For some women, menstruation arrives quietly, lasts a few days and disappears with little disruption to everyday life. For others, the monthly cycle can mean days of debilitating pain, heavy bleeding, vomiting, exhaustion, emotional distress and, in some cases, hospitalisation.
Yet in many African societies, talking openly about menstruation remains uncomfortable. Women are often expected to manage their periods discreetly, regardless of how severe the symptoms become.
A stain on clothing can trigger embarrassment. Severe cramps may be dismissed as an unavoidable part of womanhood. Heavy bleeding can be endured privately. And when menstrual pain affects productivity at work or school, women may feel compelled to hide it rather than risk being labelled weak or unproductive.
That culture of silence can become particularly troubling when what is dismissed as "just period pain" is actually a symptom of an underlying reproductive health condition.
“Unfortunately, the same society would shame a woman who is of conception age but unable to do so based on complications that might have erupted from menstrual inadequacies,” Dr. Amarachi Chuka, a fertility expert, said when asked why issues surrounding menstruation are often kept inside the closet.
For many women, the problem is not menstruation itself but the assumption that every menstrual experience is normal simply because it is common.
When Is Period Pain No Longer Normal?
Dr. Chuka explained that a normal menstrual period typically involves moderate bleeding lasting between three and seven days, occurring within a 21- to 35-day cycle and accompanied by relatively mild physical or emotional symptoms.
These may include lower abdominal or back pain caused by uterine contractions, mood changes, bloating, mild acne and breast tenderness.
But she said menstrual symptoms that become severe, persistent or disruptive should not automatically be regarded as normal.
“While abnormal or irregular period is when it is accompanied with severe pains that stops you from doing normal daily task; the bleeding soaks through the sanitary package every hour for several hours; period last longer than seven days and cycle is shorter than 21 days or longer than 35 days, or when you miss your period for three to four months in a row without being pregnant.”
According to her, abnormal menstruation may sometimes point to an underlying health problem capable of affecting a woman's reproductive health and fertility.
“With abnormal periods there is most likely an underlying health issue that can affect a woman’s reproductive health and fertility. This is because menstruation and womanhood are intertwined. A woman’s ability to conceive and become a mother is mostly dependent on how healthy her menstrual cycle leading to ovulation is.”
She added that irregular cycles can make it more difficult to predict ovulation and may reduce the chances of conception. Some underlying conditions can also increase pregnancy-related risks.
“Irregular cycles make it hard to track ovulation hereby lowering the conception chances. It can also cause gestational diabetes or high blood pressure during pregnancy.”
She identified endometriosis, polycystic ovary syndrome (PCOS) and uterine fibroids among conditions that can be associated with abnormal bleeding and menstrual problems.
The Conditions Behind the Pain
For some women, severe menstruation is not simply an uncomfortable monthly occurrence. It may be one of the visible signs of a broader medical condition.
Polycystic Ovary Syndrome
Polycystic ovary syndrome, commonly known as PCOS, is a hormonal disorder that can affect menstrual cycles and ovulation. It may be associated with elevated androgen levels, acne, excess hair growth and difficulties with fertility.
Women with PCOS may experience irregular, heavy or missed periods because ovulation does not occur regularly.
The condition can therefore affect not only the predictability of menstruation but also a woman's ability to conceive.
Endometriosis
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. It can cause significant pelvic pain, particularly around menstruation, and the pain may worsen over time.
Symptoms can include painful periods, heavy or abnormal bleeding, infertility, pain during bowel movements or urination, fatigue and digestive problems.
For women living with the condition, the monthly cycle can become a recurring period of physical and emotional distress.
Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop in or around the muscular wall of the uterus. They can cause heavy menstrual bleeding, pelvic pressure, back pain, pain during sex and frequent urination.
Not every woman with fibroids experiences symptoms, but when symptoms occur, they can significantly interfere with everyday life.
These conditions underscore why persistent changes in menstrual patterns should not simply be dismissed as an unavoidable part of being a woman.
