Late Period, Cramps—Possible Explanations Why You Might Be Cramping But Have No Period

You may associate the feeling of cramps with the imminent arrival of your period, or the first few days of your period. But what if you’re cramping and there’s no period blood? Well, there are a few possible explanations.

Let’s take a look!

13 Reasons You Might Have Cramps But No Period

There are many different reasons you might have cramps but no period. Some of these require immediate medical attention and others are less so.

1. Ovulation - It’s Called Mittelschmerz!

Ovulation pain, also known as mittelschmerz, is the abdominal pain or cramping some women experience during ovulation. It occurs when the mature egg is released from the ovary, causing irritation and mild inflammation in the surrounding tissues. 

The exact cause is not fully understood, but it may be due to the release of blood or fluid during ovulation, irritating the abdominal lining. Ovulation pain varies in intensity and typically lasts for a few minutes to a few hours. While it is considered normal for some, persistent or severe pain should be evaluated by a healthcare professional.

Distinguishing between mittelschmerz (ovulation pain) and period cramps can be challenging, but there are a few key differences to consider:

• Timing: Mittelschmerz occurs around the time of ovulation, typically in the middle of the menstrual cycle. Period cramps, on the other hand, occur during menstruation.
• Pain location: Mittelschmerz pain is typically felt on one side of the lower abdomen, depending on which ovary is releasing the egg. On the other hand, period cramps are usually felt in the lower abdomen and can radiate to the lower back.
• Duration: Mittelschmerz pain is usually short-lived, lasting from a few minutes to a few hours. Period cramps, on the other hand, can last for several days.
• Associated symptoms: Mittelschmerz is typically not accompanied by other menstrual symptoms like bleeding or bloating. In contrast, period cramps are usually associated with menstrual bleeding and other symptoms such as fatigue and mood changes.

2. Early Pregnancy

Early pregnancy pain may occur around the time when a woman expects her period to start. This can lead to confusion, especially if the woman is not actively trying to conceive or is unaware of a possible pregnancy. The pain or cramping experienced during early pregnancy can resemble period cramps. Both can involve mild to moderate lower abdominal discomfort or a sensation of pressure.

To help differentiate between early pregnancy pain and painful periods, it's important to consider additional signs and symptoms of pregnancy, such as breast tenderness, fatigue, changes in appetite, and a heightened sense of smell. If you think you may be pregnant or feel uncertain about symptoms, taking a home pregnancy test or consulting a healthcare professional is the best way to confirm pregnancy and obtain appropriate guidance.

3. Ectopic Pregnancy

An ectopic pregnancy is a potentially serious condition in which a fertilized egg implants outside of the uterus, most commonly in the fallopian tube. It is important to note that ectopic pregnancy pain can sometimes be mistaken for period pain, which can lead to a delay in diagnosis. Here are some factors that contribute to the confusion:

• Similar location of pain: Both ectopic pregnancy and period pain can cause lower abdominal discomfort or cramping. The pain may feel similar, as it originates in the pelvic region.
• Timing: Ectopic pregnancies can be misinterpreted as a regular menstrual period because the symptoms, including pain, may occur around the expected time of menstruation.
• Individual variation: The intensity and nature of period pain can vary among women. Some women may have mild period cramps, while others may experience more severe pain. This variation can further contribute to the confusion between ectopic pregnancy and normal menstrual cramps.

Ectopic pregnancies can pose significant risks to a woman's health and may require immediate medical attention. It is essential to seek prompt medical care f you suspect you may be pregnant and experience severe or persistent lower abdominal pain, especially if accompanied by other symptoms like:

• Shoulder pain
• Dizziness
• Fainting
• Abnormal bleeding

4. Miscarriage

A miscarriage without bleeding, also known as a missed miscarriage or silent miscarriage, occurs when an embryo or fetus stops developing but remains in the uterus. This situation can sometimes be confused with PMS cramps due to a few reasons:

• Similar symptoms: Miscarriage cramps can resemble PMS cramps, involving mild to moderate lower abdominal pain or discomfort.
• Timing: Miscarriages can occur around the time when a woman expects her period to start, leading to confusion if she is not aware of a possible pregnancy.
• Lack of bleeding: In some cases of missed miscarriage, there may not be any noticeable vaginal bleeding, which is commonly associated with a typical miscarriage. This absence of bleeding can further contribute to the confusion with PMS cramps.

