What to Do If Your Doctor Isn’t Taking Your Period Pain Seriously

Korin Miller
·12 min read

Danii Pollehn/Adobe Stock

If you endure hellish pain when your period rolls around, it’s (understandably!) hard to think about anything but the agony your body is going through. But you’re unfortunately not alone in this: More than half of people who get periods deal with menstrual pain, which can become so intense that it prevents them from doing their usual activities. And the general vibe from society—say, a demanding boss, a clueless classmate, a dismissive doctor—seems to be that this is just life with a uterus.

“For many years, a lot of people who menstruate have been told that period pain is ‘normal,’ when in reality, it is absolutely not normal to be incapacitated during your period,” Catherine Chan, MD, a minimally invasive gynecologic surgeon at NYU Langone Health, tells SELF. Meaning, you shouldn’t have to accept that you’ll be curled up in a ball with a heating pad attached to your pelvis for several days every month.

Unfortunately, that was Krystle Saulsberry’s experience. “[The pain] felt like someone who had on steel-toe boots was stomping on my uterus,” the 39-year-old tells SELF. “It was excruciating, to the point where I would be bedridden for days.” Saulsberry suffered for years; at 13 years old, she was told by an ob-gyn there was essentially nothing wrong with her, even though she had to leave school several times because of her pain. “I left that appointment with no real answers,” she remembers. “The doctor told my mom to give me ibuprofen.”

It wasn’t until Saulsberry landed in the ER due to extreme pain when she was 23, and then referred to a specialist, that she got answers. “The doctor pretty much told me that I had been told a lie. These periods weren’t normal,” she says. “I felt seen.” Saulsberry was diagnosed with endometriosis, a painful chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. Now she serves as an advocate for the Endometriosis Association to try to help others going through the same thing.

Unfortunately, the driving forces behind period pain, and the definition of what it should and shouldn’t feel like, aren’t fully understood by doctors—and that can complicate things if you potentially have an underlying condition at play, Dr. Chan says. Being told your agonizing monthly visit is “normal” can ultimately delay you from getting a proper diagnosis and, thus, the treatment you need, she says.

With that in mind, SELF consulted with several experts to explain what usually causes intense period pain and what to do if your doctor keeps brushing off your symptoms—because this is not something you should have to live with.

When your period becomes a painful problem

From a medical POV, period pain can typically be broken down into two categories: primary and secondary dysmenorrhea.

Primary dysmenorrhea is the cramping that most people feel before or during their periods, according to the American College of Obstetricians and Gynecologists (ACOG). This discomfort or pain is triggered by hormone-like chemicals called prostaglandins that are produced in the lining of your uterus, and it usually winds down after the first two days of your period. Secondary dysmenorrhea is very different: It’s spurred by some kind of disorder in your reproductive system. In this case, the pain worsens over time and usually lasts longer than “normal” period cramps. The pain can also set in a few days before your period gets going, feel worse after bleeding starts, and continue once your period stops.

There are some common, and sometimes sneaky, causes of secondary dysmenorrhea, including endometriosis; uterine fibroids, benign growths that form on the outside or walls of the uterus; adenomyosis, which develops when tissue that normally lines the uterus starts to grow in the muscle wall of the uterus; and genetic defects with the uterus, fallopian tubes, or other reproductive organs. Even seemingly unrelated chronic conditions, like Crohn’s disease, for example, can flare up and then set off intense pain around your period.

If your pain forces you to stop going about your daily life (say, you’re canceling plans with friends or can’t make it to the grocery store) or it gets so bad that you have to call out sick from school or work, that’s a major red flag, Aparna Sridhar, MD, an associate professor of clinical obstetrics and gynecology at the David Geffen School of Medicine at UCLA, tells SELF. You should also take note if your pain seems to ramp up as your period goes on (as it should mellow out after the first few days), and if you’re not getting relief from OTC pain meds like Tylenol, Advil, or Motrin.

And don’t underestimate the impact all of this can have on your mental health, too. “Painful periods are not normal,” Saulsberry stresses. “Don’t let that be your truth. We’re not here to be in excruciating pain.”

What to do if your doctor keeps dismissing your period pain

If you feel like your period pain is quite literally ruining your life and your doctor is still writing off your concerns, here are a few steps you can take:

1. Rethink the timing of your appointments.

Doctors are often crunched for time for a lot of reasons outside of their control, as SELF previously reported. “But that does not mean they shouldn’t have time to hear their patients’ experiences and goals,” Dr. Chan says. “Often we can make a diagnosis by simply listening to our patients.” If you find yourself waiting and waiting, only to have a lightning-fast visit that doesn’t leave you feeling heard, try to book your future appointments first thing in the morning or right after lunchtime, when offices are most likely to run on schedule. This way, you might up your chances of having a more thorough conversation and exploring your options for next steps.

It also doesn’t hurt to ask if your doctor can accommodate an extended appointment in advance, so you know you have a good chunk of time allotted, Daniel C. Martin, MD, the executive and medical director of the Endometriosis Foundation of America, tells SELF. And if you feel more comfortable with a doctor of a certain identity—say, a woman or person of color—don’t hesitate to bring that up while scheduling your appointment too.

2. Come armed with information.

Your doctor should have as much of an understanding of your symptoms as you do, including when they tend to start and stop; how long they typically last; what they feel like, and if the pain has caused you to miss work, school, or other events; what kind of pain-management strategies you’ve already tried; and anything else that’s specific to your experience.

