The thesis of Elissa Stein’s new book, “Flow: The Cultural Story of Menstruation,” co-written with Susan Kim, is that nobody ever talks about menstruation, with the exception of women who bemoan its arrival with a coded acknowledgement — Aunt Ruby’s come to visit, wearing the red badge of courage, or, in Latin America, Jenny has a red dress on. So why is language related to a natural human function experienced by half of human beings for 35 to 40 years of their lives so unspecific and allusive? This avoidance of straight talk about menstruation Stein and Kim attribute both to a societal brainwashing extending back to ancient norms based on fear of this monthly bleeding and to “femcare” companies that stand to profit from women’s ignorance.

Supporting the book’s thesis further is the fact that Stein, a nonfiction author and graphic designer, has seen many in the mainstream media determined to wrap this new book itself in a similar veil of silence by not reviewing it. When Stein talked to the publisher of People, for example, she was told the topic was too squeamish for the magazine’s readers. To this, Stein says, “Eighty percent of its readers are women, and the magazine is filled with ads for tampons and pads, and it talks about incest and teenage drug use, really shocking things.” But, she adds with a nearly audible shoulder shrug, “Talking about periods and education and history is an off-putting subject.”

Stein will do a book signing and discussion at Borders in Nassau Park on Saturday, February 6.

The book did get some fantastic reviews, for example, it was an editor’s choice in Booklist, published by the American Library Association. But mainstream Redbook slammed it with the words “Snub This One” along with a picture of the book cover. Here is how Stein summarizes the contents of the Redbook review: “Whether you love your period or hate it, I don’t care — but why on earth would you want to read about it? You should spend the money on three to five days of Ben and Jerry’s ice cream instead.” This even though in the same issue was an article about how to ask your doctor uncomfortable questions.

Stein got the idea for this book after a personal experience with her gynecologist that embarrassed and frustrated her. About 15 years ago, her period stopped. Although she was afraid that something was terribly wrong, she was also too embarrassed to tell anyone about it. Finally she confided in her therapist who told her she had to see someone right away. “She panicked for me,” recalls Stein.

When Stein told the gynecologist her story, all he did was hand her a pack of birth-control pills, “You need to jumpstart your hormones; take these for a few months, honey, and you’ll be fine.” No discussion of what the problem might be.

Well, Stein did not want to be on the pill, and she left his office feeling that the pill might not even fix the underlying problem, whatever it was. “I was frustrated in not having resources to go to and in how dismissed I was as a woman,” she says.

Two years later she finally figured out why her period had stopped — because she was anorexic. “It took two years before I could acknowledge my eating disorder,” she says, but when she did, she realized her period had stopped because she was too thin. So what was her gynecologist thinking? Stein was worried that she was dying of cancer and was suffering from anorexia, and instead of discussing what might be wrong, all he did was hand her the pack of pills. And why was she unable to engage him in this conversation herself?

Because Stein felt so silenced, she started to envision a way for women to have these conversations without having their concerns dismissed, so she started to do research. The book really got going once Stein had a daughter. “I didn’t want her to grow up in a society where she was too ashamed to talk about menstruation,” says Stein.

But once she went full swing into gathering her resources and writing the book, all her friends and acquaintances in the book publishing business, where she had worked for years, told her the book would never fly because it had no audience and no one would publish it.

Stein, luckily, did not listen to the naysayers. She had learned a lot about books and book proposals from the 10 “visual histories” she had written on subjects like cheerleaders, beauty queens, and stewardesses. “It was an education in how to tie story and visual images together and find artwork that shapes how we think about things,” she says. This was hugely helpful in her development of “Flow,” which, in addition to lively exploration of menstruation broadly defined as a social and cultural experience, features advertisements for tampons and pads, douches, pain killers, elixirs, and related items covering over a century.

Stein got hooked up with an agent who was a friend of a friend, and brought 15 to 20 book ideas with her to their first meeting. The woman looked through the crop of ideas and selected “Flow” as the book she wanted to sell first because it was such an important and needed resource.

As they were putting together a proposal, it became apparent that the book was bigger than they had originally thought, and the agent introduced Stein to her co-writer. They were a good balance, says Stein, because Kim was interested in the biological, medical, and pharmacological angle while Stein was more attuned to the educational, artistic product development, and social history side. In the end, the publisher had to cut a third of their manuscript, including a chapter on pop culture and another on people who interpret fairy tales like “Little Red Riding Hood” as coming-of-age stories about menstruation and the perils of girls meeting “wolves” once puberty sets in.

