Dr. Charis Chambers & Dr. Laura Laursen explain how to talk to your doctor about your period
Excruciating cramps, fatigue, and the intense emotions that seem to bubble up from nowhere can make your period a monthly nightmare. The only thing worse than being in severe pain (and feeling like you’re going to strangle your coworkers with your bare hands), though, is having someone negate those feelings with a verbal shrug.
Even worse than that? When the shrug comes from your very own doctor or OB/GYN. Unfortunately, as several studies have recently proven, traditional healthcare professionals often overlook or severely underestimate period pain or other troubling symptoms related to the menstrual cycle. For some, this leads to the underdiagnosis (or delayed diagnosis) of conditions like endometriosis, fibroids, or ovarian cysts.
At Flex, one of the core tenets of our mission is destigmatizing period talk. And, while we want to enact change on a societal level, the first step is helping menstruators clarify and successfully manage conversations around period pain with their provider.
In order to do so, we spoke with two incredible OB/GYNs and period specialists to get their insider tips and knowledge about how to get your doctor to take period pain seriously. Watch our video featuring Dr. Charis Chambers (a.k.a. The Period Doctor) above and learn more from OB/GYN Dr. Laura Laursen below.
Why period pain is often misunderstood
“I think for many doctors, it’s quite a common thing that is seen,” says Dr. Laura Laursen, a Chicago-based OB-GYN who specializes in family planning. “For the average patient, [period pain] can be controlled with ibuprofen and heat pads, and you don’t need to do much more. It can be hard to differentiate between someone who is having severe pain or not.”
Getting your doctor to take your period pain seriously is something lots of patients struggle with, and the reasons for this are complex and multifaceted.
I don’t know about you, but when I’m on my period, sometimes the entire bottom half of my body is out of commission. I’m talking the kind of pain that radiates from my abdomen all the way down through my thighs and even into my lower legs. I’ve tried talking to my doctors about it before, and the first line of defense always seems to be birth control.
“Birth control does a lot of things physiologically that have nothing to do with birth protection,” said Laursen. On many forms of hormonal birth control, periods tend to become lighter and less painful because the synthetic hormones (typically norethindrone and estradiol, which mimic progesterone and estrogen) thin the lining of the uterus and “trick” your body into thinking it’s already pregnant.
But what if you’re not interested in taking a hormonal contraceptive, or you have before and they haven’t worked for you – causing uncomfortable or annoying side effects like spotting, bloating, weight gain, or headaches? Or what if you’ve already tried every kind of birth control under the sun and you’re still experiencing severe pain during your period (which, on birth control, is also known as withdrawal bleeding)?
In any of those cases, Laursen says you should talk about it with your doctor, and be prepared to get specific.
Preparing for your appointment: What to say and how to say it
“When people say that they aren’t able to do their regular activities and daily living, that’s really a trigger for me and most doctors,” Laursen says. “Focus on how it’s affecting your day to day life.”
Many doctors might ask for you to rate your pain on a scale of 1 to 10, but that’s not the most effective way to get them to take your period pain seriously and start trying to treat it, because one person’s definition of a “four” is often another person’s seven, or vice versa.
Here’s how you can push back against that numeric pain scale: Tell your provider, “I’m not sure how to assign a number to it, but my period is so bad that I’m doubled over in pain for the entire first day and unable to get out of bed” or “I have to take the day off work because the pain is so intense that my hands shake when I’m trying to type at my computer.”
It’s also helpful to mention the exact type and dose of over-the-counter pain medication you take to treat your cramps and how often. Again, specific is best: Instead of “I think I take, like, one or two Advil on the morning of day one, and then I think I took some Midol later that night,” keep track of exactly how much you’re taking, at what time, and how you felt afterwards.
For example, “I took 400mg of ibuprofen at 7:00 p.m. on cycle day one, and then another 200mg ibuprofen plus 650mg of acetaminophen the next morning at 9:00 a.m. This amount of medication only improved the pain enough that I was able to take a short walk the morning of cycle day two, but I had to get back in bed again with a heating pad by 11:00 a.m. I was also unable to eat until 7:00 p.m. due to severe nausea.”
Remember: Your period should never be so painful that it’s majorly disrupting your day-to-day. Severe pain can be a sign of an underlying condition – so don’t ignore it. “Periods should not be something you dread every month and can’t get through,” Laursen reiterates.
It’s also a good idea to let your doctor know how long you’ve been suffering with the painful side effects of your period pain, and whether or not the nature and location of pain has changed over recent months. Has it been going on for years? Months? Just your last cycle or two? The more information you can provide, the better.
Tracking your menstrual cycle (whether on paper or with a smartphone app) is an especially helpful tool that will allow you to get more familiar with your body and have a written record of detailed information to explain to your provider during your next appointment. Here’s a list of our favorite cycle tracking apps, ICYMI.
“If someone is having severe period pain, I am going to want to do something to treat that,” said Laursen. “This shouldn’t be something a patient is living with long term.”
Communicating with your healthcare provider about periods: Key takeaways
Overall, the best strategy for getting doctors to take your period pain seriously is making sure to give them the full picture. How much pain someone is in is very subjective, so it’s super important to explain pain in terms of how it’s impacting your life.
Use quantifiable data whenever possible: For example, “After taking 200mg of ibuprofen at 10:00 a.m., I was able to get out of bed but continued to feel intense cramping that made it painful to walk around my apartment until 5:00 p.m.”
“There are some pathologic things that cause really painful periods,” says Laursen. Conditions like uterine fibroids, adenomyosis, and endometriosis can cause a lot of pain during your period, so if you think you may be suffering more than usual, or if your cycle has changed dramatically in length, heaviness, or regularity, tell your doctor ASAP and schedule an appointment for a pelvic exam.
Pro tip: If you’re having really bad symptoms (whether attributable to an underlying condition or not), your doctor may be able to write you a note to stay home or take a day off from work or school, especially if your symptoms are interfering with your ability to perform your work responsibilities safely.
This article is informational only and is not offered as medical advice, nor does it substitute for a consultation with your physician. If you have any gynecological/medical concerns or conditions, please consult your physician.
© 2021 The Flex Company. All Rights Reserved.