Period pain is not normal; a common phrase you will hear echoed in the Somedays community. Due to a lack of research, information and care surrounding pelvic pain, people with periods have been told time and time again that their debilitating period pain is normal, something they have to deal with, and something that is not cause for concern. The result is individuals living for years with undiagnosed chronic conditions, and individuals living in confusion about their own perception of their pain. We are here to say that we see you, we hear you and we are here for you. Your debilitating pain is valid, important and not normal. 

However, that doesn’t change how medical systems and systems that support them view period pain. In this 2022 study, 29 percent of people with periods reported their doctor has dismissed their concerns. 15 percent reported that a provider did not believe they were telling the truth. 19 percent said that their doctor assumed something without asking. 13 percent said that a provider suggested they were personally to blame for their pain. 

There are many efforts to reform the system's biases towards period pain, as well as pressure to provide more funding into the research of pelvic health and chronic reproductive conditions in people with uteruses. However, these changes take time and in the meantime, we want you to be able to feel empowered to advocate for yourself and your period pain when you walk into healthcare settings. 

1. Keep a Period Pain Journal 

I have always felt intimidated by the sterile and empirical nature of the doctor's office. Just being in the space itself can cause me to doubt my own experiences and knowledge of my own embodied experience which leads me to forget all of the things I intended to bring up during my appointment.  

Keeping a period pain journal is a great way to avoid this, as well as a great reflective practice to help you remain in touch with your period pain. 

How you organize this journal and the frequency of the entries is up to you but here are some ideas of how to approach this. 

• Start your first entry on the first day of your period. This is Day 1 of your cycle and is a good place to begin your journal. 
• Each day ask yourself a set of questions that allows you to reflect on your overall bodily experience. Some examples of questions could be: 
• How did you sleep? (Examples are: trouble falling asleep, woke up groggy, woke up refreshed, restless sleep, deep sleep with vivid dreams, sweaty sleep, etc.)
• How long did you sleep?
• How do you feel emotionally today? (Examples are: Happy, Sad, Irritated, Out of control, Sensitive, Angry, Confident, Excited, Anxious, Insecure, Indifferent, etc.) 
• Where is your pain today? (Examples are: Pain-free, breasts, headache, lower back, legs, joints, vulva, etc.) 
• How severe was your pain today? (Examples are: one, being little to no pain, to ten being debilitating pain at rest that interferes with basic movement and tasks at home such as walking to the kitchen for some water) 

How specific you are about each question is up to you. Adding in certain foods you ate, beverages you drank as well as activities you did can also be a good idea to get a sense of certain things that may trigger, worsen or improve your pain. 

Period pain journals can be great because you can personalize them to your liking and adapt the questions and prompts in them. However, there are also many apps such as Clue and Flo that provide similar prompts, period reminders and can be synced up with various health apps and tools to provide a more comprehensive picture of your cycle. 

Whatever method of recording you choose, consult this and bring this to your doctor's appointments. This is an invaluable resource for you to consult in your session and share with your doctor or healthcare professional so that they can get a sense of how pain manifests itself in your body and cycle. 

2. Be Ready to Answer Specific Questions About Your Period and Your Pain 

Most healthcare systems are overloaded and understaffed, and doctors, especially in walk-in clinics, are trying to get through as many appointments as they can in a day. A standard doctor's appointment is ten minutes, which isn’t a lot of time to communicate your concern, especially if you aren’t prepared. Doctors will often have a set of questions that they will ask you about your period pain which may look something like this: 

• How old were you when you began menstruating?
• How often do your periods occur, and how long do they last?
• When did your cramps begin, and have they worsened over time?
• Do you experience breakthrough bleeding or pain during sex?
• What remedies have you tried to alleviate your pain, and did they help?

Having this information on hand will help make the most of your visit and allow the doctor to build a comprehensive picture of your pain and experiences with your period pain. 

