The problem with women's pain

Warning: This post is going to talk about cooters and what lies beyond them.

OK, if you’re still reading:

I saw a tweet last week from a male emergency medicine doctor in his residency. He asked, in a way that seemed kind of shocked, if women really don’t get any kind of pain relief or anesthetic when an IUD (intra-uterine device) is inserted for birth control. Like he was today years old when he realized women’s pain - and so many other women’s health issues - has been completely discounted by the medical establishment for millennia. I commend him for questioning this.

If, like me, you have ever had an IUD shoved up your nethers (because most family planning falls on women), you will not be surprised that his tweet received over 2,500 responses. Most were from women who were happy he asked but indignant about the needless pain they went through. One very, very unwise male anesthesiologist decided to wade into the fray stating most women tolerate the procedure just fine, and there’s just a confirmation bias because we only hear whining from the women who can’t take it. If they don’t say anything, having a device shoved up through their undilated cervix and into their unsuspecting uterus must’ve just been like a lovely sway in a hammock on a summer’s day for them. 

My cervical dramas

I never complained about my IUD pain publicly. I didn’t get one of those doctor’s office surveys afterward. But I can tell you I was on my knees in the hospital parking garage after it was inserted weeping in pain. I was told in advance it would be fine, and I could go back to work afterward. Instead I was calling my husband because I didn’t know if I could drive home with the blinding pain. When I finally got home, I quickly discovered ibuprofen was no match for this foreign object in my womb, one I was told “may cause some mild cramping.” I found the oxycodone I’d had left over from when I was in a car crash and bruised my sternum and ribs like five years prior, and it was what got me through the next 24 hours. Most of the women in those tweets had experiences just like mine. 

According to the Washington Post, “Research also shows that physicians and other providers underestimate women’s pain during IUD insertions. In a study of 200 women, most of whom had given birth, the women reported an average maximum pain score of nearly 65 on a scale of 0 to 100.

The providers, however, rated the women’s pain at about 35.”

I have been told by many physicians and even dentists that I have a high pain tolerance. Like most women, I wonder if that’s just because I grin and bear it. Maybe I feel just as much pain as anyone else, but I keep my mouth shut because who is someone like me to tell the very educated doctor they may be doing something wrong because it hurts? I even tried to stay quiet while I gave birth unmedicated (not really by choice, btw) because I didn’t want to be seen as one of those hysterical, screaming women.      

At least with the IUD, it was a procedure I asked for (albeit without full knowledge of the pain it would entail). Something very different happened when I was 19 years old. I had to get on the birth control pill to take the drug Accutane for cystic acne. It apparently causes really bad birth defects, and despite the fact I was a virgin with a capital V, the dermatologist still insisted I get on the pill. 

To get the prescription, I had to get a pap smear. I would later learn the gynecologist I went to at the time used a very outdated type of pap smear test that resulted in a lot of false positives. It came back as possibly positive for cervical cancer (which if you know anything about HPV, it’s super unlikely to get cervical cancer if you’ve never had sex). So I had to go in for a follow up: A follow-up in which the doctor invited medical students in without my consent while I was splayed open in stirrups so they could all have a look at my cervix through basically a small telescope. Then he took a biopsy of my cervix without asking if I was OK with it - cut a chunk out of it about the size of my fingernail (I saw it floating in the container he put it into) - with no numbing or anything. I screamed. He said it shouldn’t hurt. Then he complained about how much I was bleeding, asked a nurse to put a tampon in me to soak it up and left. I stumbled to the waiting room where my mom was. I cried and told her I felt like I’d been raped. This was my first experience with women’s reproductive health care. 

I never went back to that doctor. 

The hot new thing: studying the majority

Why did doctors think my IUD insertion or a colposcopy wouldn’t hurt? Maybe it’s because we haven’t studied women’s bodies in medicine nearly enough. Did you know women - who comprise 51% of the country’s population - weren’t included in most clinical trials in the United States until 1993?! Heart attacks have different symptoms in women. Hip replacement joints work differently in women. Medications have different levels of effectiveness among the sexes. Women have whole-ass internal organs men don’t that they just assume “shouldn’t hurt.” 

