When we think of period cramps, we picture a wincing woman curled up in bed with a stream of Grey’s Anatomy and a pint of Ben & Jerry’s. She is also usually clutching her lower abdomen.
But just as binge-watching and ice cream preferences differ, many women get cramps in places besides their stomach and pelvic region. Samantha has gotten period cramps in her legs for as long as she can remember.
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“It feels like my legs are tensed up, so I usually just try to massage them to relieve them,” she tells Broadly. Britt Bartlett experiences her cramps throughout her hips and down the front of her legs as well. “A deep ache is all I can describe it as,” she says. “When they’re the worst, I’m pretty much doubled over; the only thing that helps is heat. I make my girlfriend be little spoon so I can curl up around her body heat. I call it butt magic.”
Read more: When Your Period Tries to Kill You
Sarah Pasquarelli, who also usually gets cramps in in her legs just before she begins menstruating, says she had never heard of others with the same experience. But according to Dr. Raegan McDonald-Mosley, Chief Medical Officer at Planned Parenthood Federation of America, it’s very common. She says anywhere from 50 to 90 percent of women overall experience painful period cramps. “Sometimes women feel those cramps in different ways, including referred pain to their back, their buttocks, and their thighs,” she tells Broadly. “It has to do with the release of a chemical called prostaglandins. It’s a normal part of the menstrual cycle that’s released from the endometrium, and it passes through the women’s body.”
While these seemingly abnormal cramps are actually quite normal, in some instances severe period pain in unusual areas of the body can be a sign of a serious condition, such as endometriosis, which affects one in ten women in the United States. Endometriosis occurs when endometrial tissue, which lines the uterus, forms outside the uterus, and it can cause periods that are so painful they interfere with a woman’s ability to go to work or school. “[Endometrial tissue] can form on the fallopian tube or on the ovaries, or it can be disseminated throughout the pelvic tissues and can even form in other parts of the body—although that’s much rarer,” says Dr. McDonald-Mosley.
Kaya, who always suffered from extreme periods, could tell something was wrong when she felt unbearable period cramps around her hip joints and intestines. “A month and a half ago, I had surgery for a massive cyst, and it turned out I had stage IV endometriosis,” she tells Broadly.
The pain is actually really consuming, and I’m someone who waxes my own legs.
Before her endometriosis diagnosis and surgery, a general practitioner told Kaya she likely just had IBS, and not much could be done about it. Gail* experiences excruciating period cramps that spread around her butt, hips, and lower back that used to force her to stay home from school. “The pain is actually really consuming, and I’m someone who waxes my own legs,” Gail says. “I get migraines too, and that was easier to get empathy for. People empathize with headaches and vomiting [more than period pain].”
Medical practitioners have to balance the task of normalizing periods—and the symptoms that normally come with them—with taking women’s pain seriously, “It’s hard, because menstruation is a totally normal part of a woman’s life, but at times it can be debilitating,” Dr. McDonald-Mosley says. “It can prevent women from going to school, and it can prevent women going to their jobs, so it’s really important that we not over-medicalize it but also realize that some people do need treatment.”
So how do you know if that pain in the ass is just an oddly dispersed cramp or a go-to-the-doctor dispersed cramp? “I would say that if the pain is outside of the pelvic area, outside of the uterus, and is really one-sided, that that might be a sign that something could be wrong. A woman might want to look into a provider to help her with that. But in general, lower pelvic pain and bilateral pains in the legs, buttocks, and back are totally normal and a common part of the menstrual cycle for lots of women,” says Dr. McDonald-Mosley.
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Phew. Yet even the normal aches and pains that go along with periods deserve relief. For cramps in your butt, legs, or hips, Dr. McDonald-Mosley advises a similar regimen to what you would do for abdominal cramps. “Some studies have shown that exercise, especially exercises that increases blood flow to the pelvic area, like yoga, and even having orgasms can help relieve menstrual pain, especially pain in the back and the legs,” she says. Along with using a heating pad (or in Bartlett’s case, your hot girlfriend), she also points to acupuncture and Vitamin E tablets. Hormonal birth controls, such as the pill, the patch, or the ring can also reduce period symptoms.
“I also use weed and eat about three times as much,” says Bartlett of her own pain-relieving tactics. “I find that food helps with my cramps.” When you put it that way, cramps sound almost worth it.
*Name has been changed.