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health PCOS

Bleeding to Death

PCOS Series

My menstrual cycle has never really been private.

I got my period two months shy of my 15th birthday. It was my first time away from home, at the California State Summer School for the Arts (CSSSA), where I was studying, what else, creative writing. Thanks–no really, I’m so thankful–to a genetic predisposition towards excessive vaginal discharge (oh yeah, we’re going to be biologically accurate and extremely open. This blog is about the body, remember?), I had brought with me a stash of panty liners. But I certainly was not expecting blood. My mother drove from our Northern California town to Valencia with a day’s notice to make sure I was okay. She took me for my first pedicure, got me Chili’s skillet queso dip (which to this day is still my period food), and brought with her plenty of additional period supplies.

My being a “late bloomer” was, for whatever the reason, endlessly fascinating to my female extended family members. My mother comes from a large family of sisters who all, from around the time I was 9, expressed a deep interest in my physical development, frequently commenting on my cystic acne, flat chest, absent period, and even the changes to my “beautiful blonde hair” acquired throughout puberty. These conversations left me feeling like a concave, bloodless alien with pepperoni skin.

During my time as a freshman cheerleader, having your period during practice or a travel game meant swapping pads and tampons like you would swap bobby pins, hairspray, and Nars’ Orgasm blush. I never had anything to swap, and I was also never in need. Which meant I never had to worry about bleeding through my rolled-up skirt, but I also felt even more like the odd one out. Which I already was! I missed cheer camp for creative writing camp that Summer Of The Period. Coach benched me for the season. I went to every practice and then sat in the bleachers every. single. game. You know it’s bad when the mean moms feel sorry for you, a daughter who is not theirs.

I think, without these competitive pressures so often found in groups of female family and friends, I wouldn’t have felt so alien without a period. My mom regularly reminded me, as I cried to her about my body, that she too was a late bloomer. And, wouldn’t you know it, I do take after her in almost every way.

Except one. My periods were dangerously heavy.

Nobody really tells you what to look for when it comes to period blood. You can estimate colored-in red drops on the side of the tampon box. But clots, color, and sheer amount of blood are all indicators of health. So what’s the line between regular heavy and dangerously heavy?

I certainly didn’t know. From the time I started college, at the height of my ice snacking (read the Series Intro if you haven’t yet), my period was heavy. I regularly bled through a maxi pad or super tampon in under two hours. It was the norm to use both, and to change them both every four hours. I was spending upwards of $40 a month on period supplies. Fortunately, my periods were a normal length of days.

Even with my incessant ice chewing and constant washing-of-soiled-undies, I never once thought anything of it. I assumed this is what having a period was. In fact, I also never had cramps, so I considered myself lucky. I can remember telling people my period was easy.

There is something in here about how women are conditioned. We are told women have higher pain tolerances, that women mature quicker, that women are naturally strong because eventually they will undergo childbirth. It becomes how we encourage one another. It becomes a point of bonding. Women are strong. But that doesn’t mean we have to be every moment of every day.

The strength is often silent. Menstruation is often private (unless you too have a hoard of aunts who ask you every holiday whether you’re bleeding yet.) We sneak pads from our backpacks to our back pockets in math class hoping the boy seated behind us doesn’t see. Even older women strip their blood-stained sheets from the bed in embarrassment, thinking they ought to have known better, as they toss them into the pile with the clothes of the children they birthed.

It is all exacerbated in Christian circles. We are raised gazing each Sunday at a cross of holy bleeding. We are told to offer up our sufferings, and consider the ways our blood aligns us with Christ. Rather than share with our communities the ways we are hemorrhaging, we are told to only share it with Him.

As I tried to make sense of this connection between bleeding to death and theology, it occurred to me to reach out to my dear Catholic UChicago Divinity friend Rebecca MacMaster, whose current major project is on what she’s calling “Menstrual Theology.” I reached out for her thoughts, and here’s what she said:

“In some ways there is nothing more Catholic than a woman in pain. Jesus was brought into this world by a woman’s anguish. Our feminine mystics chastised their flesh and mortified their bodies, seizing in pews and genuflecting in small cells. Our feminine mystical saints starved themselves, ridding their bodies of a monthly flow of blood while rending their flesh to create a new one. Their work was salvific, unimaginable and yet eminently imaginable.

“When I started my research into the hemorrhaging woman in Mark, I expected to read about her bleeding. I thought it would be wall to wall articles about her body and her pain and her faith. But that’s not really what I found. Instead most focused on purity laws — often warping Leviticus to further an anti-Semitic agenda. Those who mentioned her bleeding focused on the healing, often claiming that she became instantly menopausal under Jesus’ touch.