If you suspect you may be pregnant and experience persistent or severe lower abdominal pain, even without bleeding, it is advisable to seek medical attention. A healthcare professional can perform an evaluation, including an ultrasound, to assess the status of the pregnancy and determine the cause of the symptoms. Prompt medical care is crucial to ensure proper management and support during a potential miscarriage.

5. Hormonal Birth Control

Hormonal birth control, such as birth control pills, patches, or intrauterine devices (IUDs), can sometimes cause cramps that may be mistaken for period cramps. Here's why this confusion can occur:

• Adjustment period: When starting hormonal birth control or switching to a different method, your body may take some time to adjust to the new hormone levels. During this adjustment period, it's common to experience temporary changes in your menstrual cycle and associated symptoms, including cramping.
• Prostaglandin release: Menstrual cramps are primarily caused by the release of prostaglandins, hormone-like substances that trigger uterine contractions. Some hormonal birth control methods, especially those containing progestin, can affect prostaglandin levels and uterine contractions, leading to cramping.
• Hormonal fluctuations: Hormonal birth control works by altering hormone levels in the body, which can impact the regularity and characteristics of your menstrual cycle. Fluctuations in hormone levels can result in changes in the intensity or duration of cramps.

While cramping is a possible side effect of hormonal birth control, it typically improves over time as your body adjusts to the hormonal changes. However, if the cramps are severe, persistent, or significantly affect your daily life, it is advisable to consult a healthcare professional.

6. Endometriosis or Adenomyosis

Endometriosis is a condition in which the tissue lining the uterus, called the endometrium, grows outside the uterus. Adenomyosis is a condition in which the endometrial tissue, which normally lines the uterus, grows into the muscular wall of the uterus. Both endometriosis and adenomyosis can cause pain and discomfort that - for some - may be confused with PMS cramps:

• Similar location of pain: Endometriosis pain often manifests as lower abdominal or pelvic pain.
• Timing: The pain associated with endometriosis can coincide with the menstrual cycle.
• Intensity: Endometriosis pain can be more intense and debilitating compared to typical PMS cramps. However, the severity of menstrual cramps can also vary among individuals, so it is not always easy to distinguish between the two.
• Associated symptoms: PMS symptoms commonly include mood swings, breast tenderness, and bloating. Similarly, endometriosis can be associated with additional symptoms like heavy or irregular periods, pain during intercourse, fatigue, and digestive issues. These overlapping symptoms can make it challenging to differentiate between endometriosis pain and PMS cramps based solely on symptoms.

Endometriosis and adenomyosis are chronic conditions that require medical evaluation for diagnosis. If you experience persistent or severe pelvic pain, especially during your menstrual cycle, it is recommended to consult a healthcare professional.

7. Urinary Tract Infection (a UTI)

A urinary tract infection (UTI) is an infection that occurs in any part of the urinary system, including the bladder, urethra, ureters, and kidneys. While UTIs are primarily associated with urinary symptoms, they can also cause pain in the lower abdomen or pelvic area, which can be confused with PMS cramps.

Here's how you might be able to tell them apart:

• Urinary symptoms: UTIs often come with specific urinary symptoms that are not typically associated with menstrual cramps. These may include frequent urination, a strong urge to urinate, a burning sensation during urination, cloudy or strong-smelling urine, or blood in the urine. If you are experiencing any of these urinary symptoms along with abdominal pain, it is more likely to be a UTI.
• Response to pain relief: Menstrual cramps usually respond to over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. If the pain persists despite taking pain medication or worsens over time, it could indicate a UTI rather than menstrual cramps.
• Additional symptoms: Menstrual cramps are often limited to lower abdominal or pelvic pain, whereas UTIs may present with other symptoms such as fever, fatigue, general malaise, or lower back pain. These systemic symptoms are less likely to be associated with menstrual cramps alone.

8. Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, typically caused by sexually transmitted bacteria. The symptoms of PID can sometimes be confused with PMS cramps. Here are some ways to tell them apart:

• Additional symptoms: PID is often accompanied by other symptoms that are not typically associated with PMS cramps. These may include abnormal vaginal discharge (often with an unusual odor), pain or discomfort during sexual intercourse, fever, fatigue, and frequent urination. 
• Severity and persistence of pain: While PMS cramps can vary in intensity, PID-related pain tends to be more severe and persistent. 
• Risk factors: PID is commonly associated with certain risk factors, such as recent or multiple sexual partners, unprotected sex, a history of sexually transmitted infections (STIs), or previous episodes of PID. If you have any of these risk factors and are experiencing abdominal pain, it is important to consider the possibility of PID.

