The Cost of Calling Severe Period Pain “Normal”

A girl misses school again. Not because she is sick. Not because she chose to stay home. She is lying in bed with severe menstrual pain. Teachers mark her absent. Peers move ahead with lessons. At home, she hears what many girls hear: “Periods are painful. You will be fine.”

But some girls are not fine. Years later, some discover that the pain everyone called normal was never normal at all. It was the beginning of a chronic reproductive condition that would quietly shadow their fertility, pregnancies, and health for decades to come.

This is the experience of thousands of girls and women in Ghana and across Africa, whose severe menstrual pain is dismissed long before it is ever examined by a doctor. A staggering 95% of Ghanaian girls miss some school days each year due to menstrual health, and 9 out of 10 girls are absent from school during their menses, as noted in the Ghana Menstrual Health Snapshot (Days for Girls). And that is the problem. We have normalised girls missing school because of menstrual pain to the extent that we rarely ask whether something is wrong. As we observe Menstrual Hygiene Day under the theme “Together for a #PeriodFriendlyWorld,” We must start paying closer attention to what severe menstrual pain is actually trying to tell us.

When Pain Means More Than Pain
Severe menstrual pain should stop being treated as an inconvenience. For some girls, it may be the first warning sign of a reproductive condition that follows them into adulthood. Conditions like endometriosis and polycystic ovarian syndrome (PCOS, now referred to as polyendocrine metabolic ovarian syndrome, or PMOS) are closely linked to severe period pain. The World Health Organisation estimates that endometriosis, for example, affects about 1 in 10 women and girls of reproductive age worldwide. PCOS is also recognised by the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development as a major cause of ovulation-related infertility. Both conditions are associated with chronic pelvic pain, heavy bleeding, fatigue, anxiety, depression, and complications in pregnancy. Yet many women spend years being dismissed before receiving a diagnosis.

The consequences reach far beyond monthly discomfort. Girls withdraw from sports, church, and social life. They quietly reorganise their entire world around symptoms they have been taught to simply endure. Even though UNICEF Ghana has supported menstrual health education, hygiene promotion, and school-based menstrual health activities, many girls still miss school during menstruation due to persistent barriers in awareness, access, and stigma. We should be alarmed by this. Symptoms that deserve attention are being absorbed into everyday life until serious pain becomes invisible.

The problem is not only medical. It is cultural. And it is communicative.

For generations, girls have been taught that periods should be hidden, managed quietly, and discussed only when necessary. Families normalize pain with phrases such as: “Once you start having babies, the pain will stop.” “When I was your age, my period pain was worse than this.” Friends reassure one another that severe cramps are just part of life. This is the lesson many girls receive: endure first, question later. That lesson is failing them. Menstrual stigma and limited education still affect how girls experience menstruation, with many avoiding school to escape embarrassment or ridicule.

Calling severe pain “normal” does not protect girls. It teaches them to ignore symptoms that deserve attention. It delays help-seeking. And sometimes, it delays care until opportunities for earlier intervention have already passed.

These challenges extend beyond menstruation into fertility, pregnancy, and maternal health. Some women struggle with infertility years later without ever connecting it to the painful periods they were told to ignore as teenagers. We cannot continue treating menstrual health and maternal health as separate conversations. A girl’s menstrual experience is, in many ways, the first chapter of her reproductive health story.

Menstrual Health Must Move Beyond Products and Awareness

Ghana has already recognized the importance of improving reproductive and maternal health. The country’s Integrated Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAHN) Strategic Plan reflects a national commitment to supporting women, adolescent, and maternal health across the life course. Menstrual health deserves to be woven into that commitment and not treated as a separate issue limited to hygiene or awareness activities.

Attention to menstrual health is gradually growing. Vice President Jane Naana Opoku-Agyemang has called for a Ghana where no girl is held back by her period. She emphasized the need to address menstrual stigma and improve access to support and education. National Menstrual Hygiene Day campaigns also continue to advance this message under the banner of “Together for a Period-Friendly Ghana.”

The Government of Ghana also launched the Free Sanitary Pad Initiative in 2025 to provide monthly sanitary pads to approximately two million girls in public basic and secondary schools. Community organizations, including All Love Foundation, continue to support menstrual health education and product distribution across schools and communities. These are important steps. But menstrual health cannot stop at awareness campaigns or product distribution alone. Girls also need earlier recognition of symptoms, menstrual pain education, and access to care. Menstrual health is connected to education, reproductive health, fertility, maternal wellbeing, and the everyday dignity of girls and women across this country.

Public health conversations in Ghana usually focus on pregnancy, childbirth, and maternal mortality. These issues matter deeply. But maternal health does not suddenly begin when a woman becomes pregnant. It may begin with a girl missing school because of severe pain. It may begin with symptoms dismissed as ordinary. It may begin when warning signs are ignored.

What Needs to Change
Schools and teachers should recognize that repeated menstrual absences may signal more than routine discomfort and connect girls with appropriate support instead of treating missed days as ordinary absenteeism. Parents should take girls seriously when pain interferes with school or daily life and resist the urge to normalize what should be investigated. Parents must also stop using their own experiences as the standard for judging girls’ pain. Healthcare providers should listen carefully and resist the reflex to normalize period pains, particularly among adolescent girls. Public health campaigns should fold menstrual pain education into broader reproductive and maternal health conversations rather than leaving it as a footnote. And all of us must help create schools, homes, clinics, and communities where girls and women feel safe talking openly about menstrual symptoms without shame.

Too many women spend years believing that debilitating pain is simply the price of being female. It is not. How we talk about menstrual pain shapes whether it is ever taken seriously and whether girls get help before the damage compounds.

Maternal health does not begin with pregnancy. It begins with how we listen to girls. It begins with believing them when they say they are in pain. And it begins by refusing to call suffering normal.

Written by: Esther Apreku, a first-year doctoral student in the Department of Communication at the University of Missouri, Columbia. Her work focuses on health communication, with interests in health campaigns and health literacy in areas such as menstrual health and maternal health. She is also the founder of All Love Foundation, a nonprofit organisation dedicated to health education and community outreach.

Email: eapreku@missouri.edu

   Comments1