How often do you hear that cramping is normal? I know I’ve heard it a lot. I have often heard my friends and family tell me about the time when their menstrual cramping was so bad that they couldn’t go to school. They would lie in bed and cry because it hurt so much.
From parents to doctors, dismissing cramping is surprisingly common. Maybe you have been told, “oh it’s not a big deal, I dealt with it when I was your age, just take some Tylenol.” But how much is normal?
In this article, I will be exploring what exactly are cramps, what are they caused by, treatment options, and stories from twelve menstruators who suffer from bad cramps.
Why Do You Cramp?
Have you ever squished a water balloon and all the water gushed out?
In this analogy, your hand is the uterine muscle contracting to expel all of the endometrial lining that has grown in a month, but is no longer needed because a zygote didn’t attach to it. There are these tiny lipid molecules called prostaglandins, usually related to pain and inflammation, that cause the uterine muscle to contract. In particular, there are two called “PGF2α” and “PGE2” (Singh, et al., 1975) that help trigger the endometrial lining to shed and menstruation to occur.
So, to an extent, cramping during menstruation is a normal part of the process.
Okay, but when is it not normal?
When you feel like you want to die, it is not normal. I am not exaggerating when I say this. Some of the menstruators I talked to explained that their cramps felt like a knife stabbing them in the abdomen.
Five out of the twelve folks I interviewed said explicitly that these cramps leave them immobilized. They can’t stand up straight or sit in a chair. Nico told me that their cramps are so bad that they have to lie in the shower with hot water streaming down on them and wait until the cramps go away. Zadie told me a story of her father having to pick her up off of the floor because hers were so bad.
Here are some testimonials about what bad cramps feel like:
Katee says their cramps are like “sharp jabs.”
Allison says it feels like “a knife twisting in my gut” and like she has been “punched too many times in one spot.”
Arifa says it’s like her “uterus is going to drop out of my body, like it wants to get rid of your own insides.”
Doah says her cramps feel like someone is “squeezing my uterus with all their might and kicking me in the back.”
Zadie says it feels like "someone has a hand inside you, just squeezing and tearing your insides out."
Are there other abnormal symptoms besides bad cramping?
Of the folks I interviewed, all of them suffered from other symptoms besides horrible cramps.
Some of the symptoms included:
Soreness
Swelling
Leg tenderness
Lower back pain
Stomach pain
Nausea
Vomiting
Diarrhea
Hard to sleep
Can’t breathe
Weakness
Interestingly, three of the interviewees explained how they get leg tenderness. One explained that their legs become extremely sore and sensitive, perhaps due to the prostaglandins. Another said she gets pain in her right leg, and Doah explained that her legs feel heavy and tight.
I’m still unsure if my cramps are not normal. How would I know?
I asked the bad cramp sufferers how they knew their cramps weren’t normal. Unfortunately, many of them expressed that they were suffering since their early teen years and that it wasn’t until they were in their 20s and 30s that they realized how abnormal their condition was because people always told them that cramps were normal.
Zadie said it really well: "I don't experience it this way, so you must only be experiencing things the way I do.”
This was a common theme amongst the folks I talked to, especially those that expressed their concerns to their family or doctor. Cramps might be normal, but BAD cramps are not. And yet, their pain would be dismissed.
Here’s are symptoms that are not normal:
Throwing up isn’t normal
The pain in your lower back is so bad that it causes nausea isn’t normal
Missing multiple days of school isn’t normal
Pain meds not working isn’t normal
Shock-like symptoms such as dizziness, chills from pain isn’t normal
Passing out from the pain isn’t normal
Not being able to walk isn’t normal
So if these cramps aren’t normal, what exactly is causing them? And how do I get diagnosed?
Research shows that bad cramps seem to be a symptom of gynecological diseases such as:
Endometriosis - endometrial tissue grows outside of the uterus
Fibroids - noncancerous growths
Adenomyosis - endometrial lining grows into muscular walls of uterus
Pelvic inflammatory disease - infection of reproductive organs
There are a few ways to get diagnosed. An ultrasound can check to see if there are any uterine tissue adhesions in your abdomen. With a CT or MRI, you can get an even clearer picture of any tissue adhesions, but since these imaging tools can be quite expensive, your doctor might not recommend it. Finally, the most invasive diagnostic tool is an exploratory laparoscopic surgery, which looks for adhesions and removes them.
Why doesn’t everyone get diagnosed then?
From the conversations I had with the interviewees, I suspected that many of them suffered from an underlying condition such as Endometriosis or Polycystic Ovary Syndrome (PCOS). And sure enough, three of the interviewees explained that after many years, they were finally diagnosed with the root cause of their symptoms.
Six of them, however, had not seen a doctor about their cramping. When I asked why, one explained that doctors have a “tendency of not providing solutions.” There seems to be much apprehension to going to the doctor because of not wanting to be dismissed like menstruators often are.
Even amongst the ones that did see a doctor, five of them had doctors that dismissed their symptoms. One of the interviewees explained how she was “slut-shamed” for asking for hormones. Zadie explained that her primary care physician treated her cramps as normal. He ignored the warning signs. Vicky explained how her doctor didn’t listen and it took her 14 years to be diagnosed with her condition. Katee’s doctor dismissed their pain, even though they said flippantly that they “probably had endometriosis,” but didn’t test for it.
In the meantime, how do I relieve cramping and my other symptoms?
Here are some tips and tricks from the interviewees:
Hot bean bag / hot water bottle / heating pad
Anti-inflammatory pain medication: NSAIDS, ibuprofen, midol, naproxen
Muscle relaxants
Marijuana
Hot baths
Sleep
Other cramp relief include:
Sex/masturbation (No published data)
Potassium (No published data)
Vitamin B6 (No published data)
But as you can imagine, these treat the symptoms but not the root cause. The main non-specific treatment option for bad cramps is hormones. Eight of the twelve menstruators I interviewed explained that they use hormones to curb their cramps: the Estrogen-Progesterone Pill (EPP, or “The Pill”), hormonal IUD, progesterone therapy, or Nexplanon implant. One of the interviewees said acupuncture helps her.
Conclusion
Bad cramps are not normal! If you suffer from cramps that feel like you’re being stabbed or you’re in so much pain that you can’t go to school, please go to a physician. Go to as many as you can until one of them takes you seriously. It’s depressing that I’d even have to write that. While I hope the first doctor you go to is an inclusive and understanding individual, unfortunately, that is not the norm when it comes to period pain.
Throughout my research, I have found that bad cramps seem to be genetically linked. Six of the menstruators explained that a family member had similar symptoms. If you experience bad cramps, consider talking to your family members if you feel comfortable, and ask if they have similar symptoms. Unfortunately, being dismissed by family was another common theme in my exploration of this topic. Arifa explains that she has been told she’s “being dramatic” when she expressed her pain. I can’t imagine how frustrating that must be.
Thank you to Katee, Nico, Arifa, Taylor, Vicky, Anna, Allison, Courtney, Doah, Zadie, and a few Anonymous Friends who were so open about their experiences!
Commentaires