If your rear end tends to get sore when you have your period, you’re not alone-and you’re not imagining it. For some women, that time of month is literally a pain in the butt, Kelly Kasper, M.D., ob/gyn at Indiana University Health tells SELF.
Most commonly, the culprit of butt pain during period days is muscle tension.
Cramps, uterine swelling, and bloating can put pressure on your gluteal muscles-the ones that make up the buttocks. When enough tension builds, the muscles might spasm, causing pain in the lower back, pelvis, and butt. This could also make you feel like you have to pee, Elizabeth Kavaler, M.D., clinical assistant professor of urology at Weil Cornell Medical College and director of urogynecology at Lenox Hill Hospital, tells SELF.
Butt pain during period days is especially common if your uterus tilts toward your back, says Christine Herde, M.D., assistant director of ob/gyn, Mount Sinai Health System at CareMount Medical. Neighboring body parts’ nerves are interconnected, so pain that stems from one place might be felt in another. Most women’s uteruses tilt toward the front, so they feel uterus cramping in their abdomens. But if yours tilts in the reverse direction, which is less common but normal, you might feel cramps in the back or butt.
Mild butt soreness during your period is probably nothing to worry about, but if it’s severe, it could be a sign of another condition.
Dr. Kavaler recommends relaxing the muscles through exercise, a bath, a massage, or whatever you normally do for period pains. If necessary, take a painkiller.
If that doesn’t work, severe pain in the gluteal muscles could point toward endometriosis, a condition that causes the tissue normally shed during your period to grow outside the uterus, says Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies. If this tissue is growing near a nerve connected to the butt, such as the sciatic nerve, you could feel pain in the butt muscles. Less than 1 percent of women have endometriosis around the butt, though.
Another possible issue underlying butt muscle pain is enlargement of the uterus due to fibroids, noncancerous growths in the uterus that can develop during a woman’s childbearing years. Fibroids could cause the uterus to push against the back or butt. Unusually heavy bleeding could also point toward fibroids.
In some cases, the pain is in the rectum or anus rather than the muscles.
This could be due to constipation, says Dr. Kasper. This common menstrual issue might be curbed by eating fiber-rich foods and drinking plenty of water, or using stool softeners if necessary.
Anal pain could also potentially point toward endometriosis, says ob/gyn Aimee D. Eyvazzadeh, M.D., a reproductive endocrinologist and fellow of the American College of Obstetrics and Gynecology. Endometriotic lesions sometimes sit on the pudendal nerve, which has endings all over the pelvis. When irritated, this nerve can send shooting pain to the skin around the anus that intensifies during your period.
If it’s located in the rectum, pelvic colon, or other parts of the gastrointestinal tract, endometriosis can also sometimes cause pain in the bowels, says Michelle Cohen, M.D., a gastroenterologist at Mount Sinai, Brooklyn Heights. Bowel endometriosis can come with other symptoms like painful pooping, rectal bleeding, constipation, diarrhea, and bloating. It can mimic diseases like irritable bowel syndrome and inflammatory bowel disease, so a gastroenterologist and gynecologist often have to work together to figure out the true cause.
Endometriosis often goes undiagnosed because people assume the pain is normal, but postponing treatment can lead to other issues like fallopian tube scarring and diminished egg quality, says Dr. Eyvazzadeh. So it’s important to take symptoms seriously. Other signs of endometriosis include heavy or irregular periods and pain during sex.
If your butt pain worsens during your period but is present all month long, it could actually be a sign of irritable bowel syndrome or hemorrhoids, says Dr. Kasper. And, of course, there are a variety of other issues butt pain could point toward if it’s random instead of cyclical. Dr. Greves recommends keeping a diary of the pain to determine if it’s really related to your period.
So, in short, butt pain is usually just run-of-the-mill period pain. But if it doesn’t get better with painkillers or gets so bad you can’t function, see your doctor. Debilitating discomfort around your period shouldn’t be dismissed, no matter where it is.
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