Many people wonder if you can experience back pain during your period.
Menstruating can cause you to have lower back pain, which can be exacerbated if there’s an underlying condition causing the pain.
Lower back pain is one of the symptoms of dysmenorrhea, a term given to particularly painful periods.
Pain, including lower back pain, during menstruation can be caused by a few different factors.
The American College of Obstetricians and Gynecologists notes that dysmenorrhea is the most commonly reported menstrual disorder. Roughly half of people who menstruate experience pain for at least one or two days per menstrual cycle.
There are two kinds of period pain: primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhea is caused by cramps. Usually people with primary dysmenorrhea experience pain when they first start menstruating.
During menstruation, the uterus contracts in order to detach the tissue in the uterus lining. Prostaglandins, which are hormone-like chemical messengers, cause the uterus muscles to contract more.
Increased levels of prostaglandins cause more pain. These contractions can cause stomach cramps. In addition to stomach cramps, there may be pain in the lower back that radiates down the legs.
Secondary dysmenorrhea often starts later in life. The pain is caused or exacerbated by physical issues other than cramps.
That said, prostaglandins can still play a role in increasing the pain levels of those with secondary dysmenorrhea. Endometriosis, for example, often causes lower back pain.
There are a number of other underlying conditions that affect the abdomen and lower back, including:
- other conditions that affect the reproductive organs
If your lower back pain is severe, it’s best to see a doctor to determine whether you have an underlying condition.
If you have dysmenorrhea, you might experience a range of other symptoms along with back pain. These symptoms include:
- stomach cramps and pain
- diarrhea, nausea, and vomiting
- leg pain
Endometriosis is a common cause of lower back pain during menstruation. In addition to those listed above, symptoms of endometriosis include:
- extreme pain during your period
- pain during sex
- heavy bleeding during your period
- difficulty with bowel movements
It’s important to remember that endometriosis can also have very few or no noticeable symptoms.
Pelvic inflammatory disease (PID), which can also cause lower back pain, has the following symptoms in addition to dysmenorrhea:
- pain during sex and urination
- irregular bleeding
- foul-smelling discharge or an increased amount of discharge
PID is often caused by sexually transmitted infections (STIs), such as gonorrhea and chlamydia. The bacteria from the infection can spread into the reproductive organs.
It can also be caused by tampon use. If you think you have an STI or PID, contact your doctor.
There are a number of underlying conditions that could contribute to back pain during your period. These include:
- Endometriosis. A condition where the lining of the uterus, the endometrium, is found outside of the uterus.
- Adenomyosis. A condition where the lining of the uterus grows into the uterus muscles.
- PID. An infection caused by bacteria that starts in the uterus and spreads.
- Uterine fibroids. These are benign tumors.
- Abnormal pregnancy. This includes ectopic pregnancy, or miscarriage.
If you suspect you have any of these conditions, talk to your doctor.
To diagnose these conditions, or to discover the cause, you might need to undergo a number of different tests. These can include:
- a pelvic exam
- an ultrasound
- an MRI, which takes an image of the internal organs
- laparoscopy, which involves inserting a thin tube with a lens and light into the abdominal wall. This allows the healthcare provider to find abdominal growths in the pelvic and abdominal area.
- hysteroscopy, which involves inserting a viewing instrument through the vagina and into the cervical canal. This is used to view the inside of the uterus.
Lower back pain can be very painful for many people who experience it. Fortunately, there are a number of home remedies that reduce back pain. These remedies include:
- Heat. Using heating pads or hot water bottles can soothe the pain. Hot showers and baths can have the same effect.
- Back massages. Rubbing the affected area can relieve the pain.
- Exercise. This could including gentle stretching, walking, or yoga.
- Sleep. Try resting in a position that eases lower back pain.
- Acupuncture. The National Institute of Neurological Disorders and Stroke has found that acupuncture can be moderately effective at treating lower back pain.
- Avoiding alcohol, caffeine, and smoking. These can worsen painful periods.
Depending on the exact cause of your lower back pain, your doctor might prescribe certain treatments. These include:
- Birth control pills, particularly those that contain estrogen and progestin, can reduce pain. These include the pill, the patch, and the vaginal ring.
- Progesterone, which also reduces pain.
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin, soothe pain by reducing the amount of prostaglandins made by the body.
If lower back pain is caused by endometriosis, medication might be an option. Gonadotropin-releasing hormone agonists can help reduce the pain.
It might also be necessary to have certain procedures. These include:
- Endometrial ablation. A procedure that destroys the lining of the uterus.
- Endometrial resection. The lining of the uterus is removed.
- Laparoscopy. This allows the healthcare provider to see and remove endometrial tissue.
- Hysterectomy. This is a surgery to remove the uterus.
When to see a doctor
If you have very severe lower back pain that directly affects your quality of life, it’s best to see a healthcare provider. It’s also a good idea to contact your doctor if you suspect you have endometriosis, pelvic inflammatory disease, or dysmenorrhea.
If you tend to experience a range of uncomfortable symptoms during your period, it could indicate there’s an underlying cause.
The bottom line
Menstruation can cause lower back pain. This lower back pain might be particularly severe if you have a health condition such as endometriosis, pelvic inflammatory disease, or uterine fibroids.
If your symptoms are severe, it’s best to talk to a doctor. They can help you figure out the cause and treat your pain.