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Period pain, but no periods: what are the causes?

Laura Harcourt

Written byLaura Harcourt

Ms Roopa Navani

Reviewed byMs Roopa Navani

Happy tourist enjoy landscape and nature beauty opening arms and smiling happy.
Having period cramps and pain with no period can be pretty confusing. But there could be a cause. Discover what this could be in our article.

Summary

1What causes period pain?

When you have a period, the main cause of pain is uterine contractions, which we call ‘cramps’. This can cause a sharp pain or a dull ache in your...

2Reasons for period cramps before your period

The medical name for painful periods is ‘dysmenorrhea’, and there are two main types: primary and secondary...

3Can you get period pain with no periods?

As well as having period pain as the result of a period, it’s also possible to have period pains with no period at all. There are several reasons...

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Periods can be a real pain! But when you experience the pains associated with periods without actually having one, it can be a particularly confusing, and even scary, place to be.

However, there are several reasons why you might be experiencing this. 

Here, we take a look at what some of these might be, providing some answers and support to put your mind at ease. (But, if your symptoms are painful and you're concerned, make sure you speak to your GP.)

What causes period pain?

When you have a period, the main cause of pain is uterine contractions, which we call ‘cramps’. This can cause a sharp pain or a dull ache in your tummy which, for some people, can spread into the lower back and thighs.1

Throughout your monthly menstrual cycle, the lining of your uterus builds up in preparation for a potential newly fertilised egg to implant.2 Menstrual cramps happen when there’s a rise in hormone-like chemicals called prostaglandins, which trigger your uterus (womb) to contract and shed this built-up lining. These contractions are the cause of the discomfort you feel in the days leading up to and during your period.

If you track your monthly cycle – on a calendar or with an app, for example – you can get a rough idea of when your most painful days will be. For most people, the worst day will be the day their period starts, with the pain gradually easing during their period.3

Reasons for period cramps before your period

The medical name for painful periods is ‘dysmenorrhea’, and there are two main types: primary and secondary.3, 4 

  • Primary dysmenorrhea is period pain that isn’t caused by a specific condition. It’s also the most common type of period pain, and should only last for a few days.3, 4 
  • Secondary dysmenorrhea is pain caused by an underlying medical condition, which causes unusually heavy or painful periods. 

In this case, the pain you feel may be especially bad in the days before your period starts, as well as during your period. It can also get worse, rather than improve, as your period goes on.3, 4

Some of the conditions that can cause this type of painful period include: 4
It’s important to speak to your doctor if you think you may have a condition which is causing you severe period pain.

To learn more about what period pain is, why it happens, and how to relieve it, take a look at our guide to period pain.
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Can you get period pain with no periods?

As well as having period pain as the result of a period, it’s also possible to have period pains with no period at all. There are several reasons why this may happen, ranging from ovulation to medical conditions.

Ovulation pain

Ovulation usually happens once a month, around two weeks before your next period.5 

Some women will experience pain when an egg is released from an ovary, which can last for a few minutes, or up to 48 hours. When experiencing ovulation pain, it typically only affects one side of your tummy and causes either a dull ache or a sharp, sudden pinch-like pain.

The pain can also feel similar to period pain, and can sometimes cause light spotting, so the two can be easily confused.6,7
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Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus grows in other places, such as around the ovaries and fallopian tubes, and around the bowel.8 While it’s not known what causes this to happen, endometriosis is a common condition, affecting one in ten people who menstruate in the UK.9
Symptoms of endometriosis include heavy periods and bleeding between periods, which often come with severe pain.10 

The condition can also cause extreme pelvic pain on days outside of your period, pain during or after sex, and pain or discomfort when going to the toilet.8,10

PCOS

Polycystic ovary syndrome (PCOS) affects the function of your ovaries. Like endometriosis, it’s not exactly clear what causes it, but it’s often related to high levels of insulin and a hormonal imbalance.11 

Symptoms of PCOS include difficulty getting pregnant, excessive hair growth, and irregular or absent periods.11 

Research shows that the irregularity of periods in people with PCOS can cause a much heavier bleed, which can result in more intense and painful cramping. This cramping may be severe and can start a few days before your period and last for a few days after you’ve finished bleeding.12
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Pain (like period cramps) during early pregnancy

Very early on in pregnancy, you may experience something called implantation cramps. This can feel like slight twinges in your tummy and there may also be some light bleeding as the fertilised egg attaches to the wall of your uterus.13 
At around four weeks of pregnancy, the uterus also slowly begins to expand to make room for your baby to grow. This can cause mild stretching or tearing sensations very low down in your tummy, just above your pubic bone.14

So, if you’ve been cramping for a few days, and your period is overdue, it could be because you’re expecting. 

