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Cramps But No Period: Causes and Treatment

Written by Elizabeth Buescher, Gynecologist

As a rule, menstruation is accompanied by dragging pain, since it involves active contraction of the uterus, which is actually “forcing outward” rejected endometrium. In case the woman observes menstrual cramps but no period, it is appropriate to assume one of the possible causes: ovulation, presence of functioning cysts or their disruption, twisting of uterine adnexa, pelvic inflammations, neuralgia or adhesions, uterine or adnexal neoplasms, endometriosis or adenomyosis, as well as pregnancy or disturbance of its course. Apart from the mentioned reasons, cramps can also have non-gynecological etiology.

Period is the process of discharge of blood and admixtures from the vagina due to the rejection of endometrial lining (uterine mucous lining), which was preparing itself for possible pregnancy during the previous cycle. The following symptoms are considered to be classical period symptoms:

  • Rapid weight gain and general swelling;
  • Painful breasts;
  • Purulent rash on the face and low neck;
  • Digestion disorders (diarrhea or constipation);
  • Emotional instability.

Besides, in the majority of women this process provokes period cramps, which is associated with active contraction of the uterus, “pushing outwards” the no more necessary tissue.

Ovulation cramps, similar to period cramps

Approximately in the middle of the cycle the matured ovum emerges from the follicle, which turns into the so-called yellow body – a gland, producing progesterone. Ovulation itself may be accompanied by dragging abdominal pain, caused by the ovulating ovary, as well as by discharge of a little amount of blood from the vessels, affected in this process.

Cysts that can provoke menstrual cramps but no period

The situation, when for this or that reason the ovum does not emerge from the follicle, results in the formation of the so-called follicular cyst. It provokes acute cramps with no subsequent periods. Usually, the period does not occur on the expected date.

The above mentioned yellow body cysts are marked with similar symptoms. They can be functional and dysfunctional, depending on their ability to influence the menstrual cycle.

Cysts run the risk of disruption – an acute life-threatening gynecological pathology, requiring immediate hospitalization. The main symptom of this complication is pungent pain and/or vaginal bleeding.

Twisting of adnexa

Under the influence of the precipitating factor (weight lift, abrupt change of one’s position), uterine adnexa can be twisted. Both normal and cystic ovaries, as well as the tube and uterine tissues, can be engaged in this pathology.

Pressing on vessels hinders the venous outflow, leading to the swelling of organs, which eventually results in their necrosis. All this is accompanied by acute, constant or cramping pain. Such symptoms are also characteristic to apoplexy (spontaneous disruption) of the ovary. These conditions also present great danger to the life of the patient and require immediate surgical intervention.

Cramping but no period as a sign of an infectious process in the pelvis

Penetration of an infectious agent and the development of the disease, which affects this or that part of the genital tract, may provoke dragging abdominal pain in the middle of the cycle. Particularly, cramps without period accompany endometritis (infection of the uterine mucous membrane), salpingitis (inflammation of uterine tubes) and oophoritis (inflammation of ovaries). Besides, the discussed conditions can be accompanied by moderate or profuse bleeding. The following symptoms can help to tell them from periods:

  1. Inflammation is often preceded by an unprotected sexual intercourse, past history of a sexually transmitted disease or a surgical manipulation (such as abortion);
  2. Pathological spotting does not regularly occur; it may reoccur multiple times within the same cycle and often contains other admixtures (matter) with a foul odor;
  3. Infectious diseases are accompanied by disturbed well-being, rise of body temperature, etc.

Pelvic neuralgia, resembling period cramps

Presence of a focus of chronic infection often leads to neuritis, which innervates the pelvis. Appearance of chronic pelvic pain, with no relation to periods, is characteristic of this condition.

Adhesive processes should be mentioned separately. Adhesion occurs after surgical interventions (including Caesarean operation) or previous inflammations of pelvic organs.

The treatment of neuralgia should be conducted under the control of both specialists: gynecologist and neurologist. Severe cases of adhesions require surgical correction.

Tumors that show up in the form of cramps without period

In early stages, uterine tumors (such as myomas) do not provoke pain. However, significant stretching of a certain organ and the covering membrane, as well as its pressure upon adjacent organs may become the cause of abdominal cramps. Besides, twisting of pedunculated myomas, their necrosis and abasement of the myomatous nodule into the vagina, can also be the reason of acute pelvic pain. All these complications are treated through surgical intervention.

Ovarian neoplasms in themselves, including cysts, also do not provoke cramps, but bleeding, twisting, necrosis or disruptions of such neoplasms, are characterized by acute (increasing or pulsating) pain. Such a pathology also goes in line with the enlargement of the belly, sickness, vomiting, swelling of the limb, on the affected side. These conditions require exclusively surgical intervention, which should be performed with no delays.

Endometrial pathologies

Endometriosis is the proliferation of endometrial islets out of the uterine cavity and over the surface of other organs. Adenomyosis is the growth of the mucous membrane into the muscular layer of the uterus. These diseases involve a similar set of symptoms:

  • Cyclic pelvic pain, unrelated to the cycle;
  • Highly painful periods;
  • Pain during intercourse;
  • Breakthrough bleeding;
  • Infertility.

Hormonal therapy is applicable to these diseases. Exhaustive bleeding or unbearable pain can serve the ground for the eradication of the uterus.

Pregnancy and sensations, resembling period cramps

Stretching of the uterus, as well as the membrane, covering it, leads to the appearance of typical cramps, which are not followed by periods. Additionally the woman starts experiencing early pregnancy symptoms, such as morning sickness, taste disturbance, etc.

The nature of cramps is absolutely different in the case of the disturbance of the course of pregnancy: rejection of the ovum provokes powerful uterine contractions and significant bleeding. Initially, this process can easily be confused with periods. It is considered that throughout their lives women experience a great number of such micro abortions, being unaware of them.

In the second trimester or in the case of an ectopic pregnancy, the miscarriage is more palpable since all the symptoms are more distinct, and such conditions as fever and fainting are not excluded. These are direct indications for an immediate visit to a clinic.

Non-gynecological pelvic pain, resembling menstrual cramps

Acute cramps may be provoked by certain diseases of the urinary tract:

  • Cystitis (inflammation of the urinary bladder);
  • Pyelonephritis (kidney infection);
  • Urethral stricture (such as stone obstruction);
  • Abscess around the kidney.

In this case, the pain, which resembles period cramps, is accompanied by disturbance of urination, what inevitably creates an objective difference, since it is characteristic of such acute conditions, as ovarian apoplexy. A urologist can only do exclusion of kidney diseases.

Cramps without period can also be provoked by acute appendicitis, bowel obstruction, cholecystitis and strangulated hernia. All these diseases are highly virulent and also resemble acute necrotic processes, related to gynecological issues. Their differential diagnostics should be carried out by a surgeon.

Thus, cramping but no period is hardly ever an insignificant issue. Observing such a symptom one should not hesitate to consult a gynecologist and find out the actual cause of such pain.