Period stigma is defined as any social or cultural construct that stigmatizes menstruation. Therefore, contributing to the idea that periods are dirty, nasty, unclean and improper. And while period stigma creates a negative attitude towards periods as a whole. These ideals can be even more harmful to endometriosis sufferers like me. The shame and embarrassment the average woman feels regarding her period is magnified when you’re dealing with endometriosis. While American society views the average period as gross, dirty, and something that women should handle privately. Painful periods and menstrual abnormalities are met with even more shame and stigma. Thus creating a toxic environment that prevents women from struggling with painful periods and suspected endo to seek help for their symptoms. Hence, why many women hide or deny symptoms. Even worse are those that are completely unaware of how their painful periods could be a symptom of an underlying issue. This, in turn, contributes to the delay in diagnosing and treating endometriosis. 

Period Stigma Encourages Silence

I remember as a young girl struggling to understand why my periods were so painful. Sharing my experience with others only contributed to my shame and awkwardness. Especially since the majority of those experiences were met with judgment, disbelief and the general idea that I needed to deal with my pain and accept it. These early exchanges taught me to feel shame about my period, and the pain that was associated with it. Therefore, I stopped questioning my pain and struggled silently. Basically, I learned that when it came to my period and my health as a woman I needed to keep it to myself and remain silent. 

But, my experience with period shaming isn’t something new. Many others have felt shamed into silence when it came to dealing with their painful period symptoms. All while trying to seek validation from others in regards to their pain. Furthermore, this silence bleeds over into how one discusses their period with medical professionals. Feelings of embarrassment and struggles with rigid religious beliefs also impact a woman’s comfort level when discussing painful periods and menstrual abnormalities. Additionally, the distorted societal view on menstruation contributes to women becoming silent about their period struggles. 

period stigma

Silence Causes Menstrual Ignorance

Not being able to talk about periods and menstrual health increases the growth of period stigma. Consequently, period stigma is deeply rooted in miseducation, and lack of awareness surrounding women’s reproductive health and menstruation. Furthermore, the lack of proper education in regards to reproductive health and menstruation for young women increases ignorance. Thus, allowing their peers, society, and culture to fill in the blanks. It’s this grey area where misconceptions, myths, and misinformation spread. Especially as it pertains to signs and symptoms that could aid in early detection of endometriosis. 

 

Period Stigma Labels Endo As “Just a Bad Period”

Another way period stigma fails those with endometriosis is the belief that it’s “just a bad period” In reality endometriosis is so much more than having a bad period. Especially when you consider the fact that it doesn’t always mean a person with endo will have issues with painful periods. The spectrum of endometriosis symptoms is vast and no two individuals will share the same symptoms. As a matter of fact, some endo sufferers displayed no outward symptoms and were diagnosed with endometriosis after failure to conceive.  

Still, others have painful periods that indicate an underlying issue. There are still others that don’t have painful periods but deal with other menstrual abnormalities. This is why having proper awareness regarding ALL symptoms associated with endometriosis is important. Yes, painful periods and chronic pelvic pain are common symptoms. But, they’re not the only ones. More light needs to be shed on the uncommon endometriosis symptoms that are disrupting women’s daily lives outside of menstruation.  Uncommon symptoms such as painful bowel movements, painful urination, painful intercourse, low back pain, sciatica, migraines, and gastrointestinal issues.  These symptoms may seem harmless or normal. Which in turn causes the sufferer to dismiss these symptoms. 

period stigma

Period Stigma Normalizes Menstrual Pain

The normalization of menstrual pain prevents women with endometriosis from discussing their pain. Far too often when you try to open up with family, friends or even medical professionals regarding your pain it’s not believed. You’re given advice about how to manage your pain. Or, you’ll have your doctor recommend taking the pill to “cure” your painful periods. But, there’s no recognition that dealing with debilitating pain during your period is abnormal. 

Anything that contradicts the idea that periods are supposed to be painful is met with opposition and disbelief. I’ve experienced this in the past. On the occasions, I was brave enough to share my struggles with painful debilitating periods I was met with disbelief and judgment. My pain was questioned and it was perpetuated that I was exaggerating and making it up. It got to a point where I stopped trying to get anyone to listen. I learned to suffer in silence and fake it through the pain.  

