During a person’s menstrual cycle, the uterus contracts to help expel blood and other tissues from the body, which can lead to painful muscle cramps. But what if you experience abdominal cramps when you’re not bleeding? Gynecologists say the answer is not always simple.
The reproductive organs are the ones we most often think of when it comes to sources of pain in the pelvic region, but they are not the only potential culprits. Many different body parts live in your pelvic area, so pinpointing the exact cause of abdominal pain can be difficult, especially if you’re not a doctor. Here, top gynecologists explain the potential causes of cramps when you miss your period and how to know if you need to see a doctor.
“Early pregnancy can cause cramping,” says Julia Cron, MD, site chief and vice chair of the Department of Obstetrics and Gynecology at New York-Presbyterian Lower Manhattan Hospital. “I would say for people who are supposed to be menstruating, not on birth control, and sexually active with a male partner, the first thing to think about is pregnancy. »
2. Contraception hormonale
“The most common reason for not bleeding is that you’re taking a drug that makes your uterine lining so thin that there’s nothing to lose,” says Dr. Cron. “Specifically, it would be birth control pills. It’s completely normal when people take birth control pills to miss their period. She says the same can happen if you have a hormonal IUD. You may therefore experience abdominal discomfort in these cases, but no menstrual bleeding.
When a fertilized egg develops outside of the uterus (usually in a fallopian tube), this is considered an ectopic pregnancy. It can cause cramping as well as abnormal vaginal bleeding, but if left untreated, the egg can continue to grow and cause the tube to rupture, which can be life-threatening, according to the American College of Obstetricians and Gynecologists.
Yes, bleeding is the most well-known sign of a miscarriage, but cramping, back pain, or a decrease in pregnancy symptoms can also signal pregnancy loss. In some cases, you can miscarry without even knowing you were pregnant.
“If you have cramps or pain two weeks before you’re supposed to have your period, that can be completely normal — it could just be ovulation,” Dr. Cron says. “Mittelschmerz is the term used for the sensation of ovulation. Of course, if you’re on hormonal birth control, you shouldn’t ovulate, so in that case, Mittelschmerz wouldn’t be the cause of your cramps.
6. Ovarian cyst
Cysts are fluid sacs that form in or on an ovary. They often form when an egg is released and cause no symptoms. However, in some cases, ovarian cysts can cause pain, bloating or swelling in the abdomen, according to the Office on Women’s Health.
When tissues similar to the tissues that line the uterus appear in other places outside the uterus, it is a condition called endometriosis. “If a person has endometriosis, they may experience cramping or pelvic pain outside of the time of their period, simply because the endometriosis is on the ovaries, bladder, or rectum and is causing discomfort,” explains Kiarra King, MD, Board of Directors. board-certified obstetrician/gynecologist in Chicago.
“Sometimes when women have polycystic ovary syndrome, they have really irregular cycles where they don’t have any bleeding, like they could go two or three months without a period,” says Dr. King. “And sometimes, with patients like that, they can have intermittent cramps. PCOS is thought to be caused by a hormonal imbalance.
Some women develop uterine fibroids — benign tumors on the lining of the uterus that can cause pain as well as frequent urination, lower back pain, a feeling of fullness and an enlarged lower abdomen, according to the Office on Women’s Health.
10. Pelvic Inflammatory Disease
According to Dr. Cron, cramps accompanied by fever or abnormal vaginal discharge could signal a pelvic infection or pelvic inflammatory disease. Many times the culprit is a sexually transmitted disease, but that’s not the only potential cause. If you think an infection could be causing your cramps, you should definitely see a doctor.
Urinary tract infections are known to cause frequent urination and a burning sensation during urination, but these are not the only potential symptoms of a UTI. “If someone has something as simple as a urinary tract infection, it can cause pain that can be felt around the uterus because the bladder sort of sits on top of or in front of the uterus depending on the position of the person. says Dr. King. “So even something like a UTI can cause cramping. »
12. Interstitial cystitis
Interstitial cystitis occurs when the bladder is inflamed, which can lead to cramping, according to Dr. King. You may also feel tenderness or pressure in your pelvic area.
13. Ovarian Cancer
There is no routine screening test for ovarian cancer, so if you experience persistent abdominal cramps, abnormal spotting or bleeding, bloating, back pain, or changes in your toilet, tell your doctor immediately.
14. IBS ou IBD
Many parts of the body beyond your uterus, urethra, and bladder are located in the pelvic region, including your intestines. “If someone has IBS or irritable bowel syndrome or they have an inflammatory bowel disease like Crohn’s disease, these types of bowel issues can lead to cramping,” says Dr. King.
Your appendix is a small, finger-like pouch that is attached to the large intestine, and appendicitis occurs when the appendix becomes inflamed. Abdominal cramps or swelling, nausea, fever, and loss of appetite are signs of appendicitis.
16. Musculoskeletal problems
Muscle, ligament or bone problems in the pelvic area can cause pain. “It probably wouldn’t cause the same type of pain that you would mistake for a menstrual cramp, but it can definitely cause pain,” says Dr. King.
When to see a doctor if you have cramps but no period:
If you have cramps with a late period and are a sexually active woman with a man, Dr. Cron recommends taking a pregnancy test. If you’re not pregnant, pay attention to what’s going on in your body. “Think about if there are other things associated like do you have normal bowel movements? Do you have blood in your stool? Do you have pain when urinating? Do you feel like you can’t empty your bladder? Think about the other things in that area,” says Dr. Cron. If symptoms persist and you are unable to determine the root cause, see your doctor. During the visit, they will ask you to describe what you are experiencing, perform a physical exam, and order any relevant tests, such as a urine culture, ultrasound, or blood tests.