When Being a Woman is Painful: Living Well Despite Pelvic Pain
I am not going to lie, being a woman is wonderful. I am also not going to lie and say that being a woman is all hunky dory and without its challenges. We live in a gendered society with skewed statistics related to violence and inequities against women and have it within our nature’s to be birthing and the primary caregivers to our young. There is also the more ‘mundane’ unacknowledged-and-still-taboo challenge experienced by many women of the pain associated with our periods (dysmenorrhoea) and pelvic area.
And it freaking sucks. Not because of the pain so much, though that sucks too, but because of the misunderstanding about women’s menstrual cycles and the effects it can have on their lives and how belittled or shamed a woman can feel because of it. How do you say to your educator or boss ‘sorry I’m not up for work today because I have period pain or am bleeding too heavily’ or as a teenager have it thrown about that ‘you must have your rags’ anytime a female makes a stand or shows any sign of emotion. When this is a chronic condition you know also that you will go through this cycle constantly and that it will need to be endured for many many more years.
Some cultures see menarche as a rite-of-passage in the transition to womanhood and celebrate it with various traditions. In other parts of the world how it is marked is as dependent on the family you are in and how open your parents have been with you about ‘the birds and the bees’. The full spectrum from celebration to hiding and shaming is covered and in itself can affect how women experience their cycles and themselves and has the potential to pervade other areas of life.
The Pain of Periods – Dysmenorrhoea:
There is almost a taken-for-granted acceptance that women will experience period pain at some time in their life and it is just part of the package of being female. Menstrual cycles are experienced differently by different women and also differently by the same woman over time. They are affected by: your physical and emotional health; the level of activity and exercise in your life; food and medication choices you make; the level of stress in your life; pregnancy and birthing history; relationships you have; and other life experiences.
For many women the pain they experience is not ‘normal’ and can have far reaching consequences for how they live. The pain is considered not normal for a period if it lasts longer than the first 1 or 2 days, doesn’t go away with the pill or period pain medications, or is still there in women who have had children (Evans & Bush; p.28).
Diagnosing the cause of period pain can be a long and frustrating process in itself and over time pelvic pain can become chronic, when pain with periods becomes pain on most days
(Evans & Bush; p.115).
Evans & Bush (p.29) list the possible causes of period pain as:
- Endometriosis lesions in your pelvis.
- Pain from Prostaglandin chemicals made in the uterus at period time.
- Pain from Adenomyosis in the wall of the uterus.
- Pain from heavy bleeding, with clots (clot colic).
- A narrow cervix (cervical stenosis) which blocks the flow of blood at period time, or
- Painful nerve fibres only found in the lining of the uterus in women with endometriosis.
My Connection to Pelvic Pain:
My periods started when I was 12 and I have not had a very pleasant time with them due to the pain, heavy and extended bleeding that came with them and associated low iron and anaemia. I had lots of trips to the GP, investigations and attempts to manage them but I still struggled. When I was in my late teens I had a laparoscopy and it was confirmed that I had endometriosis that was treated. Throughout my twenties and early thirties I continued to have trouble that ‘resolved’ when anorexia made my cycle stop for nearly six years. They came back with a vengeance though after Mister, our second child, was born. I then had to grapple with an additional symptom of ‘flooding’ and even more pain that started to impact on my work that I had always managed to avoid until then.
In late 2014 I consulted privately to look at getting things under control and I was told that I probably had endometriosis, adenomyosis, clot colic and referred pelvic pain. Taking into account the fact we have completed our family and that the impact of pain and bleeding was increasing with no sign of easing my husband and I leaned towards a hysterectomy as the best option for me. I then had to transfer into the public health system which took time and assertiveness on my part, as well as a willingness to look at other medicated options that caused a whole lot of other problems for me. However I am now here, aged 36 and a week post surgery from a hysterectomy, healing crazily well and so happy for deciding and persisting.
How to Live Well with Period & Pelvic Pain:
>> Get Informed.
Notice how your cycle affects you. What pain and symptoms do you have? What helps you or makes things worse? How is it impacting your life?
