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Because cramps weren’t bad enough…
Your period is a pain enough as it is: You might have cramps that range from slightly uncomfortable to debilitating each month, and even persistent headaches, too. And there’s a chance you also experience period back pain. WTH?
It’s estimated that 40 to 50 percent of people deal with back pain during menstruation, though it’s an underrepresented symptom that patients aren’t routinely asked about, so those percentages may be higher, says Stacey Missmer, ScD, professor of obstetrics, gynecology, and reproductive biology at Michigan State University College of Human Medicine. The back discomfort (which typically affects the low back) could turn up as a normal symptom of your period each month, or it could be tied to an underlying reproductive condition, including endometriosis and uterine fibroids, experts point out.
First, it’s important to confer with your ob-gyn if you’re having terrible back pain that could be related to your period before you try to manage the discomfort on your own, because it may be a sign of one of the above conditions.
But for occasional back pain that comes along with your period, there are ways you can relieve the pain on your own at home. Or, there are more serious medical remedies if your period-related back pain just isn’t getting better and is impacting your day-to-day life.
Ahead, doctors explain what might be behind your period back pain—and how to help it melt away.
Typically, if you’re going to experience period back pain, it’s within the first six days of your cycle, Dr. Missmer says. The back discomfort is usually associated with primary dysmenorrhea, a medical term to describe cramps or pelvic pain that come along with your period each month. Over 80 percent of people who menstruate likely have some kind of primary dysmenorrhea during their periods. (FYI, secondary dysmenorrhea is when cramps and pain are related to an underlying reproductive disorder—but more on that in a minute.)
Period back pain (and primary dysmenorrhea in general) likely has to do with changes in prostaglandins, which are hormones that cause the uterus to contract during your period in order to shed its lining—and that added pressure can also contribute to pelvic and back pain, says Lisa Masterson, MD, ob-gyn and founder of Ocean Oasis Day Spa in Santa Monica, California. Dysmenorrhea can be mild and easily cured by popping an over-the-counter pain reliever, or the pain can be severe enough where it’s difficult to function.
In some cases, back pain may happen before your period actually does, but it’s less common. PMS symptoms (which occur ahead of your period) are more commonly breast tenderness, bloating, irritability, and headaches, explains Dr. Masterson. Symptoms of premenstrual dypshoric disorder (or PMDD, an extreme form of PMS) can include physical pain like cramps and back aches. But PMDD more often impacts mental health, causing crippling depression, mood swings, and brain fog.
Another potential cause of period back pain is secondary dysmenorrhea, or period-related pain caused by another reproductive condition. One common condition that causes back pain, especially during menstruation, is endometriosis. “Endometriosis involves the tissue from the lining of the uterus implanting itself outside the uterus, and potentially causing cysts on or around the ovaries,” Dr. Masterson says. “Implantation of the endometrial tissue in the pelvis can also cause pelvic and back pain.”
For people with endometriosis, the pain might continue throughout their cycle, not just during the days of their period, Dr. Missmer points out. Similarly, she says, adenomyosis, a condition where the endometrial tissue grows in the uterine muscles, often makes pelvic and back pain worse.
Typical period back pain usually occurs within the first six days of your cycle, Dr. Missmer says.
Basically, any condition that causes chronic inflammation and pain to the pelvic area, can also cause low back pain, research supports. Infections of the fallopian tubes or abscesses on the ovaries can be responsible for period back pain as well. Other infections, like pelvic inflammatory disease, often build up fluid and inflammation in the pelvis and can add to back pain during your period, Dr. Masterson says.
Uterine fibroids are also a common source of back pain and cramps—essentially, a benign tumor is growing on the uterus, where it shouldn’t be, explains Dr. Masterson. Many people with polycystic ovary syndrome (PCOS) may experience low back pain, too, as they typically have very heavy periods, which may involve congestion of blood leaving the uterus, and therefore cramping and pain both in and behind the uterus.
If you have primary dysmenorrhea and a surge in prostaglandins at the beginning of your period is the problem, taking a prostaglandin inhibitor like ibuprofen should help in many cases, Dr. Masterson says. If heavy periods are the main issue, whether that’s due to endometriosis, PCOS, or your normal cycle, hormonal birth control pills or injections containing the hormone progesterone can help decrease bleeding, she adds.
There are other medical interventions for moderate low back pain; physical or chiropractic therapy, massage, and acupuncture may provide relief, Dr. Missmer says. If the pain is chronic and severe, meaning it’s interfering with your ability to attend, work, school, or your regular activities, it’s important to consult a gynecologic pelvic pain specialist to work through the pain, she says.
Surgical treatments may be a *last resort* for second dysmenorrhea; some options include a myomectomy, which can remove uterine fibroids, an endometrial ablation, to remove the uterine lining and basically stop menstrual flow, or a hysterectomy, to remove the uterus altogether.
In many cases, you can treat your typical monthly period back pain with home remedies. Here are some expert-recommended tips to soothe your back aches during that time of the month.
