There seems to be a secret code among people who menstruate, in which someone mouths, "I started my period," and the other person stealthily passes them a tampon. What's less commonly discussed is the severe bloating, cramping [1], back pain, and other symptoms that can disrupt an entire school or work day, and for some people, keep them confined in bed all day. In a recent Dutch study, almost 14 percent of people surveyed reported missing work or school due to their periods [2]. Another 80 percent of the study population reported being present at work or school, but losing productivity because of the pain, resulting in about nine days a year lost, according to the authors. On top of that, only 20 percent of the study participants who missed days felt comfortable telling their supervisor or teacher the real reason they were calling out.
Why are so many people plagued with such challenging periods? In many cases, there may not be an underlying condition that's to blame for painful periods; sometimes, really bad cramps are simply categorized as primary dysmenorrhea, Alyssa Dweck [3], MD, an ob-gyn in Westchester County, NY, told POPSUGAR. Other times, period pain is associated with endometriosis [4] or uterine fibroids, benign muscular growths that can appear in the uterus. PCOS [5] is another condition that may not directly cause cramps, but can cause irregular periods and therefore very heavy and sometimes painful bleeding when menstruation finally occurs, Dr. Dweck explained. Severe cramping may also be caused by ovarian cysts or even the insertion of a copper IUD.
In some cases of especially painful periods, a doctor might prescribe a prescription pain medication or even a hormonal birth control pill to help better manage the symptoms. But birth control isn't a quick fix for everyone struggling with menstrual pain. "If pain is from another source, such as scar tissue, infection, or mechanical pressure of fibroids, one may need to address those issues in another fashion, including surgical intervention," Dr. Dweck said.
Because everyone's periods are different, it's important to track your symptoms to understand what might be going on with your menstrual cycle and causing you to be unable to carry on with your regular routine. But even just knowing that you're not alone can help make painful or heavy periods feel less isolating. Here, four menstruators raise their voices about what it's like to need to miss out on school or work because of their periods, and why more awareness would improve their own well-being.
The more we can openly discuss periods and everything that goes along with them, the less taboo they'll become — and the easier it'll be to speak to your own boss when you have cramps that are keeping you from clocking in.
Ariel, 24
Ariel's period pain was bad enough to land her in the hospital, but she didn't go at first because she was afraid of not being taken seriously. "You see this happen way too often to Black women," she told POPSUGAR. "The time I did decide to tell a doctor about my period pain and nausea, I was prescribed ibuprofen and some medication for the nausea, which made me more nauseous." She never received any kind of test or diagnosis that would help explain her severe pain.
When she would call out of work each month, Ariel faced more apathy from her supervisors. "I was blaming it on other things because of my fear of rejection or again, not being taken seriously. The time I did build up enough courage to tell them the real reason I was in pain, my supervisor told me I couldn't call off," she said. Ariel hasn't found a solution to her PMS or menstrual pain, but explained that she has found some months to be more manageable when she pays closer attention to other healthy habits, like staying hydrated and eating more veggies. "I also started using The Honey Pot menstrual products, because the herbal-infused pads bring more comfort than your average pad," she said.
Kamryn, 23
While Kamryn always struggled with PMS symptoms [7], including intense mood swings, bloating, breakouts, migraines, and cramps, it's become more difficult to function recently. "It seems over the years the cramping and migraines got significantly worse to the point that I could not leave my bed or couch and my appetite would be suppressed," Kamryn told POPSUGAR. "I also could not use screens, like a phone, TV, or laptop because of the migraines." Her doctor couldn't necessarily find anything abnormal to explain her symptoms, but suggested naproxen, which she takes in conjunction with CBD to manage the pain. Still, her periods made it difficult to attend her social work classes and work shifts.
"My social work professors would allow extensions on papers or assignments within reason and only wanted the best for me and my health," she said. "However, other professors would not sympathize and penalized me for missing class with grade deductions, and further penalized me for not wanting to go and spend money on a doctor's note to verify my 'illness.'" When it came to skipping work, Kamryn's boss was more compassionate. "She understood that it was something I could not control and would just ask me to be transparent about everything. In return, I wasn't questioned or punished for any missed shifts," she said.
Suzannah, 23
"I have never really struggled with cramps until recently, within the past year," Suzannah told POPSUGAR. They're the kind that, in the first two days, have prevented her from sleeping, but also from getting out of bed. And they're getting progressively worse, she explained. While Suzannah had planned to see her doctor to try to determine an underlying cause, the COVID-19 pandemic has made it difficult to get into an office.
At her job as a concierge at a hotel, where she had to stand at a desk all day, she was out of sick days and would have to go without pay for any additional days she called off. "People with periods are running out of sick days, and it's just one more way that female-identifying people are having a gap in pay," Suzannah said. If she shared what was going on with certain coworkers at the hotel, they were often sympathetic and let her sit down and take a break for a bit, but she didn't feel comfortable sharing anything about her period with her managers.
She's found that being really active, like going running and increasing cardio the week before menstruating, has been one of the only preventative ways to help manage the pain — but still hasn't found an ultimate solution beyond over-the-counter pain pills and hot water bottles.
Kat, 35
It took until last year for Kat to receive an official endometriosis diagnosis, even though she struggled with it since she was a teenager. "In my teen years, I missed school each month due to how debilitating my periods were and I spoke with my doctor to find medical solutions," she told POPSUGAR. Her doctor prescribed birth control to control her severe pain and heavy bleeding so she wouldn't have to call out of work. "But, the pill really didn't fully help with my periods. I still had significant pain, heavy flow, and blood clots," Kat said. She also couldn't afford to miss work, and was too scared to call out because she was embarrassed to discuss the reason why she'd be missing days. "Instead, I would go to work in pain, and try to take as much medication as I could to make it through the day," she explained.
She's tried every possible remedy, from heat wraps to birth control, supplements, exercise, and nutritional changes. "Lifestyle modifications with my nutrition and fitness also helped with decreasing my nausea and pain slightly," Kat said. "But the only thing that's been successful at reducing my pain and treating my endometriosis has been excision surgery." She had surgery in October of 2019 to remove two large benign cysts on both of her ovaries and excise the endometriosis in her abdominal area. Her symptoms, including bloating and swelling, back and leg pain, nausea, and constipation, have improved. "I also do not have debilitating, painful, heavy periods," she added.