Period Stigma Prevents Adequate Medical Treatment

On average it takes anywhere between 5 to 10 years to receive an endometriosis diagnosis. This is due to a lack of qualified professionals that can properly diagnose and treat endometriosis. Many of the medical professionals that women go to adhere to outdated definitions, research and treatment protocols. Defining endometriosis as a disease in which endometrial tissue grows outside of the uterus. Instead of correctly describing it as a disease in which tissue similar to that found in the uterus begins to grow elsewhere is huge. Why? Because these little tidbits of misinformation take us a step back. Thus contributing to public miseducation regarding endometriosis. Which in turn, contributes misunderstanding and misdiagnosing it.

Additionally, relying on outdated research (such as the retrograde menstruation theory) contributes to medical professionals recommending questionable treatments to treat endometriosis. Treatments such as hormonal birth control, lupron and surgical ablation.

period stigma

Hormonal Birth Control 

Hormonal birth control is a hot topic within the endometriosis community. Specifically the belief that it can actually aid in suppressing the growth of endometriosis. Experts have varying theories on this. Some believe that a monophasic birth control pill that contains higher levels of progesterone can actually help with suppressing endometriosis growth, decrease bleeding and lower period pain. Whereas other experts believe that birth control pills have little to no effect on suppressing endometriosis growth. While it may have a positive benefit on pain for some the risks may outweigh the rewards. 

 

Lupron/Orlissa

Another controversial treatment being offered for endometriosis is lupron/orlissa. These two drugs are advertised as being in separate drug classes. With lupron being in a class of drugs that are gonadotropin-releasing hormone agonists. And, orlissa being in a class of drugs that are gonadotropin-releasing hormone receptor antagonists. Consequently, they are prescribed to endometriosis patients to manage their pain. Yet, many patients that have taken this medication have come forward to express severe side effects and complications that have persisted after discontinuing the medication. Side effects such as bone and joint pain, suicidal thoughts, vision complications, increased risk of stroke, and muscle loss just to name a few. Many of those that were prescribed and took lupron or orlissa would rather have not taken it due to the life-altering side effects. 

 

Endometrial Ablation Surgery

This surgical therapy is popular and has been widely used by doctors to reduce the severity of endometriosis symptoms. And, while the success rate of this procedure is somewhere between 80-90%. It’s also been linked to a high failure rate. While many experience a recurrence of symptoms after 5-8 years. Others didn’t experience a resolution in symptoms. In fact, symptoms began to reoccur after a few months. In recent years this surgical procedure has come under fire for its inefficacy. Especially, with the success rate that many have found with excision surgery. The secret sauce that makes endometrial excision surgery so successful is the focus on removing the disease. Excision surgery cuts out the endometrial tissue from the affected area. In contrast to ablation which focuses on burning the endometrial tissue. Thus, increasing the potential for endometrial tissue to be left on the area. Whereby, allowing the opportunity for regrowth and proliferation. 

period stigma

Changing the Dialogue

Over the last few years, the attitude towards periods, women’s health, and diseases such as endometriosis have begun to shift. But, there is still much work to be done before period stigma and the shame surrounding women’s health is abolished. 

Education & Awareness

For starters, improvements in education that provide young women and young men knowledge regarding menstrual health and reproductive health. Not only does this increase their awareness regarding each other’s bodies and help them navigate a world of shifting hormones and sexuality. But, it can help end the negative attitude toward periods and help normalize them. Additionally, it plants the seeds of awareness regarding conditions such as endometriosis, adenomyosis, PCOS and fibroids. Which in turn could be helpful when it comes to early diagnosis and treatment. 

