Experiencing cramps but no period? It might be scary to feel pelvic pain and discomfort outside of your menstrual cycle (especially if it’s in addition to other startling symptoms), but the cause might not be as dire as you think. While cramps are a common period-related pain, “it is not uncommon for people to have cramps outside of their menstrual cycle,” explains obstetrician and gynaecologist Dr Kiarra King. “They can occur for a variety of reasons.”
There are lots of conditions that can contribute to cramping but no period, outside of the period cycle—stress, hormonal imbalances, and even pregnancy can be culprits. There are lots of non-uterine-related conditions like urinary tract infections and gastrointestinal issues that can cause severe cramps in the pelvic area too.
“Every woman experiences cramps differently,” explains women’s sexual health expert Dr Sherry Ross. “A thorough history, pelvic exam, urine pregnancy test, urine culture, STI testing, and pelvic ultrasound would help differentiate a diagnosis for the cause of unexplained cramping.” So, be sure to visit your doctor if you’re concerned about the cause of your cramps.
If your cramps are associated with debilitating pain, heavier bleeding or blood clots, fever, chills, nausea, vomiting, or a positive pregnancy test, these would be reasons to contact your healthcare provider, explains Dr Ross.
Sometimes it can be tough to tell if your cramps call for concern. Thankfully, we’re sharing some of the most common causes for cramping but no period, according to experts.
Reasons for cramps but no period
There are many conditions that cause cramping or pelvic pain not associated with your period, Dr Ross explains. Find some common reasons ahead.
1. Ovulation
Ovulation, when an egg is released from the ovary, can cause pain, cramping, discomfort, and spotting, explains Dr King. This occurrence is known in the medical world as mittelschmerz, which “generally happens mid-cycle” and refers to the pain and discomfort due to ovulation.
2. Endometriosis
Both experts agree that endometriosis is a potential cause of cramping outside your period. Endometriosis is a condition in which the uterine tissue grows outside (rather than inside) the uterus, causing “significant cramping,” Dr Ross notes. “The reason is not completely understood, but it is thought to be caused by pelvic endometrial [tissue] growing outside the uterus.”
3. Urinary tract infection
A urinary tract infection, or UTI, can also cause cramping “because [anatomically] the bladder is right in front of the uterus,” Dr King explains. “A urinary tract infection can be associated with pain and cramping as the bladder spasms, and that can be a cause of cramping that is in spite of whether someone has a period or not.”
4. Interstitial cystitis
Another urinary cause, “interstitial cystitis, also called painful bladder syndrome can cause cramping in the lower abdominal area,” Dr Ross notes. “This disease has symptoms similar to a urinary tract infection, including pelvic pain and a continual strong urge to urinate.” Dr King also notes that interstitial cystitis tends to be a chronic issue, and one that is a “diagnosis of exclusion,” and determined after other testing comes up normal.
5. Bowel issues
Bowel issues like irritable bowel syndrome (IBS), irritable bowel disease (IBD), and even constipation and diarrhoea can be culprits, both experts note. “These abnormal bowel functions cause intense cramping in the lower abdominal area,” explains Dr Ross. “Spasm of the intestines is the cause of this pain that can be debilitating.”
6. Fibroids
“Fibroids are one of the most common pelvic masses that are found, and one of the most common indications that women will undergo pelvic or gynaecologic surgery,” Dr King notes. “Fibroids are basically benign tumours of the uterus, there can be varying sizes: very small and essentially asymptomatic, or they can grow incredibly large and cause lots of symptoms.” They can certainly cause intense pelvic cramps as well as heavy menstrual bleeding.
7. Ovarian cysts
Any sort of mass or cyst on the ovary can “cause pain, discomfort, and potentially cramping,” says Dr King. Pain with intercourse is another related symptom.
8. Pain related to intercourse
“Certain sexual positions are known to be anatomically harder on the vagina and female organs including the uterus and ovaries,” Dr Ross explains. For example: “The ‘Missionary’ position tends to be easier for women and their anatomy whereas ‘Doggie Style,’ or from behind, allows for deeper penetration for the male but more discomfort and pain for many women.” Some positions don’t work for everybody, and it can be normal to experience cramping during sex depending on the position. Dr Ross recommends learning what positions feel best for you with your partner.
9. Stress
Similarly, “feeling depressed, anxious, having relationship problems, and fear of intimacy all play a role in getting sexually aroused and contribute to painful sex and uterine cramping,” Dr Ross continues. Additionally, any sort of significant stress (sex and relationships, aside,) can also throw hormones off and cause cramping, according to Dr Ross.
10. Early pregnancy
“When the embryo implants itself in the uterine lining there can be uterine cramping or spotting associated with implantation,” says Dr Ross. “The uterine cramping connected with implantation bleeding is mild compared to the more severe cramping seen with a typical period.”
11. Ectopic pregnancy
When an embryo has been implanted somewhere other than the uterus (usually the fallopian tubes or ovary), it is known as an ectopic pregnancy, and “there could absolutely be pain and cramping” associated, says Dr King. These are not viable pregnancies, so Dr King warns that anybody in early pregnancy experiencing cramping or spotting should see their doctor right away.
12. Miscarriage
Unfortunately, “every pregnant woman has a 25% chance of having a miscarriage,” says Dr Ross. “When the bleeding starts to look like a heavy period with blood clots and severe menstrual-like cramping, then it is time to be concerned that you are experiencing a miscarriage.”
13. Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is caused by some type of bacteria (STD related or not) that enters the vagina and uterus, causing an infection. Symptoms beyond pelvic pain and cramping include fever and foul-smelling discharge, Dr King explains. It can lead to infertility if left untreated, Dr Ross notes, which is why it is so important to get regular health checkups and testing between new sexual partners.
14. Thyroid issues
“Your period is often a barometer of your body’s overall health and wellness,” Dr Ross explains. “Monthly periods suggest this complex hormonal balance is working well.” When your hormones are off balance, thyroid issues may be to blame for irregular periods and cramps outside of a period.
15. Significant weight changes
Similarly, “significant weight changes—gaining or losing too much—can disrupt the delicate hormonal balance,” Dr Ross explains, causing irregular periods, pelvic pain or discomfort, and cramping outside of a period.
How to find relief from cramping
Cramps during and outside of a period can be very painful, but luckily there are a few things you can do at home to find relief. Below, find a few tips from Dr Ross:
- Relaxing in a warm bath and/or using a heating pad on the abdomen can be helpful.
- Drinking warm or hot beverages helps relax the uterine muscles.
- Taking nonsteroidal anti-inflammatory drugs (NSAIDs), which help block the action of “increased levels of prostaglandins which makes the uterus contract,” causing cramps, Dr Ross notes.
- If birth control is an option for you, try going on a hormonal birth control pill, which “shortens the length, amount, and flow of period bleeding,” leading to fewer cramps, Dr Ross says.
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