menstrual cramps

Cramps but No Period? 9 Possible Causes

Dr. Jolene BrightenPublished: Last Reviewed: Menstrual Cycle Leave a Comment

Cramping but no period? There are several gynecological and non-gynecological reasons you may be experiencing cramping. But is it normal to have cramps but no period? While they may be harmless, it's always worth investigating the root cause of having cramping but no period to ensure your symptoms aren't more serious.

Menstrual cramps are common, especially for women experiencing estrogen dominance, high prostaglandins or increased levels of inflammation. If this sounds like you, you may want to take a look at Natural Remedies for Cramps & PMS.

period cramps but no period dr brighten

Why Do I Have Cramps But No Period?

If you’re having period cramps but no period, or a late period and cramps at an unexpected time of the month, it could be due to a number of things. Common causes include pregnancy, cysts, or IBSLet’s dive into 9 of the most common reasons women experiencing cramping (other than their period) and what it means for your health.

1. Pregnancy

When a woman comes into my office with menstrual cramps and no bleeding, my first question is: is there a chance you could be pregnant?

It is common for women who have never experienced pregnancy, to have mild cramping and even some spotting that accompanies implantation.  

I can remember when I was pregnant with my son, I swore my period was coming because my cramps were so bad. But three positive pregnancy tests later, it was clear that my period wasn’t the cause of my cramps.  It’s completely common to mistake early stages of pregnancy with the beginnings of a period, which is why taking a pregnancy test is step one when you’re having cramps but no period.

If you’re a sexually active woman with cramping and a missed period, I recommend taking a pregnancy test at-home or with your doctor. It is always possible to become pregnant even while using contraceptives, so if you’re in doubt, please test. 

2. Ovulation

Some women can actually feel ovulation. This is a condition called Mittelschmerz, when a woman physically experiences the release of the egg from the ovary. Ovulation occurs mid-cycle, usually around days 10-14 of your cycle. If you feel cramping mid-cycle, especially if it only lasts for a day, it could be ovulatory pain.

Ovulation pain varies from woman to woman. Some explain it as sharp and stitching, others a dull ache, and others a burning sensation. In most cases, ovulation pain can be eased with a hot water bottle or heating pad. Light exercise can also help reduce this temporary discomfort.

Ovulation cramps are usually not concerning unless the pain becomes unbearable. If you have severe cramp pain in the middle of your cycle, you should schedule an appointment with your doctor.

Although bothersome, I think it is pretty amazing that a woman can be so in tune with her body that she’s aware of ovulation while it’s occurring.

3. Ovarian Cyst

Cysts on the ovaries can cause pain and cramping throughout the month, though they’re especially common mid-cycle. The feeling can be dull or sharp, and the pain usually subsides when the cyst has minimized or burst.

If you consistently get inexplicable cramping, especially on one side at a time, I recommend a transvaginal ultrasound. This is an imaging process that goes through the vagina to look at the ovaries. This can help see any cysts or problems with the ovary.

Most ovarian cysts are benign, but they can become problematic if the cysts become too enlarged or there are a number of them.

When the mass of the ovaries is too large, it can lead to ovarian torsion. This is when the ovary twists, cutting off blood supply. This can be life-threatening. You’ll usually know something more serious is occurring, as the extreme pain will be accompanied by nausea, vomiting, fever, and chills. If you experience any of these symptoms, seek immediate medical attention.

4. Endometriosis

Endometriosis is a disease where the tissue that lines the uterus grows in other parts of the body. That tissue is still sensitive to hormone fluctuations, so it mimics the same swelling and bleeding that happens in the uterus throughout the menstrual cycle.

Women with endometriosis can feel menstrual-like cramps throughout the month. These usually occur in the pelvis area, lower back, lower abdomen, and even the upper thighs. This cramping can often be so severe that walking can feel like a chore. For other women, though, the cramping may come and go in waves. Endometriosis pain varies dramatically from woman to woman, which can often make it challenging to diagnose.

If you experience severe cramping but no period throughout the month, you may have endometriosis. Check out this article to learn more about the causes and holistic treatments of endometriosis.

5. Ovarian Cancer

A rare but possible cause of cramps without a period could be ovarian cancer. Ovarian cancer can cause abdominal or pelvic pain that may radiate into the legs or back. It’s also often accompanied by bowel changes. This can include constipation, bloating, swollen abdomen, loss of appetite, and reduced urination.

In some cases, ovarian cancer may also cause spotting, which might lead you to believe the cramping is something else. It’s always worth a chat with your doctor if you have a change in your period or your digestion. 

6. Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection that’s made its way into the uterus,  fallopian tubes, and ovaries. PID can be caused by a variety of infections, like E.coli and staphylococcus or gut and respiratory tract organisms.

About 85% of pelvic inflammatory cases are caused by sexually transmitted infections and bacterial vaginosis.

Women with PID may not have any signs or symptoms.  When symptoms do present women experience extreme cramping without a period, along with discomfort and pain with sex. Fever and vaginal discharge are other signs you have an infection.

IUDs put women at a greater risk for pelvic inflammatory disease. The strings of the IUD actually aid a bacterial infection in making its way into your reproductive organs.

If you have unexplained cramping and a fever, seek medical attention immediately.

7. Irritable Bowel Syndrome

Cramping can also have a non-gynecological origin. The colon and sex organs are in close proximity within the body, so pain in one can often translate to pain in the other. Pelvic and lower abdomen pain can easily be confused, which is why it’s important to look at other symptoms accompanying the cramps.

For example, if you identify that certain foods trigger cramps then that point to a gut issue, which gives you a clue as to where to investigate first.

If you have cramping after eating or other bowel-related symptoms, like abdominal bloating and constipation, you may have a case of SIBO, which is commonly misdiagnosed as IBS. This can be diagnosed with an at home test that you can order yourself or ask your doctor to order.

8. Inflammatory Bowel Disease

Another colon-related cause of lower abdominal cramping is inflammatory bowel disease (IBD). IBD, which commonly presents as Chron’s or ulcerative colitis, is an autoimmune condition that affects the gut. Cramps can occur anywhere in the abdomen, and they’re often accompanied by tiredness, irritability, and even fever. If this is your root cause of missed period cramps then you’ll likely also have abnormal bowel changes, like constipation, diarrhea, or blood, mucus, and undigested food showing up in the stool (not including nuts and corn).

It’s important to catch IBD early to help rebalance the gut and improve the gut flora. Through diet and lifestyle therapies, you can nourish your immune and digestive health to end the pain.

If you believe this is what you may have, you’ll definitely need a gastroenterologist to help you get the diagnosis and counsel you on your options. A Naturopathic or Functional Medicine doctor can help you discover your root cause and creating lasting lifestyle changes to improve your health.

9. Appendicitis

Another cause of cramping in the abdomen can be appendicitis, which is when the appendix is inflamed or infected. If you have a fever and are experiencing lower abdomen pain on the lower right side or cramping around your belly button, it’s a good time to call your doctor or visit the hospital. Appendicitis is an emergency that needs immediate attention.

Diagnosing Cramps but No Period

Remember, if you have period cramps but no blood or period it can be caused by your reproductive system, gut, immune system or may even be a sign of pregnancy. So it's worth consulting your doctor, especially if your cramps are persistent or severe.

When you feel cramps, jot it down in a journal. What day is it? What time of the month in your cycle? Are you cramping before a period? How does it feel? How long does it last? What did you eat?

This can help your doctor better understand what might be causing your late period pains and how to best treat your pain.

Common tests your doctor might perform to determine the cause include:

  • An ultrasound
  • A pelvic exam
  • A Laparoscopy (surgery which looks inside your pelvic area).

Understanding different causes of cramping and their associated symptoms can help you take the appropriate steps towards regaining your health. Severe cramping is never normal. Mild to moderate cramping and lower back cramps also doesn’t have to be normal with the right holistic steps.

If you are experiencing cramps related to your menstrual cycle check out my 21-day hormone revolution detox.  It’ll help you hit the reset button on your hormones and start moving towards a period free of cramps.

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References

  1. Giovanni, G, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea?. J Pain Res. 2012. 5. 169–174.
  2. Mayo Clinic. Mittelschmerz.
  3. Mayo Clinic. Endometriosis.
  4. Schoen Lemaire, G, PhD. More Than Just Menstrual Cramps: Symptoms and Uncertainty Among Women With Endometriosis. JOGNN. 2004. 33. 71–79.
  5. Parasar, P, PhD, Ozcan, P, MD, and Terry, K, ScD.. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep.. 2017. 6. 34–41.
  6. NHS. Ovarian Cancer.
  7. Bajalan Z, Alimoradi Z & Moafi F. Nutrition as a Potential Factor of Primary Dysmenorrhea: A Systematic Review of Observational Studies. Gynecol Obstet Invest. 2019. 84. 209–224.
  8. Mayo Clinic. Inflammatory bowel disease (IBD).
  9. NHS. Appendicitis.
About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.