“The message seems clear, there is nothing in menstruation that could be for the greater glory of God.”

“To be honest, my bleeding has never felt salvific and neither has my pain. I remember dim afternoons clutching my stomach and begging God to make it stop, like Jesus pacing alone in dark Gethsemane. It felt perfectly normal and yet also unspeakable. Too ordinary but also too gross for discussion. It just was. Some cramping is normal, take an Advil. That’s all I learned in health class. Nothing worthy of a doctor’s attention let alone God’s.

“But God heard the hemorrhaging woman and He healed her — not to menopause I would argue but to a place of healthy menstruation. There is always room for the glory of God.”

Hearing these brilliant thoughts from Rebecca (who you can find here on IG), I felt things click into place. I was all at once reminded of the exact type of messaging and friendship I longed for as I navigated puberty: One that was open with real, bodily experiences without shame, while speaking the truth of a loving God.

As I bled cups of blood each month, no one ever told me “You shouldn’t be feeling that way. You shouldn’t be bleeding like that.” In fact, the consensus seemed to be “no two cycles are the same,” “everyone’s periods are different,” “offer it up,” and “being a woman is hard.” This was all reassuring when I was anxiously waiting for it to arrive. And to a certain extent, it is all true! Periods are different! Being a woman IS hard! But, our periods shouldn’t necessarily be as different and hard as they are. Without open conversations about bleeding, women suffer in silence thinking their signs of reproductive trouble, and the lack of space for them in both religious and secular circles, are all “just the way it is.”

Sometimes we don’t even have our doctors to talk to! I spent one year on iron supplements to combat the iron-deficiency anemia that resulted from my heavy cycles. I even took additional vitamins to aid in absorption. One year later, when I got my blood levels checked, my iron levels hadn’t raised at all. Not one bit. In fact, they were lower.

It is here that I imagine many women will empathize: My doctor was not concerned. She did nothing to explore what could be causing my heavy periods. She did nothing to explore why my iron wasn’t being absorbed. She didn’t run a single hormone panel. Even as I sat crying in her office, she said I needed to eat more beef and spinach and sent me on my way.

And a month later I nearly died.

I was on a ski trip in Truckee one late January weekend with Guy, who is now my partner but was not at the time, our good friend Dana, and Guy’s best friend Austin, who at the time I did not know. I was not expecting my period for another week, but on the drive up the mountain, I began to bleed. And I did not stop.

It was like an open, gushing wound. Constant blood loss for 36 hours. I was passing clots the size of my fist. I had brought with me a week of period products just in case, but even that was not enough. I exhausted Guy’s mom’s stash of maxi pads from the 80s in one evening. I went through 30 pads and 7 tampons in 24 hours.

All the while, I was trying not to draw attention. Friday night I simply went to bed early. Saturday I decided to mention my period had started, so I wasn’t feeling terrific. We played in the snow. We cooked and watched Star Wars. By Saturday evening, I was going to the bathroom every 20 minutes. I finally had to let all three in on the fact that I was bleeding nonstop and thought I needed to see a doctor.

It was actively snowing and the streets wouldn’t be plowed until early morning. We could’ve called an ambulance, but they might not have been able to reach us either and it felt too serious for “just a heavy period.”

I felt dizzy and faint. I ate a granola bar in case my blood sugar was struggling. I couldn’t lie down or I’d stain whatever I sat on. I was too weak to stand in the shower, so Guy made me a bath that quickly turned to sitting in a pool of my own blood. I was freezing and couldn’t get warm.

Around midnight I went to the bathroom and as I got up, collapsed and blacked out on the bathroom floor, pants around my ankles.

I did come to, I cleaned up the floor, and I quickly expressed immense gratitude that I had not hit my head or otherwise injured myself in the fall.

Nobody slept that night. We drove back down to our college campus at 5am Sunday morning. It amazes me that I felt well enough to be taken to campus. I sat in my dorm room and made an appointment with my “eat more beef” doctor for that afternoon. Unable to walk across my dorm room without losing my breath and collapsing, I still thought myself alert enough to drive myself home to my parents’ house. I even lugged my hamper full of dirty laundry alongside me, without second thought of its weight.

On the way home, my doctor called back and told me to go to the Emergency Room instead. Something had come up, but she was worried about me. My mom met me in the ER.

That’s when the reality of the situation became very clear. I was taken into triage where the nurse drew blood, turned sheet white, and stated in no uncertain terms that she was “extremely happy I came in.”

I had lost a third of the blood in my body.

I stayed the night in the hospital where I received three separate blood transfusions. (I also received an incorrect dosage of intravenous potassium. I was in so much pain from the corrosive liquid I couldn’t sleep a wink. The morning doctor simply rolled her eyes and said, “they shouldn’t have given you that.”)