“Failure to study medications and other interventions in a broad sampling of women has contributed to women experiencing adverse effects from medications at twice the rate of men.”  It’s even worse for women of color. 

I won’t event get into my recent visit to the museum of psychiatry in which some of the symptoms listed not so long ago for mental illness in women included “no interest in doing housework.”

Speaking of vaginas …

Another “whoopsie” in terms of not testing things that go in women’s bodies and what effects they might have: a new study just determined pretty much all commercially available tampons contain heavy metals like arsenic and lead. Quoth the news release from U.C. Berkeley on the study: “Tampons are of particular concern as a potential source of exposure to chemicals, including metals, because the skin of the vagina has a higher potential for chemical absorption than skin elsewhere on the body.”

If you are a regular reader of this blog, you will know that Facebook relentlessly advertised period underwear to me a couple years ago. While I was at first grossed out, all those targeted algorithms eventually wore me down, and I gave those washable, charcoal crotch-lined undies a shot. Turns out they’re amazing, I converted, and I’m no longer pumping arsenic up my baby chute. 

Men, this is about you, too

Men, if this was all too much vagina/cervix/period talk for you to handle, that’s tough. Because women’s health is human health. Women’s reproductive organs are how you got here. It’s how your children got here. It’s what your mother, sisters, wives and friends deal with. If they’re not well, if they’re in pain that’s perfectly preventable, if they’re being told “it shouldn’t hurt,” that’s cause for concern for you, too. And if you want to give your lady a promo code for period underwear discounts, hit me up. 

Escaping the Midwest

I love living in Kansas City, but I probably love it the least in January. You’ll get one or two 60-degree days, but mostly it’s just the kind of cold and dark that makes you want to go to bed early. You can go weeks without seeing the sun as one frigid, blah, gray day runs into the next. The only thing to really break it up is the Chiefs winning all the playoff games. And going to the Super Bowl for the fourth time in five years. But I digress. 

One of the best things you can do in Kansas City in January is leave it. So I did! My husband and I celebrated our 15th anniversary last November, and a friend was getting married on the island of Maui in Hawaii on Jan. 13. We decided we’d combine the two celebrations and stay for a week. The grandparents were gracious enough to watch the kids during this time. 

We picked the BEST WEEK EVER to flee the Midwest. It was a frozen hellscape in our absence. It snowed about six inches the day before we left. The Chiefs game at Arrowhead Stadium was the 4th-coldest in NFL history, starting at -4 degrees (Fahrenheit because America) and dropping to -7. And yes, I still had plenty of friends who went. They strapped hand warmers all over their bodies, stood on cardboard and drank beer until they were all warm and fuzzy, in their brains at least. We had a record low of -16, and I had serious concerns about whether my car would start upon our return to the airport. 

But in Maui - oh glorious Maui - it was between 75 and 80 degrees every day. The humidity (which disappears in a Midwest winter and over-appears in a Midwest summer) was enough so I didn’t have to moisturize anything but not at all oppressive. The air-conditioning at our resort went out just a couple days into our stay due to what we were informed was a “fire in the chiller,” and it was only a little stuffy. Hardly unpleasant. Meanwhile, I scrolled through social media posts of friends back home featuring the newest ice storm and bursting pipes. Then I went back to reading my book on the beach. 

Let’s talk about the beach in Hawaii. My only experience with the Pacific Ocean up to this point was in Southern California. It is COLD there. I remember feeling so betrayed. A beautiful, sunny day in June - I’ll just run right in! And then I immediately turned around squealing when the icy water hit my ankles. But in Maui, the temperature of the water matched the beauty of the day. I was so excited. Until the ocean tried to kill me. 

