The Hidden Language of Menstruation and the Silence Around Black Women’s Pain
In every doctor’s office, there is a quiet vocabulary that determines how women’s pain is recorded, treated or dismissed.
Words like dysmenorrhea, menorrhagia and amenorrhea are not just medical jargon, they are signals, codes that unlock care or close the door to it. Yet who gets to use these words and who gets heard when they do, tells a bigger story about health inequity than most of us realise.
Understanding the Terminology
Behind each clinical term lies a lived reality, an experience that reaches far beyond a line in a medical textbook. These words describe the rhythms and disruptions that can shape a woman’s physical, emotional and professional life.
Amenorrhea: The complete absence of menstruation. While it may sound simple, amenorrhea can signal stress, intense exercise, hormonal imbalance or underlying illnesses such as thyroid disorders or polycystic ovary syndrome (PCOS). For many women it is not just a missing period, it is a warning light that something deeper needs attention.
Dysmenorrhea: Painful menstrual cramps that can be debilitating. This is not merely “bad cramps.” Dysmenorrhea can interrupt workdays, force students to miss classes and strain relationships. Severe cases may point to conditions such as endometriosis or fibroids, making early evaluation essential.
Menorrhagia: Excessive or prolonged menstrual bleeding. Beyond the inconvenience, heavy bleeding can drain energy, disrupt sleep and lead to iron-deficiency anaemia. Women often normalise it, yet it can signal fibroids, hormonal imbalances or clotting disorders that deserve medical care.
Oligomenorrhea / Polymenorrhea: Menstrual cycles that come too rarely (oligo) or too frequently (poly). These irregular patterns can unsettle a woman’s sense of normal and complicate fertility planning. Causes range from stress and weight changes to thyroid disease and perimenopause.
Premenstrual Dysphoric Disorder (PMDD): A severe form of premenstrual syndrome marked by intense mood swings, irritability and difficulty concentrating. PMDD affects work, relationships and mental health and often requires both medical and psychological support to manage effectively.
Luteal and Follicular Phases: The two key halves of the menstrual cycle. The follicular phase (from the start of menstruation to ovulation) is often linked with rising energy and clearer thinking as oestrogen increases. The luteal phase (from ovulation to the next period) brings progesterone dominance, which can influence sleep, appetite and mood. Understanding these natural hormonal arcs helps women anticipate energy highs and emotional lows and plan work or training accordingly.
These terms may sound clinical, but they describe powerful experiences, each a story of how biology, lifestyle and mental health intersect. Recognising them is the first step toward informed care, self-advocacy and a deeper respect for the complexity of women’s health.
The Unequal Experience
Research reveals a stark divide. In the UK, Black women are four times more likely to experience severe menstrual pain and twice as likely to develop fibroids compared to white women (NHS England, 2023). Yet studies show they are less likely to receive timely diagnosis or appropriate pain management.
A 2022 BMJ analysis found that Black and Asian women often wait five to seven years longer for an endometriosis diagnosis than their white counterparts.
This is not biology alone, it is bias. A landmark 2016 study in the Proceedings of the National Academy of Sciences uncovered that some medical professionals still (incorrectly) believe Black patients feel less pain, a misconception that leads to under-treatment and dismissal of symptoms.
The result?
Missed workdays, chronic anaemia, fertility struggles and a quality of life that shrinks under the weight of untreated pain.
The Human Cost
When heavy bleeding or crippling cramps are waved off as “normal,” the consequences ripple outward. Careers stall from sick days, relationships strain and mental health suffers.
For Black women, who already face structural barriers in the workplace, untreated menstrual disorders compound economic and emotional stress, perpetuating cycles of inequity.
What Next?
Educate & Advocate: Learn the language of menstruation. Knowing terms like menorrhagia or dysmenorrhea arms you to demand precise care.
Challenge Bias: Healthcare leaders must address diagnostic delays and pain mismanagement that disproportionately harm Black and Asian women.
Policy & Practice: Support legislation and workplace policies that guarantee menstrual health resources, paid leave and culturally competent care.
Finally, menstrual terminology should be a bridge to better health, not a barrier built on bias. Every woman deserves to have her symptoms named, her pain acknowledged and her treatment prioritised, no matter her race.
Like, comment and share this post to help dismantle the silence around menstrual health inequities and demand a system that listens to every woman’s body.