You can take an at-home pregnancy test on or after the day your period is due to find out. Some tests you can purchase are sensitive to hCG (the hormone that indicates pregnancy) up to six days before your missed period.

Pain (like period pain) when pregnant

It can be particularly worrying to experience cramping when you’re pregnant. However, there are several common and harmless causes, including:15,16 
  • Braxton Hicks contractions (sometimes known as ‘practice contractions’) 
  • bloating 
  • trapped wind
  • constipation 
  • round ligament pain (bands of tissue that hold the uterus in place stretch)
  • uterine contractions after orgasm
  • increased blood flow to the uterus
In some cases, cramping and pain can be a sign that something is wrong. It can also be a sign that your contractions have started and your baby is ready to come into the world.15

It’s always important to seek professional medical advice if you’re worried about any of your symptoms.
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Menopause

Before you reach menopause (when you’ve not had a period for 12 months), you’ll go through a transitional time called perimenopause.17
Fluctuations in your hormones during perimenopause can cause a range of symptoms and also make premenstrual and menstrual symptoms worse than usual.18 This means that while your periods may be less often, you might still experience cramping and discomfort from time to time.

The final say

Any pain you experience is unwanted, whether it’s due to normal period pains, more severe menstrual pain, or irritating trapped wind while you’re pregnant!

To help ease your discomfort, take a look at some of our top recommended remedies and period pain advice.

However, if you’re ever concerned about your symptoms, you should always speak to your GP. They’ll then be able to provide you with tailored support and potential medical treatments to help you get back to enjoying a pain-free life. 

This article is for information only and does not constitute providing medical advice or professional services.

Disclaimer

This article is for information only and does not constitute providing medical advice or professional services.
 

Sources

  1. NHS. Period pain [Internet] 2017 [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/period-pain/.
  2. Office on Women's Health. Your menstrual cycle [Internet] 2021 [cited 2024 Feb 13]. Available from: https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle. 
  3. Bupa UK. Period pain | dysmenorrhoea (Painful periods) [Internet] 2021 [cited 2024 Feb 13]. Available from: https://www.bupa.co.uk/health-information/womens-health/dysmenorrhoea 
  4. NHS Inform. Period pain (dysmenorrhoea) [Internet] 2023 [cited 2024 April 10]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/period-pain-dysmenorrhoea/ 
  5. Holesh JE, Bass AN, Lord M. Physiology, Ovulation. [Updated 2023 May 1]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan [cited 2024 April 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441996/ 
  6. NHS. Ovulation pain. [Internet]. 2017 [cited 2024 Feb 13]. Available from:https://www.nhs.uk/conditions/ovulation-pain/ 
  7. Cleveland Clinic. Ovulation Pain [Internet] 2023. [cited 2024 Feb 13]. Available from: https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea 
  8. World Health Organization (WHO). Endometriosis [Internet]. 2023 [cited 2024 Feb 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/endometriosis 
  9. Endometriosis UK. Endometriosis action month 2024 [Internet]. [cited 2024 Feb 13]. Available from: https://www.endometriosis-uk.org/endometriosis-action-month-2024 
  10. NHS. Endometriosis. [Internet]. 2017 [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/endometriosis/ 
  11. NHS. Polycystic ovary syndrome. [Internet]. 2017 [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ 
  12. Jeong JY., et al. ‘Polycystic ovarian morphology is associated with primary dysmenorrhea in young Korean women’. Obstet Gynecol Sci [Internet]. 2019 Jul 22 [cited 2024 Feb 13];62(5):329–34. Available from: http://ogscience.org/journal/view.php?doi=10.5468/ogs.2019.62.5.329 
  13. What to expect. When does implantation occur? Symptoms, what to expect [Internet]. 2023 [cited 2024 Feb 13]. Available from: https://www.whattoexpect.com/getting-pregnant/ovulation/implantation/#signs-and-symptoms
  14. Hull University Teaching Hospitals NHS Trust. Bleeding and/or pain in early pregnancy [Internet]. 2018 [cited 2024 Feb 13]. Available from:https://www.hey.nhs.uk/patient-leaflet/bleeding-andor-pain-early-pregnancy/ 
  15. What to expect. Cramping During Pregnancy: Normal or Something More? [Internet]. 2022. [cited 2024 Feb 13]. Available from: https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/abdominal-cramps.aspx 
  16. NHS. Stomach pain in pregnancy. [Internet]. 2020 [cited 2024 Feb 13]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/stomach-pain/ 
  17. NHS. Menopause. [Internet]. 2017 [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/menopause/ 
  18. Cleveland Clinic. How to deal with perimenopause cramps. [Internet]. 2022. [cited 2024 Feb 13]. Available from: https://health.clevelandclinic.org/cramps-during-perimenopause/
 

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