No Period, No Cramps, Right? Not Always During Perimenopause
We know, not what you want to hear. While your period will likely be a no-show at times during perimenopause, cramps may still be making an appearance. And for some, the pain may intensify or last longer than normal. Phantom cramps are usually your uterus’ way of letting you know it is still building a lining and another period is somewhere on the horizon. Once you reach menopause that point when you haven’t had a period for 12 months, premenstrual (PMS) symptoms like cramps should be gone, too.
While estrogen levels decrease during perimenopause, it’s not a nice, neat linear decline. There are times—and this is one of them—when estrogen levels surge. As your ovaries struggle to produce mature eggs, your body pumps out more follicle stimulating hormone (FSH), which results in more estrogen being created. More estrogen means the uterine lining becomes even thicker. (The cause of heavier bleeding and longer periods when they do show up.) It also results in higher levels of prostaglandins, hormones responsible for the uterine contractions that open the cervix, expel the built-up uterine lining, and cause painful cramping. While these hormones are on the rise, levels of progesterone, a hormone involved in triggering menstruation, are the first to decline. These erratic hormone patterns are believed to be the reason that some months you may not experience a period, but still have cramps and other PMS symptoms like bloating and sore breasts.
What to do
You don’t have to grit your teeth until you’re postmenopausal. Here are simple remedies that can help you feel better right now.
Take a walk. Mild to moderate cardio exercise, such as walking, cycling, jogging, or taking a Zumba class, boosts feel-good chemicals in the body that may block some of the pain signals. It also improves circulation, which can relax constricted blood vessels in the uterus that result from cramping.
Apply heat. Try a heating pad or warm bath. In an analysis of 23 studies, heat was found to be just as effective as analgesics. Heat may help by increasing blood flow to the abdomen and inhibiting pain signals.
Pop a pain reliever. Ibuprofen and naproxen are some of the best medicine for this type of pain and may reduce bleeding. These anti-inflammatories work by blocking the production of prostaglandins.
Stretch it out. Gentle exercise like stretching and yoga may help by lowering stress hormones which then lower prostaglandin levels. In a review of research studies, exercise was found to be more helpful in easing pain than over-the-counter medication.
Increase these nutrients. Fiber and omega 3s may ease cramps by helping to regulate hormones. Good sources of fiber include beans, berries, whole-grain cereals and pasta, chia seeds, artichokes, and Brussel sprouts. You should aim for about 25 grams of fiber a day. For omega 3s, eat more cold-water, fatty fish like salmon and tuna; flaxseeds, chia seeds, walnuts; and plant oils like soybean and canola. Other nutrients that may help include vitamins B and E, magnesium, and zinc.
When to get help
If cramps are impacting your life, you should see your doctor for alternative treatments and to rule out other causes. Your doctor can prescribe low-dose birth control pills or a progesterone IUD like Mirena, which can reduce bleeding and pain.
If your pain is due to other culprits, such as fibroids, polyps, gastrointestinal problems, or issues with your pelvic floor muscles, your doctor can determine an appropriate treatment plan. You should also see your doctor, if you have gone more than 12 months without a period and then you have bleeding.
Many women are concerned about ovarian cancer when they experience pelvic pain, but that pain is different. First, ovarian cancer is called the “silent killer,” because there isn’t much pain until the disease has progressed. Second, this pain is likely to be more constant and severe and is commonly associated with decreased appetite and severe abdominal bloating.
It’s always good to exercise caution. If you’re concerned about the pain you’re feeling, make an appointment with your doctor—they can help you find relief and peace of mind!
We can help you
- Meet with a Menopause-certified Doctor to understand your symptoms and their impact on your overall health and wellness
- Partner with a Health Coach for actionable solutions and the support you need to get you feeling better
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The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.
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