Understanding Catamenial Sciatica: When Endometriosis Affects the Sciatic Nerve

Sciatica is a term many people associate with back problems — but not all sciatic pain originates in the spine. For some women with endometriosis, the pain follows a very specific pattern: it intensifies before or during menstruation and then fades afterward. This is known as catamenial sciatica, and it’s often misunderstood or overlooked.

What Is Catamenial Sciatica?

Unlike typical sciatica caused by a spinal disc or muscular issue, catamenial sciatica stems from endometrial tissue affecting the pelvic portion of the sciatic nerve. The sciatic nerve runs deep in the pelvis before it travels down the back of each leg, and endometrial implants or inflammation in this area can irritate or compress the nerve in a cyclical, hormone-driven way. blog.possover.com

Women often describe this pain as:

• Burning or stabbing

• Electric shock–like sensations

• Pain that travels from the buttock through the thigh and down the leg

• Disrupts sitting or walking

• Often accompanied by bladder or bowel discomfort around menstruation

Why This Condition Is Often Missed

Many healthcare providers default to looking for back or disc problems when sciatic pain is reported — especially if MRI or X-rays appear “normal.” However, in catamenial sciatica:

• The source of pain is inside the pelvis, not the spine.

• Routine imaging might not show the pelvic nerve involvement.

• Women can go years misdiagnosed, told their pain is muscular or “just stress.” blog.possover.com

  
  

This delay in proper diagnosis not only prolongs suffering but may also allow the condition to worsen over time.

If your sciatic pain:

• Gets worse with your period

• Has been difficult to explain with standard imaging

• Hasn’t responded to typical back treatments

  
  

…your pain deserves a deeper investigation. Catamenial sciatica is a real neurological condition with a recognizable pattern — and knowing about it can be the first step toward effective care.