Periods and Ankylosing Spondylitis: How I Manage

By Lisa Marie Basile

2 min read

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.

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My periods kicks my ankylosing spondylitis 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?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The AxialSpondyloarthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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EdieAdelstein Member
I know this so well. I'm sorry this is happening to you. My periods have always been bad, and on top of AS, I learned that they would trigger my abdominal epilepsy, and I would be incoherent with pain, vomiting, and nausea. Gabapentin has helped with that, but now I'm looking to see if a hysterectomy is an option. What else is possible if I didn't have these huge setbacks each month?
1. Rebecca C Moderator & Contributor
 <inline-mention username="EdieAdelstein" user-id="4610873"/> The pain and illness you've been through is an enormous burden. I hope you find relief, possibly from treatment with a hysterectomy, so that you can move past it, where you can enjoy life and the neverending possibilities waiting around the corner for you. Wishing you healing and light to guide you through. Rebecca (comm advc)
Mrs.haliray1 Member
I could have written this myself. I'm glad to know that I'm not alone, but also feel for each and everyone one that feels the same way. It is so terrible, and not many people understand
1. Lisa Marie Basile Moderator & Contributor
 <inline-mention username="Mrs.haliray1" user-id="4202710"/> It's so funny! I clicked this article (since it was written a while ago), thinking maybe someone else wrote it. And then read the line, "I need 800 milligrams of Ibuprofen and I might die today" and thought, "WOW. I could have written that." Then, I checked the byline. It was by me. Ha! Talk about brain fog. I'm sorry you understand the nightmare of the AS + period. I hope you're doing ok.
Julie Vallortigara Moderator & Contributor
Thank you Lisa Marie! That's a much needed article. Yes we don't know enough about it and we don't hear enough about it either. I have certainly noticed that my symptoms get worse depending on the phase of the menstrual cycle I am in, and in particular just before the start of my period. I attended a webinar on Women and AxSpa this Autumn and one consultant was saying that the role of females hormone in this condition is under researched. Thank you for raising awareness about it. Hopefully we will learn more in the future. I wish I could share tips on how to manage your pain better. But you seem more experienced than me here. The heat pad and hot bath are definitively a must for me. Take care, Julie.
1. Lisa Marie Basile Moderator & Contributor
 <inline-mention username="Julie Vallortigara" user-id="2107984"/> Wow, Julie. That's wild. I need to spend more time researching & thinking of the hormone/inflammatory connection when it comes to AS. I think, as ith all women's care, it's an underserved area. What was the webinar if you recall? Hope you're feeling okay today. Thanks again for reading! 
2. Julie Vallortigara Moderator & Contributor
 <inline-mention username="Lisa Marie Basile" user-id="2108259"/> Hey! I am good thanks. I hope you are well too. I absolutely agree with you, this field is under researched for sure, like other women health fields I am afraid... I talked about this webinar in my article here, if you want to read more about it. https://axialspondyloarthritis.net/living/women-diagnosis Take care, Julie.
Jessica Gama Moderator & Contributor
This post is so relatable and 100% spot on, in my opinion. My back and hip pain ramps up 10 fold on the first two days of my period, and it's just miserable. I've never really thought about why my period makes my AS worse, but that bit of information about hormones and the immune system here is fascinating and makes complete sense. Excellent article, and I appreciate the added tips at the end!
1. Lisa Marie Basile Moderator & Contributor
 <inline-mention username="Jessica Gama" user-id="2107572"/> The back and hip pain together is such a horrific combo. I LOATHE hip pain. It's just the absolutely dregs. And thanks for reading and commenting. I hope you're feeling okay and that your period coming isn't too brutal!
kthomas76 Member
So familiar every month. Ugh
1. Lisa Marie Basile Moderator & Contributor
 <inline-mention username="kthomas76" user-id="2108019"/> It's the endless cycle of "oh my god, not this again!" + the AS. So hard. Hope you're holding up ok. 
2. kthomas76 Member
 <inline-mention username="Lisa Marie Basile" user-id="2108259"/> Yes!!! The endless cycle. I am trying to use food to help with some of that, but it only helps to a point. I hope you're holding up ok too. Thank you

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