5 min read
by Morganne Skinner | 10/19/2022
Have you ever felt like your doctor was hearing the words coming out of your mouth, but not actually listening to them? I definitely have — and it’s a terrible feeling. Sometimes you just want to scream: “YOU’RE NOT LISTENING!” … But that’s usually not the most effective communication strategy. So, what *can* you do instead?
Advocating for yourself at the doctor’s office may seem daunting, but through charting your menstrual cycle, you can use that information to advocate for yourself using some savvy communication tips. But what do menstrual cycle charts and health advocacy have to do with each other? Actually, they’re surprisingly linked. The foundations of cycle charting begin with understanding how your body works. When you understand what is happening, know what things are normal and abnormal, you can quickly seek help for changes you notice!
So, what exactly is cycle charting, and why should you care? Like it sounds, menstrual cycle charting is the practice of keeping track of your menstrual cycle (not just your period). It involves noting daily menstrual bleeding patterns, cervical secretions, basal body temperature or luteinizing hormone (LH) tests, and any symptoms, like pelvic pain, insomnia, or hormonal acne.
A common misconception is that menstrual charting is only for those trying to conceive or avoid pregnancy — which is far from the truth. It’s for anyone who wants to monitor and better understand their body, because the menstrual cycle is a vital sign of health. By charting your cycle, you can get daily feedback on your hormones and identify healthy patterns or problems. For example, charting my menstrual cycle helped me get diagnosed with endometriosis. While none of my basic labs were abnormal, my cycle chart was shouting that there was a problem!
So, how exactly does cycle tracking help you self-advocate? For starters, you are creating objective data (which doctors love!) for a bodily function that is mainly subjective. You take this abstract thing and put it on paper. It immediately becomes tangible: patterns emerge, you can give a number to things, and changes can easily be spotted. Just imagine how much more confident you’d feel speaking to your doctor when equipped with all of this info!
I distinctly remember going to my gynecologist for new mid-cycle bleeding. I explained my symptoms and was told, “Oh, ovulation spotting is normal.” The thing is, I knew it wasn’t normal for me and made sure to mention this to my doctor — explaining the changes I’d experienced, as well as quantifying the days of bleeding and accompanying symptoms.
If I had just told my doctor that I had spotting, she wouldn’t have understood the reality or severity of my situation — and I would have accepted the dismissal as truth. But since I was charting my cycle, I knew how my normal menstrual cycle should look and could share numbers to quantify my cycle events.
It went like this: “I’m experiencing five to seven days of bright red bleeding with ovulation that sometimes requires a pad and has blood clots. It also comes with pain that’s a 7/10. This is a new change for me and has been happening for five months. I would like your help looking into it.”
Do you see the difference? By quantifying my experience, I gave my doctor a ton of information and made myself much more trustworthy. As annoying as it is to have to prove yourself to be a "trustworthy historian,” you should be equipped with the communication skills to advocate for yourself, even amidst lousy circumstances.
First things first — be clear with yourself about what your goals are for the doctor's visit. Use your cycle chart as your guide and prioritize what you want to address. Ask yourself, what is most important to me? Convey that.
Bring someone with you, and make sure they know your problem and the phrases to use to address it. This is especially helpful if you feel triggered during a visit and freeze up. You may know the right phrases to say but sometimes all you can do is breathe. If you bring a support person, they can speak up for you, raise questions you forgot to ask, and hold the provider accountable.
Remember that doctors are people too, and people don’t like being blamed or told they’re wrong. Even if they are to blame, it won’t open up the doors to communication (not as satisfying, I know!) and could lead to defensiveness. So, what can you do?
Try using “I” statements. It is less offensive, takes the blame off the provider, and makes you more likely to be heard.
Example: “I feel like you are listening, but I do not feel like I am being heard.”
If you are being stereotyped, try to diffuse the situation by letting them know you are aware of the bias. This helps to put it on their minds, check themselves, and remove defensiveness.
Example: “I’ve heard that women are more likely to be misdiagnosed with psychogenic diseases and have longer diagnostic times than men. Have you heard anything like that?”
Along with quantifying your symptoms, describe how symptoms affect your life. This conveys much more information than just the presence of a symptom. Your doctor’s assumption of how the pain or heavy menstrual bleeding affects you may not be your reality. Rather than saying, “I have painful periods,” share with them how the period pain affects you!
Example: “When my period pain comes, I can’t stand up, go to work, care for my kids, or eat without vomiting.”
Together, these phrases, preparation tips, and your unique cycle charting data can help you be taken seriously at your doctor's visit. But sometimes, you can say and do all the right things and still get dismissed. In times like that, the best way you can advocate for yourself is to find a different doctor. You know your body best. If you feel like there is a problem, there probably is.
Do you chart your menstrual cycle? How has it helped you advocate for yourself? Let us know in the comments!
Morganne Skinner, BSN, RN is a registered nurse of seven years, RPCV Zambia ‘18-20, freelance nurse writer, and fertility awareness educator. Her experiences with endometriosis led her to discover the wonders of fertility awareness as it helped her get diagnosed and manage her symptoms. Now she is passionate about sharing this knowledge and life-long skill with women looking for answers. She teaches women how to chart their menstrual cycle to monitor their health and understand their bodies in her business Fertility Defined. Connect with her on Instagram and say hello!
by Morganne Skinner