Sustainability for the Centre for Menstrual Cycle and Ovulation Research means Research Equity for Women
Jerilynn C. Prior BA, MD, FRCPC
The Centre for Menstrual Cycle and Ovulation Research (CeMCOR) reached its 19th anniversary this past May, 2021. This is cause for celebration!
However, we cannot celebrate, honour an important anniversary, nor cheer the many achievements of CeMCOR, until we are assured of CeMCOR’s sustainability beyond my University of British Columbia (UBC) professorship.
Why should CeMCOR be sustained?
Survival of the unique Science pioneered by CeMCOR is crucial for progress in women’s health research https://www.sciencedirect.com/science/article/pii/ S174067572030013X?via%3Dihub. CeMCOR discovered and reported that women’s everyday stresses are commonly linked to silent ovulatory disturbances despite regular cycles. These still unrecognized menstrual cycle-related hormonal imbalances are associated with common diseases in older women, such as osteoporosis, heart disease, breast and endometrial cancers.
CeMCOR also needs to continue because its website is providing invaluable support for women of all ages around the world through approachable, evidence-based and practical information.
Why is UBC’s CeMCOR NOT automatically Sustained?
There are three clear reasons:
- When I retire, my professorship and any faculty funding, even at the less expensive, Assistant Professor level, will belong to the Faculty of Medicine (FoM) Dean to use as he sees fit. He has declared this academic funding will no longer be dedicated to women’s reproductive health within the Division of Endocrinology. Consequently, there will be no academic leader for CeMCOR into the future.
- CeMCOR has never received UBC FoM funding. CeMCOR, in its first five-six years, was supported by a UBC donor and former patient of mine. CeMCOR is currently supported by the $50-70,000/year I donate from my UBC salary. Other funding comes from the grants that CeMCOR secures, usually small but very welcome donations, and the royalties from two books authored by me, Estrogen’s Storm Season—stories of perimenopause and The Estrogen Errors.
- UBC’s FoM asserts that it owns CeMCOR and thus has the power to make all decisions, including about CeMCOR’s future. However, “ownership” is based on my status as a full-time UBC professor. UBC FoM also provides a small amount of research space research in a building owned by Vancouver Coastal Health near Vancouver General Hospital. In addition, UBC finance handles all CeMCOR donations, our operating account and CeMCOR’s endowment fund.
What have we already tried to secure CeMCOR’s future?
CeMCOR’s sustainability has been a major concern of mine since even before I became 65 years old and was facing the prospect of being forced to retire. However, happily the compulsory age-65 retirement law changed. My first effort to sustain CeMCOR was to NOT retire. Although I turned 78 years old in the summer of 2021, in 2020 the Department of Medicine awarded me “Outstanding Academic Achievement” (so I’m productive, not marking time). Note that I did receive a letter of congratulations about that honour from the FoM Dean.
- I repeatedly have requested a meeting with the Dean. It has never been granted despite six+ years of trying. Four months after I was awarded the Aubrey Tingle Clinician Scientist award, and five months after that award was announced, I received a two-sentence congratulation letter signed by the FoM Dean.
- Last spring, I met by Zoom with the head of the new FoM Office of Respectful Environments, Equity, Diversity & Inclusion (REDI). After explaining about the need for CeMCOR’s sustainability, head asserted: “your issue is not about EDI.” Pivoting, I then requested, “Would you please suggest that the Dean meet with me?” The REDI head firmly replied, “I won’t. . . .”
- I met with the MD co-leader of REDI two weeks later—I felt understood and supported but she explained she had no UBC salary, little power, and also that she had no direct contact with the FoM Dean.
- Also, in spring, 2021, I met with the Associate Dean, Academic, FoM, who listened carefully, seemed to appreciate the issues I raised. In the end she asked us not to further involve her office, offering no other suggestions.
- In the spring of 2021, I wrote to and got a positive (‘but not right now’) response from a scientist leading the Women’s and Maternal Health section of the BC Ministry of Health. I will contact that scientist again now.
- In August of 2021, I wrote to the UBC Provost, asking to meet. He personally and quickly replied with many suggestions, all of which I had previously explored and that had produced no positive outcome. I explained the complexity of the issue, and further about the Science-related importance of CeMCOR’s survival; accepting the reality of silent ovulatory disturbances has profound academic implications and is not being addressed at the FoM level. I got no reply but will follow up again now.
What does CeMCOR NEED to survive and thrive into the future?
1. An endowed Professorship in Women’s Health in Endocrinology—price tag = $7-8 million
Today’s Women’s Health experts are Gynecologists, as they have been for over a century beginning before the germ theory of disease. Gynecology focusses on pelvic surgeries, infertility, menstrual cycle-related diseases (endometriosis, Polycystic Ovary Syndrome [PCOS], uterine prolapse), perimenopause and menopause as ‘estrogen deficiency’, and primarily estrogen-based therapies.
Newer Women’s Health experts are those with social sciences expertise, Women’s Studies backgrounds, but many have limited biology/physiology training. For this reason, they tend to unquestioningly accept Gynecology’s description of regular menstrual cycles as always ovulatory.
