The analysis of a long-term Australian study of period pain and its effects on 1600 teen girls’ regular activities found that around a third of 14-year-olds have experienced serious menstrual pain – defined as ‘very painful’ or ‘quite painful’ – while around half of girls aged between 16 and 18 have experienced it.
The researchers also found that experiencing this level of period pain was linked to girls missing more activities, including school, work, socialising, sport, and exercise.
As well, teenage girls with painful periods were three to five times more likely than those without pain or with ‘a little’ pain to miss school or university.
Co-author of the Deakin University study, Dr Marilla Druitt, says the statistics only verify what she and colleagues in reproductive health have long found in their own experience.
“This is what we see all the time, we know this, but unless you’ve got it documented in a paper, it’s really hard to lobby and change policies in this area,” she tells EducationHQ.
“This is a thing, this has probably been a thing for like, millennia. It’s not a new problem.”
Druitt is an Obstetrician Gynaecologist who specialises in pelvic pain at Geelong Hospital, and for much of her career has practiced and studied treating pain and how it can possibly be avoided.
She believes that better understanding, acceptance and acknowledgement of reproduction-related pain earlier, would have a range of beneficial outcomes.
“When you do gynecology training, it’s part and parcel of normal training – working out what to do for kids and teenagers,” she says.
“I’ve always been interested in that, but after I did my laparoscopic training for endometriosis surgery at Monash about 12-14 years ago, it was clear that so many people did not get better after their ‘endo’ was treated, and that’s when I got more and more interested in the pain.”
She says now she looks after countless people with persistent pain.
“And because it’s an absolute tsunami of people, then you go looking for ‘well, how did we get here in the first place?’“ she explains.
The study concluded that recognising adolescent period pain is important not only for enhancing the girls’ immediate quality of life with appropriate support and interventions, but also as part of early screening for chronic health conditions such as endometriosis.
Highlighting the prevalence of these experiences is also critical for reducing the stigmatisation of female pain, as well as for increasing awareness among medical professionals of how common it is.
“Put simply, if we can help teenagers get treatment faster, then I won’t have so many people in my pain clinic,” Druitt says.
The Deakin University researcher says parents, not surprisingly, are anxious that what has happened to them will happen to their daughters.
“So lots of 12-13 year olds have got bad periods and their mum’s are concerned, because they’ve had endometriosis and it took up to 20 years to get better,” Druitt says.
But while it is clear that parents are across the issue, schools have been slower on the uptake.
In the past they have been what Druitt calls 'pretty hopeless' at addressing this issue, however most are now ‘pretty good’.
“But it’ll depend on the individual school – do they have a nurse? Do they have the PPEP Talk program or not?” she asks.
The PPE Talk Druitt is referring to is provided by the Pelvic Pain Foundation of Australia, and is a fun, medically accurate and age-appropriate information session that incorporates the modern neuroscience of pain.
It’s of benefit to all students, but particularly the many girls with severe period pain, and importantly, to help them know when they should seek medical assistance.
Druitt is a huge fan of the national initiative.
“It’s an amazing schools education program for kids of all genders in Year 10 that we’re desperately trying to get into Victoria, because it’s so good,” Druitt says.
“I’d like all schools to run the PEP talk every year for Years 10, 11 and 12.”
The specialist says for many years schools have had successions of different people giving different talks.
“I think it works much better when you’ve got a high quality product and they come into your school, rather than relying on the people within the school to do, you know, 50,000 jobs, which is what teachers are always asked to do, as well as being expected to do the pain and menstruation education.”
While the Victorian Government is yet to come on board to providing funding for a rollout of the PEP talk in the state, it’s already making waves in Queensland, New South Wales and South Australia due to its effectiveness.
She says, thankfully, health literacy, particularly in reproductive health, is very much on the improve.
“To be able to talk about periods in the media, all of this broader societal change absolutely helps people with the problem, because if all sectors are aware of a problem, then you can call it out and understand it better,” she says.
Ideally, Druitt would love to see nurses who are well trained in looking after period problems in all schools.
“That would be amazing,” she says.
“It would also be amazing if all schools had a standardised teaching program where we proactively ask kids at school about their problems, rather than waiting for them to tell us, because so many of them think that it’s (the pain is) normal, so they don’t complain.”
She said her research has also found that pain will in many cases precede mental unwellness.
“So if you can get in early with treating pain, then you don’t get a bit depressed, a bit anxious, get a bit fatter, stop doing sport, withdraw from activities, and then your mental health deteriorates,” she says.
“So we might have another way in to help keep kids stay well.”
One thing for sure, the expert says, is we can’t rely on medical professionals for change, because there are a plethora of systemic barriers to changing what they do.
“Education is the key,” she says.
“Scandinavia has done it. They’ve done it really well. They nail it with all health things. They turned around all of their sexual wellbeing, STIs, attitudes to contraception ... They did it in a generation, almost.
“You can’t walk down to the milk bar in Norway without being measured – they’ve got really good data – but also they wanted to, and I think there’s a real appetite at the moment in Australia to improve things. So it’s very exciting.”
