What causes lower back pain during menstruation?

Menstruation is an important companion for women. During the menstrual period, you may experience various discomforts—some women suffer from abdominal pain, while others experience lower back pain. The underlying causes may differ. So, what causes lower back pain during menstruation?

What Causes Lower Back Pain During Menstruation?

Lower back pain during menstruation is associated with uterine contractions, prostaglandin release from the endometrium, gynecological inflammation, and organic lesions of the uterus or its adnexa. During menstruation, uterine contractions facilitate shedding of the endometrium. These contractions can trigger lower back pain, often accompanied by abdominal bloating and discomfort. Mild cases are considered normal and typically require no specific treatment; symptoms usually subside and resolve completely after menstruation ends. Increased prostaglandin secretion by the endometrium may intensify both lower back and abdominal pain. For individuals unable to tolerate such pain, nonsteroidal anti-inflammatory drugs (NSAIDs) may be used for symptomatic relief. In cases of gynecological inflammation—particularly pelvic inflammatory disease (PID)—with significant pelvic fluid accumulation, pelvic congestion during menstruation can markedly exacerbate lower back pain. After menstruation concludes, a follow-up examination is recommended; if necessary, active anti-inflammatory treatment should be initiated.

Menstruation commonly induces uterine bleeding and pelvic congestion. Women whose uterus is positioned posteriorly are especially prone to recurrent back pain during this time, primarily due to spastic uterine contractions. Typically, lower back pain is most severe during the first two days of menstruation and gradually subsides by the third or fourth day—without interfering with daily activities—and thus generally requires no special intervention. If menstrual lower back pain becomes unbearable, localized heat application and gentle massage may provide effective relief. Avoid using analgesics unless absolutely necessary. Most women experience some degree of discomfort during menstruation, and lower back pain is a common symptom, often accompanied by mild abdominal bloating and cramping. Symptoms usually last only a short time and tend to ease by the second day. In daily life, avoid excessive physical exertion, refrain from consuming raw or cold foods, and ensure adequate warmth for both the lower back and abdomen.

We recommend adequate rest to prevent colds, avoiding spicy and cold foods. Applying a warm towel to the abdomen or lower back may help alleviate discomfort; if pain is severe, certain medications may be taken under appropriate guidance. We hope this information proves helpful to you.