Back Pain, Cramping, Spotting & Headaches 2 Days Before a Period

Women may experience an array of symptoms right before their menstrual cycle begins, and others may go through their cycle painlessly. Experiencing back pain, spotting, cramping or headaches in the days leading up to menstruation can be quite normal; however, there are explanations for these symptoms.

Woman with headache holding her head (Image: Brand X Pictures/Stockbyte/Getty Images)

Menstrual Cycle

The menstrual cycle occurs about every 25 to 36 days, with three to seven days of bleeding. As the hormones estrogen and progesterone decline, it triggers the uterine lining to shed. As the hormone level begins to rise again, the uterine lining begins to thicken, a follicle is formed within the ovary and within the follicle forms an egg, or ovum. Midway through the menstrual cycle, the luteinizing hormone from the pituitary gland surges, causing both estrogen and progesterone to rise. This causes the follicle to burst, releasing the egg inside. Some women feel symptoms such as abdominal pain, fatigue, nausea, bloating, breast tenderness and irritability when these stages take place. Some women may also experience spotting in the days leading up to day one of menstruation.

Premenstrual Symptoms

Premenstrual syndrome, also known as PMS, is a set of symptoms that a woman experiences before menstruation. Factors such as cyclic hormonal changes, chemical changes in the brain, stress and poor eating habits can all contribute to PMS. Symptoms of PMS include anxiety, tension, crying spells, mood swings, appetite changes, abdominal bloating, breast tenderness, acne, constipation, abdominal cramping and muscle pain.


Miscarriage is the non-surgical loss of pregnancy. Early miscarriages go unnoticed much of the time, and according to MedlinePlus, up to half of fertilized eggs end in miscarriage before the seventh week, before a woman notices she's pregnant. Contributing factors to miscarriage are hormone imbalances, infection, uncontrolled diabetes, immune disorders and problems in the reproductive organs. Symptoms are low back pain or abdominal pain, passing tissue-like clots, vaginal bleeding and headache.

Reproductive Diseases

Reproductive diseases that cause internal bleeding or internal growths such as endometriosis—a disease that causes endometrial tissue to form outside of the uterus—and polycystic ovary syndrome—a disease that causes the ovaries to form multiple cysts—can cause abdominal cramping, spotting, headache, back pain, bloating and irregular menstrual cycles. Diseases such as these can be caused by imbalances in the hormones estrogen and progesterone.


Any unusual pains, spotting, bleeding or headaches should be reported to a physician. All instances of bleeding or spotting outside of normal menstruation are considered abnormal even if the cause may be harmless.

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