Why do I have cramps but no period?

Pelvic pain similar to a menstrual period can happen at times when no period is due or can occur because of conditions other than the monthly cycle. Sometimes it is hard to tell the exact reason for cramps that feel like a menstrual period.
The following 12 diseases and conditions are examples of situations that can cause pain or cramps when not on your period.
Ovulation
In the middle of the menstrual cycle, or about 10-14 days before your period, ovulation occurs. This is the release of an egg from a follicle within the ovary.
- Symptoms can include
- mild cramping that may be sharp or dull,
- lasting a few minutes to hours. It typically occurs on one side of the abdomen only.
Ovarian cyst
A cyst is an enclosed tissue sac filled with fluid. The ovary is a common location for cyst development.
- A small ovarian cyst typically does not cause symptoms, but if the cyst ruptures, it can cause sudden, sharp pains or cramps on one side of the lower abdomen.
- An enlarging cyst may cause dull pain or a feeling of fullness or heaviness in the lower abdomen or back.
Ovarian cancer
This is a rare cause of pain or pressure within the abdomen or pelvis.
- Ovarian cancer may not cause any symptoms, but if the cancer is large, it can cause
- pain or pressure in the abdomen or back,
- a feeling of heaviness or fullness,
- swelling of the abdomen, and
- feeling an urgent need to urinate.
Pregnancy, ectopic pregnancy and endometriosis
Sometimes women in the very early stages of pregnancy experienced slight cramping, similar to mild menstrual cramps, right around the time that the fertilized egg implants in the uterus. This is termed “implantation pain” and happens right around the time of the expected period.
- Usually, there are no other symptoms at this time other than the absence of a period. Sometimes there is light spotting at the time of implantation.
Ectopic pregnancy
An ectopic pregnancy refers to a fertilized egg attaching in an abnormal location outside of the uterus (womb), typically in the fallopian tubes.
- A ruptured ectopic pregnancy can lead to sudden, severe sharp pains in the lower abdomen that can spread to the back.
- Before this happens, there may be the typical symptoms of early pregnancy like
- tiredness,
- breast pain or tenderness, or
- nausea.
Endometriosis
This is a condition in which tissue, similar to that found inside the uterus, grows in other locations outside of the uterus. It is a very common condition.
- Endometriosis can cause painful menstrual cramping during the menstrual period and at other times of the month as well. It can cause
- infertility,
- painful bowel movements, or
- pain during sex in some women.

SLIDESHOW
Pelvic Pain: What's Causing Your Pelvic Pain? See SlideshowPelvic inflammatory disease (PID), interstitial cystitis or painful bladder syndrome and appendicitis
PID refers to an inflammation of the internal sex organs that usually results from the spread of a sexually transmitted disease. It is usually caused by bacteria that spread from the vagina and cervix upward into the uterus, tubes, and ovaries.
- PID causes lower abdominal pain on both sides of the body, often accompanied by
- fever,
- vaginal discharge,
- nausea,
- vomiting, and
- pain or burning with urination.
Interstitial cystitis or painful bladder syndrome
This is a condition that results from chronic inflammation of the bladder. It can cause pain at any time of the month.
- Symptoms typically get worse when the bladder is full (when you have to urinate). It can cause pain and tenderness in the low abdomen or pelvic area. Other possible symptoms are
- painful urination and
- feeling an urgent need to urinate.
Appendicitis
The appendix is a small pouch of tissue attached to one end of the large intestine. When it becomes irritated and inflamed (appendicitis), it may rupture and cause more serious problems.
- Symptoms of appendicitis include
- abdominal pain that starts in the middle and usually moves to the lower right side of the abdomen.
- fever,
- nausea, and
- vomiting.
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Inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and indigestion
IBD refers to chronic (long-term) inflammation in the bowels (intestines). Both Crohn’s disease and ulcerative colitis are forms of IBD.
- Symptoms depend on the severity and exact type of IBD but usually include some type of abdominal pain.
- Other symptoms can include
- diarrhea,
- bloody stool,
- weight loss,
- fatigue,
- fever, and
- feeling an urgent need to have a bowel movement.
Irritable bowel syndrome (IBS)
This disorder is different from IBD. With IBS there are a number of symptoms related to digestion, but there is no chronic inflammation in the intestines as with IBD.
- Symptoms of IBS can vary from mild to severe. Typical symptoms include
- diarrhea,
- constipation, and
- abdominal pain or cramping.
- The abdominal pain may be relieved by having a bowel movement. The symptoms may be more bothersome during your menstrual period.
Indigestion
This refers to having symptoms related to digestive symptoms and is a common complaint. Indigestion is also referred to as dyspepsia.
- Symptoms of indigestion usually include
- pain in the upper part of the abdomen,
- feeling overly full, or
- feeling too full after eating.
- Bloating and gas can also cause symptoms that may feel like cramping in the lower abdomen.
When to seek medical attention
Always seek medical attention for the following serious symptoms that can accompany cramps or pain:
- Abnormal vaginal bleeding
- Sudden, severe, or worsening abdominal or pelvic pain
- Pain in the chest, arm, neck, or jaw
- Frequent vomiting
- High fever
- Blood in vomit or stool
- Black or tarry stools
- Shortness of breath
- Yellowing of the skin or eyes
- Unexplained weight loss
- Slow or rapid heartbeats
- Loss of consciousness
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Health Solutions From Our Sponsors
Jameson, J.L., et al., eds. Harrison's Principles of Internal Medicine, 20th Ed. United States: McGraw-Hill Education, 2018.
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<https://www.ncbi.nlm.nih.gov/books/NBK279324/>
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