637.
2. Sundström Poromaa I, Gingnell M (2014). "Menstrual cycle influence on cognitive function and emotion processing-from a reproductive perspective". Front Neurosci. 8: 380. doi:10.3389/fnins.2014.00380. PMC 4241821. PMID 25505380.{{cite journal}}: CS1 maint: unflagged free DOI (link)
3. Gangestad SW, Thornhill R (2008). "Human oestrus". Proc Biol Sci. 275 (1638): 991–1000. doi:10.1098/rspb.2007.1425. PMC 2394562. PMID 18252670.
4. Le J, Thomas N, Gurvich C (2020). "Cognition, The Menstrual Cycle, and Premenstrual Disorders: A Review". Brain Sci. 10 (4). doi:10.3390/brainsci10040198. PMC 7226433. PMID 32230889.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link) - The "lack of consistent findings regarding cognitive functioning across the menstrual cycle", mentioned in some other sources as well, seems too important not to mention.
5. Farage MA, Osborn TW, MacLean AB (2008). "Cognitive, sensory, and emotional changes associated with the menstrual cycle: a review". Arch Gynecol Obstet. 278 (4): 299–307. doi:10.1007/s00404-008-0708-2. PMID 18592262.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• The section on Evolution and other species could possibly profit from a better-sounding heading - though I seem unable to come up with one, at least given its current content (perhaps Evolution and comparison with other species?). What is more, it could possibly profit from some more information on differentiation between estrous and menstrual cycle. Citation #3 has some interesting information on it.
• The hatnote defines Menstrual cycle as the reproductive cycle in humans. The term "reproductive cycle" is not mentioned elsewhere in the article. As a page title, it redirects to Biological life cycle, which is a bit baffling. Is perhaps reproductive cycle an umbrella term for both menstrual and estrous cycle (as differentiated in Evolution and other species)? NikosGouliaros (talk) 20:41, 5 March 2021 (UTC)

Thanks for the comments. I think the psychological aspects should be covered in Menstruation and not here, which is a physiology (endocrinology) article. I have not seen any papers that refer exclusively to the psychology of the luteal or proliferative phases for example; they all centre on the menstrual phase. I know ovulation has some psychological effects, but I don't think it warrants a section here. I am reluctant to open the door to include the clinical aspects again, which previously turned this physiology FA into a poor medical article. With regard to Evolution, may I direct you to the discussion above? I'll see what can be done about the hatnote. Graham Beards (talk) 21:54, 5 March 2021 (UTC)

Thank you for reviewing and for the helpful tidbits! In addition to what Graham says, I am concerned about the quality of the sources listed in what is not an uncontroversial subject. Nos. 2 and 4 are flagged by Headbomb’s reliability script as marginal publications; Nos. 3 and 5 are too dated to be useful, and further, No. 3 is written by the originators of the marginal Ovulatory shift hypothesis (which expresses odd opinions about women and has little validity— the article in its current state is outdated and biased); and No. 1 is focused specifically on premenstrual dysphoric disorder, a mental disorder affecting a small percentage of women. So I’m not convinced we have good enough literature specific to this topic even if we felt that kind of content should be here. With the usual “further studies needed”, I would be uncomfortable basing text on one source when “it is unclear as to what extent premenstrual disorders may have influenced the overall results in studies of healthy, naturally cycling, women. While most studies have used psychiatric interviews to exclude ongoing depressive and anxiety disorders, only one study utilized daily symptom scoring for diagnosis of PMDD and consequently, excluded PMDD patients in the healthy female group”. So there don’t seem to be good sources relating psychological aspects to the menstrual cycle itself. SandyGeorgia (Talk) 01:43, 6 March 2021 (UTC)

Thank you both for your feedback, and SandyGeorgia for referring me to User:Headbomb/unreliable and helping me become more familiar with source reliability concepts. I still feel that psychological aspects of the menstrual cycle, or the lack thereof, or the lack of conclusive evidence for or against them, do deserve a mention: their existence seems to be considered self-evident by many (including me, as it appears), and disproving any certainty about them could be useful as well (as long as a reliable source can be found). I stop here however, for lack of expertise and experience on female physiology and featured article review.NikosGouliaros (talk) 16:26, 6 March 2021 (UTC)

If we had a high quality and recent source, I would not be averse to adding a few sentences to menstrual health, but the devil is in the detail— where is that high quality MEDRS source ? One that focuses on the menstrual cycle, not disorders of menstruation or DSM disorders of menstruation complicated by comorbidities. WhatamIdoing might come up with a textbook source (she’s good at that :) but I suspect if one existed, Graham would have produced it. SandyGeorgia (Talk) 20:15, 6 March 2021 (UTC)

Um, of course the menstrual cycle has an effect on psychological status? Because if it didn't, then PMS and PMDD wouldn't be a thing. As for sources that we could use, it's tough. You might consider , which says that mood effects are "very small", seen in both pre-menstrual and menstrual phases, and that external "factors such as stress, health, and social support are more important". There is evidence for a hormonal effect, and it also indicates that the effects that are self-reported might be culturally conditioned (e.g., through movies that say women are "supposed to" have PMS, through stress caused by menstrual taboos, etc.) If you are wondering whether this is worth your time to click that link and read a few pages,I add that this source also has a delightful critique of PMS-y moods as being a "disorder" rather than being the "normal" state that is strangely alleviated during the follicular phase. This is a glass-half-full question that has little to do with science. Science can figure out whether that "very small" difference between the follicular and non-follicular phases exists, but it can't tell us which one is baseline and which one is aberrant. WhatamIdoing (talk) 05:06, 8 March 2021 (UTC)

For cognition specifically, summarizes the state of the literature as "inconsistent" and the results, when they find any, as "small". (The context for this summary is that estrogen is probably related to that menopausal thing where you can't remember the word.) WhatamIdoing (talk) 05:11, 8 March 2021 (UTC)

Else-Quest and Hyde have a short (two pages) section on Psychological Aspects of the Menstrual Cycle. It says that MC effects on mood are a common perception, but there is little evidence to support it. It adds that reported correlations with hormones do not prove causation. The authors have more, much more, to say on cultural influences than hormones.Graham Beards (talk) 14:19, 8 March 2021 (UTC)

I like your second and third sentences ... what if we add something like that? I won’t try myself, since my iPad editing is probably making everyone unhappy. SandyGeorgia (Talk) 15:39, 8 March 2021 (UTC)

I can't see anything on the menstrual cycle in Alosco and Stern. 14:30, 8 March 2021 (UTC)

Saving sources to look later:

• Else-Quest N, Hyde JS (2021). "Psychology, gender, and health: psychological aspects of the menstrual cycle". The psychology of women and gender: half the human experience + (10th ed.). Los Angeles: SAGE publications. ISBN 978-1-544-39360-5.
• Morgan KN, Kantarci K, Asthana S, Gleason CE (2019). "Neurocognition in menopause and reproductive disorders". In Alosco ML, Stern RA (eds.). The Oxford Handbook of Adult Cognitive Disorders. United States: Oxford University Press. ISBN 978-0-190-66412-1.

