Well, Actually is a column by Slate’s Shannon Palus. She tests health and wellness products to help readers figure out what they should try, what they should skip, and why.
Women rarely take time off work because of period pain. Many of us with uteruses are well familiar with this fact, based on our experiences sitting at desks or standing through shifts, but it is also the conclusion of a study published last week in the BMJ.
A team in the Netherlands surveyed more than 30,000 women, finding that they took a mean of one day off of work per year for symptoms related to their periods. But while sitting at work, distracted and in pain, they lost an estimated total of nine days of productivity each (the numbers, of course, are not distributed evenly across women as pain level can vary greatly). The reported trouble of working while bleeding may be slightly overestimated in that study, or it may differ by region—a previous study in Japan found similar absences, but only 2½ days of lost productivity while at work. Nonetheless, they add hard data to the mounting case for taking menstrual discomforts seriously.
Some solutions: A world in which ibuprofen, which works best when it’s taken at the very onset of pain, is stocked in all offices with the same diligence as toilet paper. One where employees have flexible hours, or can work from home during their periods if that helps. And because this is a product review column, perhaps one in which more of us use a weird little device called the Livia, which bills itself as an “off switch for menstrual pain.” It doesn’t work quite as well as that promises but combined with other methods, it can help; especially if you’re OK looking, to a sharp observer, a little cyborg-y.
The Livia is basically a fancy transcutaneous electrical nerve stimulation, or TENS, unit. It works by sending a small amount of electricity through sticky pads that you attach to your body, so that the current goes through your muscles (“transcutaneous” just means entering the skin). It feels like a cross between getting a massage and being a dead frog in a science experiment. Scientifically, there are a couple theories on how this interrupts pain, which more or less match up with the logical explanation: It is harder to feel pain when you are also experiencing a low-level vibration.
That the treatment is safe and poses few side effects makes it easy to prescribe. OB-GYN Jen Gunter has written that she recommends these devices for menstrual pain a couple of times a week. You might have also seen them in physical therapy offices to help with muscle pain. If you were alive in ancient Rome, you might have been issued an ancient TENS unit known as a torpedo fish for a headache or a case of gout, which entailed placing the live fish on the part of your body that was in pain and letting shocks from the fish pulse through you.
How much TENS devices of any kind help with pain is based on the person. I found while researching TENS units for the Wirecutter that clinical trials tend to be small and poorly designed. That’s in part because it’s hard to administer a convincing placebo treatment—you kind of know whether or not you are in the group that got to have their electrical current vibrating devices turned on. But multiple meta-analyses that combine them suggest there is some small benefit, for some people, one of which focused specifically on folks with menstrual cramps. A main upside of the treatment is the lack of side effects: Aside from the fact that some people don’t like the sensation, and the occasional person might find the sticky pads irritating, there are no downsides.
I first tried the Livia for deep, acute period cramps. It didn’t work that well: Whatever the electrical stimulation was doing, the pain was much stronger. I wanted the pads to be inside my body, attached to my uterus itself, instead of just on my abdomen. I also felt personally insulted by the copy on the Livia website that had promised me “instant, drug-free relief”—given that the device was doing incredibly little for my pain, I would definitely be taking lots of drugs (ibuprofen), and I had no problem with seeking relief this way. It also happened to be the weekend, and I happened to be on vacation somewhere with a tub, so I also took a warm bath, and then later, another warm bath, and was ready to conclude that this thing might be for other people but not for me. With bad period cramps, it turns out, others have had a similar experience: BuzzFeed deputy editorial director Lara Parker noted in a video testing out the device that in the case of extreme cramps, the Livia “barely touches them,”
But a week later, I got an IUD. The Monday after, the dizziness combined with a physical pain that was so bad I took a few sick hours off of work. I kept jokingly wondering to myself how much worse having a baby could really be (I know, I know). After a little lying down totally horizontal, with the pain at more of a dull gnawing feeling than sharp pangs, I popped another ibuprofen—a theme—and put the Livia on my abdomen, and sat against a pile of pillows to write this paragraph. The Livia did not make the pain go away this time either, but having it on felt much better than not, and also made working easier. When Parker used the Livia to deal with milder cramps, her experience sounded similar to mine, as she explains in the video: “It’s like vibrations instead of pain.” Distracting oneself from something terrible by introducing something less terrible, does, it turns out, seem to work. Later in the week, with my pain gone but eager to see if this might work for the next time my uterus was angry at me, I even tried the device out while sitting at my desk at work. If anyone noticed, they said nothing. The sensation felt fine.
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For a possibly mildly effective device in some circumstances, the Livia is quite expensive—$150. But it appears to be a TENS unit with an incredibly high pink tax: In reviewing generic TENS units, I previously found one that worked well enough for muscle pain (and presumably, in turn, for uterus pain) for just $25. But Livia does have several advantages over much cheaper units: It’s rechargeable (no batteries), and it clips to the edge of your pants, with wires that are exactly the right length to attach to your stomach.
While many other machines would be sort of a hassle to wear to work—or even, to use while also walking around your apartment—this one seems designed for just that. The Livia comes with a carrying case the size of a bulky ring box, making it easy to put in a bag without danger of the wires getting tangled. And while the device doesn’t technically need to be available in colors including pink, turquoise, red fractal dot, and black flower, I agree with the reviewer on Reddit who argued, “if I’m going to be wearing a medical device all day, having one in customizable colours really does make the whole thing feel a bit more humanizing.” If you know you like using a TENS unit on your period, having one that has a friendly and thoughtful design might just be worth the price.