In an article about the lack of research around painful periods, Quartz spoke to an expert who compares the worst of them to a heart attack and says doctors are failing to actively treat the condition.

The basis of the piece (which begins with the subtle lead: “It’s time to talk about period pain”) is that not enough research is being done to find treatments, despite the fact that this pain cripples about one in five women.

The problem is that even medical professionals downplay symptoms when patients complain about period pain and cramping, and the facts about it are fuzzy at best, according to Quartz:

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Frank Tu, director of gynecological pain at NorthShore University HealthSystem, tells Quartz some physicians are taught that ibuprofen “should be good enough.” Clearly, this is not an adequate response to such severe pain. How severe? John Guillebaud, professor of reproductive health at University College London, tells Quartz the cramping can be as “bad as having a heart attack.”

The source of severe period pain, writer Olivia Goldhill notes, is typically either “primary dysmenorrhea” or endometriosis, but “the distinction between the two conditions is not clear-cut, as many women suffering dysmenorrhea may have undiagnosed endometriosis.”

Goldhill goes on to share her experience with symptoms of endometriosis, explaining that the pill doesn’t help alleviate the pain:

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For now, without official diagnosis, my monthly pain is something of a mystery. But once I started talking about period pain, I learned I’m not the only who puts up with this discomfort and confusion.

Menstrual pain, most of us know, can seem like it affects damn near every woman to the point that it feels cliché to talk about:

Around half a dozen friends told me that they’d had similarly frustrating experiences—that they’d been shoved on birth control indefinitely, been prescribed Prozac to deal with their monthly bouts of depression, suffered through migraines and even vomiting whenever they had their period.

Making it worse, there aren’t many treatments available besides over-the-counter pain relievers, while doctors have yet to pinpoint the specific causes of this heart attack-like pain:

Guillebaud says the pain is partly caused by uterus cramps, while Tu says a combination of sensory processing, local uterine inflammation, and uterine blood flow issues also come into play. The specifics of why some people suffer more than others is not well understood.

And, while there’s been increased research into endometriosis and its effect on fertility, there doesn’t seem to be much optimism about figuring out causes or better treatments for that or dysmenorrhea anytime soon:

Legro says that without a lobby championing the need for research, researchers won’t start paying more attention to the condition. He points out that public discussion of period pain is widely kept hush. For example, he says that in the US, several news channels are reluctant to use the words “vagina” or “menstrual bleeding,” which makes it practically impossible to discuss painful periods.

Guillebaud adds, “Men don’t get it and it hasn’t been given the centrality it should have. I do believe it’s something that should be taken care of, like anything else in medicine.”


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