Pain is more than just physical
Researchers and clinicians often talk about pain as a biopsychosocial experience.
There are three parts to the word biopsychosocial. Each of these parts represents one of the three factors that we know affect how you feel your pain.
- The “bio” part of the word comes from biological. Biological factors are things like your genetics, your hormones, your age, and whether you've hurt a part of your body.
- The “psycho” part of the word comes from psychological. Psychological factors include how you think about your pain, your mental health, your stress, and your coping skills.
- The “social” part means just that social. Social factors include things like how we are taught to express pain, who is around when we have pain, your support system, and your culture.
Biopsychosocial factors all work together to affect how we experience pain. On the flip side, pain relates to all these spheres of our life – it can impact family life, school, social relationships, and so much more.
Maybe unsurprisingly, research in menstrual pain lags behind other areas of pain, such as chronic pain more generally. Below is a summary of what is known about various aspects of life and its relationship with menstrual pain. Some of this information comes from the research in menstrual pain, while some draws from the broader pain literature.
Mental Health
Pain and mental health concerns, such as depression and anxiety, commonly occur together. There is some uncertainty in the research which comes first, but there is consensus that they can each make the other worse.
In teens with menstrual pain, researchers have found that there are more reported symptoms of anxiety, depression, and even self-injury and suicidal ideation. It is not clear whether the pain is causing these symptoms, or whether these symptoms are making the pain worse, but it is likely that both are true.
For example, there is some evidence that anxiety and depression symptoms can make menstrual pain worse, and that menstrual pain can make anxiety and depression symptoms worse. More recently, there has been some research suggesting that menstrual pain early in adolescence is more likely to lead anxiety and depression symptoms later in adolescence, but that the opposite isn’t true. This isn’t to say that all teens with menstrual pain will experience these symptoms, but does flag that many do and it is can be important to consider the role that menstrual pain is having on a teen’s mental health and psychological functioning.
Family and Social Relationships
It is not surprising that experiencing pain can have an impact on social relationships. Many teens who experience pain, not just menstrual pain, report trouble with friendships, especially when they are experiencing pain. This can be due to number of reasons, such as not being able to participate, or perceptions that others do not understand their experience.
Teens have reported skipping events or activities with friends when they anticipate that they might get their period, which can further strain relationships.
Family relationships can also be affected by menstrual pain. How a parent or guardian responds to pain in teens can influence their willingness to bring it up again, share their experience, or their own feeling of pain. Similarly, when there is a family member that regularly experiences pain, this can be stressful for the whole family and can often bring about feelings of helplessness.
School and Extra-curricular Activities
Teens with menstrual pain are more likely to miss school or attend school while experiencing pain. Having pain while trying to learn can interfere with learning and school performance. Missing school regularly can also lead teens to fall behind and struggle.
On a greater level, there is evidence that menstrual pain can have a learn term effect on educational outcomes and career trajectories. Even many adults report frequent missed work due to menstrual pain. This is further compounded by the fact that it can be challenging to explain why you are missing work because there can be stigma associated with revealing that it is due to menstrual pain.
Long-term Pain and Other Pain Experiences
A worrisome finding that is increasingly supported by the research is that untreated menstrual pain can increase a person's risk of developing chronic pain. Researchers are also finding that people with menstrual pain report more pain at other times during their cycle and are more likely to have other pain concerns, such as migraines, chronic pain, and other pelvic pain concerns.