Different Women, Different Battles
The reality of menstrual pain varies widely from woman to woman.
For Olamide Ojo, who is above 40, the first day of her period can be particularly difficult. She described the pain as so sharp and intense that she cannot stand or function until she receives an injection.
Even then, she said, the relief is only partial.
Ojo also experiences bleeding that lasts seven days and has questioned whether the severity of her symptoms should be considered normal.
“Is this something that can be considered normal, or could there be an underlying issue causing such severe pain? I genuinely want to understand,” she asked.
Her question reflects one of the central problems surrounding menstrual health: women may endure severe symptoms for years without knowing whether what they experience falls within the range of normal menstruation.
While menstrual cramps are common, their intensity can vary considerably. Some women experience discomfort that disappears within hours. Others report pain accompanied by vomiting, back or leg pain, heavy bleeding and an inability to perform ordinary tasks.
When Menstrual Pain Changes With Age
For Mrs Ngozi, menstrual difficulties did not begin in adolescence.
She said her periods were relatively smooth when she was younger but became increasingly difficult after pregnancy and childbirth.
Her menstrual cycle subsequently became unstable and irregular, eventually leading to a diagnosis of polycystic ovary syndrome.
The changes left her frustrated and increasingly uncomfortable with the thought of menstruation.
Her experience demonstrates that menstrual health is not necessarily static. A woman whose periods were previously manageable may experience changes later in life, and those changes can sometimes be connected to underlying health conditions.
"It’s Just Your Period"
For Chidinma Ogu, the problem has not resulted in hospitalisation, but the pain has nevertheless affected her ability to work and perform everyday responsibilities.
She described the sensation as though something were constantly twisting or pulling inside her stomach.
“It’s a very intense cramping in my lower abdomen which sometimes spreads to my lower back,” she said.
Ogu said she began to recognise that her menstrual experience might be different after speaking more openly with other women and discovering that her pain and mood changes appeared to be more severe than those of some of her peers.
The pain can affect her productivity, particularly when she is required to stand for long periods.
“Things that would take less effort will seem difficult. I’ll just want to lay down in bed and wait for the pains to reduce,” she said.
She manages the symptoms by lying down in a comfortable position and using a warm compress when the pain becomes unbearable. She has never used pain-relief medication or sought medical attention specifically for the pain, although she acknowledged that perhaps she should.
The experience is also emotionally draining.
“When I am in much pain, I can become irritable, frustrated and emotionally drained. It can be difficult to remain positive at that time,” she said.
But perhaps what troubles her most is not only the pain itself but how others perceive it.
“Most times when people see when I am going through this severe menstrual pain, they would have that expression that says: it’s just your period, what is the big deal, without understanding that I am genuinely struggling internally, physically, emotionally and mentally.”
That response — the suggestion that menstrual pain is automatically ordinary because it is associated with menstruation — is one of the reasons many women continue to suffer without seeking medical help.
A Childhood Shaped by Pain
For 23-year-old Mirabel Ajero, the struggle began when she was only 12.
Her first periods came with severe stomach pain and vomiting. At times, the symptoms became so intense that she spent as many as two days in hospital.
“Growing up as a child, I hated my period, but I knew I needed to see it to make me a woman,” she said.
Years later, Ajero still dreads menstruation because of the severity of the symptoms.
“It’s not just menstrual pain for some of us – there’s a mental feeling of danger to our body and also our health, one that is inevitable,” she said.
Beyond the physical symptoms, Ajero said the reluctance to discuss severe menstrual experiences openly makes it harder for women to receive empathy and support.
She recalled telling friends and other women that she hated seeing her period, only to encounter disapproving reactions.
“I’m not surprised because in the African setting, you must go through pain or have a threshold for pain to make you qualify as a real African woman,” she said.
Her experience captures a deeply rooted expectation: that pain is part of womanhood and that enduring it without complaint is evidence of strength.
