What causes back cramps during my period

Menstrual pain

Menstrual pain(Period pain, dysmenorrhea): Pain in the lower abdomen during menstruation. About 20% of all women suffer from it; in young girls through puberty, every second is affected. Menstrual pain can usually be fought with simple means.

Leading complaints

  • Drawing, cramp-like pain in the lower abdomen, especially on the first two days of bleeding
  • Slight pain just before the menstrual period
  • a headache
  • Nausea and vomiting
  • Fatigue and listlessness.

When to the doctor

In the next few weeks if

  • the pain occurs with each menstrual period and is so severe that it interferes with the normal daily routine.
  • there are menstrual disorders at the same time.
  • the pain occurs suddenly and the menstrual period has always been painless until then.

The illness

Disease emergence

Primary dysmenorrhea. If the menstrual pain has existed since the first menstrual period, the doctor speaks of primary dysmenorrhea. In this case, the pain is caused by a spasmodic contraction of the uterus, for which the body's own substances, the prostaglandins, are responsible. Prostaglandins occur in almost all organs except in the uterine wall and can trigger muscle contractions as well as pain. With primary dysmenorrhea, the pain usually disappears in the following cycles.

Secondary dysmenorrhea. In secondary dysmenorrhea, the pain only occurs after a few years, while the menstrual bleeding was previously painless or painless. The causes are varied and must be clarified by a doctor. The pain is caused, for example, after the use of mechanical contraceptives (such as an intrauterine device or diaphragm). Menstrual cramps also occur with benign uterine tumors such as myomas or with endometriosis.

In principle, the psyche also plays a major role in the development of pain. Stress, worry, or the automatic expectation of pain, even if the girlfriend or mother suffers from it, can cause them. Sometimes young girls still feel uncomfortable and unsure about the changes in their bodies. Menstrual pain may be an expression of an unconscious attitude of rejection towards growing up.

Diagnostic assurance

Ultrasonic. With a gynecological examination and an ultrasound of the lower abdomen, the doctor rules out organic causes such as malformations, fibroids of the uterus or endometriosis.

Laparoscopy. If endometriosis is suspected, a laparoscopy is necessary.

Your pharmacy recommends

What you can do yourself


Lying down, resting and / or sleeping often help at the first sign of pain.

Heat applications.

A hot water bottle, a heated spelled or cherry stone bag or warm compresses on the lower abdomen or a warm full bath (e.g. with lemon balm, chamomile or bergamot as a bath additive) relieve cramps and relieve pain. A mud pack on the abdomen or a visit to the sauna also help.


Sex can reduce the pain, at least when it comes to orgasm. Because then the body's own endorphins are released, opiate-like substances that have a pain-relieving effect, at least for a short period of time.


Massaging the abdomen is effective against pain and cramps.

Appropriate medication

Ibuprofen inhibits prostaglandin production and in this way has a pain-relieving effect. Naproxen is also a well-tolerated prostaglandin inhibitor. Butylscopolamine is an antispasmodic agent.

Acetylsalicylic acid (e.g. Aspirin®) also alleviates pain, but is not suitable during menstruation because it has an anticoagulant effect and can therefore increase blood loss even more.

Complementary medicine

Herbal Medicine. For the treatment of menstrual pain, standardized monk's pepper extract (Vitex agnus-castus, e.g. Agnolyt®, Femicur®) is recommended. Black cohosh (Cimicifuga racemosa) and fingerweed (Potentilla anserina) serve to stabilize the hormonal balance. Belladonna, Crocus, Ignatia, Lachesis, Pulsatilla, Sepia, Uzara and Zincum metallicum also help. Although the preparations are available without a prescription, it is better to take them only after consulting a gynecologist.

Tea blends.

Mixtures of chamomile flowers (Matricaria recutita), snowball tree bark (Viburnum prunifolium) and goose weed (Potentilla anserina) have an antispasmodic effect; it is recommended to start a tea cure (up to 3 cups daily) a few days before the expected start of bleeding.

TENS therapy.

Transcutaneous electrical nerve stimulation has proven effective in the treatment of menstrual pain. The doctor sticks electrodes on the skin, through which weak electrical impulses are sent for stimulation. The TENS therapy is easy to use, but an optimal effect is only achieved if it is used several times a day. It is important that the electrical impulses that are supplied to the body have a sufficiently high frequency.


The World Health Organization generally recommends acupuncture for pain. In comparison with the TENS therapy, however, it does a little worse in terms of its effectiveness against menstrual pain.


Acupressure also helps against heavy bleeding and cramps. About a hand's breadth below the knee on the inside of the leg is a reflex point that you press for a few minutes yourself several times a day.


Remedies frequently used in homeopathy are Belladonna, Cimicifuga, Crocus, Ignatia, Lachesis, Pulsatilla, Sepia, Uzara and Zincum metallicum.


Primary dysmenorrhea. If organic causes are excluded, the doctor will prescribe short-term pain reliever or anticonvulsant medication (e.g. butylscopolamine such as Buscopan® or Spasman®). Often the symptoms can also be alleviated with self-treatment measures (see above).

Taking the "pill" also leads to lighter and shorter bleeding for many women and makes the pain go away.

Secondary dysmenorrhea. Here, the underlying cause such as endometriosis must be treated.


Move. Regular sporting exercise promotes blood circulation, relieves muscle cramps and also ensures mental equilibrium.

Relaxation procedure. In order to avoid (cramp-like) pain in advance, relaxation methods such as progressive muscle relaxation according to Jacobson or autogenic training, but also yoga and mindfulness training, help. In addition, these procedures change the perception of pain. However, it takes 2-3 months for such a relaxation technique to work.

Orthomolecular medicine. Some women respond to taking magnesium. Orthomolecular medicine attributes the trace element to a relaxing effect on the uterine lining and an inhibiting effect on the pain-inducing prostaglandin production. Which dosage is suitable in each individual case should be agreed with the attending gynecologist. The same applies to vitamin B1: in a study, the regular intake of 100 mg daily proved to be successful in some cases. However, in this case too, the dosage and intake should be clarified with the doctor. A temporary intake of iron a few days before and during menstruation helps with the formation of new blood and thus also against anemia, tiredness and listlessness.


Dr. med. Astrid Waskowiak, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "Description", "Symptoms and complaints", "The disease", "Your pharmacy recommends" and "Medical treatment": Dagmar Fernholz | last changed on at 10:28

Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.