Rosie

Brief Outline:

Rosie is 18. Her periods were manageable for the first 2 years, but then became extremely painful. For the first two days of her period, she has to be in bed and frequently vomits and faints. This has impacted on school, exams, and social and sporting opportunities. Her education in school was factual, but didn’t really equip her to manage the reality of her periods. She has had one phone appointment with a GP about her periods, but wasn’t sure about the treatment she was offered because she was worried about side effects, and so decided not to try it. She reflected that her experience of not feeling listened to has put her off going back or trying again, and would like doctors to hear young people, and offer options for treatments and explanations about these.

Rosie was 11 years old when she started her period. She was grateful that her mum (a nurse) was prepared with supplies at home for her and regarded it as normal and ‘not a big deal’.

I got my period when I was 11, which was younger than the girls around me, and I was one of the first of my friends. But obviously, there were girls in my year who’d like had it for a long time. So, I was kind of in the middle of it, and it was kind of average when I started, so it wasn’t like I had no idea what they were, I did. And then... well, I’d been out with my dad at this sort of like show thing, and I came home and it was quite late at night and I’d started my period while I was there and not noticed, so I just told my mum, and she was like: “OK.” And she had bought me already just like you know the Lillets, like little teenage pads. So, she’d bought me some of them, so I just had them in my cupboard, and I just put one in and went to sleep. It was sort of like not a big deal, like not a coming-of-age moment, I just sort of like went to bed, so... I think with my mum being a nurse, definitely, it was sort of not a massive thing; she just treated it like it was normal. And I am grateful for that because it would have been like scary otherwise.

As well as intense period pain, Rosie vomits and sometimes faints with the start of each period. She has developed her own system which includes sleep, paracetamol, hot water bottles and pillows lining her path to the bathroom at home.

Can you tell me about your systems?

So, if I know I’m gonna start my period, I will take... I get cramps for a week before in varying intensity. And that’s actually happening right now. So, what I do during the day is after every time I have food, or I drink water, I take paracetamol, and then if it gets worse, I’ll have a hot water bottle. And that’s during the week before. While I’m actually on my period, I just sort of shut myself in my room, and I have alarms that go off for me to wake up and make another hot water bottle, have some more painkillers, drink some water, then go back to sleep, for the first day. And I sort of have... you know, I leave my door open, I have a bucket next to my bed in case I’m sick. There’s a... like a sort of path of pillows into my bathroom, so if I faint, I don’t like, you know, knock myself out by accident. It’s kind of sort of, yeah, like foolproof plan, really. And then after that, life is back to normal, so... That’s what it does. I get cramps for the week before, I have the week on my period, which is sometimes a week, sometimes longer, and then, yeah, after that I feel emotionally rubbish for the next week. So, there’s a one-week-a-month where I’m symptomless and like, so normal, and then hell resumes again for another three weeks, so...

OK. So, a kinda whole... and pretty much most of them are a lot of the month.

Yes.

And you describe it as kinda hell resuming.

Yeah, it’s sort of like either one thing or another, like it’s all... there’s never any sort of like let up. But then sometimes my periods are irregular, which is... I was supposed to get it on the eighth of this month, and I’m still having the pre-cramps, but I haven’t actually started my period, so I don’t know what’s going on.

How did you kinda come to develop that system?

It happened every month. And the first time it happened, I had no idea what was going on, and I thought I was like sick, I thought I had like food poisoning, but it is just from like sheer pain. It’s like pain induced rather than it being like symptoms separate from. So, if I can sort of reduce the pain, like actual cramps, then I figure that the other symptoms kind of like let up a bit. So, I let myself sort of sleep until I need to like, you know, medicate a bit more, and then usually that works much better.

So, you’ve noticed that if you can get on top of the pain a bit, then some of the other things feel a bit better?

Yeah.

OK. So, you’ve developed this kind of very careful system, and so... with including pillows going to the bathroom in case you faint?

Yeah, that’s kind of a new one. Yeah. So, if I’m sick, usually I feel really lightheaded after and I have to like sit on the floor, but sometimes I do faint, and I like hit my head, so I kind of just have a little cushion around my neck that I keep with me as well.

Rosie had period pain and vomited before her GCSE RE exam. Her teacher asked if she could still sit the exam.

