Getting Period Pain But No Period

It is possible to experience the symptoms of your period without actually having your period – including the following symptoms:

• Stomach cramps
• Feeling bloated
• Mood swings
• Feeling sick

It can be a sign of irregular periods– in certain circumstances, it may mean you are going to have a period, but not necessarily at the time, you were expecting to. For example, if you have taken the emergencymorning-after pill, this can interfere with your normal menstrual cycle. It may also be a sign that your reproductive organs are experiencing problems, or it could be an early sign of pregnancy.

These symptoms might not be related to your periods at all – there can be several causes and so potentially it is possible to have the symptoms you would expect to have when you are on your period, but not have a period at all. Instead, you may have similar symptoms which are caused by something else.

Some other causes of period-like pain are:

Causes What it is Why it feels like period pain Pregnancy Where a female egg is fertilised by a male sperm to create a baby. You may experience cramping early on in pregnancy. This may be where your uterus is growing or stretching. In early pregnancy, some women describe the feeling as if they were about to start their period. Fibroids A non cancerous lump in the womb. These can be large or small and there could be one or multiple fibroids. Fibroids can cause pelvic pain and heavy periods. Your doctor may be able to feel a large fibroid on examination. Thyroid problems The thyroid is a gland found in the neck. It produces hormones which help to regulate the body’s metabolism. An underactive thyroid can cause changes to your periods. Stress Stress is your body’s response to any form of demand or threat. Stress can have a really powerful effect on the body including disrupting your menstrual cycle. Stress and anxiety can also increase the pain you may experience during your period. Hormonal contraception The Intrauterine System (IUS) is a form of hormonal contraception which is inserted inside the body to prevent pregnancy. The non hormonal version is called an IUD.

Some of the side effects of the IUS and IUD include:

• Pelvic cramps
• Backache

However an IUS can also be used to treat painful periods. Polycystic ovary syndrome (PCOS) PCOS is a common condition which affects the way the ovaries work. PCOS can cause excessively painful periods. Ovarian cysts An ovarian cyst is a sac usually filled with fluid found on the ovary. Most of these are harmless but if they grow large they can burst. If the cyst ruptures you may feel sudden, sharp cramps on either side of your abdomen. Endometriosis The cells that make up the lining of the womb can also attach themselves to other parts of your body, commonly in your pelvis or abdomen. Can cause symptoms like heavier, more painful periods. Pelvic inflammatory disease Infection of the female upper genital tract such as the womb, fallopian tubes and the ovaries.

Symptoms can include:

• Heavy periods
• Painful periods
• Bleeding between periods

Miscarriage Loss of pregnancy during the first 23 weeks.

Symptoms include:

• Vaginal bleeding
• Cramping in your lower tummy

In addition, cancers in the pelvis such as ovarian cancers can cause irregular bleeding, pain, changes in the urine, bloating and vaginal discharge

What you should do about these symptoms – if you are experiencing symptoms such as period pains at a time during your cycle that you are not expecting to or you have cramps but no period, you should seek medical attention. Your doctor will be able to help diagnose the cause and suggest the next course of action required.

You may need an STI test – if you know that you do not have one of the above conditions, consider an STI test. STIs such as chlamydia can cause abdominal cramping/pain and bleeding between periods. You can get an STI test from:

• Your GP
• Local GUM clinic
• Sexual health clinic
• Some pharmacies
• Online NHS and private doctor services

It can be hard to tell between period pain and other symptoms – for some women, it can be hard to distinguish between period pain and other conditions. One tell-tale sign can be the length of your cramps. For example, during your period you may experience cramping for a couple of days or for the duration of your period. Whereas if you’re pregnant for example, you may experience cramping which lasts a few weeks to a few months.

If you do have a positive pregnancy test and cramps it is important to see a doctor to make sure that you do not have something called an ectopic pregnancy.

Symptoms which may indicate other health conditions include:

• Vomiting
• Diarrhoea
• Your periods are heavier or lighter
• High temperature (fever)
• Excessive hair growth
• Weight gain or weight loss
• Irregular bleeding or bleeding after sex
• Passing urine more often
• A change in vaginal discharge

If you are experiencing any of the above symptoms you should consult your doctor.

Timing might be a clue – usually, period pain lasts for several days. It normally begins just before or when the bleeding starts and may continue for a few days or for the whole time you bleed. You can also have pain during the middle of your cycle when you ovulate. Teenage girls can sometimes experience more period pain when they first start their periods.

You should get the problem diagnosed first – before you begin treating your symptoms you should get a diagnosis from your doctor to make sure it is period pain. For example, conditions such as untreated STIs can lead to infertility or further health complications, and though you can take painkillers to help with the pain this would also need antibiotic treatment. Another condition which needs emergency medical attention is an ectopic pregnancy. This is where a fertilised egg implants itself outside of the womb such as in the fallopian tubes. If this occurs, it is not possible for the pregnancy to survive and it will need to be removed by medicine or surgery. The symptoms of an ectopic pregnancy include:

• Symptoms of pregnancy, i.e. a missed period
• Tummy pain
• Vaginal bleeding
• Discomfort when you go to the toilet
• Shoulder pain
• Diarrhoea or vomiting
• Dizziness

If you are worried that you might have an ectopic pregnancy you must see a doctor urgently.

Once you know the problem, then you can try to treat it – if you have been diagnosed with period pain there are treatment methods available to help relieve the symptoms:

• Painkillers – ibuprofen or mefenamic acid (NSAIDs) can help to manage period pain. These have been shown to be more effective at managing the pain than paracetamol, although some women prefer the latter or cannot take NSAIDs. Your doctor can prescribe stronger painkillers if you find these are not effective at managing your symptoms. Usually, naproxen or codeine are sufficient for period pain.
• Heat – try placing a hot water bottle over the painful area. Remember to wrap the hot water bottle in a tea towel before placing it on your skin prevent burning.
• Warm bath or shower – some women find that a warm bath or shower can help to relieve the pain caused by your period.
• Lifestyle changes – lifestyle changes can help to relieve the symptoms of your period including pain and mood changes.
• Quit smoking – women who smoke tend to have more painful periods than those who don’t. If you smoke, try to give up using smoking aids not only will this help to reduce your pain but will also improve your overall health.
• Exercise – keeping active such as swimming, walking or cycling can help reduce the pain associated with your period. Yoga has also been shown to be effective in managing painful periods.

Not necessarily – you can still get period pain with many contraceptives that are working properly. On the other hand, getting bleeding or pain could mean your contraceptive has failed. If you are worried you may be pregnant, you can purchase a pregnancy test from most supermarkets and pharmacies. Alternatively, your doctor will be able to confirm a pregnancy.

You may still experience period pain even if you are using contraception – some methods won’t help you manage period pain, including:

• Condoms
• Copper contraceptive coil

Some contraception can reduce period pain – using hormonal contraception like the pill can help to reduce the pain you experience during your periods. In some cases, you may still get cramping but it may be less severe than before because the pill contains hormones which induce changes in the body to prevent pregnancy.

If your period pain does not get better with a few months of treatment your GP may wish to refer you to see a gynaecologist.