Putting the citations together from an iPad took me a full hour; will look at content tomorrow. Thanks, WAID! SandyGeorgia (Talk) 05:46, 8 March 2021 (UTC)

Some further comments from Tom (LT)

• Looks great overall!
• is hormone drop causes the uterus to shed its lining in menstruation I don't think this sentence is accurate. It is more accurate to say that all parts of the endometrium except its innermost layer die

In Johnson it says "the shedding of the bloody endometrial tissue via the vagina at the end of the luteal phase. This hormonally conditioned even is called "menstruation". Graham Beards (talk) 12:41, 8 March 2021 (UTC)

And I have written under Menstruation, "The blood supply to the endometrium is cut off and the cells of the top layer of the endometrium (the stratum functionalis) become deprived of oxygen and die. Later the whole layer is shed and only the bottom layer, the stratum basalis, is left in place." Graham Beards (talk) 15:35, 9 March 2021 (UTC)

The phrasing makes it seem like (1) the uterus is an animate thing that is shedding something, when in fact the lining is falling off because it's dead, and (2) "the lining" would seem to indicate the endometrium but there is always part of it present. I will have a think about a suggested phrase here. --Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

I think it is because I have used a transitive verb. I have changed it to "Later the whole layer is lost and only the bottom layer, the stratum basalis, is left in place." There was another "shed" which I have also dealt with. Graham Beards (talk) 11:11, 10 March 2021 (UTC)

• "The follicular phase is the first part of the ovarian cycle and is characterized by maturing antral follicles" whether there is one or more antral follicles is unclear - contrast this vs. "The follicle that reaches maturity is called a tertiary or antral follicle, and it contains the ovum (egg cell)."

This was tricky to compose. Although they are maturing they don't all fully mature. We need another word for "maturing". How about "developing"? Graham Beards (talk) 12:49, 8 March 2021 (UTC)

I suggest this: remove "antral follicles" from the first part (i.e. "is characterised by maturing follicles").--Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

This sentence was deleted a couple of days ago.Graham Beards (talk) 10:42, 10 March 2021 (UTC)

For an unrelated reason (see my essay WP:ANATSIMPLIFY on this) I suggest remove the synonym "tertiary" from the second statement as there are already enough terms going around. That's just my personal feeling though - that most synonyms are better placed on the parent article as many articles are already hard enough to read.--Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

• Also suggest use either "egg cell (ovum)" or one of the two, for symmetry with the earlier "eggs (oocytes)" in the first paragraph
• "responsible for stimulating the rupture of the ovarian follicle " --> "rupture of the antral follicle" to be most specific

Done. Graham Beards (talk) 12:49, 8 March 2021 (UTC)

• Ovulation: "At around 20 weeks gestation some 7 million immature eggs " the variations between egg / egg cell / oocytes (egg cells) are confusing here. I'm wondering if it's easier to just stick to one term
• "Ovulation is the third phase within the larger uterine cycle and the second phase of the ovarian cycle in" - Wouldn't it be better to link ovarian cycle and uterine cycle up front or, given their large role here, use hatnotes?
• "Most times only one in each 15–20 follicles reaches full maturity, and just one egg is released" conflicts with the earlier "while one dominant follicle in the ovary will continue to maturity"

I don't see the contradiction, "...only one........one dominant".Graham Beards (talk) 12:53, 8 March 2021 (UTC)

To me, saying in every 20 follicles one reaches full maturity each cycle, seems to mean 1 in every 20 of the several hundred thousand follicles will mature each cycle. This is not correct and contradicts the statement that one and one only dominant follicle will reach maturity. --Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

I have expanded it to "Most times only one of the 15–20 follicles that have been stimulated reaches full maturity, and just one egg is released."Graham Beards (talk) 10:36, 10 March 2021 (UTC)

• Ovulation: "Ovulation is the third phase within the larger uterine cycle and the second phase of the ovarian cycle " confusing as in the uterine cycle desribed below, ovulation mentioned as a phase within it. Suggest just remove the uterine cycle part of this sentence, it's just confusing

I don't understand the issue. Graham Beards (talk) 12:56, 8 March 2021 (UTC)

You mention three parts of the uterine cycle in detail later. None of the parts is called "ovulation phase". To me having this in one sentence is difficult to understand. Could it be separated in order of importance using a new sentence or clause? e.g. "Ovulation is the second part of the ovarian cycle, and occurs at the same time as the secretory phase of the uterine cycle"? --Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

I see. I have deleted the sentence and plunged straight in to Ovulation. Graham Beards (talk) 10:52, 10 March 2021 (UTC)

• "the oocyte promptly matures into an ootid (immature egg cell), " of the three uses of 'immature' in the article I find this the least clear. There are a lot of developing and maturing things going on. I suggest just remove "(immature egg cell)" as that's implied by the context around it (i.e. it was just described getting fertalised and is later about to become an embryo, so it's clearly immature).

Done.Graham Beards (talk) 12:59, 8 March 2021 (UTC)

Thanks Tom, I'll do something about all the eggs. Graham Beards (talk) 12:59, 8 March 2021 (UTC)

Thanks. --Tom (LT) (talk) 10:06, 10 March 2021 (UTC)

Appreciate all your prompt changes. No concerns from this article on my part. Please ping if any further input is required from me. Great work Graham for all your work on this article. --Tom (LT) (talk) 06:59, 13 March 2021 (UTC)

Suggested page move

I think we should rename this page Human reproductive cycle. The reason is the the menstrual cycle and the ovarian cycle, although concurrent, are treated in my sources as separate events. The move would allow these cycles to be described separately and will further distance this article form the more focussed Menstruation. Note that ovarian cycle back-links to this article. Graham Beards (talk) 13:26, 25 February 2021 (UTC)

Hmmm, not sure. Isn't "menstrual cycle" correct as per WP:Commonname? Also it says: The menstrual cycle comprises the ovarian and uterine cycles. How would you thus describe them separately? I am a complete lay person though, don't have much of a clue about the different terms. Would consult Misplaced Pages to educate myself. :-) There's an article called Female reproductive system - sounds similar but it's system, not cycle. EMsmile (talk) 13:53, 25 February 2021 (UTC)