3. Be Able to Describe Your Pain 

How we describe our pain is personal to use and many times, for pain that is severe and deep, it can be hard to get into words. However, your doctor is not able to experience your pain firsthand, so prioritizing putting your pain into specific descriptors will be vital in communicating your experience to a doctor. Here are some example adjectives of how to describe your pain that you can keep track of in your journal or elsewhere, and bring to your appointments. 

• Aching, cramping, or throbbing
• Sharp, stabbing, or splitting
• Dull but persistent, or overwhelming
• In waves or constant 
• Localized or widespread 
• Long-lasting or short 
• Place your pain on a scale of one to ten, using the Chronic Pain Grade Scale. Many doctors use this scale to evaluate pain. Whilst it isn’t the most comprehensive, it is a good idea to place your pain on this scale to work with the system in order to gain the most from your visit. 

Additionally, try and think of things that alleviate or trigger your pain. Knowing these triggers and alleviations will come with time so be consistent with keeping track of those factors. 

4. Do Your Research and Be Ready to Ask Questions of Your Doctor

If you have experienced severe period pain in the age of the internet, it goes without saying that you have probably done some research, or at least a basic Google search. When researching your symptoms, make sure you consult reputable sources that you trust, such as medical journals that consult many areas of scientific research or organizations that you trust. Whilst some of this information may be hard to access in terms of jargon and medical speak, many are relatively accessible and can provide some foundational information for you to feel more empowered and informed about your own symptoms. 

From this research, you may have questions in regard to your pain that you may want to share with your doctor. Write down any questions you have beforehand. If you have specific concerns—such as the possibility of having endometriosis, PCOS, or fibroids—bring them up. Ask about specific tests, such as blood tests, ultrasounds, or laparoscopy, which can be used to diagnose conditions like endometriosis or polycystic ovary syndrome (PCOS).

Some important questions to ask include:

• Can you run tests to check for underlying conditions, like PCOS or endometriosis?
• What treatment options are available for pain management?
• Could I benefit from imaging tests, such as an MRI or ultrasound, to check for abnormalities like fibroids?

If your doctor isn’t offering tests or treatments that seem relevant, don’t hesitate to push for them or ask for a second opinion. Being your own advocate means knowing when to question, and even challenge, the information you're being given.

5. Be Informed but Avoid Self-Diagnosis

As mentioned above, doing your own research can open up many windows of inquiry and illuminate potential sources of your period pain. However,  try to avoid jumping to conclusions about what condition you may have. Instead, use your research to ask more informed questions of your doctor. If, for instance, you suspect you might have endometriosis, ask about the diagnostic process: What tests would be required to confirm this? What symptoms align with this condition?

While you shouldn’t diagnose yourself, being informed allows you to have a more meaningful conversation with your doctor and ensures that they take your concerns seriously. Bringing scientific articles or research papers to appointments can also help demonstrate that you are well informed and engaged in your care.

6. Seek a Second Opinion and Seek Specialists When Necessary

During your doctor's appointment, you should never feel dismissed, or ignored when it comes to your period pain. You should leave feeling more informed than before you went in, and leave with more options and possibilities than you had prior. Unfortunately, this is often not the case, due to the exhausted medical system, doctors' own biases toward period pain and lack of knowledge and research around menstrual disorders. 

If you feel like your current provider isn’t meeting your needs or isn’t specialized in treating menstrual disorders, it may be time to seek out an OB/GYN or even a specialist in reproductive health. Certain conditions like endometriosis, fibroids, or PCOS may require a more in-depth approach, which general practitioners may not always be equipped to handle.

However, access to specialized care isn’t always available, especially for marginalized groups, such as members of the BIPOC community or those with low income. In these cases, it’s even more important to push for a second opinion, request referrals, and continue advocating for yourself.

Advocating for yourself in healthcare is vital, especially when it comes to period pain. By tracking your symptoms, describing your pain clearly, asking the right questions, and being assertive with your doctor, you can take control of your healthcare journey. Remember, you know your body best, and if your concerns are being dismissed, you deserve to find a doctor who will listen and help you get the care you need. Period pain isn’t something you have to endure in silence—effective communication and self-advocacy can make all the difference in improving your quality of life. 

Much love.