“Your medical providers benefit from more information,” Dr. Chan says. “Tracking your period symptoms helps them put the story together, and allows them to work with you toward a diagnosis.” Saulsberry agrees that being “crystal clear” about what’s going on with your body is key. “I keep a log of all of my symptoms through an app on my phone,” she says. “It makes it easier to convey that information to my doctor.”

Dr. Chan recommends logging your symptoms for at least a few months—either in a journal or a period-tracking app—and noting things like the location of your pain, anything that seems to make it feel better or worse, and whether your baseline level of pain has changed over time. (This story on how to track birth control side effects has a helpful section that breaks down the specifics of keeping a symptoms diary.)

Other information that you might not think to jot down, per Dr. Chan: Are you also dealing with bloating and/or pelvic pressure? And do you have any unusual changes in your bathroom habits, like sudden and painful poops or peeing more than usual?

3. Bring a list of specific questions.

These can help you move the conversation forward with your doctor:

  • Is it normal for my period pain to affect my ability to do daily activities, like going to school or work?

  • Are there any tests like imaging studies that you recommend to help us make an accurate diagnosis?

  • If you do get testing, ask for basic imaging like an ultrasound of the pelvis “to start ruling possible conditions out,” Kelsey Kossl, MD, a minimally invasive gynecologic surgeon at NYU Langone Health, tells SELF. “This can also serve as a good jumping-off point if you seek a second opinion.”

  • Do you think endometriosis or another chronic pain or reproductive health condition could be a cause of my symptoms? Melissa B., 44, tells SELF that this strategy helped her when she was misdiagnosed with irritable bowel syndrome (IBS). “I knew it was not IBS in my heart,” she says. She had read online that endometriosis can often be misdiagnosed as IBS, and asked her ob-gyn if there was a chance that could be behind her symptoms instead. “She did an ultrasound and I had two large cysts on my ovaries,” Melissa says. “At that time, surgery was suggested, and I was diagnosed with endometriosis after that surgery.”

  • What are some ways I can manage my period pain while we continue our workup? And would it be helpful to track my medication regimen (like when I take meds, how much the meds help, or if I have side effects)?

4. Ask someone you trust to join you at your next appointment.

This can be a parent, partner, or close friend who can help you feel more at ease and confident during your appointment, and even bring up information you might have trouble remembering because you’re feeling stressed or anxious.

“We have a big exchange of information during our visits, and it can be overwhelming,” Dr. Kossl says. “Having an advocate with you ensures that you share all relevant information and do not minimize symptoms, and offers a second set of ears to assess if your questions and goals are being addressed.” (Just give your doctor’s office a heads-up, in case they need your advocate to provide any information in advance.)

It’s a good idea to go over things with this person before your appointment, like how you’ve been feeling physically and mentally, how long your symptoms have been going on, and how much you want them to speak up during your appointment. For example, if a close friend joins and can back up that you’re constantly canceling plans because of your pain, that’s good insight for your doctor to have. If you prefer that your advocate is just there for emotional support during the whole ordeal, that’s okay too.

5. Be honest about how you’re feeling, and hold your doctor accountable.

If your provider doesn’t seem to be taking you seriously, Dr. Chan recommends being direct and communicating that you don’t feel like your concerns were addressed. “Tell them that you would like to take a step back, and represent your symptoms factually and clearly,” she says.

This is where your notes come in handy: For example, if your doctor insists that what you’re feeling is normal, you can refer to your journal or app and say something like: “I started my period when I was 14 years old and have been keeping a detailed log of my symptoms for the past three months because they’re the worst they’ve ever been. What I’m experiencing now is not my personal normal, and it’s really affecting my day-to-day functioning, both physically and mentally.”

If you hit a wall, don’t hesitate to ask your doctor to keep a record of the appointment—for example, you can say you’d like them to document why they declined to do certain testing you asked for. If you’re concerned they won’t do this, you can ask for a copy of your medical record. The HIPAA Privacy Rule gives you the legal right to see and receive copies of the information in your health records, so your doctor can’t deny you access to this information.

6. Don’t lose hope.

If you’re not getting anywhere with your current doctor, it’s time to seek a second (and sadly sometimes a third) opinion. “For a second opinion, I recommend seeking out a provider who has a focus on the area of concern, such as pelvic pain,” Dr. Kossl says. (You’ll eventually need to make a decision about how to treat your symptoms and should feel confident that your doctor will thoroughly lay out all your options.)

If you have health insurance, contact your plan’s support line for a list of covered specialists in your area. If you don’t have health insurance, reach out to a low-cost clinic like Planned Parenthood or use the Medicare directory to filter through options near you. Your local hospital should also have a “find a doctor” tool on its website that you can browse. And don’t underestimate your inner circle—close friends and family members will want to help, so ask them if they have any doctors they have really liked and can confidently recommend.

Once you meet with a new doctor, keep all the tips above in mind—bring your symptoms log, records of imaging studies, and prescriptions for treatments you’ve received to get them up to speed quickly, Dr. Kossl says. You should also note that you’re seeking a second opinion and have had trouble feeling heard by your provider in the past.

And when you feel like giving up, remember that you deserve to feel better. And there are doctors out there who will listen. “Stay informed,” Dr. Martin says. “Knowledge can help you advocate for yourself.”

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Originally Appeared on SELF

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