Wednesday, November 29, 2006

Menstrual cramps

Natural childbirth advocates make much of the fact that the pain of childbirth is physiologic pain and not a sign that something is wrong. Evidently, they believe that physiologic pain is in a different category than other types of pain and therefore does not merit and should not need to be relieved. Let's look at another type of pain that is also physiologic and shares much in common with the pain of childbirth. I am referring to menstrual cramps.

Not only are menstrual cramps like labor pain, they share the same mechanism. The pain of contractions is visceral pain caused by the uterus contracting to expel the baby. Menstrual cramps are caused by the uterus contracting to expel the old uterine lining. There are other forms of menstrual pain that are pathologic, like the pain of endometriosis. However, menstrual cramps alone are not pathologic, are not a sign that anything is wrong, and appear to be a "normal" part of menstruation.

Let's try a thought experiment. What would you think if you heard some say any of the following, alone or in combination?

Menstrual cramps are not painful.

If you think menstrual cramps are painful it is because our culture has conditioned you to believe that. In nature, no one ever had menstrual cramps.

Menstrual cramps are sexually stimulating.

Menstrual cramps cause some women to have an orgasm.

I would never do anything to interrupt the natural process of menstrual cramps.

Menstrual cramps are a necessary part of being a woman.

Women should use only natural methods to relieve menstrual cramps, like relaxation techniques and hypnosis.

Women who take Motrin for menstrual cramps are not having "normal" menstrual cycles.

Women who take Motrin for menstrual cramps blunt the joy of being a woman.

Women who take Motrin for menstrual cramps interfere with the natural body chemistry of menstruation and therefore cannot have a completely fulfilling sexual relationship with their partners.

Absurd, perhaps? Maybe ridiculous? Possibly offensive? That's what I'd think. I'm sure you recognized that each of these statements is an analogue to specific statements made by natural childbirth advocates about the pain of labor. Is there really anything different about labor pain that makes the analogous statements about it any less absurd, ridiculous or offensive than the above statements about menstrual cramps? I will point out that the above statements have exactly the same scientific basis as the analogous statements about labor pain, that is to say, none. I'd like someone to explain to me what is different about labor pain other than the cultural meanings that a small group of women ascribe to it.


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