My first period came at the age of 10. From the very beginning, it was painful, heavy, and irregular. No worries though, I had The Care and Keeping of You - an American Girl book which said that it could take up to two years for everything to become regular. So, I waited it out. Yet, over those two years, everything seemed to get worse, not better. I'd go months without my period, and when I did get it, it was accompanied by debilitating pain, nausea, and a heaviness that kept me from playing with my friends, and I was often bedbound and couldn't go to school.
I told my family doctor, and she prescribed me ibuprofen. The ibuprofen didn't help, but she didn't care. She said that I was too young to have a regular period, that pain was just a normal part of being female. I asked about the possibility of having my uterus removed a few years later - at 14 - and was told that I had to have children first.
It was only at 17 that I broke down sobbing in an OBGYN's office, and she finally listened. Blood tests, ultrasounds, and an MRI revealed I have PCOS, polycystic ovary syndrome. This is a condition that affects 1 in 10 afab (assigned female at birth) people. An investigative laparoscopy also revealed stage I endometriosis. Endometriosis is a disorder that, again, affects about 1 in 10 afab people, and yet, it took me nearly a decade to get diagnosed. Almost a decade of pain and it took more doctors than I can count to discover I had two common conditions. Why is that?
Female pain isn't taken as seriously.
We often think of doctors as people above us in terms of discrimination— we don't think of them of being able to have biases. However, quite the opposite is true. On average, men wait 49 minutes before getting painkillers. Women, on the other hand, wait for an average of 65 minutes. Joe Fassler, a writer for The Atlantic, discusses how his wife waited hours for hours to find out she had ovarian torsion and a twisted fallopian tube caused by an ovarian cyst. He says:
I felt certain of this: The diagnosis of kidney stones—repeated by the nurses and confirmed by the attending physician’s prescribed course of treatment—was a denial of the specifically female nature of Rachel’s pain. A more careful examiner would have seen the need for gynecological evaluation; later, doctors told us that Rachel’s swollen ovary was likely palpable through the surface of her skin. But this particular ER, like many in the United States, had no attending OB-GYN. And every nurse’s shrug seemed to say, “Women cry—what can you do?”
This feels all too true to me. Although I've never had a torsioned ovary, I've been in extreme pain before. I had an IUD placed at 17 to treat my PCOS. And yet, it caused extreme pain. It got to the point I couldn't stand, so my parents rushed me to the nearest ER. There, it took hours for me to be assessed. I was never seen by an OBGYN, as there was none on staff. I was told the pain was normal. Later, I found out I have a septate uterus, and the IUD was pressing against the septum, causing the extreme pain. An ultrasound should have been done before placing the IUD, but rather, I was brushed off and told to go home. This is the reality for so many people.
What can I do?
If you're a doctor, follow what is said in The Girl Who Cried Pain. That is, "Medical schools must endorse, and teach students, an approach that best elicits the concerns of any patient in pain — an approach that does not discount the patient’s subjective reports of pain." Actively seek to avoid discounting your patients' pain, or saying it's "just" psychosomatic.
If you're an average person, please talk about your period. Talk with family members. Find out what's normal. Find out if you're normal. And, if you're suffering from pain, speak up. Self-advocate. Discuss your pain with your doctor, and don't stop talking until they give you a solution. We can change the course for female healthcare if we speak up and advocate.