Common causes of lower back pain in females include muscle strain, premenstrual syndrome (PMS), endometriosis, and painful periods. Treatments include rest, medications, and surgery.

Back pain affects people of all sexes and ages. There are a range of causes of lower back pain, including injury, overuse, arthritis, and other medical conditions, such as degenerative disk disease. People who menstruate may also experience lower back pain related to their menstrual cycles, pregnancy, and conditions such as endometriosis.

Anatomical differences related to sex can also contribute to lower back pain. For instance, the pelvis of a person assigned female at birth is generally wider than that of a person assigned male at birth, altering the alignment and stress distribution on the lumbar spine.

This article looks at lower back pain causes in females. It also explains the symptoms of various causes and their treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Lower back pain is a relatively common condition that can affect anyone.

Some general causes include:

  • Muscle strain: People can strain their muscles due to overexertion, lifting heavy objects, and making sudden movements.
  • Ligament sprains: If a person stretches or tears ligaments supporting the spine, they can experience pain and inflammation.
  • Herniated discs: The soft, gel-like material inside a spinal disc can protrude and press on nerves, causing lower back pain.
  • Osteoarthritis: Degeneration of the spinal joints over time can lead to osteoarthritis and lower back pain.
  • Spinal stenosis: The narrowing of the spinal canal can compress the nerves, causing pain.
  • Scoliosis: This is an atypical curvature of the spine that can cause lower back pain.

While these causes apply to anyone, certain conditions and factors may specifically affect females. Examples include:

  • menstrual pain
  • endometriosis
  • pelvic inflammatory disease (PID)
  • fibroids
  • pregnancy
  • ovarian cysts
  • adenomyosis

Menstrual pain, which doctors may also call dysmenorrhea, can occur just before or during menstruation. Symptoms vary from mild to severe and may include:

  • lower abdominal cramps
  • lower back pain
  • pelvic discomfort

A person may also sometimes experience headaches and nausea.

People can usually manage mild menstrual pain with over-the-counter (OTC) pain relievers such as ibuprofen (Advil) or naproxen (Aleve). Applying a heat pack to the lower abdomen can also provide relief.

For more severe pain, a doctor may prescribe stronger pain medications or hormonal contraceptives to regulate a person’s menstrual cycle and alleviate pain.

Learn more about how to manage menstrual pain.

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus. It can affect the ovaries, fallopian tubes, and other organs.

Symptoms include:

  • pelvic pain
  • painful periods
  • pain during sexual intercourse
  • fertility issues

Some individuals may also experience lower back pain and gastrointestinal symptoms during menstruation.

Treatment options include pain medications, hormonal birth control, and gonadotropin-releasing hormone (GnRH) agonists. Sometimes, a person may need surgery to remove the endometrial tissue and alleviate symptoms.

Learn more about how to manage endometriosis.

Pelvic inflammatory disease (PID) is an infection of the reproductive organs, primarily the uterus, fallopian tubes, and ovaries. It causes:

  • lower abdominal and back pain
  • fever
  • atypical vaginal discharge
  • irregular menstrual bleeding

Antibiotics can treat the infection. However, prompt treatment is essential to prevent complications such as infertility or chronic pelvic pain.

Learn more about PID.

Fibroids are noncancerous growths that develop in or on the uterus.

Depending on their size and location, fibroids may cause:

  • pelvic pain or pressure
  • heavy menstrual bleeding
  • frequent urination

Some individuals may also experience lower back pain.

Treatment includes medications to control symptoms, hormonal therapies, and surgery to remove the fibroids or uterus.

Learn more about fibroids.

Lower back pain can occur during pregnancy as the individual’s center of gravity shifts, increasing the stress on their lower back muscles. Hormonal changes can also contribute to pain and discomfort.

Gentle exercises, proper posture, and support devices such as maternity belts can help with lower back pain. In some cases, physical therapy and prenatal massages may also provide relief.

Learn more about back pain during pregnancy.

Ovarian cysts are fluid-filled sacs that form on or within the ovaries.

Small ovarian cysts may not cause symptoms, but larger ones can lead to pelvic pain or pressure and sometimes lower back pain.

If a cyst ruptures or becomes twisted, it can cause severe pain and require immediate medical attention.

Treatment for ovarian cysts depends on their size and characteristics. Small cysts often resolve on their own, while larger or persistent cysts may require intervention.

Learn more about ovarian cysts.

Adenomyosis occurs when the endometrial tissue grows into the muscular wall of the uterus. This can cause:

  • menstrual pain
  • heavy menstrual bleeding
  • pelvic pain
  • lower back pain

Treatment may include pain management with medications and hormonal therapies. In severe cases, a person may need a hysterectomy.

Learn more about adenomyosis.

If a person has persistent or severe lower back pain, they should seek medical attention.

For mild or occasional lower back pain, individuals may consider the following self-care measures:

  • Rest and activity modification: People can avoid activities that exacerbate pain, but it is best not to stay immobile for extended periods. Gentle movements and walking can help prevent stiffness.
  • Heat or cold therapy: Applying a heating pad or warm compress to the lower back can relax the muscles and reduce discomfort. Alternatively, an ice pack can help reduce inflammation and numb the area.
  • OTC medications: The following can help ease pain:
    • Acetaminophen (Tylenol)
    • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
    • topical patches (Icy Hot, lidocaine)
  • Stretching exercises: Gentle stretching of the lower back and surrounding muscles can provide relief. It is best to consult a healthcare professional or physical therapist to learn appropriate stretches for a specific condition.
  • Improving posture: Maintaining good posture, whether sitting or standing, can reduce strain on the lower back. A person may be able to use ergonomic furniture and support when necessary.
  • Lifestyle modifications: Managing stress, maintaining a moderate weight, and avoiding smoking can improve overall spine health.

While home remedies can temporarily relieve lower back pain, individuals will need to contact a healthcare professional if the pain lasts more than a few days or becomes more severe.

Pain that involves any of the following could indicate nerve involvement that may signal a medical emergency:

  • sensations that radiate down the legs
  • tingling or weakness
  • accompanying changes in urinary or bowel habits

Early diagnosis and intervention are essential for managing lower back pain effectively.

Healthcare professionals can provide a proper assessment, diagnose the underlying cause, and recommend appropriate treatments to alleviate pain.

A variety of factors can cause lower back pain in females.

While some causes are common to all sexes, conditions and factors specifically related to lower back pain among females include menstrual pain, endometriosis, pelvic inflammatory disease, fibroids, pregnancy-related back pain, ovarian cysts, and adenomyosis.

Home remedies such as rest, heat or cold therapy, OTC pain relievers, stretching exercises, and posture improvement may offer temporary relief. However, a person will need to seek medical attention for persistent or severe pain.