The Management of Chronic Gynecologic Conditions During COVID and Beyond - Episode 13

Effect of Pelvic Pain on a Patients’ Quality of Life

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Supported by: AbbVie

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Expert gynecologist discusses how concealment of pelvic pain and abnormal bleeding impact women’s ability to seek treatment thus affecting their quality of life.

Ayman Al-Hendy, MD, PhD: If you can speak to the key factors that make a patient reluctant or want to conceal their symptoms like pelvic pain and heavy menstrual bleeding, and how would that really affect their quality of life and mental health?

Stacey Missmer, ScD: Absolutely. So a bit is embarrassment; a bit is there’s some really interesting data around student athletes, and that student athletes are more likely to hide and feel anxiety around menstrual issues because they’re afraid of it being seen as a weakness or being afraid of not just not being able to participate, but actually afraid of that perception that they’ll be either seen as a weakling on the team, for example.

A key thing in terms of emerging is around the gender issues of taking the boys to 1 room and talking about sexual health and taking the girls to another room and talking about sexual health, and there’s not an overlap there that increases misunderstandings and stigma. Also breaking down our euphemisms, like “the curse” for menstrual pain. Pantone, the paint and color company, just this past month came out with the color of the year; is a red color they’re calling period. It’s amazing what is emerging. Last year, the short-form documentary that won the American Oscars was about menstruation and menstrual hygiene in India. The more those things are public, just like we’re very comfortable accepting now erectile dysfunction commercials on television and our children for a decade now have been exposed to that dialogue, the more we can have the public discourse around menstruation being a perfectly normal thing and pelvic pain being no different than if an athlete has an elbow injury that’s impacting [them]. It should be just as normal to discuss the elbow injury impacting the tennis player as it is discussing pelvic pain.

Ayman Al-Hendy, MD, PhD: Fantastic. Some of these brought me at the society level, but how specifically, at the woman level or the patient level, can we encourage them to communicate better about these symptoms of pain and heavy menstrual bleeding? I’m going to go to you, Linda, in a second. How can we do the same from the provider side? We’ll start with you, Stacey.

Stacey Missmer, ScD: The critical thing is again, those school curriculums around sexual and menstrual health, around school nursing. Now a lot of schools, unfortunately, less and less schools in the US have a school nurse. Also very much so on the kind of collagist radar which Dr Bradley will speak to but also that at the family practitioner level. It should be part of the normal routine well-check visits to be asking about menstruation and menstrual health. It should be just as normal as asking the standard questions for patients who are approaching puberty. It should be completely toned in a way that this is just a normal part of discussion, with parents present and expectations that visits during this time period of adolescence will have a conversation and questions about. Just like with small children; they ask you every time if you’re using car seats, and for adolescents, there really needs to be questions about menstrual health routinely.

Transcript edited for clarity.

ABBV-US-00348-MC v1.0 Approved 04/2021