If you experience period pain before or during your period, you may be confused when you experience period pain but your period doesn’t come. You may wonder whether you’re pregnant, if there’s an underlying medical cause, or if there are other symptoms you should be concerned about.
Unrelated abdominal pain is actually quite common and can have a variety of causes, including digestive issues, pelvic floor muscle spasms, and ovulation.
So we enlisted the help of two obstetrician-gynecologists to help us understand period cramps, including what causes them, how to tell if they’re a sign of pregnancy, and when you should see a doctor.
Common reasons for missing a period despite period pain
In fact, pelvic spasms are very common, explains Suzy Lipinski, M.D., obstetrician-gynecologist at Pediatrix Medical Group. Not only that, but these spasms can have many causes. “The nerves in the pelvic area aren’t limited to affecting one area like the nerves on the skin are,” adds Dr. Lipinski. “So pelvic spasms can be a sign of problems with any of the organs in the pelvic region, including a woman’s reproductive, bowel, bladder system, or even the pelvic floor muscles.”
Let’s look at some of the most common causes of pelvic pain.
Abdominal cramps
Pelvic pain and cramps often have digestive roots and can be caused by a variety of diseases and conditions. “One of the most common causes of non-menstrual pain is intestinal pain,” says Dr. Lipinski.
These cramps could be caused by a viral stomach infection (such as norovirus) or food poisoning, she says. Other common causes include digestive disorders like Crohn’s disease, ulcerative colitis, or celiac disease, or just plain indigestion. “These are often accompanied by diarrhea (or constipation), which may also be accompanied by nausea and vomiting,” Dr. Lipinski explains. “Severe constipation can also cause severe cramping pain.”
ovulation
You may experience pelvic pain in the middle of your menstrual cycle. “Period pain can also be caused by ovulation,” explains Anisha Farishta, MD, an obstetrician-gynecologist at Sugar Land Women’s Care. Ovulation pain (also called “mid-cycle pain”) often appears as a mild, sharp, or stabbing pain on one side of your pelvis. It can last for a few minutes or hours.
Ovarian cysts
Another potential cause of pelvic pain is ovarian cysts, says Dr Farishta. Ovarian cysts are small fluid-filled sacs that form on the ovaries. They’re usually harmless and often don’t cause any symptoms, but they can also cause pelvic spasms.
These pains can range from a dull ache to a more intense pain, and usually occur on one side of the pelvis. You may also feel a sense of fullness or pressure. In rare cases, an ovarian cyst can rupture, in which case you may need to see a doctor. If you have sudden or severe abdominal pain and symptoms like fever, dizziness, vomiting, or difficulty breathing, you should seek emergency medical attention.
Pelvic floor muscle contraction
A lesser known, but still relatively common, cause of pelvic pain has to do with your pelvic floor, which contains the muscles and ligaments that support your uterus, bladder, and bowels. When these muscles start to spasm, it can feel like a cramp, says Dr. Lipinski, who points out that these types of spasms can also occur in your lower back or tailbone.
“Pelvic floor muscle spasms can occur after trauma, such as a fall, accident, or assault,” she adds. “It can also occur after childbirth.”
子宮内膜症
Endometriosis occurs when uterine tissue begins to grow outside the uterus on other nearby organs, such as the ovaries or intestines, often causing severe menstrual pain.
However, endometriosis can cause severe pain and cramps at other times of the month, even when you’re not menstruating. For example, the condition can cause chronic pelvic and lower back pain, digestive pain, and pain during sexual intercourse. Endometriosis affects about 11 percent of people of childbearing age.
Urinary tract infection
Urinary tract infections (UTIs) are common and tend to occur more in people with vulvas. They can also be a significant cause of abdominal pain. The pain from a UTI is often felt as pressure or cramping in the lower back or lower pelvis. As the infection progresses, pain may also be felt in the sides or groin.
In addition to pain, you may also experience symptoms of a urinary tract infection, such as a burning sensation when urinating, fever, discolored or bloody urine, and urinating more frequently than usual. If you have these symptoms, you should see a doctor. Urinary tract infections usually require antibiotics.
Early pregnancy
Sometimes, menstrual cramps that occur around the time you expect your period may not actually be related to your period. “You may experience abdominal pain during early pregnancy as well,” says Dr. Farishta. And why would a new pregnancy cause these symptoms? “These are usually caused by the uterus stretching and growing as your body prepares for the birth of your baby,” she adds. Some people may also experience abdominal pain related to implantation surgery.
She adds that while these cramps are often uncomfortable, they’re not necessarily harmful. “They’re usually nothing to worry about, but if the pain gets worse or you start to feel concerned, make sure you see your obstetrician-gynaecologist,” Dr. Farishta recommends.
Menstrual cramps and pain during early pregnancy
If you’re trying to get pregnant and are experiencing period-like cramps around the time your period is due, you might be dying to know if the pain is PMS or a sign of pregnancy. Unfortunately, there’s really no way to distinguish between PMS cramps and early pregnancy cramps based on symptoms alone. The best way to find out what’s going on is to take a pregnancy test, says Dr. Lipinski. “Modern tests are very accurate, even before your period is late,” she says.
If I experience period pain when I’m not on my period, should I be worried?
In most cases, having period pain or missing a period isn’t anything to worry about, Dr. Lipinski says. But in some cases, cramps could be linked to a more serious issue. “Period pain without menstruation can be a cause for concern if the pain is severe enough to interfere with your normal activities,” she explains.
If your period pain becomes severe and interferes with your daily life, or if you experience symptoms such as abnormal bleeding, diarrhea, or blood in your urine or stool, be sure to consult a doctor.
