“It’s just how your body is.” “It’s normal for your body to change after childbirth.” “You’re probably just going to have to live with it.” All these things have been said to me by doctors during my journey to get help for debilitating period pain.
Since giving birth six years ago, I find myself crippled in pain every month and my attempts to get help have so far been fruitless, so it was interesting, but not surprising to learn that Nurofen’s Gender Pain Gap Index Report1 found that despite women being in pain more often and more severely than men, with one in six experiencing severe pain every day, one in two women felt their pain was ignored or dismissed by their GP because of their gender. And when it comes to period pain, there is often the added barrier of feeling embarrassment, or the wide belief that period pain is “normal”.
I spoke with Dr Zoe Watson, a GP and founder of Wellgood Wellbeing, to find out what symptoms require medical attention and to get details of menstrual related conditions to equip you with the knowledge to take to your GP.
What, if anything, can be considered ‘normal’ period pain?
This is really tricky to answer because pain is so subjective, we all experience it differently. Everything we know about pain is based on what a patient tells us. What one person thinks is normal, another person may find excruciating.
What level of pain and symptoms should we expect to manage at home?
Most people will experience some pain as part of their period. It tends to be felt as a cramping that comes in waves. Rather than looking for “normal”, I would look for any changes. If your period pain suddenly changes or feels different to what is normal for you then that is something that may require investigation.
What symptoms require an appointment with the GP?
Pain that stops you from doing your everyday activities would be classed as severe and requires further investigation. There are a few conditions that can cause period pains to be more severe – these include:
Endometriosis – the cells found inside the womb can sometimes be found stuck to other tissues and organs. This can feel like a severe cramping or stabbing pain during menstruation but can also cause more continuous pain. People with endometriosis may also experience:
pain during sex
pain when opening bowels during menstruation
pain when urinating/blood in urine during menstruation.
Adenomyosis – a specific type of endometriosis where the tissue invades the muscular wall of the womb, causing knifelike pain during menstruation. Adenomyosis can be characterised by:
heavy and very painful periods
an enlarged/bulky womb
abdominal swelling.
Fibroids – a benign growth in the wall of the womb. They can grow to be very large and can cause symptoms such as:
heavy painful periods
abdominal swelling
frequent urination and constipation.
While symptoms for these conditions can be debilitating, it is possible to have any of the above conditions and experience little or no symptoms.
Why is it so difficult to get help for period pain?
Every woman is different, and every patient interaction is different. Some conditions are notoriously tricky to diagnose and can have vastly varied symptoms. However, it is also true that historically, women’s reports of pain aren’t always taken seriously, as Nurofen’s Gender Pain Gap Index Report found. Another issue is that many women may not seek help as they believe the pain they are experiencing is normal.
How can women equip themselves with the knowledge to get the help they need?
We simply need you to come and tell us what you’ve been experiencing. The diagnosis or investigation is our job and all you need to do is be honest. If there’s something you’ve read about that you think fits your symptoms, tell us about it so we can work out whether that’s something we should consider. But genuinely the best thing you can do as a patient is tell us your story, let us do the rest.
What advice would you give to someone, like myself, who experiences debilitating symptoms each month but is coming up against a brick wall every time I approach a GP about it?
It is frustrating for patients who feel like their voice isn’t being heard. I always tell patients that they can seek a second opinion from another GP at the practice. You have power to do that as a patient, and sometimes if the doctor-patient relationship has broken down irreparably, the best thing to do is to seek help elsewhere.
The takeaway message here is that you know your own body. If your periods are stopping you from doing your day-to-day activities or something feels out of the ordinary, book an appointment to speak to your GP. There are a range of conditions that can be tricky to diagnose, so if you feel your pain is being dismissed as “normal” ask for tests to confirm that it is, or for a second opinion. It’s also important to consider that it was only made mandatory last year for new doctors to have compulsory women’s health training, but this won’t come into effect until 2024. It’s therefore important to request a referral to a specialist, such as a gynaecologist, if you feel your symptoms require a second opinion.
In general, we all – women and men – need to become more comfortable about having conversations about periods, and work towards overcoming the stigma that still surrounds them.
If you want to learn more about the Gender Pain Gap and read the full Gender Pain Gap Index Report commissioned by Nurofen visit nurofen.co.uk/see-my-pain
1 GPG Index Survey References Document (26.08.2022 16.00GMT)
Nurofen 200mg Tablet for short-term, mild to moderate pain. Contains Ibuprofen. Always read the label. RKT-M-18822