If you suspect you may have PID or if your symptoms are severe or persistent, it is crucial to seek medical attention.

9. Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects women of reproductive age. Here's how PCOS can be mistaken for PMS cramps and some ways to tell them apart:

• Abdominal discomfort: Both PCOS and PMS can involve abdominal discomfort or pain. However, the nature and location of the pain may differ. PMS cramps typically occur in the lower abdomen while PCOS-related discomfort is more generalized.
• Associated symptoms: PMS symptoms often include mood swings, breast tenderness, bloating, and fatigue. On the other hand, PCOS is characterized by hormonal imbalances and can lead to symptoms such as irregular periods or absent periods, excessive hair growth (hirsutism), acne, weight gain or difficulty losing weight, and insulin resistance. 
• Long-term pattern: PMS symptoms typically occur cyclically, with some variation in intensity and duration from month to month. In contrast, PCOS symptoms persist and may worsen over time. If you notice a consistent pattern of symptoms that last beyond the premenstrual phase, it could be indicative of PCOS.

PCOS is diagnosed through a comprehensive evaluation, including medical history, physical examination, and laboratory tests. Hormonal imbalances, ultrasound findings (such as the presence of ovarian cysts), and other criteria are considered for a proper diagnosis. If you suspect PCOS or have concerns about your symptoms, we recommend you consult with a healthcare professional for a thorough evaluation.

10. Ovarian Cysts

Ovarian cysts are fluid-filled sacs that can form on or within the ovaries. They are a common occurrence in women of reproductive age. Most ovarian cysts are harmless and resolve on their own without causing symptoms. Pain from ovarian cysts can sometimes be mistaken for period cramps due to their similar location and timing. Here are some differences:

• Pain characteristics: Ovarian cyst pain is often described as a sharp or stabbing sensation, while period cramps are generally described as a dull, achy, or cramping pain. However, pain perception can vary among individuals, so this may not always make it easy to tell the difference.
• Additional symptoms: Ovarian cysts can be associated with other symptoms that are not typically present with period cramps. These may include bloating, abdominal fullness or pressure, changes in bowel habits, urinary urgency or frequency, and pain during sexual intercourse. The presence of these additional symptoms can suggest that the pain is related to ovarian cysts rather than period cramps alone.

Self-diagnosis of ovarian cysts is impossible but a healthcare professional can perform imaging tests, such as an ultrasound, to visualize the ovaries and detect the presence of cysts.

11. Uterine Polyps

Uterine polyps are abnormal growths that develop in the inner lining of the uterus (endometrium). They are usually noncancerous and can vary in size and shape. Uterine polyps can cause symptoms such as irregular or heavy menstrual bleeding, bleeding between periods, prolonged periods, and in some cases, pelvic pain. Due to the location, pain from uterine polyps can be confused with period cramps, but there are some ways to tell them apart:

• Pain characteristics: Period cramps are often described as a dull, achy, or cramping pain, while pain from uterine polyps can vary. Some women with uterine polyps may experience intermittent or sharp pain, particularly if the polyps are large or cause irritation or inflammation in the uterus. However, as with ovarian cysts, it is worth noting that pain registers differently from individual to individual.
• Additional symptoms: Uterine polyps can be associated with other symptoms such as irregular bleeding, heavy menstrual flow, bleeding between periods, and infertility. If you experience these additional symptoms along with pelvic pain, it may suggest the presence of uterine polyps rather than typical period cramps alone.

12. Uterine Fibroids

Uterine fibroids, also known as leiomyomas, are noncancerous growths that develop in or around the uterus. They are made up of muscle and fibrous tissue and can vary in size, number, and location within the uterus. Uterine fibroids are relatively common and can cause symptoms such as heavy or prolonged menstrual bleeding, pelvic pain or pressure, frequent urination, constipation, and reproductive issues.

Again, because of the location, any pain from uterine fibroids might be easily conflated with period pain. Like cysts and polyps, the pain characteristics of fibroids may be noticeably different to some, but - then again - it may be difficult for others to differentiate these types of pain.

