Many women suffer from severe menstrual pain which is much worse than just cramps. Nausea, vomiting, fainting, absence from classes or work, and total absence from daily activities. However, when their results indicate the absence of PCOD/endometriosis, these symptoms are simply described as ‘normal’ pains that are controlled with painkillers.
However, severe pain is not normal pain.
Primary dysmenorrhea, which is due to excessive release of prostaglandins and leads to severe uterine contractions with diminished blood flow and resultant ischemic pain, is intense enough to mimic serious pathology. Imaging studies performed during an attack may be entirely normal, but normal imaging does not equate to normal suffering.
This therefore gives rise to an important question: Is it really right to take painkillers for 2–3 days every single month, year after year, without addressing the root cause?
The problem lies not with not being diagnosed but with normalizing pain. When a patient is repeatedly instructed to tolerate their condition, opportunities for further analysis or management strategies are lost.
Menstrual pain is something that should never be equated with endurance. The listening, confirmation of symptoms, and tailoring approach are as important as the results.
Recurring menstrual pain should prompt deeper evaluation when it is severe, progressively worsening, begins after years of painless cycles, or interferes with daily functioning despite regular painkiller use,rather than being repeatedly dismissed as “normal.” Red flags include pain starting before menstruation and lasting beyond it, poor response to NSAIDs or oral contraceptives, dyspareunia, dyschezia, heavy or irregular bleeding, infertility, anemia, or systemic symptoms, all of which raise suspicion for secondary causes such as endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, or endocrine disorders-BECAUSE RECURRENT PAIN IS A SYMPTOM TO BE EVALUATED AND NOT MERELY SUPPRESSED.
True! Some doctors don’t even care for the symptoms and if nothing significant is seen in the investigations they just ignore it. Assessing the symptoms and finding the cause should be the top priority even if investigations prove other wise because pain is not normal.
Pain that disrupts daily life every month shouldn’t be normalized. Treating symptoms without questioning the cause only delays real care. Listening itself is a clinical intervention.
Really important topic! Severe period pain that disrupts your daily life isn’t just something to ‘tolerate’ - even without endometriosis or PCOD, intense pain deserves proper evaluation and shouldn’t be normalized.
