All three monotheistic religions condemn the period. It is a little studied matter, despite the fact that 75% of women suffer from menstrual pain
The feminist Gloria Stein said at the beginning of the 1980s that if men menstruated, menstruation would become an “enviable and proud masculine event”. «Men would boast of its duration and its flow. Adolescents would mark the arrival of their period, a long-awaited symbol of virility, with religious celebrations and exclusively male festivities. Congress would create a National Dysmenorrhea Institute to combat monthly pain, and the Government would provide funds for free hygienic protections»
At all times the period has had bad press. Islam, Judaism and Christianity consider it something impure. It is enough to look at Leviticus to realize how great the curse is: «When the woman has an issue of blood, and her issue is in her body, she will be separated from her for seven days; and whoever touches it will be unclean until evening.”
Even today, thousands of years later, the rule continues to arouse many prejudices in medicine and in the organization of health services. "Menstruation is still a taboo subject for primary care and remains invisible for scientific research," says the endocrinologist Carme Valls Llobet in her book 'Invisible Women for Medicine' (Capitán Swing).
«The human body is not designed to function with pain, and menstrual pain should not be overlooked»
The preliminary draft of the new abortion law will include a specific and paid permit for women who suffer from menstruation and who are disabled. The president of the General Council of Official Colleges of Physicians, Tomás Cobo, does not see the measure with good eyes. “We must not turn physiology into pathology. It is not necessary to turn natural processes into disease. When the symptoms are important enough to suspect the existence of a pathology, it is when you have to go to the doctor, but not before. Trying to turn into a kind of disease a fact that is purely natural in the nature of the female sex is absolutely absurd », he assures.
Cobo maintains that if severe lower back pain occurs due to menstruation and the woman cannot carry out her work “what she should do is go to her doctor and have him assess whether it is only menstrual or there are other components such as the existence of uterine polyps ». “The important thing is that the doctor decides at a certain moment if this process prevents him from carrying out his professional activity”, she argues.
The co-director of the Department of Gynecology and Obstetrics of the University Clinic of Navarra, Juan Luis Alcázar, around 70-75% of women suffer from menstrual pain. This is certified by a study that was done 20 years ago in the Community of Madrid. According to Alcázar, dysmenorrhea, the pain that occurs before or during menstruation, is underdiagnosed, which often means that it is not treated. “The internalization that menstrual pain is something normal causes many women not to go to the doctor. The human body is not designed to function with pain, and menstrual pain is a symptom not to be blithely overlooked."
A study published in 2019 in the digital version of the 'British Medical Journal' highlights that women lose an average of nine days a year of productivity because of the period.
The lack of a therapeutic approach to menstrual disorders can have disastrous consequences. Endometriosis, which affects between 10 and 15% of the world's population, is often diagnosed years later. “Many women begin the development of endometriosis in the adolescent stage. This disease can have very negative consequences ten or fifteen years later. That is why it is very important to raise awareness among the female population and the medical community of the importance of menstrual pain," says Alcázar.
Women lose an average of nine days a year of productivity due to periods
In most cases, menstrual pain takes the form of primary or essential dysmenorrhea, in which the affected person does not present any pathology and the suffering is due to an increase in uterine spasm. "The uterus is a muscle that contracts intensely as a result of an exaggerated production of substances called prostaglandins in its walls," explains the specialist. In other cases, dysmenorrhea is secondary when there are pathologies, such as fibroids, adenomyosis, endometriosis or polyps at the level of the endometrium. "Around a quarter of women who suffer from menstrual pain have severe dysmenorrhea," notes Alcázar.
Menstrual pain that is not accompanied by pathology appears in girls after the first period, from 13 and 14 years old, and that which occurs with uterine diseases usually manifests after 25 years. Secondary dysmenorrhea that occurs in certain endometriosis can sometimes lead to a hysterectomy or removal of the uterus.
Although menstruation occupies a quarter of a woman's life during her fertility period, that is, about forty years, this physiological reality has not been well studied. Despite this, around menstruation there is a large market niche. The journalist Élise Thiébaut argues in the book 'This is my blood' (Tin Sheet) that the annual market for periodic protections (pads, tampons, menstrual cups, reusable wipes) represents 26,000 million euros. "That is, the equivalent of the GDP of Bahrain, an oil archipelago south of Saudi Arabia that will undoubtedly be delighted to know this data."
Migraines, breast swelling, bloating, leg swelling, acne breakouts, muscle pain, nervousness, appetite changes, fluid retention... These are some of the symptoms that affect women who suffer from premenstrual syndrome, caused by an excess of estrogens when there is a deficiency of progesterone in the second phase of the menstrual cycle.
Olga Ocón, a gynecologist at the Hospital Universitario Clínico San Cecilio, maintains that premenstrual syndrome can have severe psychological effects that result in a deterioration in quality of life. The most severe forms of premenstrual dysphoric disorder (a severe and sometimes disabling form of it) are treated with antidepressants, which offer good results between 40% and 60% of women after between 12 and 18 months of treatment.
As the neuroendocrine bases of premenstrual syndrome have been little investigated, many of the mood variations were attributed to women's rejection of their menstruation, or to their "hysterical" nature, says Valls. "Still today many are rejected by medical professionals if they dare to explain the symptoms related to the menstrual cycle."