TODAY’s Never Have I Ever series offers guidance about procedures and practices our trusted health experts would never participate in. Discover why they should be avoided and which healthy practices you should turn to instead.
For some of us, it’s a twinge on the side, back pain and the telltale cramp in the pelvis.
For others, period symptoms are debilitating, confining them to their beds. These aren’t the period symptoms you can push through, explains Dr. Annmarie Vilkins, obstetrician-gynecologist at Henry Ford Health. In fact, these aren’t the period symptoms you should ever have to push through.
Severe menstrual pain, she says, the kind that impacts your quality of life, forcing you to stay home from work to cope, for example, is often the first sign you have a condition that deserves medical attention.
Never Have I Ever: Thought Missing Work Because of My Period Was Normal
“There is an expected amount of cramping that occurs with someone’s period,” Vilkins tells TODAY.com. “Period pain when somebody is down for the count because of their period, that’s not normal.”
It is unfortunately common. Research, she says, has linked excruciating abdominal pain while you’re menstruating to missing work and reduced productivity. But the true cause might not even be your period at all.
Instead, painful periods can be the result of conditions like endometriosis, adenomyosis and fibroids, which can be treated with surgery, medication and other procedures.
Unfortunately, getting diagnosed with these conditions by a doctor who takes your pain seriously can be a challenge. A patient’s ultrasound, says Vilkins, might look totally normal.
What the imaging can’t capture is how the hormone called prostaglandin, which causes the uterus to contract when you get your period, is making your uterus cramp especially aggressively because of these conditions, which can make it feel like there’s what Vilkins calls a “fireball in your pelvis.” As a result, some patients might go undiagnosed for decades, if not forever.
What to Do Instead
While it’s your healthcare provider’s responsibility to find and treat the source of your pain, Vilkins understands that many patients will ask for help and never get it.
It’s critical, she says, to be “empowered and (be) a patient who’s going to be an advocate for their own health and say, ‘No, I’m coming to you because this really hurts, and I don’t think it’s normal.’”
Vilkins recommends logging your pain. Rate it on a scale from 1-10, document the dates you feel pain and how long it lasts. Is it especially painful the week leading up to your period? Do you feel pain during intercourse?
Take notes on how it affects your quality of life, and log everything you’ve already tried to ease the pain. If you suspect you have something specific, like endometriosis, say so. You might not be a doctor, but there are plenty of online resources that feature credible medical advice and can help you begin the process of identifying what you’re going through.
From there, a doctor who takes you seriously will investigate. They’ll likely start with an ultrasound, which can spot fibroids. But, if your imaging looks normal, says Vilkins, you might need a blood test or a laparoscopy during which doctors make a small incision in your belly to locate any potential lesions that may indicate endometriosis or adenomyosis.
In the end, you might not have any of these conditions and find that you have an overlapping condition that worsens when your period starts, such as constipation, says Vilkins. This will require you to involve other doctors.
Whatever the reason for your pain, once you get your diagnosis, you can get the proper treatment, says Vilkins. That could be surgery or, in some cases, hormonal suppression with birth control or non-hormonal medications.