Strictly speaking the uterine cycle is the menstrual cycle. The article already separates the two. We can leave a redirect from Menstrual cycle. Graham Beards (talk) 14:04, 25 February 2021 (UTC)

And Female reproductive system is an anatomy article. Graham Beards (talk) 14:07, 25 February 2021 (UTC)

As a source-based solution, I agree with Graham’s proposal (noting that very little of the other discussion on this page is based on how sources treat the topics). However ... Graham ... as a non-biologist, that means I am not entirely clear on the scope of the new article and would need you to be better spell out what goes here and what goes there ... SandyGeorgia (Talk) 15:55, 25 February 2021 (UTC)

@Tom (LT): for another anatomy opinion ... Tom, would you mind having a glance at the entire talk page (sorry :) as we attempt to sort out this article (which had become medicalized in a negative way) from menstruation, in terms of anatomy relative to medicine? SandyGeorgia (Talk) 15:57, 25 February 2021 (UTC)

The article should remain titled "Menstrual cycle." That's what it's about and it's what the sources call it. Renaming can only lead to confusion and mix in things that don't need to be here. The Human reproductive system and Female reproductive system pages already exist. At this point, we should just merge the menstrual cycle and menstruation pages. LearnerB (talk) 17:11, 25 February 2021 (UTC)

Which sources are you referring to, specifically? Have you consulted textbooks? Because my searches on that topic were not very fruitful, and Graham is consulting textbooks. SandyGeorgia (Talk) 17:16, 25 February 2021 (UTC)

Hi. Well, first, I know about the topic, but I know that alone is not good enough for Misplaced Pages. Second, the sources in the article use the term "menstrual cycle" and so do sources in general (when looking to see that) and a few biology text books I have at home. I looked at Tom (LT)'s user page. I think he can corroborate what EMsmile and myself have said about the typical term. "Human reproductive cycle" would be taken to be broader. LearnerB (talk) 17:39, 25 February 2021 (UTC)

Shall we let Tom speak for themselves? And "Human reproductive cycle" gets 133,000,000 Google hits, whereas as "menstrual cycle" garners 59,900,000. Human reproductive cycle is also the name given in the textbooks I have. Indeed, Tortora "Principles of Anatomy and Physiology" says under a section headed The Female Reproductive Cycle, "The ovarian cycle is a series of events in the ovaries that occur during and after the maturation of the oocyte. The uterine (menstrual) cycle is a concurrent series of changes in the endometrium of the uterus tot prepare for the arrival of a fertilized ovum.." Can we stick to what sources say? (And curtail the sexism).Graham Beards (talk) 18:13, 25 February 2021 (UTC)

Why did you say something about sexism? I didn't notice any sexism in the discussion here? EMsmile (talk) 02:10, 26 February 2021 (UTC)

"Human reproductive cycle" would in my mind also include men (like from the start of their fertility to the end). If anything shouldn't it be "Female human reproductive cycle"?. And wouldn't that overlap too much with Female reproductive system, or would you set it up to become a sub-article of Female reproductive system? - I am by the way in favour of merging "menstrual cycle" into "menstruation", unless there is a heap of content missing from it at this stage that would still need to be added. The way it currently stands, it is not so long that a merger wouldn't be possible. - And would a proposed renamer involve adding lots more content, and if yes, then on what? Would "menstrual and ovarian cycles" work as an article title? EMsmile (talk) 02:11, 26 February 2021 (UTC)

EMsmile, see 20:44, 24 February 2021 (UTC), a post made after Graham began corrections. In all fairness, I may have thrown the first gender jab, relating to the older work that initially damaged this article, and for that I apologize. That kind of damage was done to other articles as well, so there was no need for me to single it out as male editing. Where we are now is that we are fortunate to have Graham willing to bring a scholarly focus back to a featured article, and I hope we can let him work, deferring “what goes where” decisions until the text is cleaned up. It would be helpful to have a look at WP:MEDMOS in terms of sorting menstrual dysfunction and menstrual disorders out of the prominent organizational structure they now have at menstruation. First, discuss menstruation; separate section for complications ... right now, menstruation is still treating it like a dysfunction. SandyGeorgia (Talk) 02:17, 26 February 2021 (UTC)

Oh, OK, fair point. It didn't feel like "sexism" to me, more like a heated debate amongst some friends. :-) I think what you were referring to in your initial remarks is related to Gender bias on Misplaced Pages which is a very real problem and could affect a topic like menstruation (luckily, like you said, if we all stick to reliable sources it shouldn't be much of an issue here). And I think that's a good proposal: let's step back for a few days while Graham does some more scholarly work on this article (if he has time, thanks Graham). Also to let the dust settle and give some new editors time to ponder about this. Then, once the menstrual cycle article is improved enough, come back to the discussion of a possible merger with menstruation or a name change. Then after that, continue to clean up menstruation. And ultimately, get them both to WP:FA status but that's a long term goal. :-) EMsmile (talk) 02:31, 26 February 2021 (UTC)

This one is already FA, and has the potential to remain so. While menstruation would require considerable effort to bring to even GA. I cannot be a lot of help with content until FedEx decides to release my computer from its weather-delayed warehouse and let it continue on its way to repair in Texas, so I am grateful for whatever Graham can do ! Apologize for the snippiness of my iPad typing. SandyGeorgia (Talk) 03:01, 26 February 2021 (UTC)

But since you are motivated, User:SandyGeorgia/Achieving excellence through featured content ;) SandyGeorgia (Talk) 03:11, 26 February 2021 (UTC)

I don't think that's a good name. "Human reproductive cycle" sounds like babies are born, then they go through puberty, then they make the next generation of babies – a scale of decades, not weeks. WhatamIdoing (talk) 02:54, 26 February 2021 (UTC)

As a layperson, I agree with the point made by User:WhatamIdoing. EMsmile (talk) 12:49, 26 February 2021 (UTC)

Hi, User: Graham Beards. There's been comments (one from you too) implying that this article suffered partly or mostly because it only or mostly had men editing it. So if we throw around the word "sexism", I wouldn't say that only what I said counts as that, but I don't agree that highlighting the perspective women can bring to these pages and that men and women will often have a different perspective on a gendered topic (or other topic) is sexism. Misplaced Pages wants more women because they offer something different. Misplaced Pages says there's a gender bias because of that difference. If you look in the edit history of that page, even occasional editing tries to obscure information about the gender gap, but editors like User:Mx. Granger won't let it happen.

