Back pain with your period is caused by prostaglandins making the uterus contract and the pain spreading to the lower back. Heat and anti-inflammatory medicine can help.
Why
During a period, the uterus releases prostaglandins and contracts. Pain can spread to the lower back.
Other causes
- Endometriosis.
- Fibroids.
- Premenstrual syndrome.
- Poor posture.
Relief
- Heat on the lower back.
- NSAIDs such as ibuprofen.
- Exercise and stretching.
See a doctor
If back pain is severe, changes or lasts beyond your period.
Prostaglandins and referred pain
The uterus contracts during menstruation due to prostaglandins. These contractions and nerve pathways shared between the uterus and lower back cause pain to be felt in the lower back and thighs.
Position of the uterus
A retroverted (tilted back) uterus, found in about 20% of women, can press on the spine nerves and contribute to back pain during periods, though it is normally harmless.
Hormonal effects
Hormone changes before and during periods loosen ligaments and cause water retention and bloating, adding to back discomfort.
Conditions that can cause severe pain
- Endometriosis, in which tissue similar to the uterine lining grows outside the uterus.
- Adenomyosis.
- Uterine fibroids.
- Pelvic inflammatory disease.
- Ovarian cysts.
Non gynecologic causes
Kidney stones, urinary tract infection, muscle strain or disc problems may overlap with menstruation.
Relief
- Heat on the lower back or abdomen for 15 to 20 minutes.
- NSAIDs such as ibuprofen or naproxen, started at the first sign, with food.
- Gentle exercise like walking or yoga.
- Child’s pose and knees to chest stretches.
- Massage.
- Hormonal birth control to reduce pain.
- Magnesium and vitamin B1 or omega-3 may help according to some studies, but evidence is limited.
Sleep position
Lie on your side with a pillow between your knees or on your back with knees raised.
See a doctor if
Pain is severe, interferes with daily life, is getting worse, or comes with heavy bleeding, fever, pain during sex or irregular cycles.
Why back pain accompanies periods
Before and during a period, the uterus releases prostaglandins that cause strong contractions, and the pain can be felt in the lower back because the nerves from the uterus share pathways with the lower back. About 1 in 5 women has a retroverted (tilted back) uterus, which can press on the spine area, though this is a normal variation. Hormonal shifts also cause fluid retention and muscle tension. Endometriosis and adenomyosis can cause severe back pain with periods.
Relief and when to seek care
NSAIDs such as ibuprofen taken at the first sign work well, and heat applied to the lower back eases muscle tension. Gentle exercise, stretching and a warm bath help. Hormonal birth control can reduce pain. See a doctor if back pain with periods is severe, worsens over months, comes with heavy bleeding, pain during sex, fever, urinary symptoms or blood in urine, because kidney stones and infections also cause back pain.
Based on data from ACOG and the Mayo Clinic
