Your Period Pain Isn’t Normal, No Matter Where You Are
1 in 5 women suffer from menstrual pain severe enough to limit their daily activities, and this does not exclude women in the developing world.
I’m 13 years old; it’s only my fourth period ever and it’s the worst one yet. I step into the shower, hoping the warm water will wash away my searing menstrual cramps, but they worsen. Soon, everything goes blurry and I wake up sitting in the bath tub after passing out from the pain.
I’m 15 in English class and the teacher is angry and lecturing us about something. I can’t concentrate due to the stabbing pains in my abdomen. Now I’m sweating, and feeling uncontrollable nausea. I raise my hand to be excused but the teacher ignores me. I can’t hold it any longer so I run out of the classroom. My friend follows close behind and holds my hair while I throw up in the bathroom. Anxiety and pain keep me from going to school on the first day of my period each month from then on.
I’m 18 and at a new OB/GYN explaining my period pain. She tells me I have dysmenorrhea, which is the technical term for period pain severe enough to interfere with daily activities. She tells me I can try birth control pills to control it. I’m not sure I’m ready to start taking those and my mother really doesn’t want me to. The doctor’s alternative is ibuprofen. She ignores that I’ve taken every over-the-counter pain medicine there is. She doesn’t send me for tests. She gives me lollipops usually reserved for pregnant women to alleviate morning sickness. During my next period I take two licks and throw up. The message from this doctor is clear: suck it up, we all get menstrual cramps.
I’m 22 and my period hits during mid-terms. Stress makes it worse. My friends tend to me with gallons of Gatorade, and I’m experiencing the worst period pain of my life.
I’m 23 and I have started my first real job working as a Research Assistant in a genetics lab. I have to miss at least one day of work a month because of my periods and I don’t know how to explain this to the people I work for. They are almost all men.
I’m 25 and there is finally a doctor who does not reduce my pain to monthly PMS. I’m prescribed uninterrupted birth control pills. My period pain and the anxiety I experience from it slowly reduce.
Now I’m 30 and have been given a tentative diagnosis of adenomyosis and possible endometriosis, something I only started to learn about from celebrities who’ve raised awareness on its troubling record of misdiagnosis, and upon consulting resources available to me about what’s normal and what’s not.
As I confront what all of this means, I do so in a position of privilege; with access to information, medical care, and a job that offers paid leave and sick days. I can easily access the internet, and find solace with other women who are describing my pain. Women all over the world are not akin to this type of luxury when it comes to period pain.
It turns out my period pain has greatly influenced my line of work. I work in the realm of menstrual health, for Huru International. Huru is a non-profit that provides re-usable sanitary pads and health education to vulnerable girls and women throughout East Africa, with the aim of keeping them in school. In some of the communities we work in, 100% of girls report missing school at least 1–2 days a month due to menstruation-related challenges, like not having pads. This has serious educational consequences, the most obvious of which is the disproportionately high rate girls drop out of school compared to their male peers.
Whereas I had access to medicine, doctors, and the ability to explain my situation to employers or teachers without punishment, many of these girls experience the same period pain, with the same intensity, in resource-constrained communities where access to adequate menstrual products is limited, and information surrounding periods is not openly or accurately disseminated.
It is estimated that up to 1 in every 5 women suffers from menstrual pain severe enough to limit their daily activities. 1 in every 10 women worldwide suffers from endometriosis. It’s common to receive a diagnosis 11 years after an individual starts experiencing pain. One study in Ethiopia showed that 1 in 7 women surveyed at a university suffer from severe dysmenorrhea, and a study in Nigeria found women experiencing endometriosis at a rate consistent with the global average. A baseline survey conducted by Huru in Tanzania revealed that 87% of girls missed school each month due to period-related reasons, and 7% of girls have menstrual cramps severe enough to keep them out of school.
All of these statistics are likely grossly underestimated.
The young women I work with are afraid and ashamed of their periods. They are taught to hide menstruation; to never talk about it, never to reveal that they are struggling to get the menstrual products they need or the reason they are missing school. And while Huru provides re-usable sanitary pads, the education we give each girl offers them so much more.
Huru educates girls on what characteristics make up an irregular period. That excessive bleeding and excessive pain aren’t normal, and that girls experiencing these symptoms should visit the clinic. That their bodies are natural and beautiful, and menstruation is a sign of maturation. That their bodies are theirs, and theirs alone.
And we’ve found this works: a recent evaluation in Tanzania revealed that 88% percent of girls who received Huru education feel like they have control over their own bodies.
Importantly, at Huru, we teach girls to recognize when they need medical care and that they have the right to access it.
I think of all the times I’ve been told — subtly, condescendingly — that my pain was simply part of being a woman, and to not let it hold me back. I think of how long I endured pain and anxiety before receiving a diagnosis that made sense. Before my pain was taken seriously.
The girls with whom I work also experience pain.
The difference is that for many girls Huru serves, they may also have restricted access to water. They may not be able to afford pads, or medical care to ease their pain. Depending on geographic location, their community may perpetuate taboos or myths that make speaking openly or honestly about menstruation difficult. The girls Huru works with may have other needs that are more pressing or immediate, and thus their pain is perceived as less valuable or less real than mine.
But their pain is real; and their voices and experiences are starting to be captured by grassroots movements throughout East Africa. Millen Magese, a model from Tanzania is one of these powerful voices. “Pain at the age of 13, diagnosis after 13 years, 13 surgeries. It’s too much!” she declares. And voices from Kenyan blogs scattered across the internet tell stories that parallel my own.
“My schoolmates would tell me that period cramps were something normal that they all dealt with and could therefore not understand why I made such a big deal of mine. Why did I have to create so much hullabaloo?” says Elsie Wandera, founder of the Endometriosis Foundation of Kenya.
Bridgit Kurgat, founder of Reprodrive, explains:
“One doctor decided to tell me to my face that there are other serious issues to deal with such as cures for cancer and food shortages in arid areas rather than speak matters [of] menstruation.”
When it comes to period pain, there is much to be done. Young women still experience barriers to healthcare. For girls around the world, this can mean unreliable transportation options, dangerous routes to clinics, high medical costs, long waits, and a lack of information surrounding menstruation.
Girls around the world need medical professionals that treat them with privacy and respect, and who take their pain seriously. Girls and women need a stronger commitment from the medical and research community to study the causes of period pain. Even when their period pain is taken seriously, doctors may be limited due to lack of information and options. Menstrual pain has been neglected in the medical research community, just like many other “women’s issues” (see: migraines, postpartum depression).
There’s a lot of work to be done but we have also come a long way. Because of organizations like Huru, the Millen Magese Foundation, and the Endometriosis Foundation of Kenya, the issue is becoming less invisible and less taboo. Women all over the world are learning to stand up for themselvesand their health.
I am a confident young woman.
I am in control of my own body.
I am in control of my own health.
I make my own decisions about my own health.
These are mantras we at Huru ask girls to repeat and understand. Awareness and the confidence to stand up for your own health is a significant step in helping girls with period pain get the help they need. It’s what finally helped me find the answers I have needed for over 15 years.
About the Author: Emily Hoppes is the Program Director and Partner Liaison for Huru International. She is a travel, bioethics, and international development enthusiast, and an avid advocate for gender equality and adolescent girls. Feel free to reach out with comments and questions by email email@example.com or on twitter @HuruEmily.