A woman with axial spondyloarthritis sits on the edge of her bed at night, clutching her stomach in period pain.

Periods and Ankylosing Spondylitis: How I Manage

Whenever my period is on its way, I know the true (monthly) battle is beginning. Not only do I contend with the fatigue and pain from ankylosing spondylitis (or radiographic axial spondyloarthritis), but my period has a particularly evil brand of awfulness that seems to settle into my bones.

I've never had a "good" period. I'm the girl who has to down Advil, curl into a fetal position, and keep a bag or bathroom nearby in case I vomit. I've never been the "I guess it hurts a little, but I'm fine" type. I've been the "I need 800 milligrams of Ibuprofen and I might die today" type. I don't understand how people aren't suffering once a month.

My periods kicks my AS symptoms up

When my period hits, it somehow kicks AS up a notch — and by a "notch" I mean 100 notches. My AS back pain — as in my back feeling like one long rod that has been superglued together, broken, and then superglued together again — blends into the pain radiating from my period (for people without periods: the period pain moves from your ovaries to your thighs, hips, and lower back). It feels like one stiff, on-fire, broken, bruised, throbbing blob of pain.

The fatigue (at least on day one of my period) is like being clobbered over the head, leaving you feeling dazed and weak, exhausted and listless. Taking medicine only leads to an exaggerated version of that feeling — since I need so much of it.

The medicine takes the edge off of AS for a bit, but it always comes back; AS pokes its head through the scrim of numbness and makes its way back to the surface. And then I'm left contending with AS and my period for a few days.

I feel like I'm falling apart from inside

I'll put it bluntly: It sucks to feel like you are truly falling apart from the inside. So, if this is you — just know that I see you (especially if you contend with endometriosis or other issues).

Ever feel like your period makes AS worse? There seems to be some reason behind why AS pain acts up during the period. According to a doctor at MedicineNet, "The rationale for this short-term adjustment is that the immune system may be temporarily more active as women's hormone levels change during their periods. The additional medication can frequently help to avoid the symptom roller coaster that affects many women with arthritis."

My secret weapons

  • A heat pack or a hot water bottle. I have a plastic cushion-shaped thing that holds warm water, and I apply it to my back, my hips, and my stomach.
  • I also rely on a warm bath to settle my nerves and to lull me into a peaceful state of relaxation; this is really helpful to inspire sleep because I tend to lose sleep when in this much pain.
  • CBD and pain cream are my best friends. I take 15 drops of full-spectrum, high-quality CBD, and then I rub pain cream on my lower back and hips. I get into bed with a cup of valerian root tea and watch something funny; it's a whole ritual.

What do you do to ward off the extra pain during your period?

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