Why do I get shooting butt pain during my period?

Periods can be a real pain in the bum – literally.

For those of us who menstruate, that time of the month can mean a week-long barrage of uncomfortable stomach cramps, blood-marked undies and emotional vulnerability. Personally, it’s been almost ten years since I was first acquainted with Aunt Flo during a roadside toilet stop on a family holiday.

So, when it comes to my monthly period, I can generally guarantee how it will play out. But there is one symptom of menstruation that never fails to catch me off guard, and for a long time, I was too embarrassed to ask my friends if I was the only one who experienced it. 

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Perhaps I’m going out on a limb admitting this, but every once in a while during my period, I feel a sharp shooting pain in my rectum, as if someone has lit a firecracker up my ass. For me, it’s short and infrequent, but throughout those few seconds, I just about see my life flash before my eyes from its intensity. 

Thankfully, these split-second electric shocks to my bum have no serious impact on my daily functioning. But I have noticed they are yet another taboo we don’t talk about as women. So, I decided to change that, and spoke to Dr Elizabeth Farrell AM, gynaecologist and medical director of Jean Hailes, to find out if rectal spasms during menstruation were as much of a mystery to the medical community as they are to me.

@jalykasmithone of the funniest sounds for me 💀 #forgirlsonly♬ original sound – Josh k

Why do some menstruators feel like they’re being stabbed in the bum on their periods? 

According to Dr Farrell, the mysterious rectum pain experienced by some period-havers is still largely under-researched. Some specialists contribute the muscle spasms to proctalgia fugax, which essentially describes the spasm and contraction of the muscles in the pelvic floor and anal canal.

But Dr Farrell says there isn’t enough literature on the topic to confirm whether proctalgia fugax is the appropriate diagnosis for pelvic floor spasms during menstruation.

“Proctalgia fugax itself is quite rare… and it usually occurs at night, whereas rectal pain with periods isnt always at night, and it’s usually experienced in conjunction with uterine contractions” she says. 

So, the jury is out on whether period butt pain can be diagnosed and treated as proctalgia fugax, but do we know what causes it? “It’s also not clearly understood why this happens,” says Dr Farrell. 

Unfortunately, because of the patriarchal belief that women are weaker than men, gynaecological health concerns have a pattern of being dismissed and invalidated, and as a result, research in the area is still playing catch up. 

Nevertheless, some specialists suggest rectal pain and spasms could be a result of hormones called prostaglandins, which are responsible for making the muscles in your uterus contract during menstruation. High levels of prostaglandin could also cause muscles in the pelvic floor to contract, resulting in pelvic pain similar to period cramps. 

@dr.karanr#stitch with @jalykasmith b00ty cramps on your “.” #womenshealth #period #menstruation #schoolwithdrkaran #learnontiktok♬ original sound – Dr Karan Raj

Is rectal pain during your period a cause for concern?

While there are some lucky ducks who don’t experience rectal spasming on their periods, Dr Farrell assures me that as long as your daily functioning isn’t impaired, they aren’t a cause for concern. “Some women do get rectal pain when they’re menstruating. Usually, it’s not isolated on its own, but is experienced in conjunction with other period pain or uterine pain” she says.

But if you have pelvic pain that is more severe or consistent, or is not connected to your menstrual cycle, you could be dealing with a separate condition.

“If the pain was severe and consistent with every single period and was impacting somebody’s ability to function, then it needs to be investigated, definitely,” Dr Farrells tells me. She says severe pelvic pain could be a sign of levator ani syndrome, which occurs when the pelvic floor muscles are too tight, or even endometriosis.  

Endometriosis occurs when tissue grows outside of the uterus and into the rectum, vagina, or between them in the rectovaginal septum. Rectovaginal endometriosis is rare, but can cause chronic pelvic pain, bloating and gastrointestinal issues in addition to standard endometriosis symptoms. If your pelvic pain is severe, or worsens during your period, Dr Farrell advises you to make an appointment to see your GP. 

Sporadic instances of butthole cramps are, for the few seconds to minutes they occur, pretty unpleasant. If you’re caught off guard by one, it will probably feel like a horror movie jumpscare (without the forewarning of abandoned houses and eerie music). 

But, if you can, try having a laugh with friends next time you get a surprise shock of butt pain, because chances are, they know exactly how you feel. 

This article was originally published on July 20, 2021.

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