Cramping but No Period? Here’s 15 Possible Reasons Why
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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 Kiarra King, M.D., F.A.C.O.G., board-certified obstetrician and gynecologist. “They can occur for a variety of reasons.”
There are many conditions that can contribute to cramping outside of the period cycle—stress, hormonal imbalances, and even pregnancy can be culprits. There are also a number of various non-uterine-related conditions that can cause severe cramps in the pelvic area as well.
Meet the Experts: Melanie Bone, M.D., consultant ob/gyn and US medical director at Daye; Kiarra King, M.D., F.A.C.O.G., board-certified obstetrician and gynecologist; Sherry Ross, M.D., women’s sexual health expert, author of she-ology and the she-quel.
“Every woman experiences cramps differently,” explains Sherry Ross, M.D., women’s sexual health expert, author of she-ology and the she-quel. “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.
Still, sometimes it can be hard to tell if your cramps are 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.
What the cramps feel like: During ovulation, you’ll typically notice pain on one side of your lower belly. It can feel dull or sharp, and can last from minutes to two days. The side of the pain depends on which ovary releases the egg, so you may feel the cramping on different sides every month or in the same place each time.
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.”
What the cramps feel like: Endometriosis often causes severe menstrual cramps that may begin before the period and last for days, says Melanie Bone, M.D., consultant ob/gyn and US medical director at Daye. “The pain can be sharp and stabbing, or a deep, throbbing ache in the lower abdomen, back, and pelvic area. Cramping may also occur during or after sex, during bowel movements, or while urinating.” Longstanding, severe endometriosis can cause a condition called frozen pelvis, which may lead to chronic, daily pelvic pain, she notes.
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.”
What the cramps feel like: UTIs can cause abdominal cramping ranging from mild to intense, says Dr. Bone, and the pain is often felt in the lower abdomen or back. “Bladder spasms from the infection irritating the bladder lining can feel like sudden cramping,” she adds.
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.
What the cramps feel like: Cystitis causes a burning sensation when urinating, says Dr. Bone. “Right before urinating, there may be a pulling, squeezing, pinching or stabbing pain that is relieved during urination but returns towards the end,” she explains.
5. Bowel issues
Bowel issues like irritable bowel syndrome (IBS), irritable bowel disease (IBD), and even constipation and diarrhea 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.”
What the cramps feel like: IBS pain is usually sudden and in your belly. The cramps might go away after you poop. Some people will also feel bloating and pressure, or feel their IBS pain as spasms. Your specific pain will depend on whether you have constipation or diarrhea. Symptoms usually get worse during your period.
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 gynecologic surgery,” Dr. King notes. “Fibroids are basically benign tumors 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.
What the cramps feel like: Uterine fibroids can cause a feeling of heaviness, pressure, or cramping in the pelvic area and lower back, says Dr. Bone. “Sharp, stabbing pains may occur if a fibroid outgrows its blood supply.” Cramping is often worse right before or during the menstrual period, she notes.
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.
What the cramps feel like: Most ovarian cysts don’t cause symptoms, notes Dr. Bone. “However, larger cysts can cause pelvic pain or a dull ache that may radiate to the lower back and thighs. Sudden, severe pelvic pain may occur if a cyst ruptures or twists, cutting off its blood supply.” Cramping also may intensify during the menstrual period, she adds.
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.
What the cramps feel like: These cramps are usually felt in the lower pelvis, vagina, or even rectal area,” Alyssa Dweck, M.D., ob/gyn, author of The Complete A to Z for Your V, and sexual reproductive health expert for INTIMINA, previously told Prevention. “They can be fleeting for a few seconds or longer duration, intermittent or constant, and vary in intensity.”
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.
What the cramps feel like: People with stress-related cramping most often complain of a knotted feeling, cramping, bloating, indigestion, nausea, or diarrhea. Generally speaking, stress increases the movement and fluid secretion of your gut, which can leave you feeling like your stomach is either unusually blocked or extra active.
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.
What the cramps feel like: The uterine cramping connected with implantation bleeding is mild compared to the more severe cramping seen with a typical period, says Dr. Ross.
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.
What the cramps feel like: When you experience an ectopic pregnancy, you may have mild cramps followed by sudden, sharp, stabbing pains on one side of your lower belly. It can develop suddenly or gradually, and may be persistent or come and go. The pain can potentially get so severe that you feel it in your shoulder and lower back as well.
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.”
What the cramps feel like: The cramping will typically begin to feel like average period pain, and then get more severe.
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.
What the cramps feel like: With PID, you’ll typically experience pain on both sides of your lower belly, pelvis, and lower back.
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.
What the cramps feel like: If you are having cramps outside of a period due to hormonal imbalance, the pain will usually feel like typical menstrual pain that you feel during your regularly-scheduled 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.
What the cramps feel like: Rapid weight fluctuations can cause electrolyte imbalances, which can lead to muscle cramps. These muscle cramps are typically felt in your pelvis and can range from mild to severe.
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.
Lifestyle changes like exercise, dietary modifications, heat, and over-the-counter pain relievers may help ease cramping and pain, says Dr. Bone, “however, they are not a substitute for medical treatment.” Remember, you don’t have to suffer in silence—there are treatments available that can help manage pain and improve your quality of life, she notes.
When to see a doctor about cramps but no period
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.
Per Dr. Bone, you should also make an appointment with your doctor if you experience any of the following:
Pelvic pain or cramping that lasts for more than a few days
Pain that interferes with your daily activities or keeps you from going to work or school
Severe pain accompanied by nausea, vomiting or fever
Sudden, sharp pelvic pain, especially if it doesn't go away
Cramping along with spotting or bleeding between periods
Difficulty getting pregnant
Persistent and worsening pelvic pain with fever, chills, nausea, vomiting, abdominal pain or unusual bleeding could suggest a medical emergency, adds Dr. Ross. Following up with your healthcare provider or going to the emergency room would be recommended if any of these symptoms occur, she advises.
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