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Navigating Pelvic Pain During Periods: Causes and Coping Strategies

Medically reviewed by: Melissa A. Delgado, MD, FACOG

Melissa A. Delgado, MD, FACOG is the founder and owner of The Chronic Pelvic Pain Center of Northern Virginia. Dr. Delgado is an experienced, board-certified OB/GYN and has spent the past 10 years dedicating her time to understanding complex and persistent pelvic pain.

A black-and-white photo of a woman's torso curled up, shot from above.
Image Source: Alexander Krivitskiy via Unsplash

Periods, also known as menstruation, are a natural part of a woman's reproductive system. However, for many women, this monthly occurrence can bring about significant discomfort and pain.

One of the most common types of pain experienced during periods is pelvic pain. Understanding the causes of pelvic pain during periods can help us develop effective coping strategies to manage it.

Pelvic pain refers to any discomfort felt in the lower abdominal area between the hip bones. It can range from mild cramping to debilitating pain. This pain typically occurs a few days before menstruation starts and can last for several days. The intensity and duration of pelvic pain can vary from woman to woman.

Common Causes of Pelvic Pain During Periods

Several factors can contribute to pelvic pain during periods. One common cause is the release of prostaglandins — hormone-like substances that trigger uterine contractions. These contractions help expel the uterine lining, which results in the bleeding associated with menstruation. However, excessive levels of prostaglandins can lead to intense pelvic pain.

Another common cause of pelvic pain during periods is endometriosis. This is a condition where the tissue that lines the inside of the uterus instead grows outside of it. This misplaced tissue can cause painful inflammation during menstruation.

Other possible causes of pelvic pain during periods include uterine fibroids, ovarian cysts, pelvic inflammatory disease, and adenomyosis.


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The Link Between Period Back Pain and Pelvic Pain

Many women also experience back pain during their periods, which can sometimes be linked to pelvic pain. The uterus and the lower back share the same nerve pathways, so pain originating in the uterus can radiate to the back.

Additionally, hormonal changes during menstruation can cause muscles in the lower back to contract, leading to discomfort and pain.

It's important to note that not all women will experience both pelvic and back pain during their periods. Some may only experience one or the other. However, for those who do experience both, it can be helpful to address both types of pain when developing coping strategies.

Coping Strategies: Managing Pelvic Pain During Periods

There are several different approaches you can take to manage menstrual pelvic pain. You may find that a combination of multiple treatments and therapies is the most helpful.

Medical treatments

When it comes to managing pelvic pain during periods, various medical treatments are available. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and acetaminophen, can help reduce inflammation and alleviate pain. These work by inhibiting the production of prostaglandins, thus reducing uterine contractions.

For women with severe pelvic pain, hormonal birth control methods may be recommended. Birth control pills, patches, or intrauterine devices (IUDs) can help regulate hormonal fluctuations that contribute to pelvic pain.

In some cases, surgical interventions may be necessary to address underlying conditions such as endometriosis or fibroids.

It's important to consult with a healthcare professional to discuss the best medical treatment options for managing pelvic pain during periods. They can provide guidance based on your particular symptoms and medical history.

Psychotherapy and emotional support

Dealing with pelvic pain during periods can be a drag on your mental and emotional well-being, too. It's crucial to prioritize emotional support and seek psychotherapy if needed. Talking to a therapist can help manage any anxiety, depression, or stress resulting from chronic pain.

Additionally, joining support groups or online communities of women who experience similar symptoms can provide a sense of understanding and validation. Sharing experiences and coping strategies with others can help you take charge of your condition and help reduce feelings of isolation.

Dietary changes

Making certain dietary changes can also play a role in managing pelvic pain during periods. Some women find that reducing their consumption of caffeine, alcohol, and processed foods can help alleviate symptoms. These substances can contribute to inflammation and exacerbate pelvic pain.

On the other hand, incorporating fatty fish, walnuts, flaxseeds, and other foods rich in omega-3 fatty acids may have anti-inflammatory effects and relieve pelvic pain.

Additionally, a well-balanced diet with many whole grains, fruits, and vegetables can support overall health and reduce inflammation.


Engaging in regular physical activity, such as walking, can have numerous benefits for managing pelvic pain during periods. Exercise stimulates the release of endorphins, the natural pain-relieving chemicals in the brain. These endorphins can help reduce the perception of pain and improve mood.

Walking is a low-impact form of exercise that you can easily incorporate into daily routines. Plus, it increases blood flow to the pelvic area, which may reduce cramping and discomfort.

Aim for at least half an hour of brisk walking each day to experience the potential benefits of managing pelvic pain during periods.

Mind-body practices

Mind-body practices like yoga and meditation can be effective coping strategies for pelvic pain during periods. These practices help promote relaxation, reduce stress, and improve overall well-being.

Yoga poses, specifically designed for menstrual pain relief, can target the pelvic area and provide relief from discomfort.

Both meditation and deep breathing can help quiet the mind and alleviate the perception of pain. Incorporating these practices into a daily routine, especially during menstruation, can help manage pelvic pain and promote a sense of inner calm.

Alternative treatments

If conventional medical treatments don't seem to work for you, it may be worth seeking relief through alternative treatments. Here are some of the most popular:

  • Acupuncture: A therapy involving the insertion of fine needles into specific points on the body to promote pain relief and balance energy flow.

  • Herbal medicine: Certain herbs, such as chamomile, cinnamon, and ginger, have anti-inflammatory properties that may help alleviate pelvic pain. However, it's important to consult with a qualified herbalist or healthcare professional before trying any herbal remedies.

  • Massage therapy: Applying gentle, sustained pressure to the muscles of the lower back and pelvic area can reduce inflammation and relax those areas.

When to Seek Help for Pelvic Pain

Pelvic pain during periods can significantly impact a woman's quality of life. Understanding the common causes of pelvic pain and implementing effective coping strategies can help manage and alleviate this discomfort.

Whether through medical treatments, psychotherapy, dietary changes, physical activity, mind-body practices, or alternative treatments, there are various options to explore.

However, intense pelvic pain can be a sign of an underlying medical condition. If your pain persists after your period has ended, you may be suffering from chronic pelvic pain syndrome (CPPS).


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Certain red flags that should prompt you to consult your physician or request a referral to a specialist include:

  • Difficulty managing urination or bowel movements

  • Intense and debilitating pelvic discomfort

  • Symptoms that persist or worsen as time goes on

The Pelvic Pain Center of Northern Virginia is committed to delivering empathetic and thorough care to women grappling with CPPS. Discover relief and enhance your overall quality of life by contacting one of our skilled specialists in chronic pelvic pain without delay.

If you're experiencing severe or persistent pelvic pain during periods, it is important to consult with a healthcare professional for an accurate diagnosis and personalized treatment recommendations.


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