Back Pain Before Period: Causes, Symptoms, Treatments

Up to 90% of people who menstruate experience physical, emotional, and behavioral changes during their period and in the days leading up to it. Premenstrual physical symptoms include period cramps, nausea, diarrhea, bloating, gas, and headaches.

Back pain is a common symptom experienced before menstruation, typically concentrated in the lower back, pelvis, and hips. Back pain before your period is usually due to an increase in hormones called prostaglandins, which also cause period cramps.

Period-related back pain usually occurs in the week before and the first 1-3 days of your period. You may experience pain, throbbing, soreness, and achiness in any part of your back—but most commonly in the lower back. The pain may radiate down your legs, and you may also feel pain in your hips and pelvis.

Menstrual back pain is typically accompanied by other symptoms of PMS and period pain. These can include nausea, diarrhea, cramps, breast soreness, fatigue, sleep disruptions, mood swings, and appetite changes.

Back pain before your period is typically caused by the same factors that cause other premenstrual symptoms, including menstrual cramps.

Changes in Hormone Levels

The medical term for menstrual pain and discomfort is dysmenorrhea. Dysmenorrhea is caused by hormones called prostaglandins, which increase right before your period and during the first few days of it. Pain triggered by prostaglandins in your uterus may present as menstrual cramps, but you can also feel this pain in your back, joints, and muscles.

Changes in Uterus Size

Your uterus increases slightly in size before your period. This increase can put pressure on your nerve endings and tissues, contributing to pain and discomfort in your back, hips, and pelvis. Your uterus typically returns to its original size as you shed your uterine lining during menstruation, resolving any feelings of pain.

Health Conditions

Primary dysmenorrhea refers to period pain caused by normal menstruation. Back pain before your period is typically a normal and natural result of the bodily changes that occur because of menstruation. However, some people experience secondary dysmenorrhea, which is when a specific medical condition affects your period symptoms.

About 10% of people experience secondary dysmenorrhea. The condition most commonly associated with secondary dysmenorrhea is endometriosis, which occurs when tissue from your uterus begins to grow on your ovaries, fallopian tubes, and other surrounding tissues.

Common symptoms of endometriosis include:

• Severe menstrual cramps
• Lower back pain, which may become chronic
• Pelvic pain or pressure
• Abdominal pain or pressure
• Pain with sex
• Heavy bleeding during your period

Other conditions associated with secondary dysmenorrhea include:

• Pelvic inflammatory disease (PID), which is an infection in the female reproductive organs, such as the uterus, fallopian tubes, or ovaries
• Adenomyosis, which happens when the uterine lining grows into the uterine muscle wall
• Uterine fibroids, which are noncancerous growths in the uterus
• Interstitial cystitis, or inflammation in the bladder
• Miscarriage (loss of fetus) or ectopic pregnancy, which occurs when a fertilized egg grows outside the uterus, typically in the fallopian tube
• Abnormalities of the uterus, vagina, or hymen
• Chronic pelvic pain disorders

If you are experiencing back pain related to your period, talk to your healthcare provider about your symptoms. They can help you determine whether your pain is related to typical menstrual changes or an underlying health condition.

In either case, your provider can provide a treatment plan to relieve the pain. If your back pain is due to a medical condition, they can diagnose and treat the underlying condition to better treat and manage your pain.

Health conditions that may cause back pain during your period include endometriosis, PID, fibroids, ectopic pregnancy, adenomyosis, and interstitial cystitis. Symptoms of these medical conditions can vary but usually include severe pain beyond typical menstrual pain.

These conditions also tend to occur later in life, past the first year or two of getting your period—meaning you may notice a change in your menstrual symptoms and pain levels. However, some people experience these conditions as early as adolescence. The symptoms come on suddenly in other cases, like with an ectopic pregnancy.

If you suspect you may have a medical condition causing back pain before your period, schedule a visit with a healthcare provider. They will likely discuss your symptoms, ask about your medical history, and do a pelvic exam.

A provider may also use imaging tests, such as an ultrasound, to look at your uterus and surrounding organs. They will sometimes do a laparoscopy, which is a surgery that allows providers to see inside your pelvic region.

Treatment options for back pain before your period partly depend on what is causing the back pain. When it comes to medication for managing pain, only use medications that have been recommended or prescribed by a healthcare provider.

One commonly recommended pain reliever for period-related back pain is over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), which include medications like Advil (ibuprofen) and Aleve (naproxen). NSAIDs can be particularly helpful for menstrual pain because they treat pain and help decrease the production of prostaglandins.

NSAIDs may not be safe for people with bleeding disorders or health conditions relating to the liver, kidneys, heart, or gastrointestinal tract. Your provider may recommend other types of painkillers, such as Tylenol (acetaminophen), if NSAIDs aren’t a good choice for you.

Your healthcare provider may prescribe hormonal birth control, such as the birth control pill, patch, ring, or a hormonal IUD, to help manage severe period pain. A medical doctor may sometimes recommend a stronger painkiller, such as a prescription pain reliever.

Most cases of back pain before a period can be managed at home. Methods for easing back pain are similar to those for managing general period pain and discomforts before and during your period.

Some tips for managing menstrual back pain and promoting comfort include:

• Use a hot water bottle on your back
• Use a heating pad on your back
• Take a warm bath
• Stretch or do yoga poses
• Get gentle exercise, such as swimming or walking
• Practice meditation, breathwork, and other relaxation exercises

You should see a healthcare provider right away if your back pain comes on suddenly and is accompanied by heavy bleeding, severe pain, or fever. Other instances that require a call to your provider include:

• OTC pain relievers like NSAIDs aren’t working
• Medication and self-care measures aren’t helping, and the pain is interfering with your daily life
• You are experiencing severe cramps or back pain for the first time
• You continue to experience back pain once your period is over

Back pain is common the week before and during the first few days of your period. Your body produces higher levels of the hormone prostaglandins during menstruation, which contributes to back pain and other period pain, like menstrual cramps.

Certain underlying medical conditions can sometimes cause or worsen back pain before your period, including endometriosis and fibroids. If your back pain is new or severe, contact a healthcare professional for support and medical advice.