I am more than happy to let Tom (LT) speak for himself, but why do you keep implying that I don't know what the article is about when I do or that I'm not sticking to what the sources say when I am? The sources use the term "menstrual cycle." There are those that also use "human reproductive cycle", but they are often broader in scope and few of them exist. Since Google was invoked, I encourage editors to look at Google searches and see for themselves. See what terminology is actually being used (which terms are being used more often). For the few of them using "human reproductive cycle", it's not uncommon to see them talking about both the male and female reproductive systems, which we already have articles on.

For accuracy reasons, we can't get caught up in Google hits. They are misleading and, as a result, useless for this because there isn't much on the menstrual cycle when looking it up in scholarly searches under that term ("human reproductive cycle"). "Menstrual cycle", on the other hand, returns a lot more material and material that is actually focused on the topic. "Menstrual cycle" is specific and precise. It is more recognizable and allows readers to immediately know what the article is about.

You said "And Female reproductive system is an anatomy article." But then you pointed to the "Principles of Anatomy and Physiology" book, which goes to show that "menstrual cycle" is also an anatomy article in some regards. I think that both the anatomy and biology wikiprojects should be notified to discussions on this talk page so that they can help out. I don't think that we should defer to any one editor. We should be collaborating, which we are sort of doing already. LearnerB (talk) 20:20, 27 February 2021 (UTC)

Could we please stay off of the gender issues here? I have already apologized for being the one to open that door. OK, since uterine cycle is menstrual cycle, but this article covers the entire cycle, but others object to renaming it for various reasons, might we come up with other ideas for how to more accurately name this article, since it covers the whole cycle— ovarian and uterine? Those suggestions should be based on how the sources treat the material rather than our personal views on one subset, eg menstruation. SandyGeorgia (Talk) 13:57, 28 February 2021 (UTC)

I just want to second this opinion. I'm thankful we have an active editor trying to improve this article regardless of their gender. Thanks Graham. --Tom (LT) (talk) 09:37, 2 March 2021 (UTC)

I’m thankful we have so many editors, period (no pun), showing up to work on a Featured article! In the last year, six medical FAs were defeatured because nobody cared to show up, so I’m thrilled and grateful that all of you are helping, men and women alike! Graham, PlanetCare expressed early on that they wanted to look at readability; are we far enough along that they should be pinged back? Or is there still big work to be done? SandyGeorgia (Talk) 14:54, 2 March 2021 (UTC)

Sandy, I think I am nearly done for now. I have responded to the rest of the Prose questions above. Apart from waiting for another book to arrive, which I need just to double-check what I have already written, I don't have anymore to write. Graham Beards (talk) 15:02, 2 March 2021 (UTC)

"Human reproductive cycle" is misleading and Googling phrases is not the way to go here, per WhatamIdoing and LearnerB. Crossroads 05:18, 1 March 2021 (UTC)

I am also very sceptical of using Google as a tool. Graham, if I search for "Human reproductive cycle" without quotes, I get 141 million hits, which is similar to your 131 million, but in the top 10 results, only one (this) mentioned "human reproductive cycle" in the result snippets, and indeed that article does discuss ovarian and menstrual cycles as separate things, but enjoys also being able to discuss them together. The problem is that without quotes, google is returning results for "human", "reproduction", and "cycles", though strongly preferring articles covering all three. But look at the result snippets and the words that it bolds: "menstrual cycle" is emboldened. That indicates Google has added a synonym to your search, and included "menstrual cycle". If I put quotes round the phrase "Human reproductive cycle", I get only 258 thousand results, vs 12 million for "menstrual cycle" in quotes. At a 50× level of difference in result numbers, we can be more confident which is the most important phrase. I think "menstrual cycle" is a more than frequent enough topic of discussion to deserve its own encyclopaedia article with that name. Clearly "ovarian cycle" is separate-but-linked and maybe deserves its own article too. I can see the attraction of discussing both together, or at least referring to the other while discussing one. But this isn't a strong enough case to eliminate "menstrual cycle" as an article topic. The textbook you cite, Principles of Anatomy and Physiology, calls the topic "The Female Reproductive Cycle", which is not the same as "Human reproductive cycle", and doesn't have the same ambiguity with the cycle-of-life that WAID mentions. -- Colin° 10:46, 1 March 2021 (UTC)

Thanks Colin. I did quote from the book above, but clearly this is not one of my better ideas.Graham Beards (talk) 12:06, 1 March 2021 (UTC)

With regard to the title I personally think that 'menstrual cycle' would be more appropriate. Occasionally it is tempting to view anatomical or physiological areas from a functional standpoint i.e. menstruation is to do with reproduction so "reproductive cycle" is more appropriate. However the vast majority of cycles do not feature any reproduction. I think most people have a very clear understanding of what menstrual cycle refers to. In contrast I think reproductive cycle is quite a broad area and there is likely to be more ambiguity as to what it encompasses (e.g. physiology and behavior? male and female? parents and embryo? etc.). --Tom (LT) (talk) 09:37, 2 March 2021 (UTC)

PMS

I looked at Menstrual cycle#Menstrual health and I think it's currently self-contradictory. It says, in consecutive sentences, that:

• ≥20% of women have symptoms that disrupt daily life (i.e., at any point in the menstrual cycle).
• 20–30% of women have symptoms that interfere with normal life and are called PMS.

The problem we've had at the PMS article is that the numbers always depend on your definition. The definition that researchers use for PMS is not the one that primary care providers use. Primary care providers have been known to tell their patients that Mittelschmerz is PMS, or that menstrual cramps are PMS. (These same providers will also tell women with PCOS that taking birth control pills will help them get pregnant later, that arthroscopic knee surgery works, and that Dexamethasone will help them stop coughing when they have a cold.) The research definition requires significant mood changes (acne or bloating alone is not PMS, no matter how severe these "normal discomforts of menstruation" are), and it requires specific timing: even in the most generous timeline, the symptoms must not be present at any point between the second day of bleeding (e.g., cramps) and ovulation (e.g., mittleschmerz). Most definitions expect these symptoms to be present during 10 or fewer days.

Which takes us back to these numbers: If only 20% of women have disruptive symptoms at any point in the cycle, it is not logically possible for more than 20% of women to have disruptive symptoms during a subset of that time.