But medical experts say suffering should not be romanticised as resilience when it could be a sign that something is wrong.
The Night a Period Was Mistaken for Something Else
Adebimpe Aremu began menstruating at 13, but her painful cramps started three years later.
Her first severe episode happened in the middle of the night. Her period had not even begun, yet she was already vomiting and experiencing intense pain.
Her mother, unsure what was happening, rushed her to hospital.
“Immediately after I was admitted, I was put on a drip, and the doctor had to conduct a pregnancy test. The doctor was our family doctor, and he told my mum to ask me if I was sure I wasn’t pregnant. My mum, with so much confidence, said she was sure, especially since I had not even started menstruation.
“The pregnancy test came back negative of course. We hadn’t left the hospital before my period started. That was when we realised the pain was caused by menstrual cramps.”
Aremu said she has continued to experience painful periods since then, although subsequent episodes have not been as extreme as that first incident.
Another particularly difficult experience came in 2016, while she was at university. She was vomiting and purging when a neighbour noticed her condition and gave her Felvin, which she said provided relief.
“My neighbour told me she also experiences painful periods and uses Felvin, which works for her.”
Aremu said she had previously consulted a gynaecologist and was told that her experience was normal and simply the way her body reacted.
“I can’t really remember the details because I was very young at the time, but I was given some medications that worked.”
She later noticed that the effect of Felvin appeared similar to that of the medication prescribed by the doctor.
“My period would not flow as quickly as it normally should, and that bothers me. But I still take Felvin because, honestly, I would choose it over experiencing those cramps any day, any time.”
Her account also highlights the need for women experiencing severe menstrual pain to receive proper medical assessment rather than relying solely on informal advice or medication shared by friends and neighbours.
When Pain Becomes a Monthly Disruption
For Tumininu Adeniyi, menstrual cramps were something she had rarely thought about until she began experiencing them herself.
What started as an unfamiliar discomfort gradually became a painful part of her monthly cycle.
She said the cramps were significantly more intense than what she had observed among her friends and were accompanied by vomiting and pain in her legs.
Her story, like those of the other women, illustrates how different the menstrual experience can be. What one woman regards as mild discomfort can be incapacitating for another.
Breaking the Silence
The persistence of menstrual stigma creates a difficult contradiction.
Women are expected to menstruate, but they are often discouraged from talking about what happens when menstruation becomes painful, excessive or disruptive.
They are expected to continue working, studying, caring for families and meeting social expectations while concealing the physical and emotional effects of their periods.
According to the World Health Organisation, menstrual pain is extremely common. A 2026 systematic review cited by the WHO estimated that 71 per cent of women and girls experience dysmenorrhoea. The organisation notes that severe menstrual pain can interfere with daily activities and quality of life and may warrant medical attention.
That distinction is important: common does not necessarily mean normal or harmless.
A woman should not have to apologise for experiencing pain. She should not have to hide a stained dress, quietly endure debilitating cramps or fear being labelled unproductive because her body is undergoing a biological process.
And when menstrual symptoms change, become severe or interfere substantially with daily life, the answer should not simply be endurance.
For Ogu, the experience is not merely physical. For Ajero, it carries a psychological sense of dread. For Aremu, severe cramps once sent her to hospital before she even realised her period was beginning. For Ojo, the intensity of the pain has raised questions about whether an underlying condition may be responsible.
These experiences point to a larger conversation about women's health — one in which menstruation is treated not as an embarrassing subject to be hidden, but as an important part of reproductive health.
The question, ultimately, is not why women cannot simply endure their periods.
It is why they should be expected to endure severe pain in silence in the first place.
What is normal about pain that prevents a woman from standing, working or sleeping?
What is normal about bleeding that repeatedly disrupts everyday life?
And what is normal about dismissing symptoms that could be pointing to a condition requiring medical attention?
Breaking the silence around menstruation may not eliminate the pain. But it can help women recognise when that pain deserves to be heard — and, importantly, treated.