What causes cramps but no period? Related conditions and treatments

Cramps without a period can be caused by a variety of factors, including reproductive and gastrointestinal issues

By Ashley Broadwater | Jan. 23, 2024 Medically reviewed by Anne Jacobson, MD, MPH

Why do I have cramps but no period?

A variety of possible causes can lead to menstrual cramps, but no period, some of which are more serious than others. While some common reasons pertain to reproductive health, others don’t.

1. Ovulation

Ovulation pain, also referred to as mittelschmerz, is one of the potential causes that Shandra Scruggs, RN, a licensed labor and delivery nurse, registered doula, and founder of Simply Birthed, shares. Ovulation is when your ovaries release an egg, which happens about two weeks after the first day of menstruation. The abdominal cramping is usually lower down and one-sided. Other common symptoms include:

Bloating
Lower back pain
Tender breasts
Higher libido

2. Implantation

Implantation is another possible cause of cramping, Scruggs shares. It may be a sign of early pregnancy. Implantation happens after a fertilized egg finds its way into the uterine lining. You may notice lower back pain and mild cramping, as well as other symptoms of pregnancy listed below:

Vaginal bleeding
Clear, stretchy, and slippery discharge
Bloating
Tender breasts
Nausea
Headaches
Mood changes

3. Pelvic inflammatory disease (PID)

PID, a potential cause Scruggs suggests, is an infection in the uterus, fallopian tubes, or ovaries. You’ll feel pain and tenderness in the lower part of your abdomen and may experience other symptoms, such as:

Abnormal vaginal discharge
Chills or fever
Nausea or vomiting
A burning sensation when you pee
Pain during penetrative sex

4. Uterine fibroids

Uterine fibroids are essentially extra growth in your uterus (but not cancers). Uterine fibroids cause pain in the abdomen and lower back, as well as pressure or pain in the pelvis. Both Scruggs and Mary T. Jacobson, MD, an OB-GYN and the chief medical officer at Hello Alpha, mention fibroids. You may also notice the following common symptoms:

Either frequent peeing or struggling to pee
Period pain
Constipation
Your stomach looks larger
Pain during penetrative sex

5. Endometriosis

Also mentioned by both experts, endometriosis is when the endometrium (a tissue) grows outside the uterus where it shouldn’t, whether that’s on the ovaries, fallopian tubes, bladder, or around the uterus. Endometriosis can cause pain in the abdomen, pelvic area, lower back, and middle part of the back. It can also cause:

Pain during penetrative sex
Irregular periods
Constipation
Fertility issues
Pain during urination or bowel movements
Nausea
Bloating
Joint pain and nerve pain

6. Ectopic pregnancy

Ectopic pregnancy is “pregnancy located outside of the uterus (womb), usually in a Fallopian tube,” Dr. Jacobson says. She notes you may feel pain near the ovary and tube on the side of the ectopic, as well as in the lower abdomen or pelvis area. Other common symptoms include the following:

Dizziness
Vaginal bleeding
Weakness
Low blood pressure
Shoulder pain
Pressure in your rectum or bowel problems

7. Appendicitis

Appendicitis is inflammation of the appendix. Dr. Jacobson says this most commonly causes abdominal cramping in the lower right area. You’ll likely also notice other common symptoms, such as:

Fever
Pain around the belly button
Nausea and/or vomiting
Loss of appetite
Diarrhea
Increased urination or more of an urge to go

8. Kidney stone

Kidney stones, different from urinary tract infections, are hard deposits in your urine. Dr. Jacobson says they cause pain in your back, on one side of your lower abdomen or pelvic area, and central pelvic colicky pain, depending on where the stone is located. Other signs of a kidney stone include:

Severe, sharp pain
Pain that fluctuates
A burning sensation when you pee
Cloudy urine or urine that’s red, pink, or brown
Nausea and/or vomiting
Needing to pee more often
Peeing smaller amounts

9. Irritable bowel syndrome

Irritable bowel syndrome (IBS), a gastrointestinal condition, “can cause cramping along the course of the intestines, most commonly the colon in the left abdominal/pelvic area,” Dr. Jacobson says. You may also notice the signs of IBS listed below, especially after eating certain foods:

Diarrhea and/or constipation
Bloating
Gas

10. Inflammatory bowel disease

Inflammatory bowel disease (IBD) is the umbrella term covering both Crohn’s disease and ulcerative colitis. IBD can cause abdominal cramping, and the other common symptoms are listed below:

Diarrhea
Fatigue
Weight loss
Blood in your stool
Decreased appetite

Should I be worried about period cramps but no period?