Period Positive Conversations

Consequently, society and culture impact how others perceive particular concepts. For instance, marketing and advertising campaigns that reflect the true and accurate reality of what it’s like to have a period. While also spreading awareness about painful periods. As well as the fact that they are a common symptom associated with various disorders. Specifically, endometriosis, adenomyosis, fibroids and in some instances PCOS. Breaking the silence on taboo topics regarding menstruation such as period flow, pelvic pain, and other symptoms can encourage women to open up about their symptoms. Thus, increasing the desire for women to discuss these symptoms with their doctors and get properly evaluated. 

period stigma

Reframe Oppressive Religious Views

There is nothing inherently wrong with adhering to conservative, modest values. Wanting to uphold the values and traditions of your faith regarding sex, sexuality, and intimacy is perfectly acceptable. But, it becomes oppressive when these views discriminate against women because of their period. This sends the message that periods are dirty and wrong. Which in turn leads to women feeling voiceless and not discussing symptoms and menstrual abnormalities that could signify endometriosis. Educating those with oppressive religious views and practices on the importance of menstrual health and how it doesn’t compromise one’s modesty can help in decreasing stigma for these populations. 

This starts by teaching them about diseases such as endometriosis and correctly defining what it is. No, it’s not just a bad period or a period disease. Hence why it becomes important to explain how it impacts a woman’s body and reproductive health outside of menstruation. This can be accomplished by focusing on complications such as fertility, chronic pain, IBS, and decreased quality of life. Allowing women the space to understand their menstrual cycle and most importantly their period can help with detecting compromising health issues early on.  

 

Improve Education & Awareness in the Medical Community

Lastly, improvements regarding how medical professionals address women that are complaining of painful periods need to be had. Especially, if the patient has a medical history of endometriosis. Instead of prescribing the pill as a “fix” for those complaining of painful periods, chronic pelvic pain, and painful intercourse should undergo a screening process. This process could help with isolating the root cause of these issues whether it’s due to endometriosis or another underlying cause. Only then should the birth control pill be discussed with the patient as a potential method to help with managing pain. In no way should it be packaged as a cure for painful periods or endometriosis. Patients should know how it works as well as the risks and benefits of taking it. 

In addition to better screening in the treatment room, doctors should also know when it’s time to refer a patient to an endometriosis specialist. A specialist is better equipped to properly diagnose and treat endometriosis. Precious time is typically lost when doctors try to fix it on their own or insist there’s nothing wrong. Additionally, having more sensitivity and empathy towards women with painful periods and menstrual abnormalities can encourage women to discuss their symptoms more. If you trust your doctor and believe that they will hear you then you’re more willing to open up. 

Forever Hopeful

While much work needs to be done before period stigma is a thing of the past I am hopeful by the small improvements I see. There have been so many changes since I was a young girl. Marketing campaigns by menstrual hygiene brands such as Flex and Thinx are sparking new conversations regarding period wellness. Which in turn empowers women to speak up about their period experiences.  Furthermore, social media has played a large factor in helping spread period awareness. Through its ability to provide a platform for open discussion about all things periods many women are finding their voice and ability to talk about and share their period struggles. In turn, more light is shed on diseases that impact menstrual health. Indeed, we are on the cusp of a revolutionary time for periods and women’s health. 

References.

  1. UN Women | End the Stigma. Period | published October 6, 2019
  2. Teen Vogue | Endometriosis is Going Undiagnosed Due to The Normalization of Menstrual Pain | by Maya Dusenbery published March 15, 2018
  3. Endometriosis Foundation of America | All Birth Control Pills ARen’t Created Equally by Joanie Cox-Henry posted on July 9, 2018
  4. Vox | Women with Endometriosis Experience Terrible Pain. There’s Finally A New Treatment by Julia Belluz updated July 26, 2018
  5. Journal of the Society of Laparoscopic and Robotic Surgeries | Characteristics of Patients Under Going Hysterectomy for Failed Endometrial Ablation by Kristin A Riley MD, Matthew F. Davies MD, Gerald J. Harkins MD Oct-Dec 2013 ; 17 (4) 503-507

 

About the Author.

women's health and wellness blogger

Hi, my name is Kathleen but you can call me Kat. I’m a health and wellness professional turned freelance writer and content creator.  You can find me on YouTube and Instagram. If you take the opportunity to visit me on my other platforms don’t hesitate to leave a message, I would love to hear from you!

 

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