Cramps But No Period: What Are the Causes?

Do you have menstrual cramps, but you’re not expecting your period? Have you had extended periods of abdominal cramping, bloating, and swelling that feels exactly like your period but isn’t?

Many people experience symptoms akin to menstrual cramping even when they are not on their periods. It’s surprisingly common, and various factors can contribute to it, including changes in hormone levels, imbalances in your body's natural chemicals, and fluctuations in your immune system.

Why Do I Have Cramps But No Period?

Dr. Tara Brandner DNP, FNP-C explains, "Experiencing cramps without a period can often be attributed to hormonal shifts within the body. These shifts, particularly involving hormones like prostaglandins, play a pivotal role in triggering cramp-like sensations.

"Prostaglandins are naturally occurring compounds that are involved in various bodily processes, including inflammation and smooth muscle contraction. During the menstrual cycle, higher levels of prostaglandins are released in the uterus as part of the body's preparation for shedding the uterine lining. These prostaglandins cause the uterine muscles to contract, leading to the characteristic cramping experienced during menstruation."

These issues can cause inflammation, leading to the pain and discomfort associated with menstrual cramping. Some can be temporary due to switching your birth control. But there are many other reasons, too, from sexually transmitted infections, early pregnancy, and menopause, to urinary tract infections like cystitis and more serious conditions like endometriosis or ovarian cancer.

So while there’s no need to panic every time you get a cramp, it is crucial to track and monitor how often and how severe these cramps are so you can address any health issues sooner rather than later. Here are a few to watch out for:

Pregnancy

Pregnancy is one of the most common reasons you may experience cramping during your menstrual cycle (even before you skip your period). Cramping is a typical symptom of early pregnancy, as this is when an embryo begins to implant itself into the uterine lining to grow and develop.

As a result, you may experience cramping or other uncomfortable symptoms as this embryo implants itself into your uterine lining. In some cases, cramps that come on as an early sign of pregnancy will be mild, similar to PMS symptoms.

However, in some cases, these cramps may cause abdominal pain, discomfort, or even nausea, so it is important to be aware of the potential for early pregnancy. 

While not all women will experience pre-period cramps throughout their pregnancy journey, it is worth being aware of this possibility so that you can take steps to treat your symptoms if needed.

Occasionally, cramps like this can be warning signs of ectopic pregnancies. So, if you’re sexually active (even if you’re on birth control or use other contraceptives), get an over-the-counter pregnancy test and seek medical attention if necessary. 

Endometriosis

As you may have read in our article about endometriosis, it occurs when the uterine lining (the endometrium) begins growing outside the uterus. It can happen in various places throughout the body, such as in the fallopian tubes, ovaries, or bladder. In some cases, endometriosis can also spread to the digestive system or lungs.

Endometriosis usually develops during a woman’s childbearing years and may affect approximately two to 10 percent of women between 25 and 40 worldwide. Although the exact cause of endometriosis is unknown, there are several theories about how it may develop.

One theory suggests that endometriosis may be due to retrograde menstruation when menstrual blood flows backward through the Fallopian tubes and into the pelvis. Another theory suggests that an immune system disorder may cause endometriosis. Regardless of its cause, endometriosis can cause various symptoms, including pelvic pain, cramps, and infertility.  

‍Dr. Tara Brandner DNP, FNP-C says, "Conditions like endometriosis and polycystic ovary syndrome (PCOS) can lead to chronic hormonal imbalances. In these cases, abnormal levels of hormones such as estrogen and progesterone can result in heightened prostaglandin production, even in the absence of a regular menstrual cycle. This excess of prostaglandins can lead to more frequent and intense cramping sensations."

Endometriosis diagnosis involves a combination of medical history, physical examination, and imaging tests. Dr. Tara Brandner DNP, FNP-C shares, "in my practice, I see this in undiagnosed endometriosis almost always. I see providers overlooking this disease and dismissing it. So many women have it and don't even know it."

Treatments for endometriosis may include medication, surgery, or a combination of both. If you think you may have endometriosis, book an appointment with your gynecologist to discuss your symptoms.

Ovulation

Ovulation is when an ovum, or egg, is released from a woman's ovaries into her fallopian tubes. It typically occurs once per month, during your fertile window—the limited period of each menstrual cycle in which conception can occur.

While ovulation is necessary for reproduction and conception, it can also cause several uncomfortable side effects, including cramps and discomfort in the lower abdominal area. 

These cramps may be due to a sudden release of prostaglandins, hormone-like chemicals that trigger uterine contractions and inflammation. While not everyone experiences these ovulation-related cramps outside their period, they are the simplest and most common reason for such discomfort. 

Commonly called "ovulation cramps," the mild contractions can cause a dull ache on one side of the lower abdomen or lower back. While these cramps occur naturally and often go unnoticed, they can also be a sign of hormonal imbalance or other underlying health conditions.

So if you notice any unusual discomfort in your lower abdomen during ovulation, it's best to consult with your doctor to ensure that you stay healthy and avoid complications.

Miscarriage

A miscarriage, which is the loss of a pregnancy before it’s come to term (the NIH describes it as loss of pregnancy less than 20 weeks gestation), is another reason for menstrual cycle-like cramps.