This is typically normal, according to Scruggs, especially when it’s related to ovulation, implantation, stress, weight changes, or lifestyle. Less common causes that might require more aid, she adds, include conditions such as polycystic ovarian syndrome (PCOS) and endometriosis, as well as infections like PID.

“Consulting a healthcare provider is recommended if cramps are severe, persistent, or accompanied by concerning symptoms, particularly for individuals with a history of reproductive health issues,” Scruggs continues. “While occasional cramping is common, significant deviations from the typical cycle or severe pain should prompt professional evaluation.”

Dr. Jacobson agrees that it’s important to pay close attention to pain. “For acute onset of pain that starts suddenly and is unrelenting, or when in doubt, patients should seek medical advice from a healthcare professional,” she says.

Additionally, she encourages taking a urine pregnancy test if needed. If it’s positive, contact your clinician “or seek in-person care with cramps but no period due to concern of an ectopic pregnancy, which is an emergency.”

If the cramps are left unaddressed or untreated, there could be complications. Primarily, they deal with fertility, but that’s not all. And, of course, the cause matters, too.

For example, if the cause is endometriosis, Scruggs says, there’s “a risk of progression, causing pain and potential fertility issues.” Conditions affecting ovulation or the uterine lining, she continues, can also lead to fertility challenges. Untreated infections not only increase the risk of infertility but can also cause long-term damage to reproductive organs.

There are serious risks with an ectopic pregnancy, Dr. Jacobson adds, such as blood transfusion and even death. Ignoring appendix pain could lead to a rupture, sepsis (the spread of infection), and death, as well.

More generally, if stress is at play, Scruggs says it can impact your menstrual cycles and period cramps, affecting your overall health and well-being.

All of those concerns emphasize the importance of having a healthcare provider give you medical attention and check everything out. But at what point is that necessary?

“If cramps persist without the onset of a period for an extended period, or if there are additional concerning symptoms, like abnormal bleeding, fever, or signs of infection, or if the cramping is severe and not relieved by over-the-counter medication, it’s advisable to seek the guidance of a healthcare provider,” Scruggs says.

The type of provider will depend on whether you’ve talked to a doctor about this before and what piece of it all concerns you. “A general practitioner can be a good starting point for an initial evaluation, assessing general health, taking a medical history, and performing preliminary tests,” Scruggs says.

Then, that professional may encourage you to meet with a more specialized professional. “For issues related to the reproductive system, a gynecologist can provide a more in-depth evaluation, performing pelvic exams and ordering relevant tests.” (More on those tests in a bit.) Lastly, if infertility is what you’re worried about, she suggests consulting with a reproductive endocrinologist.

Again, if you’re experiencing more sudden or severe cramps, a trip to the emergency room is appropriate, Scruggs adds, especially if the cramps are accompanied by fever, heavy bleeding, or signs of infection.

How is the cause of cramps but no period diagnosed?

There isn’t one test or set of questions that answer this; rather, it’s a mix. “When assessing cramps without a period, healthcare providers typically use a combination of medical history, physical examination, and diagnostic tests,” Scruggs says.

Dr. Jacobson shares the list of questions your provider will probably ask to assess your history.

