Butt pain during periods is, frankly, the absolute worst. If you experience butt pain during your period, welcome to the reluctant club. No, you’re not the only one, and no, you’re also not imagining it. For some people, that time of month is quite literally a pain in the butt, Kelly Kasper, M.D., ob-gyn at Indiana University Health tells SELF. But why does butt pain during your period happen? And is there anything you can do to get rid of it? Keep reading to find out.
What is period butt pain, actually?
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.
Causes of period butt pain
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.