By Helen King (regular contributor)

A recent YouGov survey of 1000 British women showed that the majority had period pain, and 52% had found it affected their ability to work. John Guillebaud, a professor of reproductive health at University College London, suggested that the level of pain is almost as bad as a heart attack. Have women always suffered pain? This early twentieth-century advertisement for ‘Hall’s Coca Wine‘ is one of many types of evidence suggesting that they did; the tonic is effective for a range of conditions including ‘sickness, so common to ladies‘, a form of shorthand for menstruation and its associated pain.

Pain, like everything else – including menstruation itself – has a history. However, pain is very difficult to measure – there isn’t a ‘pain thermometer’, which is why patient questionnaires work on ‘is it better or worse than it was?’ rather than trying to compare one individual with another. If you rate your pain now as ‘8’, what matters isn’t whether your ‘8’ is the same as someone else’s, but whether next week you’ll put it above or below that personal baseline.

Labor pain

Women’s bodies have particular pains which men can’t experience: labor pains and period pains. In the eighteenth century, the obstetrician William Osborn wrote of ‘the calamitous condition of the [female] Sex, who at all times of parturition, are exposed to the severest bodily pain’. We have records of women’s comments on the level of pain experienced while giving birth, including those transmitted to us by male physicians; nineteenth-century women used words like ‘grinding’, ‘cutting’ and ‘sawing’ to describe what it felt like. In the mid-nineteenth century, in a lecture on the role of ether in childbirth, William Tyler Smith expressed the view that ‘No human suffering, perhaps, exceeds in intensity the piercing agonies of child-bearing’.

However, pain was seen as a necessary part of the process with some men even suggesting that the pain should be encouraged, because crying out in agony took some of the pressure off the womb. And, notoriously, as late as the nineteenth century some considered that labor pains were part of God’s purpose, reminding people of the ‘curse of Eve’ for offering Adam the apple in the Garden of Eden (Genesis 3:16-17). Those physicians promoting pain relief countered these Bible verses with others, such as James 4:17, ‘Therefore to him that knoweth to do good and doeth it not, to him it is a Sin’, which Sir James Young Simpson – pioneer of chloroform in childbirth – put on the title page of his 1847 Answer to the Religious Objections.

There are interesting questions here about whether the expectation of extreme pain was based on the fact that, by definition, medical practitioners saw those for whom things were not progressing normally. Some male writers went the other way and idealized menstruation; for example, Granville Stanley Hall, who in 1904 wrote that ‘The flow itself has been a pleasure and the end of it is a slight shock’!

Menstrual cramps

Questions about medical practitioners’ expectations apply even more to period pains. Simpson considered that these too should be treated, recommending blood-letting, warm baths and fomentations, enemas and sedatives – the latter including opium – as well as treatment between the periods to relieve any underlying inflammation or congestion. Different theories as to what caused the pain existed; was it due to the blood being ‘too thick’, to an obstruction, or to the veins which send the blood into the womb being stretched by the sheer quantity?

Here, too, women’s voices can be heard even in male-authored texts. In her book Maids, Wives, Widows: Exploring Early Modern Woman’s Lives 1540-1714, Dr Sara Read noted a passage in Helkiah Crooke’s Microcosmographia (1615)

Between the kidneys and the womb the consent is evident in the torments and pains in the loins which women and maids have in or about the time of their courses. In so much as some have told me they had at least bear a child as endure that pain; and myself have seen some to my thinking by their deportment; in as great extremity in the one as in the other.

This explains why pain can be felt in other parts of the body; there is ‘consent’ or ‘sympathy’ between the organs. One way out of experiencing period pain was to get pregnant before your first period, and this was thought to be good for the baby as well: The English Midwife (1682) states that ‘if a virgin conceive before her first flowers [a traditional word for periods], it proves lusty and perfect child’.

After women’s roles started to change following the First World War, and in the popular literature of my mother’s day, the expectation of pain was played down in favor of the image of the girl who simply needs to ‘take things a little easier during those days’, the phrasing of a 1930 booklet for girls, Mary P. Callender’s Marjorie May’s Twelfth Birthday (a marketing device for Kotex pads). A similar message is promoted today, for example in the information campaign linked to the marketing of one brand of sanitary towel, which mentions cramps, tiredness and backache but emphasizes ‘stretches’ and ‘a positive mindset’.

And in the fifth-century BCE…?

It’s harder to tell what expectations were if we go even further back in time. In the Hippocratic corpus, the treatise on the diseases of young girls describes the first period as a difficult time but, in the alarming list of symptoms, pain as such does not feature. The ancient Greeks believed that the blood needed to make a passage through the veins to the womb, causing pain, but we could read the texts as suggesting that this process was expected to become easier – and therefore less painful – as the girl grew older. Giving birth was seen as a cure for period pains because it ‘opened up’ the body even more.

But, of course, ancient Greek women weren’t in the modern workplace! Elite women could simply let their slaves and servants get on with their jobs. Poor women would still have to collect water, do housework or go to the market.

For women from the late nineteenth century onwards, including those today, who’ve wanted to be taken seriously in the workplace, it’s important to play down period pains; we need to show that women shouldn’t be excluded from various roles in society simply because they are women. It may be significant here that one of the first women physicians, Mary Putnam Jacobi, argued in her The Question of Rest During Menstruation (1877) that normal women didn’t need to rest during menstruation. But I do wonder whether this view may have led to what has turned out to be an unhelpful denial of the reality of period pains.

Periods hurt in the past, too; maybe what’s new isn’t the pain, but a greater willingness to admit to suffering it. Mary Putnam Jacobi urged employers to allow women to rest during their periods if necessary: and that’s precisely what some women are suggesting today.

To find out more:

Helen King, Midwifery, Obstetrics and the Rise of Gynaecology (2007)

Sara Read, Maids, Wives, Widows: Exploring Early Modern Woman’s Lives 1540-1714 (2015)