Pain ripped through my abdomen and pulled me onto the cold tile floor of the empty hallway. The new medication wasn’t working, just like the last one didn’t, and the next wouldn’t. I’d snuck out of class so I could text my mom to pick me up. This would be the fourth day of junior year I’d miss.
Intense period pain is not normal. At all. We’ve just been taught that it is. Instead, period pain reflects a greater issue: whether that’s endometriosis, poor hormone detoxing, inflammation, or something else. And the medical field is woefully inept in treating women’s ills because women were not included in most medical studies until the late 90s. As a result, women’s healthcare is so bad that you have to be your own doctor.
Why women’s health fell behind
Before the 1970s, period pain was commonly labeled as psychological or as hysteria. After research in the 1960s connected the body’s production of muscle cramping chemicals called prostaglandins to period cramping, research began to acknowledge a physiological cause of period pain. Later, in the 1970s, pain medication like Ibuprofen became available to women with a doctor’s prescription to treat pain.
Now, if you tell your healthcare provider you have period pain, the odds are they will recommend hormonal birth control. Three-fourths of OBGYNs regularly prescribe it. Sometimes they recommend it even if you explicitly tell them you are not interested in birth control. (This has happened to me too many times!)
Why do they continually recommend hormonal birth control? Well, doctors simply do not have tests accessible to them to diagnose the cause of period pain, and even if they did test and diagnose you, the answer would likely be the same: pain medications and hormonal birth control. Not only is there a lack of research on other possible treatments or cures, but doctors are not trained in alternatives either.
Hormonal birth control consists of synthetic hormones that work to prevent ovulation, the body’s release of an egg, by communicating to the brain that you are already pregnant. Essentially, it’s a negative feedback loop. With the supplementation of synthetic hormones, some of your naturally produced hormones shut down, thus alleviating the hormonal imbalances that can cause period pain and PMS.
When treatment isn’t really treatment
I started the pill in my junior year of high school, hoping to better my attendance (and end my debilitating periods). I wasn’t informed of any side effects, except for blood clots. After experiencing negative side effects like fatigue and lack of muscle growth (birth control suppresses testosterone), I decided to go off the pill after two years and see if my period pain still brought me to my knees.
It did. And worse, the mood swings that followed going off the pill nearly placed me in the hospital. When I reached out to my former OB for help, they prescribed myo-inositol, an insulin regulator that assists some women who suffer from polycystic ovarian syndrome (PCOS), a chronic disease I had never been tested for and do not have. Myo-inositol worsened every symptom I had.
After that, I decided to take my health into my own hands — I started researching diagnostic tests that could provide greater context for my pain, like hormone panels, and I directly requested my new providers to take the tests. I warded off invitations to restart birth control, and I dug into every online resource I found.
And, after seven years of chronic period pain, I randomly found my answer in an Instagram reel from a gastroenterologist.
Fiber. The answer was fiber.
What clinicians failed to see about my chronic symptoms was “estrogen dominance.” Excess estrogen in the body can cause PMS symptoms and period pain. The body attempts to get rid of excess estrogen through the intestines, removing it like it would food. However, estrogen can be reabsorbed; in short, estrogen can re-enter the body by leaving the gut and flowing back into the bloodstream. When you eat fiber, it creates a “gel” in the gut, preventing both excess estrogen and progesterone from re-entering the bloodstream and forcing detox.
Crazy, right? So, my theory is that estrogen was being recycled instead of detoxed in my gut, leading to PMS, pain, and other symptoms. When I started eating 25-30 grams of fiber the week before my cycle, it felt like 60% of my symptoms melted away. On day one of my period, a day I would typically spend stuck in bed cycling through maximum doses of Ibuprofen and Tylenol, I found myself standing upright and vacuuming.
The answer to my chronic pain? The problem that Aleve, prescription pain medication, myo-inositol, birth control, Ibuprofen, Tylenol, spearmint tea, heating pads, low sugar, cutting out gluten and dairy, exercise, and electrolytes could not solve? Fiber. Just fiber. I could not believe that my doctors missed such a simple solution.
the bigger picture
In many ways, healthcare has failed women. Over the years, I have spoken to friends and family about their experiences with medical care, from advocating for diagnoses to managing pregancies and I hear the same inadequacies repeated: women’s healthcare is dehumanizing and under-researched.
I brought my healthcare critiques to my aunt (the nurse of 40 years), and she had a very different perspective. Where I saw failure, she saw years of improvement. The fact that women are increasingly aware of healthcare’s gaps speaks to the presence of advocacy — women are speaking up and demanding research.
I want to believe her. I am hopeful for a future where we do not have to be our own doctors.