By contrast, I am an expert in women’s hormones within internal medicine with past family physician and public health practice and a first degree in Literature; I also grew up poor and have lived and worked in Indigenous communities for nine years of my life. Perhaps this background allowed me to “see” that the menstrual cycle is integral to general health, and that balanced estrogen and progesterone actions are necessary. I also perceive most symptoms menstruating and perimenopausal women experience arise because of estrogen-progesterone imbalance. My background and trainingallow me to see dogma that lacks scientific evidence.
A key current dogma is that regular, normal-length cycles are always ovulatory. Although Gynecology asserts that as fact, Science does not support that concept 1-3. There are strong implications for women of the reality that regular cycles may be without ovulation or with too few days of high progesterone levels (i.e. short luteal phases). Silent ovulatory disturbances within regular cycles are related to fertility issues, contribute to early miscarriages, cause heavy flow with anemia, and likely aggravate the intensity of menstrual cramps, as well as promoting the development of endometriosis and fibroids. There are also important treatment implications. About a third of normal-length, predictable cycles in the population have subclinical ovulatory disturbances 3. These silent disturbances are adaptive responses to women’s social inequality, physical and emotional stresses, as well as nutritional insufficiencies 4. A Professorship is necessary to lead research and teaching related to this innovative understanding of women’s menstrual cycles.
2. Development and Marketing of a Simple, Inexpensive Once/Cycle Home Test of Normal Ovulation
CeMCOR has a patentable idea for a test of normal ovulation. If CeMCOR were able to fund, develop, pilot and market this test, even at a low cost/test ($1.00-2.50) this revenue could eventually provide the ongoing annual support of about $100,000/year that CeMCOR needs. It will also provide the research tool needed for long-term population-based documentation of the relationship of silent ovulatory disturbances with women’s diseases and disabilities.
Our hypothesis is that Normal Ovulation Test could be performed once per cycle, telling a woman whether that cycle was normally ovulatory or not. It will be sufficiently convenient and inexpensive that women would do it every cycle over many years.
Once developed, validated, pilot-tested and marketed for world-wide accessibility, this test could help women decide when (by age, position in careers, or life choices) to start a family, whether emotional/social support were needed and/or lifestyle, job or relationship changes. If responses to these interventions were too slow, there is the option to provide “luteal phase replacement therapy” with short-term cyclic progesterone therapy https://www.cemcor.ca/resources/topics/cyclic-progesterone-therapy. Importantly, this Normal Ovulation Test would also allow population-based scientific documentation of the likely relationship of higher-than-average premenopausal subclinical ovulatory disturbances with increased older women’s risks for osteoporotic fracture2, heart attacks 5 6, breast 7 8 https://www.cemcor.ca/resources/does-taking-progesterone-alone-or-estrogen-increase-women%E2%80%99s-risk-breast-cancer and endometrial cancers 9.
3. Support from YOU!
We need evidence that CeMCOR is making, or has made, a difference in your life.
Please write an email we can share https://www.cemcor.ca/contact putting “Sustain CeMCOR” in the subject line. Or contact us on Facebook or Twitter #sustainCemcor.
Please also donate once or monthly if you can https://www.cemcor.ca/donate.
Thank you from me personally, from all those around the globe who have volunteered with CeMCOR over the years (on her Community and Scientific Advisory Councils, and by doing research with us), and also into the future, from our daughters and granddaughters.
Reference List
1. Prior JC, Vigna YM, Schechter MT, et al. Spinal bone loss and ovulatory disturbances. New Engl J Med 1990;323:1221-27.
2. Li D, Hitchcock CL, Barr SI, et al. Negative Spinal Bone Mineral Density Changes and Subclinical Ovulatory Disturbances--Prospective Data in Healthy Premenopausal Women With Regular Menstrual Cycles. Epidemiol Rev 2014;36(137):147.
3. Prior JC, Naess M, Langhammer A, et al. Ovulation Prevalence in Women with Spontaneous Normal-Length Menstrual Cycles - A Population-Based Cohort from HUNT3, Norway. PLOS One 2015;10(8):e0134473.
4. Prior JC. The Menstrual Cycle. Its biology in the context of silent ovulatory disturbances. In: Ussher JM, Chrisler J, Perz J, eds. Routledge international handbook of women's sexual and reproductive health 2020:39-54.
5. Gorgels WJ, Graaf Y, Blankenstein MA, et al. Urinary sex hormone excretions in premenopausal women and coronary heart disease risk: a nested case-referent study in the DOM-cohort. J Clin Epidemiol 1997;50(3):275-81.
6. Prior JC. Progesterone within ovulatory menstrual cycles needed for cardiovascular protection- an evidence-based hypothesis. Journal of Restorative Medicine 2014;3:85-103.
7. Mohammed H, Russell IA, Stark R, et al. Progesterone receptor modulates ERalpha action in breast cancer. Nature 2015;523(7560):313-17.
8. Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat 2008;107(1):103-11. doi:
9. Modan B, Ron E, Lerner-Geva L, et al. Cancer incidence in a cohort of infertile women. Am J Epidemiol 1998;147(11):1038-42.
