Dr C’s check-up: “In pain? Don’t be fobbed off!”

A two-year independent review that looked into the vaginal mesh scandal says women’s pain is routinely brushed off. Dr C explains how to get yourself heard when you need help

Anew report has revealed that women are routinely brushed off, patronised, and told they’re overacting when they ask for help with pain. The report was specifically looking at vaginal mesh, but it’s part of a bigger problem when it comes to pain, particularly gynaecological discomfort, and has clearly shown how often female pain is dismissed as “women’s problems”.

DON’T ASSUME YOUR PAIN IS ‘NORMAL’

I like to think doctors are more aware now than they used to be, but because this problem has been around for so long, it’s potentially put women off asking for help. Also, women only know their own experience of pain, so they may have terrible discomfort when they have their period but just think it’s “normal” and is how everybody feels, when they could have a serious – and treatable – condition like endometriosis.

ASK FOR HELP – AND A SECOND OPINION

If your period pain – or any pain – is impacting your quality of life, see your doctor. There will be things we can do to help, or there may be another health problem going on that we can diagnose and treat. If you never ask your doctor, you’ll never know. If you feel your doctor isn’t listening and you’re in terrible pain, ask to see somebody else. It doesn’t put my nose out of joint when people ask for a second opinion, so your doctor shouldn’t mind either. With things like gynaecological problems or chronic pain, there are associated societies too, like

The British Pain Society and Endometreosis UK, so go to their websites to read up. They have expert advice, lists of specialists, and they share patients’ experiences. It’s a good way to get informed. The only thing I would be wary of is angry chat forums, which I don’t think help.

FIGHT YOUR CORNER

Chronic pain conditions, so things like fibromyalgia and painful bladder syndrome, disproportionately affect women. We don’t know why but I suspect it’s because hormones play a role in pain. Women already feel pain more during certain times of the month, so I suspect it’s tied in with that. One problem women can face is that if you go to your doctor with an ongoing pain condition, you can get labelled with that condition, and then everything you ask about is seen as part of it. If that feels like it’s happening, argue your case, and again this is another time when a second opinion can be helpful, or ask to be referred to a specialist.

It’s one of the few downsides of having a family doctor, a bit like how you don’t notice your hair growing until it gets to a certain point – your doctor can get used to the types of problems you have. Whereas if someone new sees you, they have to ask a lot of questions and assess you afresh – that’s the argument for a second opinion.

STRETCH YOUR BODY

It used to be thought that if you were in pain, you should stay still, but that’s definitely not the case now – it’s good to stretch, exercise and keep your body moving. It depends on the pain, of course – if you have terrible period pain and you feel like curling up on the sofa with a hot water bottle, then do so. Do what your body needs. For things like pelvic pain, or chronic pain, stretching and exercise is helpful, so things like yoga. If you want to try something like reiki or acupuncture – and if you can afford it and you feel it helps – go for it. Just don’t do it instead of asking for medical help.

RESEARCH ALTERNATIVE OPTIONS

People may think that, even with a diagnosis, there aren’t many options to ease pain besides painkillers, but that’s not true. The NHS has specific pain clinics with specialists. If it’s a gynaecological issue you’re suffering with, a gynaecologist ought to be able to sort it out. You also get sub-specialties within sub-specialities, so gynaecologists who are specialists in pelvic pain only, for example. It may take some time, but the NHS is good at putting you in front of the right specialist, so don’t be afraid to ask.

KNOW YOU AREN’T WASTING OUR TIME!

Because of the pandemic, people are worried about taking up NHS time, but that’s led to a big backlog of health problems so don’t think that way – ask your doctor if there’s a specialist you can be referred to.

SEE WHAT WORKS

There’s a lot of marketing behind CBD (cannabidiol), but the evidence isn’t overwhelming. It’s fine to try it, and if it works for you that’s great, but if it’s costing you a lot of money, that could make you stressed and stress adds to pain. Sleep is important too, because it’s when your body regenerates and repairs itself. That’s the horrible irony, because if you’re in pain you’re not sleeping well, and if you’re not sleeping well, the pain gets worse. It’s another reason to look for treatment, and to try to make your bed and pillow comfortable.

IT’S OK TO TAKE PAINKILLERS

There have been a lot of dramatic headlines about us all being “hooked” on painkillers, and doctors over-prescribing them, but I don’t agree and I think it stigmatises those with chronic pain who need these medications, like codeine. Some people need to be on strong painkillers for a long time, so if you’re suffering, don’t be afraid of taking tablets. It’s very wearying to be in pain all the time. Let us help you. Even if you do become a bit dependent, it’s OK – it’s not a street drug, we know exactly what’s in it, we know how much you’re taking; it’s all regulated and we know how to manage it. You can also get prescribed antidepressants for pain, but if the doctor doesn’t explain that properly, people can get disgruntled because they think they have been wrongly diagnosed with depression.

DON’T ACCEPT PAIN

Things like SSRIs (selective serotonin reuptake inhibitors) are known as “atypical” antidepressants, so we use them more often for pain than for depression. That’s because pain is a sensation felt in the brain, so painkillers change brain chemistry, and these antidepressants do too. If you need painkillers, don’t be nervous to take them. The pain is far more detrimental to your life than the medicine that treats it.