What is Menstrual Matters?
Menstrual-Matters is a non-profit online information hub where you can;
- Check- if your symptoms are menstrual cycle-related.
- Track- your symptoms over time (at least 2 cycles), to help your doctor make a more-informed diagnosis
- Manage- your health and wellbeing through evidence-based dietary and lifestyle changes, plus helpful medications
- & Learn- about your body, and how ancient myths and taboos continue to affect the way in which people who menstruate are treated in society
A note for Clinicians and Researchers:
We are developing resources for clinicians and academic researchers. Please sign up to our clinician or researcher email lists to receive updates.
In collaboration with several UK-based clinicians, health associations, and leading research organisations, we work hard to ensure that our products and information are as evidence-based as possible, in line with relevant professional guidelines, and meet with the NHS Information Standard.
We hope to become a certified member of the Information Standard.
Why is Menstrual Matters needed?
Inadequate diagnostic practice
A combination of social, economic, and political factors have resulted in an inadequate diagnostic process to differentiate between 'normal (pre)menstrual changes', the symptoms of various female-prevalent health issues, and those triggered, worsened, or caused by the menstrual cycle.
For example, female people of reproductive age are known to be disproportionately affected (at least 2:1) by chronic health issues that share many of the same symptoms as PMI (Pre)Menstrual Inflammation [1];
- IBS (Irritable Bowel Syndrome)
- Migraine
- Chronic Fatigue Syndrome
- Depression
- Anxiety
- Anaemia
However, patients are not typically asked to track their symptoms over time (at least 2 cycles), to enable a fully-informed differential diagnosis.
In fact, several factors have combined to effectively obscure the role of the menstrual cycle in triggering, worsening, or causing such symptoms;
- The menstruation taboo (linked to the bleeding part of the cycle) can prevent doctors and patients from mentioning, or adequately considering, the menstrual cycle as a potential factor in, ill health [2] [3].
- Cyclical symptoms and other female-prevalent chronic health issues are more likely to be misunderstood, disbelieved, or dismissed by others, including clinicians [4-6].
“I don’t consult [a doctor]… I haven’t bothered again- I don’t feel they understand the problem and it’s so hard to explain.”- Research participant from menstrual symptoms help-seeking behaviour study [7].
“We have evidence that over half of our patients have to see three clinicians before somebody takes them seriously.” -Lawrence Nelson, a gynaecologist at the US National Institute of Health (NIH) [8].
- Time limited (and, therefore, economically pressured) appointments typically force a prioritisation of symptoms to inform a ‘most likely’ differential diagnosis, rather than allowing the clinician to understand the full range, and changing severity, of symptoms, as experienced over time i.e. in relation to the menstrual cycle [9-10].
- A clinical (and public) focus on the psychological symptoms (PMS), obscures the role of the menstrual cycle in triggering, or exacerbating numerous physical symptoms [11-12]. Additionally, the lack of any medical specialisation in the menstrual cycle (other than in relation to fertility, or as a signifier of gynaecological disease or abnormality) undermines its role in a range of female-prevalent symptoms.
So, patients may be misdiagnosed with a chronic health issue (or left without a diagnosis), when, in fact, their symptoms are triggered by their menstrual cycle.
What is the impact of misdiagnosis?
The misdiagnosis, or a lack of diagnosis, of cyclical symptoms can have a serious impact on patients and the healthcare sector; especially in terms of costs, health outcomes, patient well-being, and societal perceptions of female-prevalent conditions.
