‘You Don’t Have to Live in Pain’: Doctors Debate Period Leave
Period pain is subjective and real - people who menstruate need specific period leave and don’t have to live in pain
(Editor: Prashant Chauhan)
“If men had periods, I can assure you there would be day 1 and day 2 off built into the system.”Dr Munjaal Kapadia, Gynecologist, Namaha Hospital
We’ve often wondered how different the world would be if men had periods. Gloria Steinem’s famous essay, ‘If Men Could Menstruate,’ imagines a radically different world, where men would have great pride as they bleed, it would be considered virtuous and macho even.
“I think we are late about this discussion about period leaves by a few hundred years. This discussion should have started centuries ago, when women had started entering workplaces.”Dr Kamna Kakkar, MD Anaesthesiology
Dr Kakkar adds, “ I've seen women with endometritis, PMS, undergoing hormonal therapy to conceive, severe ovulatory pain, severe migraines. And these are not rare women, these are women who are around us. These are stories of our sisters, our mothers which have been untold so far. And I think the taboo related to periods needs to end.”
Periods are still shrouded in much mystery. From taboos of women being impure and unclean to women being assumed as weaker, these unfounded accusations have caused a generation of women to grit their teeth and bear the pain to prove their worth at work.
But is it time for a change?
Take Women’s Pain Seriously
It is commendable that women used to deal with their pain on their own and work through it. But we need to normalise the idea of resting when required as well.
“Many women are taught this pain is normal, older women went through it and its a part of life. No, it needs to be treated,” says Dr Kapadia. He adds that many things were normalised, like casteism, sexual harassment or ragging - but that doesn't mean they should continue.
Dr Kamna adds another dimension to the debate - women who take an off or complain about pain are often called attention-seeking. Historically, women have been called ‘hysterical’ and medically, women’s pain has remained under-researched.
We’ve been fed a consistent lie - that pain is normal.
“It was considered sinful to opt for anaesthesia for the birthing process.They said that it interfered with the act of God or with nature. That is how women have been traditionally brainwashed into not opting for pain relief. Even now in India, epidurals are yet to catch up as an attractive option for women to opt for painless, normal, vaginal delivery.”Dr Kamna Kakkar, MD Anaesthesiology
So what benefit does a period leave have?
- It will normalise periods and bring the word into workplace discussions - hopefully this will sensitize people to the real issues half the population deals with monthly
- It will normalise the fact that period pain is common. Most women have some form of discomfort and deserve time off
- It will normalise respecting your body and prioritising health
“Women are used to saying we have a stomach ache or a headache instead of directly saying we are on our period and we have cramps. We can ask for a leave when we have other pain so why can’t we call it period leave and take it?,” asks Dr Kakkar.
“The very fact is that for things to get normalised you have to give them a chance to get normalised. You have to begin somewhere.”Dr Munjaal Kapadia, Gynecologist, Namaha Hospital
What Kinds of Pain Is There?
Dysmenorrhea literally means painful periods and can be due to many reasons like endometriosis, PCO, multiple fibroids or adenomyosis, where there is the thickening of the uterine walls.
“Endometriosis is a disease entity where some amounts of endometrial tissue is present where it shouldn’t be,” adds Dr Kapadia. PCO means polycystic ovaries. He adds, “About 1 in 10 women at least suffer from this condition. Because of poor ovulation, or anovulation causes predominantly irregular periods scanty periods, sometimes frequent periods heavy periods, weight gain, skin changes, acne excessive hair on the face, skin pigmentation.”
PCO often causes irregular periods, and so women who get them after a gap of six or four or even two months, can find their next period to be heavy and painful.
“Very often, if clinically you don’t find something it’s so easy to assume that that woman has a very, very low pain threshold.Or making statements like’If you get married this will go away.’‘Once you become sexually active this will go away.’‘Once you have a normal delivery this will go away.’The idea is to investigate, and investigate with a high degree of clinical suspicion.”Dr Munjaal Kapadia, Gynecologist, Namaha Hospital
In other ways, your pain may not be the same as mine - but ANY pain should be treated and doctors need to believe women in pain.
As FIT earlier reported, stories of medical neglect and bias towards women’s pain runs rampant. For example, women in emergency departments who reported having acute pain were less likely to be prescribed opioid painkillers than men. If prescribed, they wait longer to receive them. Women were also seven times more likely to be misdiagnosed and discharged in the middle of having a heart attack.
The idea of period leave is to de-stigmatise periods but also to give agency to women and empower them to take their health seriously. It should not be a choice between health and employment ever.
“There is no threshold.’How painful are you periods?’ is a silly question. It’s painful enough that she comes to you, so that’s enough.”Dr Munjaal Kapadia, Gynecologist, Namaha Hospital
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