Bloating? Check. Cramps? Check. Irritability? Don’t even ask. Between the blood and the breakouts, your period can really be a pain in the neck. It can also be a pain in your lower back.

Cramps are one of the most common reasons you might experience lower back pain during your period. But it’s also possible that a medical condition or a strained muscle is causing your pain. Here’s how to deal.

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Painful periods (aka dysmenorrhea) don’t just cause abdominal cramps. The red tide can also bring other uncomfortable symptoms, including headaches, nausea, diarrhea, fatigue, and even back pain.

Wondering what’s to blame for your lower back pain? There are several possible culprits.

Cramps

Prostaglandins, which are similar to hormones, let your uterus know when it’s time to shed its lining. This leads to contractions that act like a uterine bouncer, pushing out all the tissue that has built up during your cycle.

But prostaglandins’ efforts, although effective, can cause a sucky side effect: cramping.

Sometimes these cramps can also affect the web of nerves in your pelvic area. They can press on nearby blood vessels and temporarily cut off the supply of oxygen to some of your muscles. That can cause pain in all kinds of different parts of your body, including your lower back.

FYI: Most of the time, cramps start when the bleeding does and are at their worst when bleeding is the heaviest.

PMS

Premenstrual syndrome (aka PMS) is a condition that affects about 75 percent of people who menstruate. In the week leading up to the start of your period, PMS can cause a variety of symptoms, including:

Endometriosis

Endometriosis is a condition in which your uterine lining grows outside your uterus (typically on your fallopian tubes or into your lower abdomen). This can cause severe pain in your pelvis and lower back.

Other symptoms of endometriosis:

Fibroids

Fibroids, which are noncancerous growths in the muscle of your uterus, can cause lower back pain.

Other symptoms of fibroids:

Adenomyosis

This is a condition in which the uterine lining grows into the uterine wall, which can cause low back pain.

Other symptoms include pelvic pain or heaviness before your period, pain during sex, and pain while pooping.

Certain cancers

Don’t panic, but uterine and cervical cancers can cause lower back pain. However, they would probably come with other symptoms, too, such as:

Your IUD

Copper intrauterine devices (IUDs) have been known to cause back pain, cramping, and irregular periods. They can also cause heavy bleeding or spotting, especially in the first year.

A strained muscle

Did you try a new exercise or pick up something heavy without proper form? It could be causing some soreness in your lower back.

Back pain stinks, but it doesn’t have to stick around. There are lots of at-home methods you can try to ease the pain.

1. Try a heating pad

Why is a person clutching a heating pad the go-to image for cramps? Because research suggests these warm wraps really can help.

Warmth increases blood flow, which can relax your muscles and relieve pain. So grab your heating pad, cozy up on the couch, and turn on your favorite show.

2. Take a warm bath

Even if you’re a shower person, it may be time to make an exception. That warm heat all over your body can work wonders to relax you and ease your cramps.

3. Take a pain reliever

You can try taking an over-the-counter pain medication, specifically a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen. These medications can even block those pain-causing prostaglandins.

FYI: Don’t take NSAIDs if you have a history of stomach ulcers.

4. Go for a walk

Research suggests that exercise of any kind can decrease period pain by reducing the amount of prostaglandins in your system and boosting your endorphins. It can also help you feel less stressed.

For the best results, try to do 30 minutes of aerobic exercise 3 times a week.

5. Try yoga or meditation

Both yoga and meditation can help relax your muscles. That can mean a sigh of relief when it comes to your lower back pain.

6. Get a massage

Book a professional massage or ask a friend or partner to give you one. The pressure can help ease period pain by releasing tension. A small 2010 study suggests that massage can relieve pain in people with endometriosis.

7. Skip the wine, drink the water

Alcohol can make pain worse because it’s a diuretic. That means it will make you need to pee more often, which will dehydrate you faster. This can make cramps even more painful.

Depending on what’s causing your pain, there may be steps you can take to prevent it in the future.

Try hormonal birth control

Hormonal birth control methods (like the pill, patch, and implant) can be used to manage period pain, including lower back pain.

Why? Because the hormones they provide can thin your uterine lining and even stop ovulation. That means less-intense contractions and less pain.

Take some supplements

Some research, including a 2012 study, suggests that taking magnesium alone or in combination with vitamin B6 supplements could help decrease PMS symptoms.

Small studies have also suggested that that vitamin B1, vitamin D, and vitamin E could be beneficial, but more research is needed to be sure.

Before taking any supplements, be sure to check in with a healthcare professional. They can help you make sure you’re getting the right doses and that the supplements won’t interact with your other medications.

Mild backaches, especially in the first day or two of your period, aren’t much cause for concern.

But if your pain is preventing you from doing your normal activities or if it drags on for more than 3 days, contact a doctor. An underlying condition or muscle issue could be causing the pain.

If you’re having other symptoms, let the doctor know. Symptoms like these could indicate a more serious condition:

Back pain is an uncomfortable side effect of your period, but it’s pretty common. It’s typically caused by PMS or cramps, but it’s possible that something a little more serious is going on. If the pain doesn’t go away in a few days, contact a healthcare professional.