By Monday morning, while I had regained full blood levels and every ounce of desire to chew ice evaporated and is still gone to this day, we still had not discussed what caused the bleeding. I was visited in the morning by the on-call OBGYN who quickly prescribed me–and every woman knows what’s coming– the birth control pill (which will be the topic of the next PCOS series entry.)

The experience was not immediately scary while it was happening. Again, there was still a large part of me that was convinced this was just how periods were. It was only once I was in the hospital that I realized how deeply, deeply fortunate I was to be alive and healthy, with all organs intact.

This is the beginnings of my offering to the budding online discussion about the nitty gritty of periods. Especially in Christian communities that celebrate modesty and privacy, we are comfortable speaking in general terms about cycles, in the context of fertility only. We echo the general culture’s displeasure with red liquid in tampon commercials. Men and women alike still joke about how women go to the bathroom in groups, with very little consideration for how deeply biological the vulnerability of bleeding is for animal species like us. It’s not for talking sh*t about whoever isn’t in the bathroom with us, it’s about needing someone to clean and pin up my white winter formal dress because I bled through the bottom hem and can’t reach it on my own. We laugh about the women with severe PMS and how inconvenient it is for those they are around. But we still don’t talk enough about quantity or quality of period symptoms: Blood, cramps, clots, mood swings, aches, fatigue. The number of women who have reached out to me over Instagram to ask what signs and symptoms informed my PCOS diagnosis makes me all at once hopeful and sad: So many women lack information, community, and trustworthy medical care. So many women are fed up and paving their own way outside the doctor’s office.

One of these newest, way-paving resources is the online women’s forum femUnity. You can visit their website or find them on IG here. FemUnity provides a constructive, community-focused solution to panicked symptom-searching, led by women for women. Both their forum and their social media presence center on crowd-sourced information of real-life experiences, to paint a picture of the many possibilities and intricacies of women’s health, both reproductive and otherwise. I highly encourage you to check them out!

So yes, everyone’s period is different, but I’m going to lay out the things I wished I’d been told (informed by facts I’ve received from practitioners I’ve worked with post-near-death-experience.)

If you bleed through a maxi pad or super tampon in less than 4 hours, you should talk to a doctor.

If you need to use both at the same time and still bleed through them in less than 6 hours, talk to a doctor.

If you go through more than 8 period products a day, talk to a doctor.

If you pass clots larger than a quarter, talk to a doctor.

If you experience cramps that are not alleviated by traditional ibuprofen or acetaminophen…

If you experience mood swings or feelings of anxiety or depression outside of 2-3 day windows at the start of your period…

If you experience any of these period symptoms outside of a 7-10 day window…

Talk to a doctor.

I know it’s not always that simple. I know that doctor might not listen. I know I can say “talk to another one,” and that might not be an option for you (it wasn’t for me until I had access to my university’s medical center while I got my MA.) I know doctors with online practices have put their expertise behind giant paywalls. It can be incredibly frustrating pursuing a diagnosis. I believe you. You are doing your best. You are not failing because you can’t find an answer. (I will be providing a list of the resources that have helped me later in the series, but even then, if they don’t work for you, you are not failing.)

If you do talk to a doctor, you might think, “Madison, what do I say? What do I ask?” I would suggest…

1). Asking for a blood test that includes a “comprehensive hormone panel.” They’ll look at estrogen, progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, cortisol, and more!

2). Asking for a pelvic ultrasound

3). Making sure you’re current on your yearly physical exam and pap smear. In many cases your primary care provider can do it, you don’t necessarily need to have a designated OBGYN.

Beyond that, my biggest suggestion is to talk to the women in your life whom you trust about your period. If something feels odd, ask someone in your life if they experience it too. If they say no, don’t take that as a point of shame but a point of motivation! Keep asking.

How did I know to do these things? I’ll share my list of PCOS tips, tricks, and resources soon. I didn’t know to start looking for these things until much further into my journey to a diagnosis. Coming up next we’re going to talk about my experience on the birth control pill, then we’ll talk about how it has intersected with my gastrointestinal health, and then about PCOS resources and how it all intersects with family planning.

If you’re struggling with your period: You are surviving. You are doing your best. Your body knows what to do and how to keep you alive. Christ loves you and personally cares about your healthy bleeding. I am always here to chat. <3

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4 replies on “Bleeding to Death”

Thank you Madison! As someone who has struggled with doctor’s listening, I’d add one thing to your list for the doc’s office – if they deny your request for any tests, demand that their denial be documented in writing. Oftentimes that’ll do the trick!

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