While not exactly welcome, most women expect to experience some cramping before their period. For some, the pain is mild and they can move through their daily life with little change. For others, it’s excruciating and can lead to missing work and events. (If you identify with the latter, it’s worth it to book an appointment with your OB-GYN to explore ways to make your period cramps less intense.)
But most people don’t expect to get cramps after their period. In fact, Dr. Felice Gersh, MD, a board-certified ob-gyn and integrative medicine doctor, says it isn’t normal. Dr. BreAnna Guan, ND, a licensed naturopathic physician specializing in women's hormone health, echoes this saying, “Cramping after the period can be a sign that something else is going on with [your] reproductive system. It's important to learn more about the pain pattern to better understand the underlying causes.” What could these causes possibly be? Keep reading to find out.
Possible Causes for Cramps After Your Period
According to Dr. Guan, the most common cause of post-period cramps is endometriosis, a gynecological condition that affects between two to 10 percent of American women of childbearing age. People with endometriosis have endometrial-like tissue (tissue that lines the uterus) outside of the uterus. Excessive cramping is a hallmark symptom of endometriosis.
Both doctors say that another possible cause for cramps after your period is fibroids—tumors made of smooth muscle cells and fibrous connective tissue that develop in the uterus. “Fibroids are rare in adolescents but become more common after the age of 35,” Dr. Guan says. She adds that fibroids are non-cancerous tumors and are associated with irregular menstrual bleeding and pelvic pain not related to one’s menstrual cycle. “Pain can often result from the pressure of the fibroids,” Dr. Guan says. She says that fibroids can cause bloating, issues with bowel or bladder function, low-back pain, pelvic pain or menstrual pain.
“Chronic pelvic pain could also be related to irritable bowel disease, bladder issues, adhesions, musculoskeletal causes or the use of an intrauterine contraceptive device,” Dr. Guan says, listing some other possible causes for post-period cramps.
Dr. Gersh says that post-period cramping could also indicate an underlying pelvic floor issue. “Some women could have pelvic floor myofascial pain as a source of pain after periods,” she says, adding that this problem involves the muscles and fascia of the pelvic floor. “A careful pelvic exam and history can help with this diagnosis,” she says.
If you are wondering whether post-period cramping could be a sign of (very) early pregnancy, Dr. Gersh says it’s possible, but not likely. In fact, she says it’s more likely that it’s connected to a miscarriage or subchorionic hemorrhage. “It can also be a symptom of an ectopic (or tubal) pregnancy,” she says.
Dr. Guan says that post-period cramping is also unlikely to be associated with polycystic ovary syndrome (PCOS). “PCOS is not associated with pain patterns specifically. Women with PCOS may be more likely to develop endometriosis and fibroids, however,” she says.
Finally, Dr. Guan says that experiencing cramps after your period could be a sign of pelvic inflammatory disease. This type of illness can cause chronic pelvic pain.
When to See a Doctor About Cramping After Your Period
Since getting cramps after your period isn’t normal, both doctors recommend seeing your healthcare provider if it’s something you’re experiencing. “It is important to act quickly to be able to prevent any disease progression [if necessary] and provide relief,” Dr. Guan says. “Pain is not normal and must be checked out,” Dr. Gersh agrees. She says that experiencing this type of pain doesn't necessarily mean that there’s a serious problem, but you won’t know for sure unless you get checked out.
Once you’re at the doctor, Dr. Gersh says you can expect them to ask about your medical history thoroughly. Then, they will perform an abdominal and pelvic examination. “Most likely, a pelvic ultrasound will be ordered or performed at that time,” she says, adding that laboratory testing may be done as well.
The bottom line is that it isn’t normal to experience cramping after your period. Seeing your doctor is important for figuring out what’s causing your pain. There could be an underlying reason or there may not, but at the very least your doctor will be able to offer possible solutions to make the cramping go away. That way, you can get back to living your life—pain-free.