It is worth noting that uterine fibroids can be associated with other symptoms such as heavy menstrual bleeding, prolonged periods, frequent urination, constipation, and reproductive issues like infertility or recurrent miscarriages. If they’re large, you may be able to feel uterine fibroids when you palpate your abdomen. However, a proper diagnosis requires imaging tests and needs to be performed by a healthcare provider. 

13. Thyroid Problems

Thyroid problems, specifically hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), can sometimes cause symptoms that may be mistaken for period cramping. Here's how thyroid problems can lead to pain that could be confused with period cramps:

• Pelvic congestion: Thyroid disorders can cause hormonal imbalances that affect blood flow in the pelvic region. This can result in pelvic congestion, which may lead to pain and discomfort similar to menstrual cramps.
• Sensitization of pain receptors: Thyroid dysfunction can affect the function of nerves and pain receptors, leading to an increased sensitivity to pain. This heightened pain perception can cause abdominal pain that may resemble or overlap with period cramps.

Note: It May Be Hard to Tell the Difference Between General Abdominal Pain and Uterine Cramps

I don’t know about you, but sometimes I feel like I can be the most unreliable narrator of what’s happening in my body. My massage therapist will ask me where I’m stiff and I’ll struggle to pinpoint pain. If you’re like me, you may be generalizing a feeling of stomach pain, pelvic pain, or even "middle pain" with period cramps. Here are some (not all) possible things that might be going on but that you’re registering as “cramps”:

Irritable Bowel Syndrome (IBS) and Other Bowel Issues

Both IBS and period cramps can cause pain in the lower abdomen or pelvic area. However,  IBS is typically associated with additional gastrointestinal symptoms such as changes in bowel movements (diarrhea, constipation, or both), bloating, gas, and abdominal discomfort or pain that may improve after a bowel movement.

Appendicitis 

Appendicitis can sometimes be mistaken for period cramps due to the similarity in their location and initial symptoms. Appendicitis is often accompanied by additional symptoms including nausea, vomiting, loss of appetite, fever, and localized tenderness or rebound tenderness in the lower right abdomen.

Pelvic Floor Muscle Dysfunction 

The pelvic floor muscles provide support to the pelvic organs, including the bladder, uterus, and rectum, and play a crucial role in controlling urinary and bowel function, sexual function, and maintaining pelvic stability. Both pelvic floor muscle dysfunction and period cramps can cause pain and discomfort in the lower abdomen or pelvic area.  However, pelvic floor muscle dysfunction may be associated with additional symptoms such as pain during intercourse (dyspareunia), urinary urgency or frequency, pain or difficulty with bowel movements, and a feeling of heaviness or pressure in the pelvic area.

Interstitial Cystitis

Interstitial cystitis (IC), also known as painful bladder syndrome, can be mistaken for period cramps due to the similarity in the location of pain and the timing of symptoms. However, IC is primarily characterized by chronic bladder pain or discomfort, urinary urgency, frequency, and a feeling of pressure or fullness in the bladder. If these bladder-related symptoms accompany the pain, it may suggest IC rather than period cramps alone.

Overtraining / Too Much Exercise

Pain from excessive exercise is often related to muscle soreness, fatigue, or overuse. It may be localized to specific muscle groups or be more generalized. If the pain is predominantly felt in specific muscles or is related to recent intense physical activity, it suggests exercise-related pain rather than menstrual cramps alone.

How to Find Relief from Cramping

We get it: The list of things that might cause feelings like PMS or period cramps is long and confusing. Many of these things are impossible to self-diagnose and most require medical help. If you are experiencing cramping - especially severe cramping - and the reason is not clear, please see your healthcare provider.

In the meantime, here are some things that may help with cramps:

• Heat therapy: Applying a heating pad or taking a warm bath can help relax the muscles and alleviate cramping.
• Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce menstrual cramp pain and inflammation.
• Gentle exercise: Engaging in light physical activity, such as walking or stretching, can promote blood flow and ease cramping.
• Relaxation techniques: Practicing relaxation techniques like deep breathing, meditation, or yoga can help reduce stress and muscle tension associated with cramping.
• Dietary adjustments: Consuming a balanced diet, staying hydrated, and reducing the intake of caffeine, salt, and processed foods may help alleviate cramps for some individuals.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.