Just Take a Painkiller

Read This First

Danger now?

If you or someone you're with has heavy bleeding with fainting, chest pain, a racing heart or breathlessness; sudden, severe pain low on one side of the belly with vomiting or fainting; a positive pregnancy test (or a late period) with belly pain, shoulder-tip pain or bleeding; or a high fever with pelvic pain: stop reading. Call your local emergency number (911 in the US, 999 or 112 in the UK, 999 or 112 in Kenya) or go to the nearest emergency department.

The full list is on the Go Now Card at the back of this book. Photograph it now.

You've probably been told some version of it. Just take a painkiller. Everyone gets cramps. It'll settle when you have a baby. Some women just have heavy periods. Maybe your mother said it, or a teacher, or a nurse at the school clinic. Maybe a doctor said it, more than once, while you sat there with a pad you'd already bled through.

This book is for the woman who has heard that so many times she half believes it. It tells you what a normal period actually looks like, what endometriosis, fibroids and adenomyosis are, why it so often takes years to get a name for what's happening, what every treatment can and can't do (hysterectomy included), and exactly how to walk into an appointment and be taken seriously.

What this book is

We don't judge. You might have spent years coping on painkillers and hot-water bottles, missing days you couldn't explain, planning your life around your heaviest day. That's not weakness or drama. It's what people do when nobody gives them a better option.

We don't soften anything. Heavy bleeding can drain your iron until you can barely climb stairs. Some of the pain in this book comes from disease that grows on your bowel and bladder. Some operations take away your fertility for good. When something can hurt you, we say so plainly, with a source.

We start from where you are. That means we tell you what to ask for, what a good answer and a bad answer sound like, and when to stop waiting and go to an emergency department.

What this book is not

• It is not medical advice or a diagnosis. It can't examine you, scan you or read your blood results. It's here so you can walk into a conversation with a clinician prepared.
• It is not a dosing guide. When we quote a drug label, it's to explain a risk, not to tell you how much to take.
• It doesn't sell anything. No herbal "womb cleanse", no fibroid tea, no clinic recommendations.
• It doesn't recommend surgery for or against you. It tells you what each operation does, so you can weigh it up with someone who knows your body.
• MediQuestAI does not prescribe, sell or dispense anything. The link at the back of this book helps you keep your symptom diary and history in one place before an appointment. That's all it does.

Who it's for

Mainly for you if your periods stop you working, studying or leaving the house; if you bleed through your clothes; if you have pain during sex or on the toilet; or if you've been told for years that this is just how periods are. You might be 16 or 50. You might be in Nairobi, Manchester, Houston or anywhere in between.

It's also for:

• parents of a teenager who curls up on the bathroom floor every month
• partners who watch it happen and don't know what to say
• women who've been told they need a hysterectomy and want to understand every option first
• women trying to get pregnant with painful or heavy periods

How to read it

Read chapters 1 and 2 first. They define normal and give you the words. After that, jump to what fits you.

• Chapters 3 and 4: endometriosis, and why diagnosis takes so long.
• Chapter 5: fibroids. Chapter 6: adenomyosis.
• Chapter 7: heavy bleeding and the iron it takes with it.
• Chapter 8: pain during sex, on the toilet and in the bladder.
• Chapters 9 and 10: medicines, then surgery and the hysterectomy question.
• Chapter 11: fertility.
• Chapter 12: work, school and money.
• Chapter 13: getting taken seriously. It turns the whole book into an appointment plan.

At the back: the Go Now Card, the Period Symptom Diary and Appointment Pack, a glossary and every source.

The boxes you'll see:

• Go Now: signs that mean emergency care, now.
• Ask This: the exact words to say, with a good and a bad answer.
• Myth / What the evidence says: something you've heard, checked.
• The One Thing: the single fact in each chapter that people get hurt for not knowing.

Where are you right now?

• I think my periods aren't normal, but nobody's agreed. Read 1, 2, then 13. Start the diary today.
• I've been told I have endometriosis, fibroids or adenomyosis. Read the chapter on your condition, then 9 and 10.
• I'm exhausted all the time and my periods are heavy. Read 7 first.
• Someone has offered me a hysterectomy. Read 10 before you sign anything.
• I'm trying to get pregnant. Read 11, then the chapter on your condition.

About the stories

Some chapters open with real words from published reports, such as patient survey comments, and we cite them. Everything else is labelled.

Some stories are composites; names and details are changed. No composite in this book contains a real patient's words, a real clinic's name or a statistic. The numbers live in the main text, each with its source.

About this book

This book is educational. It is not medical advice, and it is not a substitute for a clinician who knows your history. If you have warning signs now, use the Go Now card or call your local emergency number. For everything else, take the questions in this book to a doctor, nurse or pharmacist.

*Facts in this book were checked against sources available in October

1. Drug approvals, guidelines and prices change. Check the date on any advice before you rely on it.*

When "Normal" Pain Isn't

"When I first went to the GP as a teenager, I was told I was being dramatic and would get used to the period pain I was having."

"A&E nurses told me that everyone has period pain so take paracetamol and go home."

"I was constantly dismissed, ignored and belittled by medical professionals telling me that my symptoms were simply due to stress and tiredness. I persevered for over 10 years desperate for help."

Those are three real people. They are among 4,371 people in the UK who answered a 2023 survey by the charity Endometriosis UK after they had finally been diagnosed with endometriosis. Their names weren't published. Their stories didn't need to be, because almost everyone in that survey told a version of the same one. On average, it took them 8 years and 10 months to get a diagnosis in England and Scotland, and longer in Wales and Northern Ireland. 78% said at least one doctor had told them they were making a fuss about nothing, or something like it .

Nearly nine years. If your pain started at 15, that's your whole school career, your exams, your first job and your twenties, spent being told it's normal.