Why Am I Having Cramps and Back Pain But No Period?

1. Endometriosis

Endometriosis is a condition in which the endometrial tissue that lines the uterus spreads outside the uterus and affixes to other bodily organs or structures, such as the ovaries or fallopian tubes. These abnormal growths are known as endometrial implants, and they can inflame surrounding tissues along with adhesions (scar tissue that can cause internal organs to bind together). 

Endometriosis does not need to damage vast areas of the pelvic organs to cause aching or stabbing pain; even small implants can cause cramps and back pain. You may experience pain right around your period, during or after sex, and during a bowel movement. The pain may be felt in the back, abdomen, and pelvic region.

2. Adenomyosis

Adenomyosis is frequently referred to as the "sister" condition of endometriosis because it also involves abnormal cell development. However, with adenomyosis, the cells grow into the muscular wall of the uterus. Similar to endometriosis, this condition is characterized by abnormal or heavy menstrual bleeding, painful periods (often after years of painless periods), and painful sex. The pain may radiate to one or both legs or feel like a lower backache.

3. Fibroids

Fibroids typically develop on the inner or outer wall of the uterus and are benign or noncancerous tissue growths. They rarely cause pelvic pain unless they are large and encroach on nearby organs or nerves. Some women experience pain or discomfort during menstruation, urination, bowel movements, or sexual activity. Additionally, the condition may cause painful periods or irregular vaginal bleeding.

4. Interstitial cystitis

Interstitial cystitis is a chronic bladder disorder that results in frequent urination and moderate-to-severe pain in the bladder and surrounding areas. Cramping and pain in the pelvis during sexual activity or urination are possible effects. Symptoms may change depending on what you eat and can be misinterpreted as a urinary tract infection (UTI).

5. Ovarian cysts

An ovarian cyst is a fluid-filled sac that can develop in or on the ovaries. It is a benign (noncancerous) growth that can cause both pelvic and low back pain if it ruptures or leaks. 

Pain may strike quickly or gradually develop over time and feel like a dull aching or lingering pressure as the cyst pushes up against another pelvic organ, such as the bladder. Exercise, urinating, or sexual activity can all worsen the cramps and pain. 

Some ovarian cysts resolve on their own, but others, particularly those associated with endometriosis or other conditions, may require surgery. Large ovarian cysts can twist the ovary and cut off its blood supply, necessitating emergency surgery.

6. Pelvic inflammatory disease (PID)

PID affects over one million women annually and is an infection of the reproductive system caused by the same bacteria that cause gonorrhea and chlamydia. PID can also result from nonsexually transmitted illnesses, such as bacterial vaginosis. 

Some women with PID experience no symptoms at all or only minor discomfort. PID can manifest in cramps, abnormal vaginal discharge, unexpected menstrual bleeding, painful urination, nausea, fever, chills, and pain during sex.

7. Pelvic organ prolapse

Pelvic organ prolapse is caused by a deterioration or strain in the ligaments and muscles that keep the organs in the pelvis in place. It can cause the uterus, vagina, rectum, urethra, bladder, or bowel to prolapse or slip, sometimes multiple organs at the same time. 

Women with pelvic organ prolapse frequently experience pelvic pain during sex or menstruation. They may sense pressure or pain in their low back if one or more pelvic organs press up against the vaginal wall.

8. Irritable bowel syndrome (IBS)

IBS can cause cramp-like pain and bloat due to the unevenly contracting muscular wall of the gut. Most of the time, this type of pelvic pain subsides after passing gas or stools. Common therapeutic interventions include dietary changes (increasing the amount of fiber in your diet and avoiding potential triggers) and lifestyle modifications.

9. Urinary tract infection (UTI)

UTIs affect more than 50% of women and are another common cause of pelvic pain and cramping. Symptoms include lower abdominal pain and/or a burning feeling when passing urine, fever, chills, back pain, nausea, and vomiting. If left untreated, UTIs can develop into more serious kidney infections.

Once your doctor identifies the cause of your cramps and back pain, a treatment strategy can be recommended.

For example, if you have endometriosis, your doctor can recommend hormonal drugs (such as an oral birth control pill) to relieve painful menstruation. For endometriosis and associated disorders such as fibroids, surgery is another possibility. 

If the cause of your pain cannot be found, your doctor may recommend the following to reduce your symptoms and enhance your quality of life:

• Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen 
• Muscle relaxants
• Hormonal treatments (oral or intravenous)
• Physical therapy
• Rest
• Heating pads 
• Lifestyle changes, such as a balanced diet, regular exercise, and improved posture