Dr. Patricia Farrell on Medika Life

Women Suffer Because of Medical Misinformation About Debilitating Menstrual Pain

Menstrual pain isn't something like a stomach ache, and it isn't caused by mental conflict about being female, but too often, it is seen as either, and the monthly pain persists.

Monthly menstrual pain (aka dysmenorrhea) can be debilitating to the point that some women are left wracked by it month after month. I know because I was one of those victims of medical/healthcare ignorance where nurses and physicians chose to see it as a normal part of being a woman and acceptable. It was none of those as mentioned above.

Researchers are waking up, but in the meantime, women suffer. A recent newspaper article summed up part of the problem.

A survey by ResearchGate, a social networking site for researchers, of studies on the site found five times more research on erectile dysfunction, which affects 19 per cent of men, than on premenstrual syndrome, which affects 90 per cent of women.

The journey I had may serve as an illustration of medical information neglect. I was taken from a train at Grand Central Station in NYC, hauled off to the downstairs medical office, and scoffed and scolded by a nurse who said I would have to be quiet and lie there. OK, perhaps they had nothing for me in terms of a pill, but a few comforting words might have helped.

I had doubled over on the train, nauseous, unable to walk because of the intense pain, and this was the care I got. Hours later, I would be put on another train to go home alone after they gave me aspirin.

It wouldn’t be the first time the pain had incapacitated me, nor the only time I couldn’t go to work that day because of it. I’d suffer with it despite many visits to various physicians and medical centers. One famous NYC gynecologist insisted she’d only prescribe birth control pills to control the pain — didn’t help, but she refused anything else.

The situation in the professional literature is summed up as follows:

Primary dysmenorrhea, or painful menstruation in the absence of pelvic pathology, is a common, and often debilitating, gynecological condition that affects between 45 and 95% of menstruating women. Despite the high prevalence, dysmenorrhea is often poorly treated, and even disregarded, by health professionals, pain researchers, and the women themselves, who may accept it as a normal part of the menstrual cycle.

Yes, I’ve even had to depend on the kindness of strangers. Once, while at work, the pain and lowering of my blood pressure struck, and I had to go home via subway that time. Of course, to get to my home in my mother’s house, I’d have to change trains, and that was where a kindly Black woman came to my aid.

She saw how I looked and that I couldn’t possibly walk up the two flights of stairs to the next train, so she called my mother and asked her to come to get me. “I’ll stay with you until your mother arrives,” she said, and we sat on a bench together. We didn’t speak but knowing she was there provided more comfort than I had ever received while in this state. My mother came, and the woman left with a wish for me to feel better. I will never forget her.

After the unsatisfying appointment with the NYC OB/GYN (featured in Cosmo, BTW), I tried a major NYC medical center. The physician there told me he would be “your doctor now” and proceeded to put me into a clinical trial and “treat” me with a diuretic medication that lowered my potassium levels. Do you know what that does? It does nothing for menstrual pain, but it brings on a host of other problems instead. I stopped going back to him.

My next venture was to a physician (I can’t remember how I got his name), and he prescribed what turned out to be an addictive, highly effective medication that stopped the pain but increased my activity levels 100-fold and had me sweating profusely. It worked, and I was determined to stick with it until it was taken off the market because of its addictive qualities. Sorry, I can’t remember its name. I know a major NYC corporation’s onsite medical office regularly gave it to female employees.

Years later, I would be told how an aunt of mine had similar pain, and while taking her home, my mother met her future husband, who gave the two women a lift home. Yes, it ran in the family.

Still more years later, I discovered we have a genetic anomaly that may cause the pain as well as migraine, depression, miscarriage and a variety of other ailments. But, a researcher told me I shouldn’t worry because there’s a town in Australia where “half of the population has that genetic signature.” Oh, so comforting to know.

Menstrual Pain Known Causes

The evidence is there that women suffer, and there’s a paucity of research on why they suffer from this pain. But the literature has suggested several areas where some research has shown promise as to its roots in their research. Results of this work’s applicability to most women may be sadly limited.

After ruling out physical problems in adolescent females, such as endometriosis, fibroid tumors or underlying pathology, dysmenorrhea is often treated with NSAIDs, hormonal therapy, lifestyle changes and perhaps complementary medicine. The complementary medicines that are most usually recommended are peppermint, cinnamon, ginger and other herbs and supplements.

If endometriosis is a potential cause of the pain, referral to a gynecologist is recommended. The article, however, has an important caveat that indicates the etiology of primary dysmenorrhea is not completely understood…

The presence of a specific genetic configuration was found to be involved in a sample of women who experienced menstrual pain. Those with this genetic component were three times more likely to have pain than those who did not have the genetic condition. Not only did the condition cause pain, it had major implications for education and careers because of the lost days in school and work as a result of pain.

An investigation of a plethora of 566 articles on menstrual pain found that childhood adversity played a role. Sexual abuse and posttraumatic stress disorder appeared to be associated with dysmenorrhea, pelvic pain, and dyspareunia, but it was unclear whether this relationship was mediated by poorer mental health.

Now, those researchers brought in the factor of mental health. Are they intimating that the females had mental health issues that brought on their pain? Is this more “unconscious conflict” possibly about being female? Sounds like a throwback to me.

We are reminded, however, of the paucity of research (as noted in the ResearchGate investigation) on the subject and question the potential skewing of the pool of subjects for the studies. How many of those studies included a genetic component?

Another study looked at postural stability and menstrual pain. Did women who had this pain have difficulties in this area? It seems they concluded they did, but how would that account for the pain? More research needed and they recommended preventive rehabilitation strategies can be given to improve postural stability. Suppose they had included a genetic evaluation and didn’t concentrate solely on postural stability? Would they have come to a different conclusion?

The jury is still out on this one and there is no question that women deserve better information to provide relief that will benefit every area of their lives.

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Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

DR PATRICIA FARRELL

Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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