Painful periods: a rule more than an exception
Ways menstruating folks are suffering from chronic pain
September is chronic pain awareness month, an initiative started with the goal of raising public awareness and understanding of pain and chronic illnesses.
The thing is — many chronic illnesses go without being noticed by other people. If the condition is not visible, strangers rarely realise that a person is actually suffering. This is what is happening to women and menstruating folks on a monthly and even daily basis.
Roughly one third of the world menstruates, but there is little wide-spread knowledge around issues that affect us deeply. This collective has been suffering from numerous conditions without being able to receive much relief. The causes are always very mysterious and, the remedies, scarce. Many women have resorted to online searches and alternative medicines in order to escape the pain they experience, in silence, everyday.
Throughout history, there have been a lot of misconceptions around women’s bodies and menstrual health. Medical knowledge was held and exercised by a very low percentage of men. Even to this day, there is a general lack of knowledge about the source of many different processes and there is a gender health gap that is far from being closed.
Today, I want to bring light to the main conditions that cause menstruating folks pain during their monthly cycle. After all, knowledge is power. And even if we are still unsure about many of the reasons why they happen or how to cure them, knowledge, even if limited, is still power.
“Genuine understanding about women bodies and minds had been obscured for centuries by unseemly superstitions about female sexuality and the reproductive organs”.
From Unwell Women, by Elinor Cleghorn
The aim of this article is not to give medical advice — I am not a medical professional-, but to give visibility to a matter of conditions that are usually overlooked, and that people don’t generally know unless they are suffering from them.
When I started experiencing menstrual issues, I didn’t even know what my options were, how to name the pain or what were the names of the conditions I could be suffering from. Nobody was able to explain much to me. As much as I knew what “diabetes” and “anaemia” was, I had never heard “endometriosis” before I was twenty-three years old (and 8 years menstruating).
This is why, today, I want to go through the main ways in which women and menstruating folks are experiencing chronic pain in a somehow invisible way. This is far from an exhaustive list, but it is a start.
Endometriosis
The big “E”. It affects roughly 10% of women in reproductive age (quivalent to a staggering 190 million women…). Though more visibilized in later years, it still takes roughly seven to ten years to receive a diagnosis as its symptoms get generally mistaken for menstrual cramps.
Endometriosis is a condition through which endometrial cells, present in the lining of the uterus, start growing outside the uterine walls, spreading to ovaries, fallopian tubes, bowel, bladder or anywhere inside the abdominal cavity. Generally, the abnormal uterine lining will shed during menstruation, leading to inflammation, bleeding and scarring.
So, no, it is not just normal cramps.
People diagnosed with endometriosis report increased levels of pain during every cycle, sometimes not being able to even stand. Many women experience nausea, bloating, overall body aches… leaving them in bed for 3 to 5 days of every month. Imagine that (if you’re not already part of that 10%…).
And, of course, as always “the problem of getting an accurate diagnosis and treatment is worse for some minority groups, including people of color and indigenous people”, according to the Endometriosis Foundation of America.
PCOS
Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, which disrupts a woman’s menstrual cycle as there might not be enough hormones for the egg to release, which means ovulation does not take place.
As with a lot of conditions arising in our menstrual cycles, there are no clear drivers for PCOS, what is causing it and how to deal with it. As with endometriosis, diagnosis takes long and sometimes it does not even happen.
PCOS is generally related to hormonal imbalances — in general, people with PCOS do show a higher level of insulin. They tend to show irregular periods, tendency to weight gain, acne and excessive body hair, but at the same time thinning hair in the head or baldness (as if the pain was not enough!).
Fibrosis
Uterine fibroids are noncancerous growths that develop in the uterus. They are more common than you would expect — according to the U.S. Department of Health & Human Services, up to 80% of women develop fibroids by age 50.
Once again, the causes are not clear and the symptoms vary a lot — some individuals might have barely any symptoms, whilst for others they can be quite extreme: heavy menstrual bleeding, abdominal pain, difficult bowel movements…
The reality is, if you are having a 7-day long cycle where you are bleeding heavily everyday, something is wrong and you should consult a doctor.
PMS
PMS stands for “Premenstrual Syndrome” and it is a variety of symptoms we experience before menstruating. Some of the symptoms are mood swings, tiredness, headaches, bloating… not a nice symptom in the house!
It is only in recent years that society (myself included) has become more aware that, actually, PMS is not “normal”. Periods are not supposed to make you suffer and you should not have to endure excruciating pain.
However, it has been normalised for such a long time, we tend to not think about it at all. I remember my first period, when my mom just gave me a pad, bought me some chocolate and told me that I would be having stomach pain every month.
No, thanks.
PMS affects quality of life tremendously, so much so that some countries have started giving menstrual leave. Visibilising this pain and understanding how we can avoid it is key to improving women’s quality of life.
PMDD
Premenstrual dysphoric disorder (PMDD) is the bad sibling of PMS. It is a severe form of PMS, characterised by mood disturbances, irritability, and physical symptoms that can significantly impact daily functioning. It is a chronic condition that should not be taken lightly — in the most extreme cases, it can even cause vision changes, paranoia and fainting. Once again, these conditions make it so that your everyday function is impacted.
The causes are, unsurprisingly, not well known. However, it has usually been related to serotonin deficiencies coming from the hormonal changes during the menstrual cycle.
To get a diagnosis, you will need to consult a doctor and even a mental health professional given the severity of symptoms. It is useful to look at family history to understand if the menstruating folks in your family experienced similar symptoms during their cycles.
What now?
It is quite unsettling that we do not know many reasons why these illnesses occur or how to prevent them. However, we must persist and keep learning. My hope is that through this article you have learnt that suffering during your periods is not normal, and its contents will help you speak up and defend your right for painless periods.
By being vocal about our pain we are able to call out the issues we are experiencing and bring attention to the gender health gaps that need to be solved. Even if women’s pain generally gets underestimated by health professionals, we should advocate for our bodies and our suffering.
We deserve a painless life.
Disclaimer: This article is for informational purposes. If you are experiencing any issues with your period, you should seek help from a medical professional.
hormonal stories is a publication born to give a voice to all menstruating folks and break the silence on period pain. We want to rewrite old narratives and visibilise hidden struggles. Join the conversation! Write for us (link) #hormonalstories