No. And one time, I did start my period before my RE GCSE and I nearly didn’t sit the exam because... well, so they let me come out of the room... Basically, our sixth form was like Alcatraz and they made us like do like a session beforehand from like seven in the morning until the 9am exam. So, I was in that, and I was crying, I begged my teacher: “Please, like, let me leave,” so they did. And a head of staff, or someone, came and got me and left me in a room by myself, and I was like: ‘OK.’ I fainted in the room. And a slightly nicer member of staff came and she gave me some apple juice and like a bar of chocolate before. And then they rang my mum, and she came into school to sit with me, and I was being sick into a bu... like I was in the process of being sick, and the head of sixth form was asking me if she thought I could still sit the exam. And then my mum shouted at her. But there was quite little in the way of understanding about periods at school. I’d said to one of my science teachers where I’d said, you know, like: “I think I’m gonna faint, can I... you know, sit outside or maybe get some air?” and he went “no”, so I just had to stay in the lesson. Yeah, but at the times I have been at school and started my period and had the first 2 days, I usually either come home or don’t go in at all.

Period pain meant Rosie missed out on a family trip to celebrate her Grandmother’s birthday because she did not feel she could travel in the car for a long journey.

Would your period get in the way of doing things like that now, do you think?

Definitely, yeah. I did quit football and rowing. Well, I quit football to do rowing, and then I quit rowing because it was lockdown and we couldn’t go on the boats, or anything, so there’s no point, really. I still walk with my Dad, but I do have to cancel events for my period. So, it was my Grandma’s birthday who lives in [place name] and we had like a two-and-a-half hour drive from there a couple of months ago, and I couldn’t go ’cause my cramps were so bad, I just literally, I just couldn’t get out of bed. And I couldn’t imagine sitting in a car for two and a half hours, you know, like feeling like that, so I just said I... I... I couldn’t go.  But yeah, it probably would get in the way, especially with your physical activity, sports.

Rosie explains how her experience of periods and periods pain felt “isolating”.

It is sometimes sort of isolating if you’re the only person you know who experiences it, and you haven’t really been taught about it at home either. There can be some sort of like... yeah, you can be a bit fearful, even that you’ll be seen as, you know, different, or other. And you are made to feel like that sometimes. But yeah, it is understandable, obviously, and we’re sort of made to feel like it’s a dirty thing that we shouldn’t talk about. But yeah, I’ve never been sort of that way myself.

Rosie learned about the biology of periods, but not about cramps or the ‘physical experience of a period’. She had to find that out for herself.

And it became sort of like... I don’t know, we got taught about it in Biology, in a very sort of like inhuman way, and there was not... you know like a picture of a woman, and we didn’t get taught what, you know, pads were, but it was just like, literally, like cycles of hormones and things, which was weird. But I kind of... you know, by that age, we all already knew what it was, and we’d figured out for ourselves, so it was all right. But interesting that none of the boys would be able to sort of like help some... or like another girl, because they hadn’t been taught anything.

Yeah. I’m interested that you say it felt inhuman.

Yeah, there was never sort of any personality tied to it. There was no sort of like humanity and was quite, you know, cold and reified, sort of like you were kind of just... it was just like a picture of a womb and then ovaries and you were like: ‘OK.’  But there was no sort of... it was just like how we were taught about the digestive system, or brain cycles, and things like that. It was just like just another thing that was like biology, rather than it being something that affected your life, or that was like, biologically, like already happening to you. I’m not explaining it very well.

No, you are actually explaining it absolutely... you’re explaining it really brilliantly and really clearly. So, it was almost, it was objective, but it didn’t relate to your experience. And I think you’re saying that it also made you think that it maybe wasn’t equipping the boys to know how to support someone, or what it might feel like. Have I got that right?

Yeah. We were never taught about cramps or like a physical experience of a period. It was literally just the biology behind it and why, or like at what point in the cycle which hormone correlated with menstruation or the like ovulation, and things like that, there was never any... Again, no-one ever taught us about what cramps were. No-one taught us about pads or tampons and which one to use. There was never any kind of even like pain relief advice. There wasn’t any of that, which was strange. And we all had to kind of find out ourselves.

Rosie borrowed a book from the library about growing up, and that was how she had learned about periods when she was about 8 or 9.

So, you said you had to kinda find things out yourselves.  Can you tell me a bit about that, kinda where you looked or what you found and what that was like?

I had a family who was like obsessed with the library. So, my dad would take us every Saturday and I’d sort of take out the American Girl doll books that were like ones about growing up. Or like, I don’t know what American girl scouts is called, but it was there was like sort of information books about like, you know, how to... cute hairstyles, or whatever, and one of them was about periods, and I was like: ‘OK, I’ll read this one.’ So, I did. And that was maybe when I was about eight or nine. And obviously, it feels very grown up and like something that you should look forward to.

Rosie finds that paracetamol with ibuprofen works best for her, but needing to have a full stomach to take ibuprofen can be difficult if she is vomiting.

