Shubhangi Bodhankar teaches mathematics in a college. Every day, starting from July until late October or early November every year, she pops a pill called 'pali lambaonyachi goli' (menstruation delaying pill). This is Bodhankar's way of ensuring that she is not in an 'impure' state during any of the numerous festivals and fasts that fall during these months. It is a different story altogether that once she stops taking the pill, she is laid up for as many as 10-12 days with heavy bleeding and weakness. "There is no choice," she says, "Who will do all the work?"
Bodhankar does not remember the brand name of the pill she takes and relies on her chemist to give her the 'right thing'. This practice of indiscriminate consumption of hormonal pills to manipulate menstruation is very common, especially during the four-month festival season beginning from the monsoon month of July. It is not uncommon for women, especially those belonging to the more orthodox communities, to consume these pills over a long period of time, sometimes two months or more at a stretch.
Even educated women do not feel the need to consult a doctor on this. "The practice is quite widespread and its extent can hardly be estimated," says Dr Jayashree Shembalkar, a hormonologist (a doctor treating hormonal disorders). "Actually less than 20 per cent of the women who consume hormonal pills with the express purpose of manipulating their periods, do so with the doctor's advice. Even those who do get a prescription once continue to use the same drug for years." As hormonal pills are easily available over the counter, indiscriminate consumption becomes easier.
However, this indiscriminate use can lead to serious health problems. "By taking these pills, you are artificially raising the level of hormones in the body, so that menstruation - which occurs when the hormone level drops to a threshold and the inner lining of the uterus is shed - is prevented. Basically, you are tampering with the body's natural rhythm," says Shembalkar. Apart from heavy, debilitating withdrawal bleeding (bleeding that occurs when oral contraceptives or hormonal pills are stopped, because the body experiences 'withdrawal' from the lack of hormones), these pills can cause other complications like high blood pressure and obesity.
The pills available in the market consist of either progestron (pills like Orgagest, Deviary, Meprate, Rejestron or Primolut-N) or a combination of estrogen and progestron (Novelon, Ovural, Triquilar), which also work as contraceptives. Taken indiscriminately, progestron can raise blood pressure and can also cause obesity and water retention. Overdose of estrogen can cause blood clots, raising the risk of a heart condition. And more dangerously, both the hormones can cause irregularity in the menstrual cycle and swelling in the liver.
"But there is little awareness regarding this. There is this belief that these pills are just contraceptives, and hence harmless. Also, after years of abuse, when the complications do occur, the pill connection is not obvious," Shembalkar says.
Another disturbing aspect of the practice is that the social and psychological pressures behind this harmful and regressive practice are hardly understood. As an issue pertaining to women's health, it has hardly been raised, let alone studied.
"The 'impurity' argument is still as effective as ever," says Shubhada Deshmukh, a gender and political rights activist. "Even in progressive families where the stringent 'vitaal' (impurity pertaining to a menstruating woman) rules have been relaxed in other contexts, they continue to be as strict as ever when it comes to religious rituals."
"It is not even perceived as a problem," says Dr Rupa Kulkarni, a well-known social activist. "Women themselves - even educated ones - sincerely believe in the impurity theory that has been fed to them since childhood. They believe that they are doing the right thing by consuming pills so that their 'inauspicious' menstruation don't interfere with the auspicious proceedings."
The practice is sustained and passed on by women themselves, without any obvious outside pressure. And rebels are few. "The pressure becomes very much obvious the moment you refuse to comply," says Archana Mane, who comes from a liberal family and does not believe in 'playing tricks' with her system. Married into an orthodox Maharashtrian family, Mane remembers spending three hours sitting on a stool in the front yard of her house with her one-year-old son. "The pothi (book) of Lord Hanuman was being read in our house that day, and my mother-in-law told me that even a menstruating woman's voice is considered inauspicious on such an occasion. She first suggested that I take the pill, and when I refused, on the day of the ceremony, she told me to remain outside."
The rationale women have for this practice are varied and often surprising. Amruta Sathe, a chartered accountant, believes that the nuclear family is the reason why women are 'compelled' to pop the pill. "If you are in an 'impure' state, there is no one else to do the work," she says.
"A negative attitude towards one's body and its functions is generated by the rejection and the virtual untouchability that a girl is subjected to since her very first menstruation," says Shembalkar. "The result of this negativity is that women do not have any respect for their natural body rhythm and do not hesitate to manipulate it for, what is perceived, as more important ends."
Awareness, agree experts, is the only way to counteract this dangerous and degenerating practice. "The protest has to come from women themselves. They have to learn to treat the body and its processes with respect, and reject systems of belief that belittle them and encourage manipulation."