Kidney Stones and Women: Small Crystals, Big Pain

I’ve always said there are two kinds of people in the world: People who have had kidney stones and people who haven’t. 

If you fall into the former category, thank your lucky stars, because take it from me, there is no worse pain in the world (not even childbirth). I’m so grateful to Rescripted for giving me a platform to share my story. 

In the fall of 2012, I had a CT scan that revealed I had kidney stones. “Kidney stones are tiny, hard crystals that form in the kidneys when there’s an imbalance of minerals and salts in the urine,” explains David Shusterman, MD, a board-certified urologist and Medical Director of Urology at NY Urology in New York City. “These crystals can clump together, turning into stones of all sizes. Some are as small as a grain of sand, while others can be as big as a golf ball.” 

At the time, the doctors didn’t do anything about my stones. But if I had known that these millimeter-sized deposits (mainly of minerals and salts) forming in my kidneys were about to send me into rip-roaring agony, I would’ve pleaded with my doctor to do something, because as I learned the hard way, ignorance is not bliss.

Read on to learn more about how one tiny, hard crystal once sent me to the emergency room, and how women can prevent kidney stones from forming in the first place. 

Kidney stones, the ER, and me

That December, I was at my Rolling Stone staff job in Manhattan, closing our latest issue, when suddenly I was doubled over at my desk, moaning and wailing. The first thing I remember, other than the agonizing pain, was how nobody seemed to care. While most of my colleagues were consumed with putting the magazine to bed, I had to beg my coworkers to help me. 

The research chief (a woman, naturally) immediately sprang into action: She called an ambulance and got my husband on the phone too. Meanwhile, another female colleague guided me through some calming visualization techniques. 

The ambulance arrived and EMTs wheeled me out of the office on a gurney — not exactly an everyday sight. Once I arrived at the emergency department, the pain intensity was definitely at a 10, so much so that I began throwing up into a kidney dish. I'll never forget how the insurance intake person kept trying to obtain my info while I was heaving into a plastic bowl (he probably saw people like me daily, but still!). Oh, right, soon afterward, I was wheeled away from an aggressive man in handcuffs — for my safety. Is this starting to sound like an episode of The Pitt yet?

My husband arrived at the ED as soon as he could (he was coming from Brooklyn), though the wait felt interminable.

Also interminable? That entire night. Whether you’re an ER or The Pitt fan — or you’ve had to visit the emergency department, then you know Everything. Takes. Forever. All of the doctors and nurses were overworked because it seemed like every drunk and belligerent individual wound up in their ED that night; it was the height of the holiday party season, after all. My most vivid memory of that night isn’t even my own: My husband walked into the men's room to find someone passed out cold on the floor. At some point, a male doctor gave me a rushed pelvic exam and ordered another CT scan — and it was several hours before anyone would administer any much-needed painkillers. I’ve never been more grateful for a morphine drip in my life. 

Why are kidney stones so painful?

Eventually, the doctors determined what I had been suspecting all along: The source of my excruciating pain was a large, jagged kidney stone. Here’s the kicker: I’m calling the stone “large,” right? But size is relative here. My stone was about 6mm. The worst pain I’ve ever experienced wasn’t from my 4 lb. 13 oz. baby a few years later — it was from something the size of a grain of rice. As it turns out, size doesn’t necessarily matter when it comes to kidney stones: “If a stone gets stuck in the kidney or moves through the urinary tract, it can cause sharp pain, nausea, and even blood in the urine,” says Dr. Shusterman. 

Unfortunately, for women, kidney stones have the potential to be even more painful than they are for men, thanks to our hormones and certain medical conditions. “Hormonal changes can play a role” in potentially increased pain or recurrence, says Dr. Shusterman. “Estrogen levels, which fluctuate during things like menopause or when using birth control, can mess with how calcium and oxalate are processed in the body, which can lead to stones.” He also points out that women with “conditions like PCOS or those on hormone therapy might also face a higher risk [of kidney stones].”

Urinary tract infections (UTIs) are another risk factor for women because we “tend to get them more often” than men, “and if these infections keep coming back, they can lead to a specific type of stone called struvite stones,” says Dr. Shusterman. “These stones can grow quickly and get pretty large.” I can attest to this — I was diagnosed with struvite stones a few years after the ER incident, and required surgery to eliminate them.

But back to me and my 2012 emergency: I was discharged from the hospital around 3 a.m. with orders to see my urologist ASAP. After beseeching my urologist's office for a same-day appointment, my doctor recommended a procedure called lithotripsy, which uses shockwaves to break up large kidney stones, thus making them easier to pee out. But I couldn’t get the lithotripsy right away (because of course not), which meant I had to suffer for another four days straight, because Advil — or any over-the-counter meds — wasn't even coming close to easing my pain. I couldn't lie down. I was only comfortable standing up. So forget sleeping that week.

The punchline to all of this was I wound up passing the kidney stone on my own the morning of my procedure. No lithotripsy necessary.

It's still hard for me to write about this experience because, at the time, I didn’t know how to advocate for myself. I accepted not only my coworkers’ apathy but the lack of compassion from my urologists. Why didn’t they warn me when they first discovered the stones that I was a ticking time bomb? Why didn’t they care when I told them about my unrelenting pain? It would be years before I took it upon myself to find a new urology practice. 

Although this wasn’t the last of my ongoing kidney stone trauma, I did eventually find a caring urologist who listens to my concerns and regularly monitors my stones. I haven’t had an issue since 2018, knock on wood! 

How to prevent kidney stones

So how can you prevent kidney stones from forming in the first place? In addition to keeping an eye on your UTI frequency, it's time to make sure you're getting in your eight glasses of water a day. “Not drinking enough water is one of the top culprits,” says Dr. Shusterman. “When you’re dehydrated, the urine becomes more concentrated, making it easier for crystals to form.” He also highlights diet as a potential cause of kidney stones: “Eating too much salt or animal protein, or even foods that are high in oxalates like spinach and chocolate, can also raise the chances of getting stones.” And if you’re considering a “trendy diet like keto,” keep in mind these kinds of diets can “increase uric acid levels and lead to stones.”

In addition to hydration and diet factors, Dr. Shusterman also warns that “women with medical conditions like obesity, diabetes, or metabolic syndrome are at a higher risk” of kidney stones. If you take diuretic medications or “high doses of vitamin C,” bear in mind that these treatments “can also tip the scale toward kidney stones.”

Remember, don’t ever accept, “Oh, you have kidney stones!” as the final word from your doctor. Advocate for yourself whenever needed — and more importantly, drink plenty of water every day. 

Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.