Hi, Noted the history of back pain, discomfort when trying to have bowel movements, menstrual cramps are more intense than normal, Fallopian tubes already tied. The most probable causes of your symptoms can be as follows: Back ache can have local cause like muscle spasm, sprain or sprain of back muscles. PID hat is pelvic inflammatory disease is rare to occur after Fallopian tubes ligation hence almost ruled out. Constipation, need to be evaluated and treated well with stool softeners and laxatives. This may help you the most. As for the cramps during menstruation the cause can be blood clots bigger than the cervix hence cause cramps as the uterus tried to expel these clots. Best is to consult a Gynecologist and have ultrasonography of abdomen. and further management if required. Till then take an antispasmodic like Dicyclomine and Mefenamic acid. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon