Why Do I Have Butt Pain During Periods?

What is period butt pain? | Causes of period butt pain | Period butt pain treatments | When to see a doctor

Butt pain during your period means you're experiencing aching, cramping, or other kinds of discomfort in some part of your rear end while you're also in the bleeding portion of your menstrual cycle. But it's worth acknowledging here that, as you'll soon see, there are different types of butt pain you can experience during your period. So it's important to know a bit more about the actual anatomy of your butt to better understand what may be going on.

Your butt, or buttocks if you want to get fancy with it, is comprised of large, fleshy muscles that obviously sit below your hips and above your thighs. Specifically, there are three butt muscles to know: the gluteus maximus, the gluteus medius, and the gluteus minimus¹. Together, these muscles can help you do everything from sitting to running down a new trail to hustling up a flight of stairs so you don't miss an important appointment.

But there's another important section of your butt that might experience pain: your anus and rectum. The anus is the bottom-most end of the digestive tract². It's one of the main avenues through which your body disposes of waste. In this case, that happens in the form of stool. The anus is connected to the rectum, or final section of the large intestine.

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Cramps, uterine swelling, and bloating are common period symptoms. Unfortunately, they can also 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 may be especially common if your uterus tilts toward your back, says Christine Herde, M.D., F.A.C.O.G., vice chair of ob-gyn at CareMount Medical in New York. Neighboring body parts’ nerves are interconnected, so pain that stems from one place might be felt in another. Most people'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.

Severe pain in the gluteal muscles could also point toward endometriosis. This condition is primarily thought to happen when the endometrial (uterine) lining starts to grow on other organs outside of the uterus, says Christine Greves, M.D., a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies. Some schools of thought believe it's not this exact tissue, but a slightly different type, that is the culprit behind endometriosis. Either way, these lesions can bleed and cause terrible pain both during and outside of a person's period. If this wayward tissue is growing near a nerve connected to the butt, such as the sciatic nerve, you could feel pain in your butt muscles.

Another possible issue underlying butt muscle pain is having an enlarged uterus due to fibroids³. Fibroids are noncancerous growths in the uterus that can develop during a person's childbearing years. Fibroids could cause the uterus to push against the back or butt. Fibroids don't always cause symptoms. But sometimes they can make life very difficult from day to day. When symptomatic, fibroids can cause unusually heavy bleeding (during or outside of your period), abdominal pain, pain during sex, trouble urinating, constipation, infertility issues, and more.

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. Endometriosis lesions sometimes sit on the pudendal nerve, which extends 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 on the rectum 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, especially during periods. 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.

Then there's constipation, which can cause butt pain during your period specifically because it may lead to anal pain, says Dr. Kasper. This condition happens when you're not able to poop often enough or when pooping is harder than it should be⁴. Specifically, if you poop fewer than three times a week, have very hard stool that's difficult to expel, or your poop is tough, dry, and lumpy, you may be dealing with constipation. In addition to anal pain, constipation can cause symptoms like bloody poop, abdominal and lower back pain, vomiting, fever, and more.

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The way you handle butt pain during your period of course depends on the exact cause. It may require some trial and error, especially for the more complex sources of butt pain during your period.

• If it's general muscle tension: Dr. Kavaler recommends relaxing your muscles through a bath, a massage, gentle physical activity, or whatever you normally do for period pains. If necessary, take a pain-relieving drug like an NSAID (nonsteroidal anti-inflammatory drug).
• If it's endometriosis: The gold standard treatment for endometriosis is laparoscopy, a minimally invasive surgery in which a surgeon removes as many endometriosis lesions as possible. But not this is not a cure—new lesions may crop up. That's why endometriosis treatment is often multifaceted and can involve hormonal treatment (such as birth control pills) and self-care strategies such as using heating pads. It may also involve taking pain-relieving drugs like NSAIDs. NSAIDs block your body from creating more prostaglandins, which are hormone-like substances that cause smooth-muscle contraction, which is why you experience period cramps. The thinking is that people with endo may make more prostaglandins or be more sensitive to their effects. So taking NSAIDs early at the first sign of endo pain may help ward off even more discomfort for some people, though many people with endometriosis have such terrible pain that NSAIDs don't make a difference. In the most severe cases, a person with endometriosis may undergo a hysterectomy to remove the uterus and potentially other related organs such as the ovaries. Unfortunately, this is also not a cure, as symptoms may persist due to endometriosis lesions and tissue that remains in the body⁵.
• If it's fibroids: Similarly, certain drugs may help reduce fibroid pain and other symptoms. As with endometriosis, these can include hormonal treatments and pain relievers such as NSAIDs, along with self-care management strategies. Surgical options for treating fibroids include myomectomy (removing the fibroids themselves) and hysterectomy⁶.
• If it's constipation: You can try to curb this issue by eating fiber-rich foods and drinking plenty of water, or using stool softeners if necessary.
  
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Butt pain during your period can unfortunately just be run of the mill. But Dr. Greves recommends keeping a diary of the pain to help determine if it’s really related to your period. It's also smart to track the severity of your symptoms. If butt pain during your period doesn’t get better with painkillers or gets so bad you can’t function, see your doctor. Debilitating discomfort around your period is something worth addressing, no matter where it is.

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Footnotes:

Related:

• My Uterine Fibroids Are Trying to Ruin My Life—But I Won’t Let Them
• 7 'Weird' Vagina Things That Are Actually Completely Normal
• I Started Using a Menstrual Cup Instead of Tampons and My Vagina Is So Grateful