If you are experiencing period pain but are not expecting your period, the situation can be confusing and alarming. Many women experience pelvic pain, often cramping, but the cause may not always be your period.
There are several other medical conditions which can cause you pain or discomfort like that of your period. You may not be able to tell what the cause of the pain is, but if the pain happens when you’re not on your period, then this may not be the cause.
It is possible to experience the symptoms of your period without actually having your period – including the following symptoms:
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 emergency morning-after pill, this can interfere with your normal menstrual cycle. It may also be a sign that your reproductive organs are experiencing problems.
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. |
| Anovulation | Where the ovaries don’t release an egg during the menstrual cycle so ovulation doesn’t take place. | You may still menstruate as normal during an anovulatory cycle, so may experience the usual PMS symptoms. |
| 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 longer menstrual periods, a heavier flow and increased cramping. When the thyroid is underactive it doesn’t produce enough hormones. |
| 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 Device (IUD) is a form of hormonal contraception which is inserted inside the body to prevent pregnancy. | Some of the side effects of the IUD include:
|
| 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 of fluid found on the ovary. Most of these are harmless but if they grow large they can burst. | If the cyst ruptures to may feel sudden, sharp cramps on either side of your abdomen. |
| Uterine polyps | Fleshy growths of tissue which can be found in the uterus and cervix. | Can cause symptoms like heavy periods bleeding between your periods. Larger polyps can cause period-like cramps. |
| Pelvic inflammatory disease | Infection of the female upper genital tract such as the womb, fallopian tubes and the ovaries. | Symptoms can include:
|
| Miscarriage | Loss of pregnancy during the first 23 weeks. | Symptoms include:
|
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:
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.
Symptoms which may indicate other health conditions include:
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 when the bleeding starts and may continue for a few days or for the whole time you bleed. Teenage girls can sometimes experience more period pain when they first start their periods. It is hard to use the timing of your usual periods to rule out the period pain. This is because you may experience pain both at the time of your period and during the middle of your cycle when you ovulate.
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 just period pain. For example, conditions such as anovulation, PCOS, untreated STIs can lead to infertility or further health complications. 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:
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:
Not necessarily – you can still get period pain with many contraceptives that are working properly. On the other hand, getting an unexpected period 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:
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.
You contraception could be giving you side effects – if you’re experiencing any side effects from your contraception, you should consult your doctor. Side effects may include:
Hightower, M. (1997) Effects of exercise participation on menstrual pain and symptoms. Women Health; 26(4): 15-27.
Insulite Health. (2018). Excessive menstrual pain or dysmenorrhea and PCOS. [online] Available at: https://pcos.com/excessive-menstrual-pain-or-dysmenorrhea-and-pcos/ [accessed 10th August 2018].
Merrifield, S. (2017). Period pain but no period? What stress could have to do with it? [online] Available at: https://thefemedic.com/menstruation/period-pain-no-period-stress/ [accessed 10th August 2018].
Refaat, B., Dalton, E. and Ledger, W. L. (2015). Ectopic pregnancy secondary to in vitro fertilisation-embryo transfer: pathogenic mechanisms and management strategies. Reproductive Biology and Endocrinology; 13(30).
Stones, R. W., Cheong, Y. C. and Howard, F. M. (2005). Interventions for treating chronic pelvic pain in women. Cochrane Database of Systematic Reviews.
Yonglitthipagon, P. et al (2017). Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea. Journal of Bodywork and Movement Therapies; 21: 840-846.
