<s>[INST] well Im trying to understand why I am having lower back pain, hot flashes and menstural type cramping.  Im 39, and took two preg tests and they are negaitve. Cycle is late. no best tenderness and I always have breast tenderness with my cycle and my pregnancies. am I menapausal? [/INST] Hello, I had gone through the case and found that it might be climectric phase or any cyst in uterus.So go for ultrasound of lower abdomen and female hormone test.After getting the proper diagnosis take treatment.Meanwhile do yoga and meditation with proper diet.Hope my answer will be effective for you.Thanks </s>