I'm not sure how to address this. We probably have sources that disagree on the definitions, and therefore end up with different numbers of affected women. Maybe we need to find a single source that provides both numbers? WhatamIdoing (talk) 19:41, 28 February 2021 (UTC)

PMDD criteria were defined in DSM5 in 2013; what about if we just use sources that discuss PMDD specifically, and leave the rest of the detail and sorting out of different definitions to those specific articles? Would that not give us something more standard across the board (question, I ask, as not sure it will). SandyGeorgia (Talk) 19:59, 28 February 2021 (UTC)

PS, do you care if I merge this section to the FAR section, so it will all archive together, rather than out of order, or do you consider it separate? SandyGeorgia (Talk) 20:00, 28 February 2021 (UTC)

This is the salient paragraph from the paper by Wendy Biggs and Robin Demuth:

Up to 80 percent of women report one or more physical, psychological, or behavioral symptoms during the luteal phase of their menstrual cycle without experiencing substantial disruption to their daily functioning. PMS, in which mild to moderate symptoms affect some facet of the woman's life, occurs in 20 to 32 percent of premenopausal women; the more severe symptoms of PMDD affect 3 to 8 percent of premenopausal women. However, the prevalence of PMDD varies substantially among studies, likely because of different study definitions for PMDD. Initially, PMS and PMDD appeared to be limited to women in Western cultures, but more recent studies have demonstrated symptoms suggesting that PMS and PMDD occur at similar rates internationally.

The paper is a little old, which is why I looked for a another one that supports the figures. This is how the inconsistency has arisen. Should we just stick with the Bigg's data until we can find a more recent review that gives both sets of epidemiological data? Graham Beards (talk) 20:19, 28 February 2021 (UTC)

That sounds reasonable.

SandyGeorgia, I've removed the link to Activities of daily living. If you have problems with ADLs, you are having problems with DEATH: (Dressing, Eating, Ambulating, Toileting, Hygiene). If you have ADL limitations, that means you can't stand up, use the toilet, and/or comb your hair by yourself. PMS problems are more like feeling tired, having difficulty concentrating, yelling at someone for a mistake that you'd normally think was minor, or feeling physically uncomfortable. WhatamIdoing (talk) 23:11, 1 March 2021 (UTC)

Brain fart ... harkening back to DLB! SandyGeorgia (Talk) 23:25, 1 March 2021 (UTC)

Queries

I've just changed the third and fourth sentences from:

• "These cycles are concurrent and coordinated, and each cycle is between 25 and 30 days. The median length of one menstrual cycle is 28 days."

to:

• "These cycles are concurrent and coordinated, and last between 25 and 30 days, with a median length of 28 days."

Did I get it right? Tony (talk) 05:59, 6 March 2021 (UTC)

And more wreckage, probably, in the second paragraph. Tony (talk) 06:05, 6 March 2021 (UTC)

Tony, I find that the existing copy is easier to read and understand than your version. Gandydancer (talk) 09:05, 6 March 2021 (UTC)

I disagree and was racking my brain to simplify the above sentence myself. I like the shortened version. FemkeMilene (talk) 09:07, 6 March 2021 (UTC)

Thanks Tony, they are correct and indeed an improvement. I especially like how you have recast the "accommodation" sentence; I was struggling with that one. Graham Beards (talk) 09:31, 6 March 2021 (UTC)

Very nice, Tony1; glad to see you here! SandyGeorgia (Talk) 14:58, 6 March 2021 (UTC)

• So when should "In humans," be introduced? (We removed it from the text above in deference to the article title—many creatures have menstrual cycles.) Where does the information narrow in its scope of species? Should the phrase be inserted perhaps at the opening of the second paragraph, or of the third paragraph? I'm used to scientific text that uses numerals from 10 or 11 up, and day 1, etc, would be fine for consistency, do you think? I just think it's easier to read—and years of age are in numeral further down. Tony (talk) 00:16, 7 March 2021 (UTC)

I suggested earlier the article should be renamed Human reproductive cycle, but nobody liked it and Colin talked me out of it with a solid argument. But we are still left with the problem that the timings given throughout the article are only for humans, although the endocrinology is the same for all menstruating mammals. Take the lengths of the cycle for example; in bonobos (the apes that spend all day shagging) their cycle is relatively long at 32-35 days. In orangutan it is around 29 days, chimps 36 and gorilla 29. In bats it is around 33 days.Graham Beards (talk) 09:17, 7 March 2021 (UTC)

I don't think this edit was good. The sentence was already on the outer limits for complexity in the lead paragraph, and has gone over that IMO. The edit suggests numbers (and facts, presumably) are going to be consistently qualified as human/not-human. I do not think we should make this article about animal menstrual cycles. That way leads to the madness of having to add "in humans" to nearly every sentence because our sources are about humans. Does it disrupt the daily life of gorillas? Do chimps get acne? Do orangutans take birth control pills? When is menarche for a elephant shrew? Next to nobody coming to this article is asking those questions.

We mustn't get so concerned to title the article "correctly" that we end up with a title nobody expects or is searching for (e.g. Human reproductive cycle) nor get so concerned that the title lacks "human" that we need to over complicating things to try to encompass the dozen or so other animals that have a menstrual cycle. Consider Near-sightedness does not waste any time explaining to the reader that it is not Myopia in animals. WP:WEIGHT should guide us here. We already estimated by 50:1 that people refer to this subject as "menstrual cycle" and not "human reproductive cycle". Would it be a reasonable guess that nearly all literature on the menstrual cycle is about humans and cares not to mention that, by the way, elephant shrews also menstruate? Our sources are virtually all human biology textbooks and articles. Let's keep the "in other animals" as a tail section with Menstruation (mammal) as the main page for that topic.

I note that an earlier edit and hatnote both stated up-front that this article was about humans. The hatnote remains but the earlier edit was lost. How about the lead sentence says "The menstrual cycle in humans is a series of natural changes...". -- Colin° 10:39, 8 March 2021 (UTC)

Thanks. I have deleted the "in humans". With regard to your suggestion "The menstrual cycle in humans is a series of natural changes...". This sounds like it is something else in other species, which it is not as you know.Graham Beards (talk) 12:14, 8 March 2021 (UTC)

Perhaps we should just live with the hat note. We are perhaps over-thinking an issue that most of our readers will not be concerned with. -- Colin° 14:41, 8 March 2021 (UTC)

Yes indeed, the textbooks don't seem that bothered.Graham Beards (talk) 15:33, 8 March 2021 (UTC)

• I got completely balled up in here about how to deal with WP:MOSNUM, and defer to you on that. I ended up with menarche and childhood ages as digits, but menopause ages spelled out. Defer to Graham on where to introduce “In humans”. SandyGeorgia (Talk) 00:29, 7 March 2021 (UTC)

  Oops, I wrote that backwards ... menarche spelled out (eight to twelve), menopause as digits (45 to 55). SandyGeorgia (Talk) 12:56, 7 March 2021 (UTC)

• In "Follicular phase", one sentence apparently lacks a verb: "During this phase, the ovarian follicles and get ready to release an egg." Tony (talk) 11:18, 7 March 2021 (UTC)

Thanks Tony, I have changed it to "During this phase usually only one ovarian follicle fully matures and gets ready to release an egg." Graham Beards (talk) 11:30, 7 March 2021 (UTC)

Cheat code

This page has gotten really big. If you are struggling with finding the right spot to insert your comment, I recommend trying a new tool, especially if your name starts with "Sandy" and ends with "Georgia". Just click this: https://en.wikipedia.org/Talk:Menstrual_cycle?dtenable=1 and then see if you get buttons after each signature. Click one of those and see if you like the mini-editor.

