For a group of people that have been constantly reprimanded for being weak and overly sensitive, the pain — physical and otherwise — that women and people who menstruate go through when navigating the medical system is astounding.
Menstruation isn’t only identified by the blood that comes with the shedding of the uterus lining. Bleeding poses mental, social, physical and cultural challenges too. At their best, periods are a minor inconvenience. At their worst, periods can significantly decrease a person’s quality of life.
Since she was 12, Natasha’s periods have been heavy. As a teenager, they saw her regularly taking the mornings off school, and as a mother of three, each childbirth saw her periods get progressively worse.
"It's not just the heavy bleeding, but everything that comes with that,” she tells Refinery29 Australia. "For example, because you have to change your tampon multiple times during the night, you wouldn't get a full night's sleep and then you're not your best self the next day." It was after a particularly hard day, which ended in a teary phone call with her sister, that spurred her decision to go seek professional help.
Physical pain, bloating, fatigue, loss of control over emotions, anxiety… the most confronting thing about heavy menstrual bleeding is often not its wide-ranging effects, but the fact its sufferers are told that these symptoms are normal.
Also known as menorrhagia, this condition is characterised by abnormally heavy or prolonged bleeding and periods that end up dictating what you can or can’t do, thus altering your standard of living.
A few years ago, the periods of Olympic gold medalist and GWS Giants AFLW player Chloe Dalton took a painful turn. Her heavy bleeding created an “isolating” fear around going to work and training and while alarm bells quietly warned that something “didn’t feel right,” she also had another voice telling her that it was probably normal.
"It started to impact my daily life and I didn't feel like I could do things normally without having to almost take time out to lie in a foetal position until it subsided,” Dalton tells Refinery29 Australia. It amplified her anxiety about not being in her own home whenever she was bleeding. “For me, there was a lot of fear around being in an unknown environment… I didn't necessarily feel comfortable telling my employer or my coach that I was really struggling… I almost felt like I had to push through.”
These experiences are far from one-off stories. ‘The Period Perspective Survey’, commissioned by Bayer and including over 1,000 Australians, found that one in three menstruators between 18-60 believe they have undiagnosed heavy menstrual bleeding.
The survey found that 32% of Australian women reportedly have to change menstrual products every hour or so (and therefore also pay more for period products), are passing blood clots bigger than 50 cent pieces, are feeling dizzy and fatigued, and are beholden to organising their social schedules around their unforgiving bleeding.
"A large number of women genuinely don't know that they are bleeding heavily because of how society has trivialised their concerns… [we] end up with a condition that's under-recognised and under-diagnosed."
Dr. Talat Uppal
The survey found that 40% of people say that menstruation drastically affects their ability to work and 41% of people admit that it makes it difficult to maintain a normal, daily routine because of fatigue.
Adding to that, almost half of people who struggle with heavy bleeding also experience pelvic pain, obstetrician and gynaecologist Dr. Talat Uppal tells Refinery29 Australia, “so they're now suffering on two fronts”.
“A large number of women genuinely don't know they are bleeding heavily because of how society has trivialised their concerns… [we] end up with a condition that's under-recognised and under-diagnosed,” she says.
Dr. Uppal points to the self-minimisation of health concerns she’s noticed in her doctor’s room. “Women are typically carers and they're just champions in life,” she says, adding that women typically fall into high-pressure situations that include caring for elderly parents, juggling job deadlines and looking after children.
“I’m like, ‘Where are you on this list of priority tasks? You are not on that list.’ And part of my job is actually outside of the medical, to say, ‘Look, it's your time darling, we just need to focus on you and make sure there's nothing nasty going on,’” Dr. Uppal says.
"I am upset with misogyny, robbing me of some of the best years of my life."
In Dr. Uppal's experience, when her patients who experience heavy bleeding are offered a safe space where they're allowed to be vulnerable, the floodgates open. “My uterus is a curse, the bleeding is a joy thief.” “My tub was a blood bath, my house like a murder scene.” “My month is 30 days, minus six, as those are just survival days.” “I am upset with misogyny, robbing me of some of the best years of my life.”
These confessions made in her office make no secret of just how devastating and all-consuming irregular menstruation can be. Stigma and shame cloud and stilt conversations about this: of the people who would like health care professionals to proactively discuss menstrual bleeding, almost one in five say uncomfortableness is what’s stopped them from broaching the subjects themselves, according to Bayer’s survey.
Dalton shares that it feels like there’s a distinct line in the sand between sports injuries (which are “well researched and well respected”) and period pain. She’s proud to share that the GWS Giants’ medical team has been making strides in closing the menstruation education gap.
“They do a lot of [menstruation] education for us as players around what's normal [and] what’s not normal. They also get the male high-performance staff in there as well, because I think there’s been quite a big knowledge gap traditionally,” she explains.
It mirrors the AFL’s decision to remove the mandatory wearing of white shorts from all on-field uniforms late last year, a move made to quell performance anxieties around menstruation. Dalton says she was “very relieved” about the announcement, and that it’s one that “makes a lot of sense”. Now, she’s thankful she’s got a team of medical professionals around her who is helping her on her journey.
Meanwhile, Natasha decided on getting an ablation (a surgery that destroys the lining of the uterus) after a string of pills and other medications did all they could to reduce her bleeding.
“I came to that decision out of sheer desperation. Honestly, I just had enough," she says. "I couldn't wear the right clothes. I couldn’t exercise the week before I'd have my period because… I didn't want to be caught out at the gym. I couldn’t sleep. I was getting headaches, dizziness, slowness, diarrhoea and constipation."
Natasha went from being fearful of exercise and having to arrange holidays with her friends around her period, to being able to be the mother she wanted to be. “It just gives me freedom. I don't have any anxiety about my period anymore, or depression,” she says.
Dr. Uppal, Dalton and Natasha ended our respective conversations the same way, providing almost identical pieces of advice for readers who think they might be experiencing heavy menstrual bleeding.
“I would encourage them to seek help because I often say that this is a problem with many solutions, both medical and surgical. It's sad to see needless suffering on this front,” Dr. Uppal offers.
“You don't have to keep pushing through in silence. Go and speak to your healthcare professional who is equipped with the right information and knowledge,” Dalton says.
“It's not normal. You don't need to put up with it. You need to go and see your doctor. I wish that I'd done that earlier. I put up with it for a lot longer than I needed to,” Natasha adds.
Please note: the medical information in this article is general in nature. Please always consult your GP to obtain advice specific to your medical condition.