Raising awareness of the menstrual cycle’s role for women’s health

Multiple health conditions are affected by the menstrual cycle, but awareness about this relationship is low – both among physicians and patients – which can lead to misdiagnosis or inappropriate treatment. Therefore, Sally King set up Menstrual Matters, a research and information hub, to raise awareness about the role of the menstrual cycle, and hormonal medications, in female-prevalent chronic ill-health.

King identified this knowledge gap after experiencing health problems herself. She spent over two years struggling with severe nausea and vomiting (incorrectly diagnosed as ‘anxiety’) before independently deciding to track her symptoms, which revealed a cyclical pattern. As a professional researcher, she turned her skills to investigating the role of the menstrual cycle in ill-health after it became clear that there is a distinct lack of evidence-based, and unbiased, clinical information on this topic.

In addition to running Menstrual Matters, King is currently undertaking a PhD in the Sociology of Medicine at King’s College London, where she is writing a thesis on Premenstrual Syndrome. She hopes to integrate clinical research with a critical analysis of historical social factors, in order to explain why medicine has sometimes tended to categorise female-prevalent symptoms, such as those associated with the menstrual cycle, as more psychological than physical in origin.

– Currently, many physicians only consider the menstrual cycle in connection to fertility, or gynaecological, issues. They are not adequately trained on the relationship between the normal functioning of the menstrual cycle, and the triggering, or worsening of female-prevalent symptoms. If a woman of reproductive age goes to the doctor with a recurring upset stomach or abdominal pain, the doctor may provide a ‘most likely’ diagnosis of IBS (Irritable Bowel Syndrome) without ever asking about menstrual cycle or hormonal medication.

According to King, there are various reasons for this. One is the silencing effect of the menstrual taboo, which can prevent patients and physicians from mentioning the menstrual cycle (especially menstruation itself), another is that clinical research and practice is split across different medical specialities. A patient who experiences anxiety and digestive symptoms may be referred to either a psychiatrist or gastroenterologist, depending upon which symptoms are worse – even though the underlying cause could be hormonal, in both cases.

The solution is actually very simple. Asking patients to track symptoms over 2-3 menstrual cycles.

By raising awareness among physicians and the public about how the menstrual cycle can impact and trigger female-prevalent symptoms, King hopes to help reduce misdiagnosis and the over-medication of patients. Knowledge is key here, and the solution is actually very simple. Asking patients to track symptoms over 2-3 menstrual cycles allows the physician to better differentiate between more chronic symptoms and those that are potentially hormonal in origin.

– Once a patient is aware that their condition is perhaps hormone-related, they may start to notice patterns that can help them to manage their health. For example, asthma may worsen around ovulation, or menstruation. If doctors start asking patients about their menstrual cycle and hormonal medication as a natural part of the consultation, they might notice an improvement in their patient outcomes, whilst also helping to reduce some of the unnecessary stigma attached to the menstrual cycle, too.