This is a one-time secret code, so it will go away if you reload the page (click the "Talk" tab at the top) and won't appear on any other pages. Ping me (which is easy in the tool's visual mode) or stop by my talk page if you want to have this set up in your account for all talk pages. WhatamIdoing (talk) 21:14, 8 March 2021 (UTC)

@WhatamIdoing: Best thing since sliced bread. Know at least one editor— who likes to reply to every post even when they have nothing to say— we will regret giving it to. My computer has been stalled in TX FedEx warehouse since last Wednesday; this saves clicks. Cannot see what advanced button does. To whom do I send love letters? SandyGeorgia (Talk) 21:35, 8 March 2021 (UTC)

The advanced button is to write an edit summary and to watch/unwatch the page. FemkeMilene (talk) 21:38, 8 March 2021 (UTC)

There may eventually be some other stuff in the Advanced space. (If you click on the "Advanced ▿" and nothing happens, then ping me, and I'll go file a bug report for you.) The designer has some ideas about how to make our lives easier. Imagine, for example, pinging people by default, without having to type their names, and then there's a "Actually, this time, don't bother pinging anyone" button in the Advanced space.

Love letters go to the mw:Editing team. I know the PM will see anything you post at Misplaced Pages talk:Talk pages project, and you can reach the designer at User talk:JKlein (WMF).

If you want to make this happen everywhere, instead of just on this page/when you click that link, then your options are to wait until the Beta Feature gets out (next week, I hope, but there are no guarantees), to manually add the secret code to the end of the talk page's URL (and reload) every time you want to use it, or to copy the "Happiness" lines at the top of m:User:Whatamidoing (WMF)/global.js into either your own /global.js file at Meta-Wiki (which will enable it at all the wikis), or into your /common.js file here (e.g., User:SandyGeorgia/common.js) (will only work here at the English Misplaced Pages). WhatamIdoing (talk) 21:51, 8 March 2021 (UTC)

Loose ends

Starting a section to look at what's left to do. SandyGeorgia (Talk) 15:57, 11 March 2021 (UTC)

From Talk:Menstrual cycle#Some thoughts on content

Else-Quest and Hyde have a short (two pages) section on Psychological Aspects of the Menstrual Cycle. It says that MC effects on mood are a common perception, but there is little evidence to support it. It adds that reported correlations with hormones do not prove causation. The authors have more, much more, to say on cultural influences than hormones.Graham Beards (talk) 14:19, 8 March 2021 (UTC)

I like your second and third sentences ... what if we add something like that? I won’t try myself, since my iPad editing is probably making everyone unhappy. SandyGeorgia (Talk) 15:39, 8 March 2021 (UTC)

I can't see anything on the menstrual cycle in Alosco and Stern. Graham Beards (talk) 14:30, 8 March 2021 (UTC)

• Else-Quest N, Hyde JS (2021). "Psychology, gender, and health: psychological aspects of the menstrual cycle". The psychology of women and gender: half the human experience + (10th ed.). Los Angeles: SAGE publications. ISBN 978-1-544-39360-5.
• Morgan KN, Kantarci K, Asthana S, Gleason CE (2019). "Neurocognition in menopause and reproductive disorders". In Alosco ML, Stern RA (eds.). The Oxford Handbook of Adult Cognitive Disorders. United States: Oxford University Press. ISBN 978-0-190-66412-1.

Where do we stand on this? SandyGeorgia (Talk) 15:57, 11 March 2021 (UTC)

• We're still using a source about the luteal phase (Wendy Biggs and Robin Demuth) for the 80% of women that don't experience disruption to daily life, but implying that it's about the entire menstrual cycle. As menstruation is not part of the luteal phase, I doubt that is correct. FemkeMilene (talk) 17:06, 11 March 2021 (UTC)

Can you find a better source? Graham Beards (talk) 17:40, 11 March 2021 (UTC)

This might be useful if we can precis the salient conclusions.

• Iacovides S, Avidon I, Baker FC (2015). "What we know about primary dysmenorrhea today: a critical review". Human Reproduction Update. 21 (6): 762–78. doi:10.1093/humupd/dmv039. PMID 26346058.

-Graham Beards (talk) 17:53, 11 March 2021 (UTC)

(Graham asked me to comment on the 80%/most issue, on my talk page). I see the above paper is on pain and its consequences, rather than on other impacts on life/health that don't necessarily have a source in pain or cramping. I'm really not sure how to solve the issue, though I see the lead says 80% and the body say 20% (for the opposite) so that's not consistent. Would it help to say "four out of every five" which is the same but sounds suitably less precise?

The article currently claims "about 67.2% of adolescents" get dysmenorrhea. This cites a primary research paper that interviewed 198 girls age 13-19 from two slum areas in New Delhi, India. The 67.2% figure is only appropriate for referring to the sample under study (i.e., 133 girls), not for interpreting in the wider population. We need a secondary source that gives the figure for the population, and the figure is more likely to be "about two thirds of adolescents" than a percentage to three significant figures. -- Colin° 15:44, 12 March 2021 (UTC)

And the New Delhi primary source is 2008. Fiddlesticks. I thought we had cleaned out all of the junk that found its way in to this article via menstruation and disease model, and am now worried that we need to take a closer look. I will look through every source in the article when I am home again (traveling now). SandyGeorgia (Talk) 15:56, 12 March 2021 (UTC)

Thank you both. I think we have got the (rather complex) endocrinology correct now and it is properly sourced Sandy. It's just this little bit of epidemiology, which I have been asked to include (against my better judgement) that is a problem. The Lead and the Body are saying the same, it's just one statement says how many "do" and the other says how many "don't". (I can't see how that crept; I don't think it was me). I agree with Colin that we need a simple ratio that is globally applicable and from a WP:MEDRS source. If we can't find a source, I think we should delete the statement.Graham Beards (talk) 16:27, 12 March 2021 (UTC)

It will still help (me, at least) going forward if I go through and do what I usually do ... put a type=Review, etc., on every (Pubmed) source so I know which I have checked. SandyGeorgia (Talk) 16:39, 12 March 2021 (UTC)

