I'm not sure how much of this is my difficulty with the health care system due to autism vs an overall issue related to healthcare for people who menstruate but I'd like to have a little rant. I hope this is okay to post on this community given that it's not exclusive to women but I do think it's a byproduct of misogyny in healthcare.

About a decade ago in my early 30s I went to the doctor about irregular but heavy and painful periods. I got a referral to a gynecologist who ordered ultrasounds, but nothing abnormal was found. I had been on various forms of hormonal birth control for around 15 years at that point and when my IUD was due for removal, I stopped. They thought maybe my body was adjusting to ending the BC or maybe it was a very early perimenopause so the plan was to "keep an eye on it".

I have not had consistent medical care throughout my life. A misunderstanding led to my belief that annual physicals were no longer available (in reality they have changed and are called "Periodic Health Visits" now) so I simply haven't had one ever as an adult until this year. I've moved to a different city and have a different doctor. I saw they were an available appointment type so I booked one.

Turns out I have a rather extreme case of vitamin D deficiency and this is known to be associated with irregular and painful periods.

When I mentioned my periods and suspicion it was perimenopause to my current doctor during this health check he kind of shrugged, but to his credit he had ordered a broad range of tests based on our discussion so in retrospect I understand not wanting to guess at things until he had the results back.

I can't say for sure when the vitamin deficiency started. I don't know if it is the cause. I'm just really disappointed that I wasn't tested for it earlier. I found some old lab results from around the time I first brought it up: one from two years prior when I had cyclospora (how topical, lol) and one from the same time as the ultrasound. Neither included a test for vitamin D. Even with my current testing I think it was included because of an injury I had last year and the radiologist notes on the X-ray indicating potential bone loss.

I typically have one or two nights of sleeping less than 3 hours each time I have a period. This is a result of the pain or "feeling wrong" so strongly that I cannot relax. I can't help but wonder what an improved quality of life I would have had if this was caught earlier. There are other impacts low Vit D has likely had, but this one is currently driving me mad because it appears to be a well established correlation. I understand doctors are overworked and only human but it still sucks.

I don't recall if it was my previous doctor or the gynocologist who mentioned that these problems weren't immediately concerning because I wasn't trying to have children. It's uncharitable, but this makes me think that menstrual concerns are not a concern to general medicine unless it impacts the ability to make babies. This is why I consider it a result of misogyny. (If you are able to suggest a better word that reflects that not all women have periods and not all people who have periods are women please don't hesitate to correct me in the comments. I could use the assist.)

I now know I have trouble quantifying and communicating my pain levels as a result of differences related to autism but I didn't know I was autistic back then. Therefore when doctors shrug something off I just assumed I was wrong and was being a wimp 🤷‍♀️ . Maybe if I didn't have these challenges they would understand that it has deeply impacted my life and more investigation would have been done.

Thanks for the space to rant. I hope that this will also help other people who may have mysterious menstrual issues and haven't looked at this potential cause yet.