‘Half the world’s population bleeds every month. Deal with it.’
‘Why don’t you just pop a painkiller?’
‘Have you tried losing weight?’
‘It’s all in your head.’
If you’ve heard these lines frequently, it’s because everyone around women – family members, friends, even doctors - tends to dismiss instances of period pain and discomfort. In fact, did you know, the word ‘hysteria’ actually comes from the Greek word for uterus? For decades now, the conversation around women’s menstrual cycles has been relegated to doctor’s clinics or in hushed tones in women’s bathrooms. Even though we have started normalising conversations around women’s periods and the requirement for sanitary napkins and access to hygiene, we have failed to discuss the impact that it has on the quality of life for women.
‘First of all, demonstrating pain or discomfort means that you’re also openly telling the world that you have your period. This is a social taboo even now in several communities – including mine - and leads to women brushing period pain and ancillary health issues under the carpet,’ says lawyer and women’s rights researcher Dr Haripriya Roy. ‘My menstrual cycles used to be extremely painful and accompanied by heavy bleeding that required me to change my pad every 2-3 hours. My education and extracurriculars used to be impacted in school, but everyone really thought I was making a mountain out of a molehill. Because symptoms often vary from person to person, they cite examples of other women who manage period symptoms wonderfully. My own mother used to call me out on severe period pain because she never had any. My advice is for women who have painful periods to shut out the noise. If you’re too young to visit a doctor yourself, find someone at home who will take you seriously, and visit a gynaecologist who is non-judgemental and understands your needs.’
According to Gynoveda, an Indian FemTech brand, an overwhelming 83 per cent of Indian women experienced painful periods, with 25 per cent of these citing severe pain. The most popular recourse for period pain is the use of painkillers. In addition to period pain, women also suffer from other menstrual disorders such as Poly Cystic Ovary Syndrome, Fibroids and Pelvic Inflammatory Disease.
‘Very painful periods are characterised by what is called dysmenorrhea,’ says gynaecologist Dr Usha Rachel, who runs an independent practice in Kochi. ‘It is a Greek word that literally means painful bleeding every month. In women who experience this, the pain is excruciating, and usually radiates past the lower abdomen, to the back, and even the thighs. In my experience, painful periods usually begin in adolescence and last for the first two days of the cycle. They could be accompanied by nausea, gastrointestinal trouble, headaches, and fatigue. From the third day onwards, this starts to ease a bit. So yes, menstrual pain is a very real problem plaguing women, and they should never be allowed to feel otherwise. This is especially true in the case of women who live with conditions like endometriosis, where menstrual bleeding is severe since the uterine lining that needs to be shed is very thick. These women go through significant physical and emotional stress each time they have their period. Unfortunately, they aren’t taken very seriously each time they complain of symptoms, and this only delays the diagnosis and treatment. Heavy menstrual bleeding can also cause other related problems such as iron deficiency.’
Regulating one’s exercise and diet can only go so far in overall pain management during menstrual cycles. Applying heat to the lower abdomen can provide temporary relief without any side effects. If your dysmenorrhea is too severe, painkillers and anti-inflammatory drugs are often prescribed, and hormonal contraception in some cases – but only after you have checked with your gynaecologist. Surgeries are only a last resort option.
When neglected, painful periods and heavy menstrual bleeding can impact the lives and livelihoods of women significantly. A study published in the BMJ Open Journal revealed that it results in almost nine days a year of lost productivity for each woman. One in seven girls or women miss school or work during their period. When women called in sick during this period, only one in five informed their employer about the real reason. 68 per cent of the respondents also wished for flexible hours to study or work. So, it is important for families, communities, schools and workplaces to understand that period pain and other complications can profoundly affect women’s performance and productivity.
‘Gaslighting women medically exists across a spectrum of health issues, but menstrual problems are taken far more lightly,’ says Dr Haripriya. ‘This also includes the emotional rollercoaster that comes with the period. We say ‘hormonal’ like it’s a bad thing – but hormones actually do have medical consequences and cause an imbalance in how we feel. If a woman is angry or upset, a casual reference to PMS will be made and then dismissed just as easily. Also, up until now, a lot of the research and texts available were by men. Women did not contribute to the conversation until recently. And men did not understand the way women’s bodies functioned and felt, so they could not get the full extent of period pain.’
Women are conditioned to believe that their doctor is right, and they might be imagining and amplifying their accompanying issues in their heads. The truth is, they need to feel empowered enough to raise their voice and insist on being taken seriously and diagnosed properly. Pain cannot be quantified, but you will need to communicate about how it affects you. Make conversations about period pain normal at home, school, and work. Have a chat with your human resources team or your boss on how to manage those 2-3 days a month. You might actually be more productive from the comfort of your home, working at your own time and pace, rather than uncomfortably at work.
Often when something is not infectious or life-threatening, it tends to be brushed under the carpet and we fail to seek care for it – especially if there is stigma attached to the condition. You don’t have to let that happen to you.