I think it's good that the 80% figure was removed. It was inaccurate as is. Things like tender breasts, cramps, bloating, feeling tired, irritability and mood changes do disrupt most women's lives at one or more points during their cycle. I would think that obvious. Disrupting their daily life and being severe enough to stop them from going about their typical day are two different things. I imagine that is why the Hong Ju, Mark Jones, Gita Mishra source says "severe pain limiting daily activities is less common" and this source (Wendy Biggs and Robin Demuth) says "substantial disruption." These sources use the words "limiting" and "substantial disruption." A woman can have disruption because of her period without it being substantial disruption. And then there's the inconsistency on what qualifies as PMS (also mentioned in the PMS section back up on the page). Regardless, according to these and other sources, most women will get one or more painful symptoms during their cycle/near or during their period. These are enough of an issue for the women to take medication for it. The reality that many women need to take medication for it, most commonly for cramps, is indicative that the symptom has disrupted the woman's daily life. The menstrual health section said, "Painful cramping in the abdomen, back, or upper thighs can occur during the first few days of menstruation. Severe uterine pain during menstruation is known as dysmenorrhea, and it is most common among adolescents and younger women (affecting about 67.2% of adolescents)." That's disrupting daily life, and 67% is not a minority. I know that this information has been reworked, but I'm commenting on the adolescent thing in the case we come about a better source for it.

When we use the words "disrupt daily life", we have to be careful to not report this as occurring in a minority of women. The Wendy Biggs and Robin Demuth source says "without substantial disruption", which is not the same thing as "no disruption." It's just that a minority of women experience symptoms that significantly limit/interfere with their daily activities. So, based on the sources, it's probably more prudent to alter "During their menstrual cycle, some women experience problems that disrupt daily life" so that we have it saying "During their menstrual cycle, many women experience painful symptoms." If we re-add the "no disruption to daily life" phrasing at some point, it should be altered so that we have it saying "no substantial disruption to daily life" or "no significant disruption to daily life." By the way, I think "cramps" should replace "acne" in the introduction. Cramps are the most common of the symptoms. "Acne" (mentioned in this discussion back up on the page) isn't as serious a concern as the others (for most women, I'd say). ApproximateLand (talk) 23:59, 12 March 2021 (UTC)

Thanks you for these useful comments, which I will keep in mind if any further chnages to that (tricky) paragraph are made. I have replaced Acne in the Lead as you suggested.Graham Beards (talk) 08:01, 13 March 2021 (UTC)

The penultimate sentence needs to be rewritten now that we're focussing on the women with problems again. I came up blank in terms of good prose. FemkeMilene (talk) 09:43, 13 March 2021 (UTC)

Of which section? Graham Beards (talk) 10:11, 13 March 2021 (UTC)

The last paragraph of the lede. Directly after the sentence you just improved. FemkeMilene (talk) 10:17, 13 March 2021 (UTC)

OK. Graham Beards (talk) 10:56, 13 March 2021 (UTC)

Thank you, Graham Beards. ApproximateLand (talk) 17:45, 13 March 2021 (UTC)

We seem to have gone backwards, to again focusing on what TWO sources say are 20 to 32% of women, medicalizing the cycle, while we have lost the specificity that (68 to) 80% of women do not experience disruption in their daily lives— what is stated clearly in two sources. This article is not PMS, and most women do not have PMS, yet we introduce now what is 20% of women prominently in the lead. My understanding early on was that GandyDancer, Graham, Femke and I all objected to this. We need to go back to what the sources say about 80% (in one source, expressed as 20-32 in the other) of women, as “some women” is too vague and we are leaving the impression that menstruation is more than a bother to a lot of women. Why are we using PMS sources rather than menstrual cycle sources? I thought this section had highlighted sources that specifically discuss the cycle so that we could get away from medical disorders that affect “some”? Or, as Femke says, we are “focusing on the women with problems again” even though a) that is borderline offtopic, and b) those women are a minority. I hope we can stick to sources about the menstrual cycle and not get into the netherlands of every medical issue that affects a minority to the point of undue attention: yes, having to use products to contain flow is a “bother”, but the medical definition of disruption to daily life means something entirely different. Shall we examine the sources originally provided by WAID, listed above, and use them if helpful to get away from PMS, which is not what this article is about? We have a high quality recent source that says:

Else-Quest and Hyde have a short (two pages) section on Psychological Aspects of the Menstrual Cycle. It says that MC effects on mood are a common perception, but there is little evidence to support it. It adds that reported correlations with hormones do not prove causation. The authors have more, much more, to say on cultural influences than hormones.Graham Beards (talk) 14:19, 8 March 2021 (UTC)

so there is no need to get off into medical conditions affecting the minority— particularly when we are sourcing those statements to articles about PMS. SandyGeorgia (Talk) 13:52, 13 March 2021 (UTC)

One of those sources only refers to the luteal phase not the full cycle so we only have one source. Graham Beards (talk) 13:59, 13 March 2021 (UTC)

All four of the sources used in those two sentences of the final para of the lead are PMS sources; we are opening the door again for the article to become about medicalization of the reproductive cycle, while giving undue attention to a minority. At minimum, we might move that out of the lead, but I also suggest we should be using Else-Quest if anything. SandyGeorgia (Talk) 14:34, 13 March 2021 (UTC)

I think we should delete all of it but I anticipate a lot of opposition. By using Else-Quest, do you mean the take home message I wrote above? Graham Beards (talk) 14:41, 13 March 2021 (UTC)

Or similar; I am unsure if that commentary was based on a quick glance or if you would want to expand it. It is a source specific to the cycle, and if we preferences sources about individual conditions (even in the lead, even when they affect a minority), that could end with re-medicalizing the entire article again. As to delete or just leave out of the lead, we should gather other opinions. I am unsure why we are focusing on PMS as opposed to any other medical condition that can affect a part of the cycle. Graham, PMID 26346058 which you found demonstrates the issue(s) well (is it really a reproductive cycle issue?) and offers an explanation for why menstruation is merely a “bother”, but not disruptive, for most women. SandyGeorgia (Talk) 14:50, 13 March 2021 (UTC)

The first thing I noticed in that paper was the enormous range in those affected ("between 45 and 95%") and this paragraph "few affected women seek medical treatment, despite the substantial distress experienced, as many consider the pain to be a normal part of the menstrual cycle rather than a disorder". It didn't have the answer to my question; for how many women is it a minor disruption? (Or a "bother" as you put it). I didn't pursue it further because it was leading me astray down the medicalization path. We should certainly move away from PMS.Graham Beards (talk) 17:01, 13 March 2021 (UTC)