The book was rejected by 25 editors. “That was pretty surprising,” says Stein. “I thought at that point that the world would be more open.” But then St. Martin’s Press accepted the book, with no caveats, only asking Stein, “What do you want this book to be?” Stein’s answer: a beautiful, coffee-table book, filled with the art that is so much part of story, and so well designed that people can’t put it down. The editor agreed to all of her suggestions.

Stein’s initial approach to the subject of menstruation was through the lens of how advertising has shaped how women think about their bodies and their periods. It starts with television ads that young children see and continues with health education in schools to today’s ads for femcare products. Ever since these products came on the market, adds Stein, advertisements have been teaching girls and women that menstruation is something shameful and embarrassing that they needed to maintain secrecy about at all costs.

As she delved more deeply into her subject, Stein uncovered many facts that are downright scary. For example, drugs for hormonal replacement therapy were prescribed for millions of women in menopause, with advertisements touting them as an elixir for eternal youth. Unfortunately, says Stein, the Food and Drug Administration at that time only required 12 weeks of testing such drugs, and it took a tremendous up-tick in breast cancer for people to start putting the pieces together and understanding their dangers.

“The goal of ‘Flow’ is to start a conversation,” says Stein. “If people talk about menstruation and bodies more, there won’t be so much discomfort and embarrassment.” The book is also designed to encourage people to think and make their own decisions about themselves, their bodies, and the environment.” For example, what do we do about the estrogen in our water supply that is secreted by millions of women on birth control when they pee? And what happens to all those disposable, nonbiodegradable tampons and pads when they are thrown away? And what are the unidentified chemicals in the perfumes on sanitary products to which women are exposing the most sensitive, absorbent parts of their bodies? “I hope women will start thinking more instead of accepting what’s out there,” Stein says.

Particularly scary for Stein is the newest rage on the pharma market for women — pills that entirely suppress menstruation, pretty much long-running birth control pills. In the book, she notes that one of these drugs, Seasonale from Barr Laboratories, advertises that it is safe to take from one’s teens through menopause. “But,” writes Stein and Kim in “Flow,” “before you go rushing out to fill that prescription for your 15-year-old, do you want to know what this claim is based on? A study of 300 women who were tested for one year . . . total. To us, this is exactly not what we’d call reassuring.”

Stein grew up on Long Island, but claims she has been in the city for so long that it “negates the island part.” Her father is an oncologist. Her mother and stepfather live in Florida.

Stein attended Brandeis University for two years and eventually graduated from the School of Visual Arts in New York City with a degree in graphic design. But even when she was in school, she remembers her portfolio teacher telling her, “You need to be writer; all of your projects are about words.”

Stein’s books all combine the words with images that tell the story. “We are a very visual society, and how people learn is through commercials, advertising, billboards, packaging,” she says. “I’ve found a way of doing books that combine those two things.” A list of all her books is on her website,

Stein thinks “Flow” is for absolutely everyone. Certainly every teenage girl should read it, she says, especially in a time when New York State has no mandatory sex education until eighth grade, whereas by then many children are already having sex. But Stein says the book reaches far beyond the adolescent and preadolescent market. “It is a book about women’s history through the lens of menstruation.” And even men have been interested, Stein reports. “So many said, ‘I’ve always been curious but afraid to ask.’”

Stein relates the story of a taxi driver who surprised her by being very interested in talking about her subject. Six months ago she had committed herself to talking to one person every day about “Flow,” only to find herself that very day in a taxi to the airport driven by a 60ish Greek man. When he asked her what she did, she replied, with heart pounding and fearing that he would kick her out of his cab, “I’m a writer, and I’m writing a book about menstruation.”

It turns out, though, that he was actually looking for information on that very subject — but had no one to ask. He replied to Stein, “My wife suffers horribly from hot flashes. Do you know anything that will help her?”

One thing Stein feels she has achieved through the process of writing “Flow” is to make her children comfortable with menstruation. Her son and daughter, she says, have discovered how to make tampons into rockets. For Stein, the best part of this whole experience was the day she heard her son yelling from the next room, “Mom, I need another tampon.” She observes, “I’m sending my children into the world with no shame about menstruation whatsoever.”

Author Event, Borders Books, 601 Nassau Park. Saturday, February 6, 1 p.m. Elissa Stein, author of “Flow,” a social, psychological, historical, and medical look at menstruation. 609-514-0040 or

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