Onset of pain
Characterization of pain, e.g., sharp and stabbing or dull?
Frequency of the pain
Location of the pain
Radiation of the pain, e.g., right lower abdominal pain radiating to the back and/or shoulder
Whether the pain changes location
What makes the pain better or worse, e.g., moving around, lying still, hot compresses
Associated symptoms, e.g., fever, nausea, vomiting, diarrhea/constipation
First day of the last menstrual period
The interval between menstrual periods
Sexual activity/sexual partners
Contraceptive use, if applicable
Last bowel movement
Past medical history
Past surgical history
Family history
Medications
Allergies
Social history—exercise, occupation, and use of substances, alcohol, and tobacco

“Open and honest communication with the healthcare provider is crucial for an accurate diagnosis and appropriate management,” Scruggs says.

After that discussion, your healthcare provider may consider more physical tests. “A pelvic exam may be conducted to assess reproductive organs, check for abnormalities, and identify signs of infection,” Scruggs says. “Laboratory tests, including a pregnancy test, blood tests for hormone levels and infection, and potentially an STD test [if there’s a possibility of sexually transmitted infections], may be performed based on the medical history. Imaging studies like ultrasound, CT scan, or MRI might visualize reproductive organs for abnormalities.”

How long does cramps but no period last?

The duration of cramps also varies widely depending on what’s behind them. “There aren’t universally applicable stages or phases,” Scruggs says.

More generally, however, she says cramps from hormonal fluctuations tend to resolve on their own, while cramps from irregular ovulation may persist until your cycle is back on track. If you have an underlying condition, like those mentioned above, how long the cramps last depends on the specific condition and the management of it.

You may not know which one is affecting you. “Managing cramps involves identifying the cause through medical evaluation,” Scruggs adds.

How to stop cramps but no period

Wondering how to treat cramps but no period? You may or may not need treatment to stop these cramps—but more causes require treatment than causes that don’t.

For example, while temporary hormonal fluctuations may resolve without treatment, according to Scruggs, irregular ovulation and various medical conditions may require hormonal medications, surgery, or lifestyle changes.

“The duration varies,” Scruggs notes. “Addressing cycles or conditions can take time.”

Let’s talk medication. Scruggs lists several that could help you get rid of cramps but no period, such as ibuprofen, which is a pain reliever. For period cramps, the recommended dosage is 200-400 mg orally every 4 to 6 hours as needed.

Additionally, she mentions birth control pills or contraceptives and fertility medications. If an infection is present, she adds, your healthcare provider may prescribe antibiotics or antifungals.

But again, talking to a healthcare provider first about cramps but no period treatments is vital, especially since taking the wrong medicine can have serious side effects. “For example, non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, taken on a schedule may help with pain due to fibroids and endometriosis, but people with a history of upper gastrointestinal bleeding, chronic kidney disease, or allergies to these medications should not take NSAIDs,” Dr. Jacobson says.

While more serious treatments may be needed, they may also not be. “Prescription pain medications might be considered for severe pain but are used cautiously due to the risk of dependence,” Scruggs adds.

Living with cramps but no period

1. Stress relief practices

There are many ways to engage in this. “Stress reduction, through practices like deep breathing or meditation, can help,” Scruggs says. “Herbal teas like peppermint may ease discomfort, and some find relief with essential oils like lavender.”

2. Lifestyle changes

Even baby steps can be helpful here. “Regular exercise, such as yoga, releases endorphins for pain relief,” Scruggs says. “Adequate sleep is crucial for overall well-being and symptom relief.”

Other steps she advises are staying hydrated, using a heating pad, and trying acupuncture.

3. Acupuncture

This option can increase the “feel good” hormones, according to Dr. Jacobson. “Small clinical studies suggest that acupuncture may reduce endometriosis-related pain by increasing pain thresholds and increasing the body’s release of endorphins, which is a natural pain reducer,” she says.

But again, she adds, it all depends on the cause of your pain.

Most importantly, see a doctor if the pain is severe

Cramps but no period causes may include anything from reproductive health conditions to bathroom problems. The cause of cramps, but no period may resolve without treatment. However, if cramps continue, worsen, or accompany other reproductive health issues or a fever, they could be a sign of an infection or ectopic pregnancy, for starters. These conditions require immediate medical attention to avoid complications. Only your healthcare provider can rule out infection or other serious health conditions. Visit your doctor to determine the best treatment.

What’s next? Additional resources for people with cramps but no period