Helping Pelvic & Period Pain

For so long, many of us have believed that period pain or pelvic pain, is part of our lot in life as women. We take pain killers and push on through, still trying to be as productive as we can be. We can feel betrayed by our body or that we are at war with our body. We have tried so many different treatments to help ease our pain, yet we only get so much relief from our pain or the pain does not improve at all. This treatment can include having laparoscopy surgery. Or the flipside is that for years we sought help from multiple doctors only to have our pain dismissed as “it’s just period pain, take some pain relief and rest”. Or to have it implied that it’s all in our head and to be offered more medication, rather than seeing us for the patient sitting there in the chair asking for help.

We view pain and our periods as the enemy, and being born female is seen as drawing the short straw. Having surgery and hormonal medications offered as our only option reinforces that our bodies are dangerous and not to be trusted.

Getting a diagnosis of endometriosis is often the only way a woman’s pain is validated, and this diagnosis on average takes 10 years. That’s 10 years of not being taken seriously as a woman with pain before finally getting some solid answers.

My own personal journey took 14 years to get diagnosed with Poly Cystic Ovarian Syndrome (PCOS). I also have experienced significant period pain at times, sometimes so bad that it caused vomiting from the extreme pain, yet even a female GP dismissed it as having gastro at the same time as my period.

As women we can feel inherently flawed and broken, so much so that we feel at war with ourselves and detach from our bodies, viewing them as ugly, not worthy, and not having reverence for the beauty of being a woman.

There are several studies now that show that more pain does not always equal endometriosis, and that in some women they can have endometriosis lesions but not experience pain. What is being found in those with pelvic pain is that over protection and fear avoidance is a bigger predictor for pain. What this means is that a dysregulated nervous system combined with a fear of pain, is a huge contributor to the experience of pelvic pain. We need to start looking outside of the pelvis and start looking at our ecosystem and culture. This includes looking at:

·       The brain

·       The autonomic nervous system

·       The gut

·       The immune system

There are several studies showing that social psychogenic (defined as originating in the mind) stress can promote the development of endometriosis. We know that Adverse Childhood Events (ACE) has a huge influence over health status in adults.

When looking at women experiencing pelvic pain, we need to be looking at trauma, which is an event or events or even systems that change our physiology. This includes:

·       During our developmental years- looking at sexual, verbal, physical abuse and/or neglect. Neglect is a big cause of pain, and also includes if parents were emotionally distant/absent which ruptured your attachment as a child.

·       Systems- both schools and the medical system

·       Intolerance of differences- racial, neurodivergence, or being female

·       Technology- never switching off with constant notifications can keep our nervous systems on high alert

·       Beauty standards- driven more so by filters on social media

·       Loss of connection and community

·       Disembodiment- we don’t spend much time in nature anymore and as adults we don’t get enough play time

·       Constant doingness and busyness without being present in the moment and slowing down

·       Loss of the sacred feminine and reverence for the female body

·       Pressures of patriarchal capitalism and neoliberal feminism which combine to mean that perceived success as a woman is being held up to the values of patriarchy= needing to be constantly productive and not being “held back” by our biology.

We need to look at how we can support ourselves and other women, so that we can support our body’s and our nervous systems.

Stress greatly impacts on our bodies. The more stress we experience in childhood the higher our risk for disease and ill health in adulthood. Stress promotes pain and the growth of endo lesions. When we support stress and our nervous system, we are calmer and more resilient but we can also reduce our pain and growth of endo. It’s not all in your head, our bodies are connected as a whole. What happens in one area of the body, impacts on other areas.

Yes, pain is inevitable in life but periods should not be painful, yet up to 96% of women experience pain.

We have a window of regulation (where we are able to cope, process and respond to what is happening to and around us) and the narrower the window of regulation, the bigger the increase in overprotection and fear immobilisation which generally equals more pain.

The more stress, particularly chronic stress we experience, the narrower our window of regulation is. Chronic stress can be from what we are exposed to on a daily basis e.g. sleep, diet, technology, work and school, but it also includes:

·       Developmental trauma

·       Disconnection with ourselves and others

·       Disembodiment

·       Medical trauma- not being taken seriously, having multiple surgeries and/or medications, and feeling like you are not improving.