If you’re pregnant, one of the most common signs of a miscarriage is cramping, which feels like menstrual cramps. It can be one of the early signs caused by the uterus contracting to expel the tissue growing inside it. The cramps may be accompanied by light bleeding or spotting, which can often be mistaken for a normal period. 

Some spotting during pregnancy is usually no cause for alarm. But if you're bleeding, and it's heavier than a normal period and accompanied by severe cramps, it’s essential to seek medical attention, as this may be a sign of an incomplete miscarriage.

Incomplete miscarriages occur when not all of the pregnancy tissue has been expelled from the uterus and can often lead to infection. As a rule, if you experience any abnormal bleeding or cramping during pregnancy, it’s crucial to speak to your doctor as soon as possible.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the reproductive organs that can cause severe pain and cramping. The most common symptom of PID is pelvic pain, which can feel like menstrual cramps.

Other symptoms may include fever, chills, vaginal discharge, pain during sex, and burning urination. If left untreated, PID can lead to infertility and ectopic pregnancy. 

PID is usually caused by bacteria transmitted during sexual intercourse. Anyone sexually active is at risk for PID, but those with multiple sexual partners or who douche regularly are at increased risk.

Treatment for PID typically involves antibiotics. In severe cases, hospitalization may be necessary. Prompt treatment is essential to preventing long-term complications from PID.

Ovarian Cancer

Many people experience cramps at some point in their lives, and most of the time, these cramps are nothing to worry about. However, they can be a sign of a more serious condition or complication in some cases, including infections in your cervix, ovarian cysts, or ovarian cancer. Cancer of the ovaries is a relatively rare form of cancer but is challenging to detect in its early stages. 

One of the first signs of ovarian cancer is persistent or severe pelvic pain. This pain may feel like cramps, which can occur even when you are not menstruating. Other symptoms include bloating, difficulty eating, and sudden and unexplained weight loss.

If you experience any of these symptoms, it’s essential to see a doctor for a diagnosis. Early detection is crucial for the successful treatment of ovarian cancer.

Irritable Bowel Syndrome (IBS)

Do you find yourself running to the bathroom when you eat certain foods or are experiencing a lot of stress? If this is accompanied by bloating and severe cramping, you may have irritable bowel syndrome.

Irritable bowel syndrome, or IBS, is a relatively common functional disorder that affects the large intestine. Characterized by such symptoms as abdominal pain and cramping, irregular bowel movements, constipation, and bloating, IBS can be a painful and disruptive syndrome for those who suffer from it. 

For many, IBS cramps can feel very much like the cramps you feel during a menstrual cycle. IBS can also make menstrual cramps feel worse. People with IBS describe feeling sharp pains in their abdominal region just before or during their period. 

While the exact cause is still being studied, some researchers believe it may be due to changes in hormone levels that occur naturally during menstruation.

Regardless of its underlying cause, numerous effective treatments can help you manage IBS-related cramps. For those dealing with this symptom of IBS, making lifestyle changes such as maintaining a healthy, IBS-friendly diet and exercise regime may help alleviate discomfort and improve quality of life. Through adequate management strategies and support from healthcare providers and loved ones, it is possible to cope with irritable bowel syndrome and associated stomach cramps.

Sometimes, severe abdominal cramping can also be a symptom of IBD or inflammatory bowel disease. IBD, which includes conditions like ulcerative colitis and Crohn’s disease, is similar to IBS but with more serious symptoms, including bleeding and inflammation in the GI tract. It’s a good idea to consult with a healthcare professional to rule it out, even if you have mild symptoms.

Appendicitis

Another possible cause of your cramping can be appendicitis. To understand this, let’s focus on the appendix for a minute.

The appendix is a small pouch of tissue attached to the large intestine, which is responsible for absorbing water and electrolytes from indigestible food products.

Your body eliminates these indigestible food products via fecal waste. The appendix is thought to assist in this process by storing good bacteria.

However, when the appendix becomes irritated and inflamed, it can rupture and cause problems and health conditions like appendicitis. Symptoms of appendicitis include abdominal cramping, nausea, and vomiting. If you’re experiencing these symptoms for a prolonged period, seek medical attention since a ruptured appendix can be serious.

Treatment for appendicitis typically involves surgery to remove the inflamed appendix. In most cases, the surgery is successful, and the patient makes a full recovery. However, complications can occur in some cases, so discussing the risks with your surgeon before opting for the procedure is important.

How To Diagnose What Your Cramps Mean

Whether you have severe or mild cramps, ignoring them just because you don’t have your period is a bad idea. But it can be challenging to diagnose cramps with no period. Is it just a tummy ache? Is it painful bladder syndrome?

To find possible causes, start by tracking your menstrual cycle—and pay particular attention to any missed periods. Look for other symptoms when you get a cramp, like pain or discomfort in the pelvic area or legs, onset of back pain or headaches at about the same time as the missed period, or other symptoms of cramp-like pain. 

When you track your menstrual cycle, you can stay aware of any other unusual symptoms that occur at around the same time each month. And remember, if your cramping is accompanied by nausea or bleeding that is not associated with your normal period pain, it's important to see your doctor immediately. 

To properly diagnose your cramps, track any other symptoms or health issues. Additionally, share any relevant medical history with your doctor for a more accurate diagnosis. If necessary, testing such as ultrasounds or blood work may also be conducted.