Find information and read about what other people have tried and see if there is anything worth trying for yourself. In accessing information always judge the quality of the information and relevance to yourself and be cautious of how much you take on and worry about without validating it with professionals who know your exact context and circumstances. I started with associations, peak bodies and organisations set up to help people through these experiences.
Don’t assume the worst case scenario for yourself based on what you read. An example is that whilst endometriosis is associated with trouble falling pregnant and fertility problems my experience was completely opposite and we had a number of ‘accidental’ pregnancies.
>> Access Support.
Know that you are not alone and that you are not weak because you experience period pain. Period pain and associated conditions are an increasing problem for women and they are real. As more women speak up more research is done and more becomes known about how to treat them. That is important.
Seek professional help and advice. There are a number of treatment and management options available for period pain that work to eradicate or minimise the suffering you go through. Holistic health options are available to address all areas of your experience that could include a: GP; gynaecologist; naturopath or other alternative practitioners; nutritionist; physiotherapist; yoga classes or other means for managing stress and relaxation; and a counsellor or coach. It is about finding the right team for you and practitioners that you are comfortable seeking guidance and support from. This is a sensitive area and it is totally ok to be selective about who you allow to treat you within your capacities to access services and how you do so.
Get a second opinion if you need to. If you feel unheard or are unsure of what you are told or the options suggested seek a second opinion. It is ok to do that. You are your best advocate.
Link in with helpful communities. There is a wealth of information online and a number of forums where women share their stories, seek support and offer advice. These spaces can be a wonderful way to receive and give support in a way that is more personal but with distance. Again it is assessing the quality and relevance of the information for yourself.
Make decisions based on the stage of life you are in. Some of the treatment and management options are dependent on the time of life that you are in and can be influenced by hopes you have around having a family or how invasive you want the interventions to be. It is important to know all that is available so that over time as your needs and circumstances change so can your decisions around treatment. As you come to know more of yourself as well you will learn more ways for managing the pain and other symptoms yourself that will influence your decisions.
>> Make it easier for yourself by Informing Those that Need to Know.
You don’t need to suffer in silence.
Let your partner in. You may have ideas for how your partner could help you or just knowing that they know could be all that you need. When we share our pain with others it allows us to receive love and care more easily. It can also reduce the unconscious resentment that may be present when we fall into believing that they should see what we are going through even though we don’t tell them.
Decide if it would be helpful for your workplace / education provider to know. If your work or education is impacted by your condition it may be helpful to be upfront about what you are actually experiencing rather than using general sickness as the explanation. If your condition is ongoing and unpredictable having them know can be a level of support that even if you don’t do anything different with can ease your mind and be one less thing for you to worry about.
>> Have a Personal Care Plan and Stick to It.
Know yourself and what helps and be committed to acting in your own best interests when you need to. You are the main person responsible for managing and living with your period pain and you make the decisions about how you look after yourself. Be kind and wise toward yourself and respond early. You deserve that and if you are unsure on how to make a plan or proceed that is something I can help you with as a coach.
Make room for acceptance and being gentle. Living with period pain is no fun and navigating the medical system can be frustrating and emotionally tiring but struggling with it more with additional anger, blame and feelings of being less than won’t help either. It is important to find ways to accept where you are with your condition and know that you are trying to get help for it without it consuming your life. Having ways to manage and calm yourself will help with this and are extremely helpful for managing pain too. You don’t need to struggle anymore than you already are.
When living with period pain it is sometimes hard but always helpful to remember that there are options available to you and to keep in mind that your needs will change over time and so will your responses. If you are affected by period or other pelvic pain know that you are not alone and that you don’t need to suffer in silence. The book referenced by Dr Susan Evans with Deborah Bush is a great first-step resource of holistic information for each of the types of period pain and ideas for living well despite. The book also includes broad information on other pelvic conditions like IBS and neural pathway pain. I wish you well.
If you find this post helpful please share it and inbox me with questions.
… with heart.
PS. I have no affiliation to Dr Susan Evans and in no way benefit from including a link to the book or her page. It is a freaking awesome resource that needs to be in more people’s hands!!