Fear is the fuel for pain. When we want to get rid of pain this reinforces that pain is bad. Chronic pain is a sign that the nervous system is overwhelmed. Pain neuroscience tells us that pain is a function of fear and learned neural pathways. Fear also includes frustration, annoyance, worry and pre-occupation.

What if the goal of healing pelvic pain is to reduce fear and not pain? How can we start? We start by focusing on the nervous system as it is the fire not the alarm. The alarm is the pain we feel.

There is growing evidence of the role of the vagus nerve in treating chronic pain. This includes pain education, yoga, breathwork, timeout in nature, and movement.

We need to learn how to get curious with our pain and learn how to hold pain without trying to fix it. Regulation of our nervous systems comes through self-inquiry and self-care. For supporting painful periods or pelvic pain, start with:

·       Looking at your schedule. Is it overloaded and overwhelming? Is there anything you can take off your plate? Are you able to have some quieter/rest days during the first few days of your period?

·       Ask what is your body telling you what she needs? Start to tune in and when you get the answers follow through. E.g. she may want a soak in the bath or she might want sunshine on her skin.

·       Ask how you can nourish yourself with movement, food and rest?

·       Do you have a spiritual practice? Can you use this to turn towards your pain e.g. through meditation or prayer?

·       Have your tool kit ready for menstrual pain e.g. hot water bottle, warm cosy socks, ginger tea (great for nausea and pain).

Holistic pain management includes:

·       Embracing your menstrual cycle, rather than viewing it as an annoying thing that is to be endured

·       Viewing your body as whole and complete rather than broken or that it betrays you

·       Seeking out Dr’s and specialists who take you seriously so that severe endometriosis can be ruled out early on

·       Pelvic floor physio

·       Using food as medicine to support your health

·       Reducing inflammation through diet and supplementation e.g. good quality fish oil

·       Using body-mind therapies to reduce central pain amplification

·       Judicious use of surgery and hormonal therapies

·       We have a choice over what therapies we want to utilise, it’s your body and you get to choose as it’s YOUR healing journey.

Our bodies are not our enemy. They are wise and send messages to you from you and when we can understand this and embrace this, we cease to feel helpless and become empowered. Our bodies are intelligent and have the ability to change, we can learn new ways and transform.

Ways to empower yourself include:

·       Connecting to your cycle.

·       Listening to your body

·       Listening to your intuition

·       Accepting we are emotional beings and this is ok, there is a whole spectrum of emotions and it’s ok to express every single emotion, including anger and rage

·       Allowing ourselves to receive help and rest. We don’t have to do it all.

·       Connecting to nature

·       Allowing the seasons of life. There will be times of creation and productivity (Spring and Summer) but these are always followed by turning inward and resting (Autumn and Winter)

·       Being creative

·       Connection- with ourselves, others (humans and animals) and nature e.g. hug a person, pet or a tree

·       Experiencing joy and pleasure. What makes you feel alive?

·       Bring beauty into your life e.g. watch the sunrise or sunset, admire artwork, buy yourself flowers

·       Using mantra’s e.g. I am sore but I am safe and I have a plan.

·       Breathwork

·       Movement e.g. yoga, dance

·       Singing/chanting

·       Somatic therapy

·       Acupuncture

My job as a naturopath is not to promise to take away your pain and fix it, but rather to support the process of teaching you how to come back to yourself to find safety within your body. Yes, there are supplements that can help reduce your pain, but I’ve found in my clinical practice that the best results come from embracing your health journey and learning how to connect with your body. When we reduce stress and regulate your nervous system, a lot of symptoms start to disappear. We start here and this helps to clear the muddy waters so that we can see clearly what else we need to support in your healing journey e.g. your gut or immune system.

Reference

Dr Peta Wright (2023). Healing Pelvic Pain: Transforming the trauma of period pain, endometriosis and chronic pelvic distress.