What causes backache during menstruation?

Backache during menstruation may be related to pelvic congestion, increased prostaglandin secretion, abnormal uterine position, lumbar muscle strain, endometriosis and other factors. Symptoms usually include distension in the lower abdomen, soreness in the waist, and poor discharge of menstrual blood.

1. Pelvic congestion

During menstruation, pelvic blood vessels dilate, causing local congestion, which may compress lumbar nerves and cause pain. It is recommended to apply heat to the lower abdomen, avoid sitting or standing for long periods of time, and perform appropriate soothing waist stretching exercises.

2. Increased secretion of prostaglandins

When the endometrium is shed, prostaglandins are released, which stimulates uterine contraction and may cause referred pain in the waist. You can use ibuprofen sustained-release capsules, acetaminophen tablets, diclofenac sodium suppositories and other drugs as directed by your doctor for relief.

3. Abnormal uterine position

Retroversion of the uterus may directly compress the sacral nerve plexus, and menstrual congestion will aggravate the compression symptoms. It manifests as persistent soreness in the lumbosacral region, which can be improved by knee-chest positioning. In severe cases, pelvic floor muscle rehabilitation training is required.

4. Lumbar muscle strain

Hormonal changes during menstruation cause ligaments to relax, and the original symptoms of lumbar muscle strain may be aggravated. Be careful to avoid lifting heavy objects, use a hard bed to rest, and perform massage therapy if necessary.

5. Endometriosis

When ectopic endometrium invades the sacral ligaments or pelvic nerves, progressively worsening low back pain will occur during menstruation. It may be accompanied by deep sexual intercourse pain and painful defecation, and needs to be diagnosed through laparoscopy. Commonly used drugs include dienogest tablets, goserelin sustained-release implants, etc.

People with backache during menstruation should maintain a daily intake of 1500-2000 ml of warm water, choose a low-salt diet to reduce water and sodium retention, and wear loose clothing to avoid abdominal compression. You can perform 15-20 minutes/time of supine knee-holding exercise to promote the discharge of menstrual blood. When the pain is obvious, you can use a hot water bottle at about 40°C to apply heat to the lumbosacral area for 10-15 minutes. If low back pain is accompanied by fever, odor of menstrual blood, or lasts for more than 3 menstrual cycles, it is recommended to seek gynecological consultation in time to check for organic diseases.