Female 40 menstrual cramps a lot, lower back pain, fatigue.

Seek MD evaluation: While symptoms of menstrual cramps, lower back pain, and fatigue may be related, important to seek md evaluation. Possible that symptoms may or may not be related and management would be determined by results of evaluation. Endometriosis, premenstrual dysphoric disorder, hypothyroidism, depression, musculoskeletal (strained muscle, bulging disc) are just a few of the many different possibilities.