While back pain tends to occur in both sexes equally, women are more likely to develop back pain linked to hormonal fluctuations throughout life. 

The lower back consists of many different structures, including muscles, soft connective tissue, ligaments, blood vessels, nerves, joints, discs, and bone. They can all cause or worsen the pain. In women, reproductive organs can lead to pain as well. 

Depending on the root cause, lower back pain can persist for weeks or months. It can be dull or sharp and is sometimes accompanied by numbness, weakness, or pain that can radiate to other parts of the body like your buttocks or legs. You might be more prone to back pain if you are overweight or obese, smoke, or follow a sedentary lifestyle.

Both sexes can develop lower back pain caused by overexertion, a fall, extra weight, improper lifting, or psychological stress. Let’s review the specific reasons for lower back pain in women.

1. PMS 

Premenstrual syndrome (PMS) is a set of symptoms that typically occur a week or two before your period. Many women have lower back pain before their menstruation. Experts still don’t know exactly why this symptom occurs, but it is possibly linked to hormonal fluctuations leading to menstruation.

2. Endometriosis 

Endometriosis is a condition in which tissue that is similar to the uterine lining grows outside of your uterus leading to bleeding, swelling, and inflammation in the pelvic cavity. The condition can provoke pain in many areas, including your lower back. You may also have painful cramping during your menstruation, pain during or after sex, and sometimes pain during urination.

3. PMDD

Premenstrual dysmorphic disorder (PMDD) is a more severe version of PMS and triggers more intense and debilitating symptoms. Like with PMS, scientists are not 100 percent sure what triggers PMDD, but the theory is that your brain has an abnormal reaction to the hormone changes causing some of the symptoms. PMDD often leads to back pain as well as severe irritability, depression, or anxiety in the week or two before your period.

4. Pregnancy 

The muscles and ligaments have to adapt to that new location of weight depending on how the baby sits. When the body is adjusting to where the weight is, some women might develop additional pain.

Hormonal and mechanical changes that come with pregnancy and labor can also contribute to sacroiliac joint dysfunction. The sacroiliac joint connects the pelvis to the lower spine. This is one common reason for lower back pain in women who had a pregnancy. 

5. Dysmenorrhea 

Dysmenorrhea, or painful periods, often varies in severity. Most women experience some discomfort during menstruation while others can have more intense pain that radiates to their lower back. Dysmenorrhea is caused by contractions of the uterus that occur to help the uterine lining leave your body. It might also be linked to other health issues like endometriosis.

6. Menopause 

During menopause, a woman experiences a dramatic drop in the female sex hormone called estrogen, and this impacts everything from your hair and skin to your mood, bones, and heart. Postmenopausal hormonal fluctuations predispose women to osteoporosis (weakened bones), and this can contribute to more fractures of the spine, which can result in severe back pain. 

If you are in menopause, your risk for osteoporosis rises because of the lack of estrogen. Brittle bones are more likely to crack, and osteoporosis-related spinal fractures affect nearly 700,000 people each year.

The Bottom Line 

Back pain is not only about arthritis or spinal injuries. The problem can stem from more complex reasons, such as menopause or endometriosis. If you experience unexplained back pain, consult your healthcare provider as soon as possible.