What Words Do We Use To Describe Cramps, and Why Does it Matter?
Or, How Do I Tell You How Much This Hurts?
Language is subjective, which is usually something I love - what we both call “blue” we may actually see/experience very differently, that’s so cool! The fact that I cannot get inside your head and see what you see or experience what you experience, that we have to struggle to express ourselves to each other using words or images or sounds in interesting combinations is the whole basis of language and creativity, probably. The feeling of listening to a song or seeing a piece of art and having something inside you go “YES, I recognize that, I relate to that, this has expressed something that is also inside me, and has never been articulated in that way before!” - that feeling of being seen and understood is one of the great joys of being human and alive. But that subjectivity I love in a Boy Genius song isn’t as thrilling in a medical context (yes of course I’m obsessed with Boy Genius, I’m a bi woman in a straight marriage in my mid-30s, JUST LET ME HAVE THIS).
But when it comes to describing the pain of my severe dysmenorrhea (extremely painful period cramps), that subjective part of language becomes a problem. Pain has always been tricky to measure, because it is also subjective! Doctors often use the 1-10 scale - “how much does it hurt on a scale of 1-10, 1 being very mild discomfort and 10 being the worst pain you’ve ever experienced?”. But that and any method that relies on self-reporting has a huge problem: different people have experienced (and acclimated to) vastly different amounts of pain. Also, from what the research on pain has shown, experiences of pain can vary vastly based on physiology, neurology, and even cultural upbringings! Theoretically, two people can be suffering the same amount of pain from the same medical issue, but one person could rate that pain a 3 and the other could rate it a 9. I say theoretically because there is currently no objective way to measure pain - there’s no machine a doctor could hook you up to to definitively say “this is the amount of pain this person is in”. They can measure blood pressure and heart rate and pupil contraction and how much your skin sweats, but all this does is measure the amount of distress your body is in due to the pain you are EXPERIENCING. We are getting into “what even IS pain??” territory, and I simply do not know anymore, so lets talk more about words.
One way we get around the subjective nature of experienced reality is by having commonly used words or expressions for common experiences. We describe a certain kind of pain as “burning”, even when it isn’t literally caused by a burn. It’s called “heartburn” because that’s what it feels like for a lot of people! When we tell a doctor we have a “stabbing” pain, the first thing they assume is that it has to do with nerves being compressed or damaged, because thats how nerve pain tends to be described. When I say “nausea”, I’m referencing a set of physical experiences most of us are familiar with - waves of stomach pain, sweating, saliva flooding my mouth, breaking out into a sweat - even reading that you might have felt some of those sensations! We are endlessly empathetic creatures in some ways, words are cool!
But even though 90% of menstruating people experience dysmenorrhea, and menstruating people make up about 26% of the global population1, we don’t really have a shared language around this pain experience. Sure, we have “cramping”, but personally I don’t think that one word, which we also use to describe a host of other experiences like stomach cramps and calf cramps, is adequate or accurate. I mean, we even have a phrase to describe when a muscle cramp gets REALLY bad - a “charley horse”. We understand when I say “omg I got the worst charley horse in my calf when I was watching Bones the other day!” that my viewing of the classic 2000s forensic procedural series was interrupted by intense, unbearable, surprisingly sudden pain that in retrospect was kind of funny.
But whether I’m having a dull lower back ache thats just kind of annoying, or if I’m in the worst pain I’ve ever experienced, the only word for what’s happening that I can offer to other people is “I’m having cramps”, or “I’m having really bad cramps” - which is such a hilarious understatement.
This is why I started calling my “really bad” cramps Death Cramps to close friends and family. They understood that for me, there were “cramps” (painful, annoying, achey, but bearable), and there were “Death Cramps” (incapacitating, spending hours and hours throwing up, passing out, needing help to get to the ER or urgent care sometimes). These are two vastly different experiences that require vastly different responses and care. But I wasn’t able to use "Death Cramps” with my employers to explain why I had to leave work suddenly, or couldn’t come in, or had spent 4 hours locked in the employee bathroom.
My sister also gets Death Cramps, and recently we tried to explain to each other what the cramps felt like, to see if we were feeling the same sensations. And it was way harder than I expected! I couldn’t believe we hadn’t ever tried to do this before.
Here’s how my sister describes her pain:
It feels like I imagine contractions feel when you’re giving birth, it builds and builds and builds to unbelievable pain, and then there’s a moment of release, a break, and then it builds again.
I have to get on all fours or lean over on something, I can’t be lying down, my body is overwhelmed by all the sensations.
The sensation in the womb area is like an intense squeezing but like if someone was wearing spiked gloves - it’s pressure, but it’s also pain. Squeezing and then stretching it out with spiked gloves.
It’s SO painful and all-consuming. I absolutely could not drive, or walk, or pay attention to anything if I had to.
And here’s how I described my pain to her:
Lots of aching and twinging in my lower back - deep aches, but thats not a big enough word.
Feels hot, and heavy - hot metal. A burning, hard feeling.
It’s like a hot bowling ball is sitting in my lower belly. It’s filling up my whole lower torso from front to back, and it hates me and is angry, and it rolls around when I move and hurts everything it touches
The whole middle of my body is twisting around itself and every time it twists it gets more of my organs in its twist
VERY fatigued - my whole body feels heavy and slow
This feeling of dissociation - floating away from my body when I’m sitting still or lying down. Blunted. Dead. Either in severe pain or dissociating and numb, no moments of normal.
It feels like my uterus and the whole middle of my body is suddenly my enemy - something that is attacking me instead of part of my body and part of me. It’s working against me and it wants to kill me.
I love her description of “squeezing with spiked gloves” - it’s a visceral and vivid picture, and it also gets at that feeling I tried to describe of my body DOING something to me - something is attacking and hurting me.
Here’s where you come in: I have a wish for the podcast. I want to collect examples of people describing what their cramps feel like, and I want to play them on the podcast to see if we can start using more and better words and phrases to communicate the experience of pain we’re having. Because the more ways we have to describe our pain, the more these phrases and images become part of our common language, the easier it will be to understand, empathize, and give a shit about the pain so many people are in.
So start my collection right now - hit reply and describe your cramps with whatever words or phrases feel right to you! If you’re inspired, you can record a Voice Note and attach it to the email reply so I can have the option of playing it on the podcast, but just typing it out is also great!
Forward this email to people you know so we can get as many descriptions of cramps and period pain as we possibly can!
Ok thank you, I’m very very happy you’re on this trip with me.
https://www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-menstruation