Paracetamol’s the way to go, I think. And ibuprofen. But I don’t like taking ibuprofen either because you have to have... you have a full stomach to be able to have them. And usually, I’ve been sick about four or five times, so there’s not much in there.

Yeah, I can see that would be tricky.

So, I would say paracetamol with ibuprofen works the best for me, but that’s in the circumstances where it’s day two and I’m not having to lie in bed and be sick and I can, you know, have some food. Sometimes when I’m feeling a bit better on like sort of afternoon-ish, I’ll have dry cereal and I’ll have an ibuprofen. Yeah, sort of normal painkillers is what I usually turn to.

Now as you said, you've got a system.

Yeah.

Rosie looks out for her younger sister in school, and tries to be there for her when she asks for advice as well as supporting her with products at school.

Now, I think... well, there’s only one younger girl in my family, but when I got my period, she was quite scared ’cause she didn’t know what to expect, and I was just like... Well, whenever she has cramps, or whatever, she comes to find me in school and I give her paracetamol, or whatever, or... and she always knows that I have pads on me so that she can come to me. But it’s not like... and it’s never been presented to her as like something that’s a coming-of-age moment, because I don’t think it is, and it shouldn’t be treated as such. But yeah, she was like: “Can you give me advice for when I start my period?” and she’s like quite a few years younger than me, and I was just like a bit confused.  ’cause I’ve never understood why it was treated like that, or why, you know, anyone look forward to it, so I just thought it was a bit scary.

Rosie grew up with an expectation of keeping periods hidden. She thinks it is important to talk about them because of the difficulties they cause her.

But...  Yeah, I guess with my Mum, she’s always felt like it’s something you need to keep to yourself. But she grew up with three sisters and her Mum, and her Dad was the only man in the house, so I don’t understand why she feels like that anymore. But my house now is two boys and two girls. And I just think if it’s something we’re subject to and we have to go through it, and it’s horrible, I feel like we have bragging rights and that we should just be allowed to say whatever. And I will always say that I’m on my period or I’m... you know, I’ve got cramps, or I’m gonna start my period soon, to my Dad, and it’s not sort of like a crazy thing and I’m not treated sort of like I should be quiet about it. But I feel like the only reason they think that is because I’ve earned it because of how bad my periods are. So maybe it’s different.

Rosie thinks it is hard to “convey” pain, so instead she explains that she faints and vomits and is bedbound when she has period pain.

And so... so how did you find explaining the pain and... and...?

I can’t... usually when I’m asked about it, I’ll just explain like the physical symptoms, rather than like how painful it is, because you can’t really convey pain to somebody. But also like, I guess, it’s less believable, or like it du... you can’t conceptualise how much it hurts, least of all if you’re a man. So, I tend to sort of say that I faint and vomit and I’m bedbound rather than I have really bad pain, because like physical symptoms are more likely to like get you listened to. Yeah, so that’s what I explained to the GP.

Rosie hadn’t heard about PCOS (Polycystic Ovary Syndrome) or endometriosis until she could access the internet. She didn’t want the focus to be on her weight if she saw a GP.

I think yes, in that no-one sort of talked about the different severities of periods, and like the most we would learn was that some people had, you know, like a three-day period and some people’s lasted a full week. But even that wasn’t true because some people just have like two days of bleeding and that’s it for them. Then some people... like I sometimes bleed for more than a week, which I know isn’t regular, but it happens sometimes. Also sort of illnesses that affect your period, I would have liked to know about, like, you know, endometriosis or PCOS. I didn’t know what they were till I had sort of like access to the internet, really.  And I’ve never considered going back to the doctor for it because, you know, if you... So, like if they suspect you have PCOS, you go and they say lose some weight and then, you know, it’s not really supported, or like a productive environment where you feel like you come away and have sort of like something that you can rely on or that makes you feel better about having gone there.

So yeah, discussion of why periods are so bad and that there might be actually something underlying, and support with that would've been helpful.

Rosie was offered a medication that she decided she did not want to take. She didn’t feel she was heard or given other options. This has influenced her thinking about whether to go back to see a GP about her periods and period pain.

I guess for health professionals and teachers, I would kind of have the same advice of sort of like... especially men, that I’m not too empathetic towards, but if you are dismissive of somebody who, you know, it’s obviously taking them courage to come to you and ask for help, it’s probably going to affect how they view reaching out for help for the rest of their life. And it also could completely change their sort of quality of life, especially for health professionals, if you listen to them.  And I think sort of like female pain shouldn’t be viewed as something that is intrinsic to women and that is normal, because it’s not, and to have sort of like this presence of like constant pain in your life, it’s very difficult and something that all women are always gonna sort of struggle with, and to be dismissed is scary as well, because it’s sort of like confirming that this is something that has to happen to you for the rest of your life. It’s difficult.