Misdiagnosis can have a serious impact on patients [13]:
- Lack of efficacy of prescribed medication or treatment
- Prolonged inability to work, or maintain a social life
- Inability to understand, predict, or manage symptoms
- Poor well-being, low mood
For the healthcare sector, this can result in [14];
- Repeat consultation and treatment costs
- A loss of trust between patient and clinician/health service
- Incorrect clinical data
- Inappropriate resource allocation
What’s more, cyclical symptoms are often quite simple to treat, without necessarily requiring prescription medication. Plus, there is a big psychological difference between a diagnosis of a chronic ill-health condition, and one of ‘(pre)menstrual inflammation', especially in terms of long term patient health and well-being…
Finally, by ignoring the physiological causes of symptoms, female-prevalent conditions will continue to be dismissed as somehow entirely ‘psychological in origin’ i.e. the “it’s all in her head” mentality. Studies show that female-prevalent health issues (such as IBS, anxiety, depression, migraine, chronic fatigue syndrome, fibromyalgia, and auto-immune conditions) are more likely to be dismissed as ‘not real’ or thought to be ‘exaggerated’ by sufferers [4- 6], even if the patient is male…
The simultaneous medicalisation of normal menstruation and normalisation of severe menstrual health experiences
The social and political factors described above have also resulted in a strange paradoxical situation. Many clinical guidelines and research articles unintentionally reinforce the sexist idea that the menstrual cycle is somehow pathological in itself. They may do this by vastly exaggerating the prevalence of a menstrual health issue, or by implying that such extreme symptoms are merely the severe end of a ‘normal curve’ of menstrual experiences, rather than due to an underlying health issue in that individual [15].
At the same time, people who do experience severe symptoms are often positioned in a way to suggest that they are exaggerating, or are simply less able to handle the natural and healthy changes associated with the menstrual cycle, even though they typically have some sort of underlying condition in need of medical treatment [4-6].
These twin assumptions are incredibly pervasive and so it is only with careful and critical evidence-based research that we can unpick and redefine menstrual health in a way that does not unintentionally reinforce problematic gender stereotypes. This is why the social and natural sciences are combined in the Menstrual Matters research approach and blogs.
The rise of problematic interpretations of menstrual experiences
Recent years have seen significant growth in alternative therapies and mystical descriptions of menstrual health. While some are harmless and can provide useful alternative cultural perspectives and treatment options, others are simply selling products and services that are ineffective at best, or harmful at their worst [16]. The accompanying narratives about menstrual health typically reproduce sexist beliefs that position people who menstruate as ‘other’, or ‘inferior’ types of humans [17]. Again, it is only with careful and critical social and scientific research that we can effectively counter such narratives.
At the same time, there has been a rise in gender discrimination against transgender and non-binary people. Sadly, such discrimination has also gained traction within supposedly human rights-based political movements, including feminism(s). Misinformed and exclusionary beliefs based on pseudo-scientific premises underpin much of the debates surrounding sex/ gender. For example, people often confuse the terms sex/ gender, female/woman, feminist/ female supremacist.
My own deep political belief in equal human rights (regardless of sex or gender identity, or any other intersecting social identity) provides further motivation to help counter this disturbing trend with evidence-based and inclusive research approaches and content. I am very proud of the why we say ‘people who menstruate’ blog, even though the social media backlash it unleashed was, and remains, deeply upsetting. At least I have the support of the wider menstrual health and rights movement. Menstrual health matters, language matters and fighting social and political discrimination also matters.
References are at the bottom of this page...
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Who is behind Menstrual Matters?
Dr Sally King
In 2013, I started researching the role of the menstrual cycle in ill health after experiencing unexplained nausea and vomiting, and then developing asthma after taking hormonal medication to deal with this issue. The difficulty I faced in trying to find evidence-based and unbiased information on this 'taboo' topic led to the creation of Menstrual Matters. The website helps people to 'check, track, manage and learn about' their cyclical experiences. The blog looks into how menstrual taboos and gender myths directly contribute to ‘bad science’, inadequate medical knowledge and training, and wider social inequalities.
Before specialising in menstrual health research, I spent nearly a decade reviewing and evaluating interventions and policies for several international human rights organisations. I have an undergraduate degree in Anthropology, an MA degree in Research Methods (qualitative & quantitative) and a PhD in Medical Sociology. My recent academic work focuses on the unintentional perpetuation of gender and racial myths in clinical and lay descriptions of menstrual health.
I received an 'impact award' commendation from the Social Science and Public Policy faculty at King's College London- for public engagement activities relating to my PhD. I have recently been awarded the 2022/23 Sociological Review Fellowship- a prestigious funded year to write up my findings in an academic book. Watch this space for related events, activities and content!
