Why do I have period pains, but no period?
Period pain, no period? This predicament can be confusing for women, as the tell-tale cramps are usually a sure-fire sign that their flow is imminent.
What are the causes of period pain?
The main cause of period pain is uterine contractions.
These occur when the muscular walls of the uterus tighten involuntarily in order to expel the newly-thickened lining. This lining has been built up over the course of the monthly menstrual cycle, in preparation for a potential newly-fertilised egg to implant there. 1
When no fertilisation takes place, a physical and chemical reaction is triggered by the body in order to rid the uterus of the thickened lining which isn’t needed that month. The resulting contractions can restrict the blood supply to the uterus walls, causing further pain. 2
If you track your monthly cycle – for instance on a calendar or with an app – you can get a rough idea of when your most painful days will be. Most women feel their greatest pain with the onset of the blood flow, with the pain gradually easing over the duration of the period.
There are some conditions which cause unusually heavy or painful periods.
These include: 3
- Uterine fibrous
- Pelvic inflammatory disease (PID)
- Poly cystic ovary syndrome (PCOS)
Speak to you doctor if you think you may have a condition which is giving you excessive period pain.
Can you get period pain before your period?
Some women get period pain before period commencement as part of their pre-menstrual (PMS) symptoms. This is not uncommon and is usually a sign of the uterus contracting in preparation to expel its lining.
Cramps are usually the last sign that your period is coming, though, and happen 1-2 days before the blood appears. It could also be caused by bloating, a common symptom around the time a period is due. Pain caused by bloating isn’t usually as low down in the abdomen as period cramps.
If you’re having them mid-cycle they could be down to trapped wind.
If you regularly experience mid-cycle cramps, keep a symptoms diary and speak to your doctor.
Read more: 5 signs that your period is coming.
Can you have period symptoms without period?
Yes. Certain forms of contraception, such as the contraceptive implant, can lead women to experience period symptoms, including cramping, without a period.
The contraceptive implant prevents eggs being released each month for fertilisation, and in some women, stops periods for the duration the implant is present in the body.
Although your period may have stopped, other symptoms such as mood swings and cramps may still be present during the time you’d usually be bleeding, as your hormones can trigger uterine contractions even though there’s no thick uterus lining to expel. 4
Can early pregnancy feel like period cramps?
Yes. By week 4 of pregnancy, (around the same time you’d notice a missed period), a foetus isn’t even formed properly and is the size of a tiny poppy seed. However, the uterus is slowly expanding to make room for the growing foetus to come. This can cause mild stretching or tearing sensations very low down in the abdomen, above the pubic bone. 5
So, if your period is due and you’ve been lightly cramping for more than a couple of days with no blood, consider whether you could be pregnant.
Take a home pregnancy test from the day your period is due if you think you might be pregnant. (Some tests are extra sensitive and can detect the HCG hormone up to 6 days before your missed period).
Can you have period pains and be pregnant?
Yes. While the lower-abdominal cramps you’re feeling won’t strictly be period pain, if you’re pregnant you can experience some mild cramping around the same time your period would be due.
As well as the uterus growth pain mentioned above, you can also feel cramping before this stage. In very early pregnancy, you might experience implantation cramping, which can feel like period cramps.
Implantation cramping occurs when the fertilised egg ‘implants’ or burrows into the uterus lining. Not all women feel this, but those that do are likely to do so around two weeks after ovulation – before your period is due to arrive. 6
You’re unlikely to get blood flow around the time your period is due if you’re pregnant, (although spotting is possible). Again, a pregnancy test is the only way to be sure.
Last Updated: 30th November 2020
Author: Bhupesh Panchal, Regulatory Affairs
Bhupesh started his career as a clinical toxicologist for Public Health England, advising healthcare professionals all around the country on how to manage clinical cases of adverse exposure to supplements, pharmaceuticals, cosmetics, industrial chemicals and agricultural products. After 7 years in this role and a further year working as a drug safety officer in the pharmaceutical industry, Bhupesh joined Holland & Barrett as a Senior Regulatory Affairs Associate in 2019.
In his spare time, Bhupesh likes to cycle and has been learning to speak Korean for several years.