Rosie was worried about the side effects of medications, and thought she might try the hormonal implant. When she called her GP, she was only offered tranexamic acid. Having looked into it, she decided she didn’t want to try this medication.

But I’ve had one GP visit about how bad my period cramps are, and it was on the phone, and she just said, “Have you heard of tranexamic acid?” And I said, “No,” and she sent me a link to look at what the tablets were. And she said, “Well, we’ll do that then,” after like, you know, not much sort of talking about it or explaining what they were. She said, “I’ll send you a link, read that and I’ll, you know, put you down as a, like, prescription and you can come and get it,” and that was sort of the phone call.

And I read this sort of information page that she’d sent me. And I didn’t really want to go on it because one of my other friends had been on it for period pain, and she said it didn’t work for her. And reading the side effects, I’m sort of like always apprehensive of, if this isn’t gonna like drastically change anything, I’m not gonna risk anything. So, you know, they kind of asked me if I wanted to go on Accutane for my acne earlier and there were, like, horrible side effects, like strokes, and I’d have to go on birth control as well because of, you know, sort of it causes birth defects.  So, I was just like, I’m not bothered enough about my acne to like risk all these things. I’m quite functional, you know, a practical person. But yeah, so...

And... but did ever try... did you ever try the birth control for your...? No, and... and that wasn’t offered for your periods?

No, she just said “tranexamic acid.” And she was like: “’cause that’s what we usually offer the first time,” and she’s like: “if that doesn’t work for you, I can move you up to something else,” and I was like, you know, a little bit confused as to why I couldn’t have something stronger after sort of explaining all my symptoms, and things like that, so... yeah.

And so... so how did you find explaining the pain and... and...?

I can’t... usually when I’m asked about it, I’ll just explain like the physical symptoms, rather than like how painful it is, because you can’t really convey pain to somebody. But also like, I guess, it’s less believable, or like it du... you can’t conceptualise how much it hurts, least of all if you’re a man. So, I tend to sort of say that I faint and vomit and I’m bedbound rather than I have really bad pain, because like physical symptoms are more likely to like get you listened to. Yeah, so that’s what I explained to the GP. Yeah. So, I had that phone call.  And I said to my Mum that I didn’t want to do tranexamic acid, and she said, “OK.” Because I’d meant to ring her to ask for the insert or, you know, just—

You mean the implant thing?

Yeah, just for my arm, because I was too scared to get like an actual IUD or, you know, have tablet birth control because I’m very scared of side effects.  And that’s like a big thing for me. I’m very scared of medical sort of, you know, unnatural things happening in my body, because I already have really bad periods, so I think... And then some people say it makes it worse or, you know, their periods are more heavy, and I’m just like: ‘Oh, my God, I can’t imagine that happening,’ so I just kind of stay out of it. Yeah, I just sort of let natural... I just let it run its course, even if it is like terrible. ’cause there’s not much sort of advice on what to do with yourself, you know, like if you don’t want to go on birth control, the side effects are too much.

Rosie wants health professionals to respond with kindness and options when young people have the courage to ask about their periods. She worries if young people don’t feel heard, that this might have long-lasting impacts on asking for help.

I guess for health professionals and teachers, I would kind of have the same advice of sort of like... especially men, that I’m not too empathetic towards, but if you are dismissive of somebody who, you know, it’s obviously taking them courage to come to you and ask for help, it’s probably going to affect how they view reaching out for help for the rest of their life. And it also could completely change their sort of quality of life, especially for health professionals, if you listen to them.  And I think sort of like female pain shouldn’t be viewed as something that is intrinsic to women and that is normal, because it’s not, and to have sort of like this presence of like constant pain in your life, it’s very difficult and something that all women are always gonna sort of struggle with, and to be dismissed is scary as well, because it’s sort of like confirming that this is something that has to happen to you for the rest of your life. It’s difficult.

Yeah, so I think just if somebody comes to you with concerns with their menstruation, and it isn’t natural, because anything other than, you know, like cramps and sort of fluctuation in mood isn’t normal and it’s treated as normal or else it’ll become normal.  I think especially with younger people, just to be listened to, or in general, you could kind of, you know, have compassion, but then also sort of like explain steps forward or kind of what you would do to find out if you did have this disease would be helpful, rather than to be just, you know, like sent away, or just general advice with how you deal with cramps, and things like that, because I didn’t get that when I had like, you know, my phone consultation.  So just advice and to be listened to is helpful, I think.