What are period cramps?
About every month, the ovaries release an egg into the uterus. The endometrial lining thickens as it prepares the body for pregnancy. When the egg isn’t fertilized, the uterus sheds its lining and starts the process over again.
To shed the lining and move the blood out of the body, the uterus must contract. This contraction causes pain which many female bodies experience as cramping. Some women have period cramps but no blood, which can be a sign of different health conditions.
Signs of period cramps but no blood
Signs of period cramps may include pain in the lower abdomen or lower back.
Period cramps are pain associated with menstruation, but they may come at different times. There are two categories of period pain, which include:
Primary Dysmenorrhea is the pain that occurs just before or during menstruation. Primary dysmenorrhea usually presents itself during adolescence and varies in intensity.
Secondary dysmenorrhea is pain caused by a disorder in the reproductive organs. This pain can occur before, during, or after menstruation and usually gets worse instead of better over time.
Causes of period cramps but no blood
While period cramps are a normal sign of menstruation, there may be times when you don’t have blood. These may be signs of other conditions, including:
You may experience a sharp pain or dull cramp when your ovaries release an egg. This is called ovulation and can sometimes be mistaken for period cramps. Because this is earlier in the menstruation cycle, your uterus isn’t ready to shed its lining yet, so there is no blood.
Ovulation usually occurs about 14 days after your period and is sometimes called mittelschmerz, which is German for “middle pain” or “pain in the middle of the month”.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection in the fallopian tubes, ovaries, uterus, or cervix. This is caused by bacteria often introduced into the area through sexually transmitted diseases such as gonorrhea. Symptoms of pelvic inflammatory disease include:
- Pain in the lower abdomen
- Vaginal discharge
- Pain during sex
- Irregular periods like no blood or missed periods
Ruptured ovarian cyst
An ovarian cyst is a fluid-filled sac that develops on or in one of your ovaries. These cysts can develop for different reasons and can rupture. Some women may experience mild symptoms including pain in the belly or lower abdomen if they have an ovarian cyst.
Endometriosis is a reproductive disorder that causes endometrial tissue to grow outside of the uterus. Every month, this tissue builds up as it waits for pregnancy then sheds as part of menstruation. When this tissue grows outside of the uterus, it still responds to hormonal changes and can bleed into the pelvis.
This causes inflammation, swelling, and scarring around the tissue. You may experience pain and what feels like period cramps but have no blood. This is because people who have endometriosis can have pain even while not menstruating. Sometimes the pain may be worse than period cramps.
You may experience period cramps a day or two before your period starts. It is common to experience period symptoms but no blood yet. This may be a sign your period is starting in a few days.
Irritable bowel syndrome symptoms
Sometimes it can be difficult to tell lower abdomen pain apart from other pains in your body. You may have what feels like period cramps without blood which may instead be indigestion, trapped wind, constipation, or irritable bowel syndrome.
Tests for period cramps but no blood
To diagnose the cause of your period cramps, your doctor will take your personal and medical history and your symptoms. They may ask you to track your period and your symptoms for a few months to see your body’s patterns.
They may also include:
Your doctor may test your blood for your luteinizing hormone, follicle stimulating hormone, estrogen, progesterone, and prostaglandin levels, and to check for pregnancy.
Your doctor may perform an ultrasound to check for pregnancy or cysts and to check your pelvis. They may also perform a computed tomography (CT) scan or magnetic resonance imaging (MRI) to check the structure of your reproductive organs.
Your doctor may perform a procedure called a laparoscopy. This involves a small instrument with a light and camera that allows your doctor to see your pelvis and remove growths without creating a large incision.
Treatments for period cramps
Your doctor may recommend over-the-counter medication to relieve mild period cramps.
For other conditions that cause period cramps but no blood, your doctor may prescribe one or more of the following to manage the underlying condition:
- Birth control pills
- Other hormone therapy medications
- Antibiotics for infection
- Hysterectomy — surgery to remove uterus and ovaries
- Lifestyle treatments like exercise, more sleep, stress reduction
- Warm baths
- Hot water bottles
Some people also benefit from complementary treatments like:
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Johns Hopkins Medicine: "Management of Ruptured Ovarian Cyst."
Johns Hopkins Medicine: "Endometriosis."
National Health Service: "Laparoscopy."
National Health Service: "Ovulation pain."
Office on Women's Health: "Pelvic inflammatory disease."
Office on Women's Health: "Your menstrual cycle."
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