Severe Period Pain Is Not ‘Normal’

Topic: Endometriosis awareness

We have normalized pain in women. From a young age, many girls are told that cramps are “just part of being a woman.” They are told to use a hot water bottle, take a painkiller, and get on with their day.

But there is a line between “discomfort” and “disease.” When pain forces you to miss school, call in sick to work, or vomit from intensity, it is not normal. It is a sign of inflammation, and frequently, a sign of Endometriosis.

The “Normal” Baseline

Normal menstruation involves the uterus contracting to shed its lining.

• Normal: Mild cramping on Day 1-2. Manageable with over-the-counter medication. You can still go to work/school.
• Not Normal (Dysmenorrhea): Pain that starts days before the bleed. Pain that radiates down the legs or into the back. Pain that makes you pass out. Pain during ovulation (mittelschmerz) that lasts for days.

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus (on the ovaries, fallopian tubes, bowel, or bladder).

• Every month, this tissue responds to hormones. It bleeds.
• But unlike the uterus, this blood has nowhere to go.
• It causes inflammation, scar tissue (adhesions), and excruciating pain.

The 7-Year Delay

On average, it takes 7 to 10 years for a woman to get an Endometriosis diagnosis. Why?

1. Normalization: “It’s just bad cramps.”
2. Invisible on Scans: Mild to moderate endometriosis often doesn’t show up on a standard ultrasound. A clear scan does not mean you don’t have it.
3. Symptom Overlap: It is often misdiagnosed as IBS (Irritable Bowel Syndrome) because it causes bloating and diarrhea during periods.

Red Flags to Watch

If you answer “Yes” to 2 or more of these, you need a specialist (not just a general GP):

1. The “Killer Cramps”: Do you have to stay in bed for 1-2 days every cycle?
2. Painful Sex: Deep pain during or after intercourse?
3. Bowel/Bladder Pain: Does it hurt to pee or poop specifically during your period?
4. Chronic Fatigue: Do you feel exhausted all the time, unrelated to sleep?

Advocating for Yourself

If your doctor says “your ultrasound is normal” but you are in pain:

• Ask: “I know endo doesn’t always show on ultrasound. Basted on my symptoms, should I see an Endometriosis specialist?”
• Track: Keep a pain diary. “Day 1: Level 8 pain. Vomited. Missed work.” Data is hard to ignore.

Pain is your body’s alarm system. Don’t silence it. Investigate it.