Severe Lower Back Pain Before Menstruation: When to Seek Help?

Sudden lower back pain before menstruation feels like a strain and is very painful?

Hello doctor, since last year, about 2-3 days before my menstrual period, I suddenly experience severe lower back pain that feels like I've pulled a muscle.
The pain is so intense that I can't stand or lie down comfortably, and even putting my feet down causes weakness in my lower back.
Previously, the pain would subside after a day, but this time it has lasted for 3 days.
Should I see a gynecologist for an examination, or is it better to consult another specialty?

QQ, 30~39 year old female. Ask Date: 2021/07/05

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
There are numerous causes of premenstrual syndrome, and accurate assessment requires blood tests, pelvic examinations, and transvaginal ultrasound.
2.
Endometriosis is one of the most common causes.

Reply Date: 2021/07/05

More Info

Severe lower back pain that occurs before menstruation can be a concerning symptom, and it is important to understand the potential causes and when to seek medical help. Based on your description, it seems that you experience acute pain in your lower back that is exacerbated during your menstrual cycle, which can significantly impact your daily activities.
Firstly, it is essential to recognize that menstrual-related back pain can be attributed to several factors. Hormonal changes during the menstrual cycle can lead to increased sensitivity to pain and muscle tension. Additionally, conditions such as endometriosis, fibroids, or pelvic inflammatory disease can contribute to severe back pain during menstruation. These conditions may cause inflammation or pressure on surrounding structures, leading to discomfort that can radiate to the lower back.

Given that your pain has persisted for three days this time, which is longer than your previous experiences, it is advisable to seek medical attention. You have a couple of options regarding which specialist to consult. A gynecologist would be a suitable choice, as they can evaluate any gynecological issues that may be contributing to your symptoms. They can perform a pelvic examination, order imaging studies if necessary, and discuss potential treatments for any underlying conditions.

However, if your lower back pain is severe and affects your mobility, it may also be beneficial to consult a primary care physician or an orthopedic specialist. They can assess your back pain from a musculoskeletal perspective, checking for any issues related to the spine, muscles, or nerves. Conditions such as muscle strain, herniated discs, or sciatica could also be responsible for your symptoms, and these would require a different treatment approach.

In summary, it is crucial to address your severe lower back pain, especially since it has changed in intensity and duration. Start by scheduling an appointment with a gynecologist to rule out any menstrual-related issues. If necessary, they may refer you to another specialist for further evaluation. Early intervention can help manage your symptoms effectively and improve your quality of life. Remember, you should not have to endure pain that limits your daily activities, and seeking help is the first step towards finding relief.

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