SandyGeorgia, did you read what I said? Why do you say "minority" and "medicalizing the cycle" when reporting on common facets of it? In the PMS section back up on the page, Graham Beards quoted information from the Wendy Biggs and Robin Demuth source. One thing it says is "Up to 80 percent of women report one or more physical, psychological, or behavioral symptoms during the luteal phase of their menstrual cycle without experiencing substantial disruption to their daily functioning." It says "without experiencing substantial disruption", not "without experiencing any disruption." The Hong Ju, Mark Jones, Gita Mishra source says that dysmenorrhea, what our Misplaced Pages article alternatively calls menstrual cramps, "is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization." It says that "the prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%–29% of the women studied." So dysmenorrhea is common. Menstrual cramping is painful and happens near or during the woman's period. While estimates vary, it occurs in most teenage girls and women during their cycle, not in a minority. These cramps do typically disrupt teenage girls' and women's lives enough to, as one of the sources says, result in a complaint about the cramps affecting their quality of life. Disruption does not need to be debilitating to be disruption. Many teenage girls and women take medication for the cramps. If these cramps did not disrupt their lives at all, they would not need the medication. There are other menstrual cycle symptoms, such as bloating and irritability, that are common. Women can also get these symptoms during their cycle without the symptoms being diagnosed as PMS. Our PMS article mentions this. Graham Beards has also quoted a piece from a source that says "few affected women seek medical treatment, despite the substantial distress experienced, as many consider the pain to be a normal part of the menstrual cycle rather than a disorder." Well, as substantial distress is substantial, I wouldn't say that's not disruption. I object to removing the information on pain or other troubles that teenage girls and women commonly experience during the cycle. This isn't medicalizing the topic. It's a medical facet of a biological topic. It's just a reality that comes with the cycle. If concerned about focusing on the luteal phase, one suggestion I have is to say "During the luteal phase of their menstrual cycle, some women experience problems that disrupt daily life." I still think "some" should be "many" or that we should just remove "disrupt daily life" and replace the sentence with "During their menstrual cycle, many women experience painful symptoms." We could also say "During the luteal phase of their menstrual cycle, many women experience painful symptoms." ApproximateLand (talk) 17:45, 13 March 2021 (UTC)

Hold on. Can we stop going around in circles? We have already agreed that medical problems associated with menstruation belong in menstruation and not here. Could somebody point out any issues associated the follicular, secretory and luteal phases that are important enough to be mentioned? And backed up with reliable sources and not opinions. Also, given this article is around 99% about endocrinology, I am amazed that no one has checked what I have written about the complex interplay of hormones — or at least said they have read it and it's correct. Graham Beards (talk) 19:32, 13 March 2021 (UTC)

Graham Beards, please be patient with me. You've been a tremendous help with the page and I also want to help. What I think should be in the article aside, please know that I'm not commenting from a personal viewpoint. As to "We have already agreed that medical problems associated with menstruation belong in menstruation and not here." But the cycle is intrinsically linked to those problems ("80 percent of women report one or more physical, psychological, or behavioral symptoms during the luteal phase of their menstrual cycle") and should be mentioned on this page too. They already are, and the article would have excluded pertinent information if it weren't on the page. That is all I support including on the page about issues that teenage girls and women have during their cycle. We don't need to go into any unnecessary depth about menstruation or anything else. I've looked at refs on this topic today. I read all of the reviews that have been discussed here and others (a Turkish one too), and then I took a look at what books have say. A couple of books have been mentioned on this discussion page. As to what I read, well, there's this ref. It's a Nancy Caroline's Emergency Care in the Streets Advantage Package (Canadian Edition) ref and says, "Some women may experience abdominal pain and cramping in the middle of the menstrual cycle. This pain and its accompanying symptoms result from the physiologic rupture of an ovarian follicle and are collectively called mittelschmerz (German for middle pain). In most cases, the pain is not severe; it may last only a few minutes or as long as 48 hours (average, 6 to 8 hours). Signs and symptoms include sharp, cramping pain in the lower abdomen, localized to one side, beginning midcycle, with a history of similar pain episodes during previous periods. The pain may also be reported as switching sides from month to month. The condition itself is not serious, and the pain can be relieved by over-the-counter analgesics."

The ref also says, "Dysmenorrhea is painful menses. It is classified into two categories: primary and secondary. Primary dysmenorrhea occurs with the advent of the menstrual flow and normally lasts for the first 1 to 2 days with gradual relief. Mild cramping is normal, but some women experience severe cramping, with pain originating in the area of the pubic symphysis and radiating downward to the vulva and outward to the thighs. Primary dysmenorrhea accounts for approximately 80% of patients presenting with painful menses and accompanies a regular period. Secondary dysmenorrhea is pain that is present before, during, and after the menstrual flow. It is generally organic in nature (not hormonal) and may signal an underlying illness or structural abnormality. As with PMS, prehospital treatment is largely supportive." So this source (not too dissimilar to others on the subject) is saying what I've said. These symptoms are common, may or may not be characterized as PMS, and while, in most women, they are not severe enough to substantially affect their daily routine, pain is involved and medication is needed for many of these women. And so I'm concerned about having this page misdirect readers by making them believe that there is no menstrual pain or other discomfort, or no issue with pain or other discomfort, for most women at certain points during their cycle. While something like menstrual cramps won't be debilitating for most women, they are enough of a problem in that the pain can last for hours, especially without medication. What I keep seeing with the 80% figure is acknowledgement that at least 80% of women experience some sort of pain or other discomfort at some points during their cycle, with some of the references acknowledging the issues with diagnosing all or some of these as PMS.

This ref (A Pocket Guide to Clinical Midwifery) says, "Although 80% of women report symptoms of PMS, only 20–32% have recurrent lifestyle modifications indicating a diagnosis of PMS (Schuiling & Likis, 2017)." And the Anatomy and Physiology - E-Book ref says, "Dysmenorrhea, meaning 'painful menstruation', is the term used to describe menstrual cramps, the painful periods that affect 75% to 80% of women at some time during their reproductive years." ApproximateLand (talk) 04:01, 14 March 2021 (UTC)

This is unnecessarily long and does not attempt to address my questions. Your only valid concern is "this page misdirect(s) readers by making them believe that there is no menstrual pain or other discomfort, or no issue with pain or other discomfort". It doesn't. I suggest you direct your energy to improving menstruation. Graham Beards (talk) 10:25, 14 March 2021 (UTC)

Identifying reviews

Done, and I standardized journal articles to sentence case, as we had a mix (book titles use title case). SandyGeorgia (Talk) 00:27, 13 March 2021 (UTC)

Thanks. Graham Beards (talk) 08:01, 13 March 2021 (UTC)

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