Confession: When I'm on my period, I don't just get regular cramps. Sometimes, it feels like my butthole is repetitively making a fist. The feeling doesn't usually last long, but when it happens, it's like my butt got struck by a paralyzing lightning bolt.
Whenever I tell someone about these cramps, I'm met with some combo of "OMG, what?!?" and "Sounds awful, can't relate." But, when this TikTok about butthole cramps got over 1 million likes and thousands of "same, girl!" comments, I knew I wasn't alone. So, I reached out to a few doctors to better understand the phenomenon.
"It's the charley horse of your ass," says Evan Goldstein, DO, anal surgeon and founder of Future Method. "The terminology is proctalgia fugax." That translates to "anal pain of unknown cause." It occurs when the muscles that control your butthole (in the pelvic floor and anal canal) spasm and contract. Doctors don't know exactly why butthole spasms happen, but they can be triggered by a few things, including, you guessed it, menstruation.
Why do I get anus cramps during my period?
Jessica Shepherd, MD, a Chicago-based OB/GYN, says that butthole cramps tied to your period are likely the result of prostaglandins, hormones that, among other things, cause the blood vessels in your uterus to constrict and expel blood right before your period. "These prostaglandins also increase contractions of the uterine muscles and the bowels which can cause pain and cramping as well as loose bowel movements of diarrhea," she says. Some lucky people (like me!) thus may also experience anal cramps as a side-effect of overactive prostaglandins.
Dr. Goldstein explains that those anus cramps may also be tied to dreaded period poops. Your estrogen and progesterone levels drop dramatically right before your period. Since progesterone also controls how things move through your digestive tract, losing a lot of it all at once changes your motility, which depending on the person can cause constipation, diarrhea, and anything in between. These hormonal changes (or just the act of pooping more frequently/having a harder time pooping) might trigger a bout of anal cramps.
Butthole cramps aside, you can actually use food to help make your period symptoms less gnarly. Here's how:
Can butthole cramps happen that are unrelated to your menstrual cycle?
In a word, yes, says Dr. Goldstein. He theorizes that it could potentially be caused by too much sitting, which he says puts a lot of physical pressure on the pelvic floor. "We spend all of our days so contracted [from sitting] that now all of a sudden there potentially could become some spasming that happens."
Butthole cramps can also be triggered by a heavy leg day. "People are going to the gym and they're concentrating on doing a lot of leg lifting, squats, and kettlebell swings, and they really are contracting their pelvic floor way, way, way too much," says Dr. Goldstein. He recommends making sure that when you squeeze your glutes that you're not also squeezing your butthole (easier than it sounds, believe me).
Okay, so what can I do about these anal cramps?
As I can personally attest, anal cramps are annoying AF. But they're thankfully pretty easy to deal with. Dr. Goldstein says taking a walk or a warm bath can help relax the muscles and ease the cramping. Over-the-counter pain killers and supplements like evening primrose oil ($30) or magnesium ($13) can also help, he says—just be sure to consult your doctor before starting any new supplements.
He also recommends finding ways to relax the pelvic floor in order to manage anal cramping. "I tell a lot of my clients that the best way [to manage anus cramps] is to actually have sex and to play with yourself with toys," says Dr. Goldstein. Not just because it's fun, but because stretching out your muscles with things like butt plugs and dilators can help counteract the contraction and stress that can build in the pelvic floor, he says. Even if you have no desire to engage in anal intercourse, he says vaginal sex can also help to relax the pelvic floor.
However, if you're frequently dealing with anal cramps, Dr. Goldstein recommends talking to your doctor in order to rule out something more serious like anal fissures or hemorrhoids.
For the most part though, this type of cramping is annoying, but pretty benign. If you too get butthole cramps, remember that they're more common than you think and that you're not alone. 'It's super, super common and normal," says Dr. Goldstein. "Don't feel as if you're singled out."
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