Cramping before the start of a period is common and is caused by the uterus contracting (due to prostaglandin) to expel its blood vessel-filled lining. The lining builds up during the first two weeks of the menstrual cycle in order to house and nourish an embryo, but if no pregnancy occurs, the body breaks it down and removes it.
Menstrual cramps typically happen right before menstruation and are either dull or extremely painfully and throbbing sensations that spread from the lower abdomen to the back and thighs. If the cramps become bad enough they can even disrupt everyday activities.
However, if there is an absence of menstruation, but a woman still gets uterine cramps it can be a confusing and frightening experience. While both symptoms are common, when they happen at the same time, no period and cramping can signal a serious issue.
The following are common causes of cramping but no period.
- Eating Disorders
Eating disorders are conditions that result from changes in the diet and include factors such as dramatic overeating or undereating on a daily basis.
- Anorexia, obesity, bulimia and other eating disorders can lead to cramps without a period.
- Ovulation and Late Periods
When an egg matures and is released into the fallopian tubes to be fertilized, ovulation has taken place.
- Common symptoms of delayed menstruation due to ovulation include gas, constipation and cramps with no bleeding.
- Irregular menstruation can cause periods that are absent, early or late.
- Cramps without a period is often the result of a miscalculation of ovulation and expected period date, which are often made worse by worry.
- Menopause and Perimenopause
Menopause is a natural biological process that usually occurs in the 40s or 50s, but the average age is 51.
- Common symptoms of menopause include uterine cramps, hot flashes, trouble sleeping and missed or late menstruation.
An FSH (follicle stimulating hormone) test can detect perimenopause, which usually occurs in women in their 30s and 40s.
- Perimenopause precedes menopause and is marked by changes in ovulation, such as irregular ovulation patterns and menstrual cycles.
- Pregnancy and Ectopic Pregnancy
Pregnancy is the most common and likely reasons for cramps in the lower abdomen in the absence of menses.
- After a fertilized egg attaches to the wall of the uterus, the uterus begins to stretch to get ready for the embryo’s rapid growth.
- Common symptoms of early pregnancy include darker areolas, morning sickness, implantation bleeding (spotting) painful and larger breasts and a stronger sense of smell.
- Take a home pregnancy test to confirm conception and implantation. Use the first urine of the day (which contains the concentration of pregnancy hormone) and wait several days after missing a period to get the most accurate results.
If a fertilized egg implants in the fallopian tubes (tubal pregnancy) or anywhere outside the uterus, the condition (which is serious and potentially fatal) is called an ectopic pregnancy.
- While mild cramps are usually associated with the early stages of pregnancy, severe cramps in the absence of menstruation can be caused by an ectopic pregnancy.
- It is often difficult for women to tell the difference between cramping caused by a normal pregnancy as opposed to an ectopic one.
- Common symptoms of ectopic pregnancy typically show up two weeks after missing mensuration and display similar symptoms to normal pregnancy symptoms which include nausea, breast soreness, urinary urgency and menstrual cramping and spotting but no period.
Warning: See a physician immediately if there is a negative pregnancy test along with cramping and no menstruation, as it can be a sign of a serious problem.
- Ovarian Cyst
Ovarian cysts (sacs of fluid in the ovaries) are a common condition that affects many women at some point in time. It happens when a follicle cyst does not release an egg during a menstrual cycle. It is also a result of the sac (corpus luteum cyst) not being reabsorbed into the body after ovulation.
- Cramps in the lower abdomen occur without menstruation when there is a buildup of fluid in the sac, which causes cysts to form and grow bigger.
- Unless complications that involve ovarian cysts growing and twisting happen, they typically go away completely without any treatment within three months.
- Autoimmune Oophoritis
Autoimmune oophoritis it an uncommon disorder, in which cells of the body attack itself as a result of ovarian inflammation. The condition often results in ovarian failure, loss of hormone production and primary or secondary amenorrhea (abnormal menstrual absence).
- One in ten cases of premature ovarian failure is the result of oophoritis, which causes the ovaries to get hard and damaged. This results in lower hormone production cause by inflammation, which leads to infertility.
- Common symptoms of oophoritis include no period, fever, vaginal discharge and cramps in the lower abdomen.
- Cervical Stenosis
When the opening of the cervix (endocervical canal) is much narrower than it should be, or is completely closed, the condition is known as cervical stenosis.
- The condition may be a result of infections, uterine cancer, surgery or trauma and can lead to endometriosis and cause mild or severe cramping.
Endometriosis (pronounced en-doe-me-tree-o-sis) is a condition that occurs when tissues of the inner lining of the uterus begin to grow outside of the endometrial implant (uterus) into the bowel, the lining of the pelvis and on the ovaries. Severe pain typically accompanies endometriosis, particularly during menstruation.
- Endometrial tissues behave normally, building up, breaking down and bleeding during the mensural cycle. However, because they are located throughout the body, the blood and tissues cannot be excreted through the usual channels.
- Endometriosis causes adhesions and scar tissue that develop abnormally and makes organs fuse together, which leads to irritation of the surrounding tissues.
- Enometriomas are cysts in the ovaries caused by endometriosis.
- Cramps a week or two before a period and delays in menstruation are sometimes caused by endometriosis, which results in cramping in the absence of menstruation.
- Ovarian Cancer
While it is not usually the cause of cramping without a period, ovarian cancer (also known as an ovarian tumor) is a result of cancer growth that starts in the ovaries.
- Cancer of the ovaries can imitate other health issues such as irritable bowel syndrome and display symptoms such as swelling, pelvic discomfort, pressure and a full feeling in the abdomen, bloating and an increased urgency to urinate.
- Menstrual cycle changes also occur with ovarian tumors and the condition is known as a silent killer because of the difficulty of detection.
- If a woman’s clothing begins to suddenly feel tight around the waist, it is a sign that should be followed by a thorough evaluation.
- This type of cancer responds well to treatment if caught in its earliest stages, so it is important to see a gynecologist if ovarian cancer is suspected.
Menstrual cycles can altered by the effects of physical and emotional stress on the body.
- Issues such as losing a loved one, moving, problems with family and relationships as well as intensive exercise, vigorous training and other kinds of anxiety and stress promoting circumstances can cause stomach cramping but no period by negatively affecting the body.
Warning: Abnormal mensural cycles and cramping can also be caused by taking certain medications and by some illnesses.