Emergency room or 911
Some symptoms need attention today. These are the ones that can't wait.
The signs
Six things. For each one, what it can mean and what to do — because 'seek help immediately' on its own has never told anyone whether their pain qualifies.
Period cramps build over hours and ease with heat or painkillers. Pain that arrives all at once and keeps climbing is a different thing — it can mean an ovarian cyst has ruptured or twisted (ovarian torsion), which cuts off the ovary's blood supply and is treated as a surgical emergency.
Go to the emergency room. Torsion is time-sensitive: the sooner it's untwisted, the more likely the ovary is saved.
That is roughly ten times a normal flow rate. Sustained bleeding at that level can drop your blood volume faster than your body replaces it, which is why it comes with dizziness and a racing heart.
Go to the emergency room, and don't drive yourself if you feel faint. Passing clots larger than a golf ball, or bleeding that soaks through your clothes and bedding, counts too.
Fever plus pelvic pain suggests an infection that has moved up into the uterus, tubes, or ovaries — pelvic inflammatory disease. Untreated, it can scar the tubes within days and cause lasting fertility damage.
Get seen the same day — emergency room, urgent care, or a same-day clinic appointment. This is treated with antibiotics, and speed is what protects the tubes.
This is the pattern of toxic shock syndrome. It is rare, but it moves fast and gets dangerous within hours, which is why it's on this list at all.
Remove the tampon or cup and go to the emergency room now. Say the words 'I've been wearing a tampon' — it changes how quickly they work you up.
Briefly greying out at the peak of a bad cramp happens and isn't usually dangerous on its own. Actually losing consciousness, or feeling faint alongside heavy bleeding, means your body isn't keeping enough blood to your brain.
Get to the emergency room. If someone lost consciousness and didn't come round within a minute, call 911.
A pregnancy growing outside the uterus — usually in a fallopian tube — cannot continue, and can rupture the tube. Shoulder-tip pain alongside it is a warning sign of internal bleeding.
Emergency room, today. Tell them your last period date and that a pregnancy test was positive, or that you aren't sure.
Getting seen
Where you go, what it costs, and who to call when you're not sure it's bad enough.
Fainting, confusion, bleeding that won't slow. Otherwise, getting a ride to the emergency room is usually faster than waiting for an ambulance.
Most provinces run a free 24-hour nurse line (811 in most of the country, 8-1-1 or Health Link depending on the province). A registered nurse will talk through your symptoms and tell you whether to go in, and where. It is not a waste of their time — it is what the line is for.
Emergency care is covered by your provincial plan. If you can't find your card, go anyway — they will look you up or sort out billing later. Nobody is turned away from an emergency room for arriving without a card.
Walk-ins can't do imaging, bloodwork, or surgery. For anything on the list above, go to a hospital emergency department — a walk-in will just send you there and cost you hours.
At the door
Emergency departments sort by how sick you sound, and a triage nurse gets about a minute with you. Specifics move you up the list. 'Bad cramps' does not.
Bring your phone, a charger, and someone if you can. Write down when the pain started, the date your last period began, and anything you've taken today — you will be asked all three, and it's hard to remember while you're in pain.
The worry that stops people going is being sent home embarrassed. Emergency departments would rather see a hundred ruptured cysts that turned out to be nothing than miss the one that was torsion. Going and being reassured is a good outcome, not a wasted trip — and it is not your job to diagnose yourself correctly before you're allowed to ask for help.
Educational only. Not a substitute for medical advice. In an emergency, call emergency services.