Cliche as it may be, it turns out I like long walks on the beach. Maybe because it’s such a novelty to a Midwest girl. My husband doesn’t like the feeling of sand on his feet, but I love it! The beach was maybe 100 to 200 feet from our room at the resort. I walked on it alone frequently. Sometimes the waves would rush up higher than expected and soak my shorts, but it was part of the fun. Then I decided I wanted to frolic in the waves. I have the most experience with wave pools at water parks, where it beeps before the waves come on and then you bob up and down, bumping into all the inner tubes full of people with much more body confidence than me, based on their size relative to the size of swimsuits they’re wearing. Then you can lay in bed at night, still feeling that wavy feeling. That’s what I wanted, and this beautiful, uncrowded beach offered it. I tried so hard to frolic, but the ocean was not having it. It would suck me under, drag me on the sandy bottom, then throw me back on shore. Over and over. (Because I was stupid enough to keep trying it over and over.) It went like this in my head: 

1. “This is so fun!”

2. “Oh God, that’s stronger than I thought it would be.”

3. “I’m drowning! I’m drowning!”

4. Thud - back on land.

I saw other people doing it and couldn’t figure out why I couldn’t. I’m a decent swimmer. A woman who was at least my mother’s age or older said, “You have to time it right,” then she ran in with aplomb. But my cornfed brain could not get the timing right. Literally bloody and bruised, I finally gave up. I had sand in every possible orifice. My bikini bottom was like a loaded diaper. More than two weeks after our return, I discovered some grains of sand still in my ear. I will now confine my wave frolicking to much more controlled, amusement park environments. 

I expected lovely beaches in Hawaii. What I did not expect were the abundance of feral chickens. They were EVERYWHERE. In the grocery store and gas station parking lots. In the outdoor shopping malls. Strutting along the side of the highway. We also saw a lot of stray cats, all of whom seemed fat and happy. I expect there’s a correlation there somewhere. 

Other than failing at wave frolicking, the most terrifying thing I did in Maui was drive from the west side of it to the east side. We agreed I would drive the whole time we were there because I freak out way less driving in unfamiliar environments. I’m glad my husband has finally come to terms with this fact. The drive to the Pipiwai Trail in Haleakala National Park involved going across numerous cow grates, stopping to avoid aforementioned cows, and going on one-lane roads that wound along the sides of cliffs that plunged to the sea and ancient volcanic rock hundreds of feet below. My husband kept saying, “Oh God! It’s so far down! Oh God! Oh God!” If I had taken my eyes off the road to look, I probably would have felt the same way and killed us both. And if a car came at you around the bend, there was nowhere you could go. Someone had to back up until there was a semblance of a shoulder. 

All in all, however, it was an amazing, childless vacation. We hadn’t been together without the kids for more than 24 hours for at least five years. I got to see some of my favorites friends from around the country who were there for the wedding. My husband and I went horseback-riding in the mountains. We saw baby humpback whales breaching alongside their mothers. We didn’t have to care for our own children. We visited tropical gardens, and I ate probably the weight of my head in tropical fruit. There were no kids. We slept whenever we wanted. We got massages. My work phone was dead. The kids weren’t with us. 

We were, however, right down the road from where the wildfires struck in August. We saw the devastation and memorials. We encountered numerous Red Cross and FEMA workers. Several of the guests at our resort were housed there because their homes had been destroyed. So many of the surviving businesses had signs up saying, “We are open! Please come in!” We did our part in stimulating their economy, but they still need a lot of help. Here’s a great, legit place you can donate: 

Coming home was sad. The USDA screener at the airport made me throw away the apple I’d gotten at the grocery store as part of their rule that you can’t take Hawaii fruits back to the continental U.S. The apple still had the store’s sticker on it saying it had come from California. I’m still mad about it. 

After a full day of travel, we arrived back in Kansas City. We’d arrived on a lucky day - the temperature had spiked to 30 degrees! My car started. Unfortunately, it had gotten some ice on it in our absence, and I’d left the scraper in a different car. As a Midwesterner, however, I’m prepared for just about any weather situation (except hurricanes). I whipped out a gift card I had for a free Chick-fil-A chicken sandwich. My husband didn’t believe it would work, but I knew better. He was pleasantly surprised by how that sucker scraped the ice right off. (This is the same man who didn’t believe bread bags could turn any shoes into snow boots. I have so much left to teach him.)