Cramps are common before and during menstruation. However, some people also experience cramping after a period has ended, which may indicate an underlying condition.
Cramps that occur directly before and during the period are due to the uterus contracting as it sheds its lining. This is called primary dysmenorrhea, and it usually lasts for a few days.
Cramps caused by anything other than menstruation are called secondary dysmenorrhea. They can occur at any time in the menstrual cycle.
Secondary dysmenorrhea may be natural, or it may require diagnosis and treatment by a doctor or specialist. A person should discuss any unexpected cramping with a healthcare professional.
This article covers some of the possible causes of cramps after menstruation. It also looks at symptoms and ways to relieve the pain caused by period cramps.
A person may experience cramps during ovulation — when an ovary releases an egg. Ovulation occurs around the middle of the menstrual cycle. These cramps are called mittelschmerz.
Ovulation is a part of most regular menstrual cycles. An individual may or may not be able to feel it happening.
Ovulation cramps often affect one side of the body. They may last for a few minutes or a couple of days and will go away on their own.
Mild uterine cramps can be a very early sign of pregnancy. These cramps are associated with implantation — when a fertilized egg or embryo attaches itself to the uterus lining.
Implantation-related cramps are typically mild and temporary, and often accompany dark red or brown spotting, known as implantation bleeding. This bleeding generally occurs around the time that the next period would be due.
Other symptoms of pregnancy may occur during this time, such as breast heaviness, increased urination, and mood changes.
The best way to test for pregnancy is to take a test at home or in a doctor’s office.
An ectopic pregnancy occurs when the fertilized egg attaches itself anywhere outside the uterus.
Ectopic pregnancies begin like regular pregnancies, but an individual may soon experience severe cramping and pain in the uterus.
Other symptoms may include:
- abnormal bleeding
- sharp, often severe pelvic pain
- shoulder pain
- abdominal pain, typically one-sided, but can be experienced on both sides
The pressure involved in an ectopic pregnancy can cause the fallopian tube to rupture. This can result in heavy bleeding, which may lead to fainting, shock, or feeling lightheaded. A ruptured fallopian tube requires emergency medical care.
Ectopic pregnancies are not common, occurring in
Endometriosis is a condition that causes uterine tissue to grow outside the uterus. Endometriosis is manageable, but there is currently no cure.
Individuals with endometriosis may experience highly painful menstrual cramps that
Other symptoms of endometriosis include:
- heavy periods
- painful ovulation
- pain in the lower back and pelvis
- pain during or after sex
- digestive issues, such as constipation, diarrhea, and bloating
Chronic pelvic pain, lower back pain, or abdominal cramps that get worse during menstruation should be discussed with a healthcare professional.
Adenomyosis causes endometrial tissue to grow in the muscles of the uterus rather than in the uterine lining. This makes the uterine walls thicker, which can lead to especially heavy menstrual bleeding and prolonged cramping.
Treatment for adenomyosis typically involves medication. In some extreme cases, a hysterectomy may be required.
Cysts forming in the ovaries can cause cramps and bleeding after the period has ended. Most cysts will clear up on their own, but if they are especially large, they may cause other symptoms.
Treatment for ovarian cysts may include pain medication or surgery.
Fibroids are benign, noncancerous growths that can form anywhere in the uterus. Symptoms differ based on the location, size, and number of fibroids in the uterus.
Uterine fibroids may cause symptoms such as:
- irregular bleeding
- especially heavy menstruation
- long lasting menstruation
- pressure or pain in the pelvis
- difficulty urinating or frequent urination
In some cases, uterine fibroids can cause infertility. They are often treated with medication, surgery, or a combination of the two.
Some people have a smaller opening in their cervix. This is called cervical stenosis, and it can slow down the menstrual flow, which may cause painful pressure in the uterus.
Cervical stenosis can be treated with medication or surgery. Alternatively, an intrauterine device (IUD)
Pain in the uterus or vagina accompanied by foul-smelling discharge can be a sign of a vaginal or uterine infection. This
Symptoms may not be obvious at first and may begin with a sudden and persistent cramp-like pain in the abdomen. PID can become life threatening if not correctly treated.
Other symptoms of PID include:
- heavy or abnormal vaginal discharge
- abnormal menstrual bleeding
- general fatigue
- flu-like symptoms, such as a fever or chills
- pain, discomfort, or bleeding during intercourse
- difficult or painful urination
Most uterine cramps will feel similar, regardless of when they occur.
When cramping follows menstruation, it may be felt in the lower abdomen and lower back, though it can spread to the hips and thighs.
The severity of these cramps varies from person to person, but they may be more severe than typical menstrual cramps.
Many people experience symptoms that accompany their cramps, including:
Each person experiences menstrual cramps differently. Some may have severe cramping throughout their period, while others notice only mild discomfort before menstruation.
Cramps that follow menstruation are treated in the same way as most uterine cramps.
The severity of cramping can be reduced using the following methods:
- taking pain medications or anti-inflammatories
- placing a heating pad or hot water bottle on the abdomen
- lightly massaging the area
- increasing water intake
- eating a diet high in whole foods, such as fruits and vegetables
- reducing stress levels
- reducing tobacco and alcohol use or avoiding them altogether
- doing light exercises, such as biking or walking
Healthy lifestyle choices and self-care routines can help reduce the severity of menstrual cramps.
The following are some questions people frequently ask about cramps after their period.
Can you have a painful period and be pregnant?
Cramps and light bleeding can be a sign of implantation bleeding, which occurs when the fertilized egg implants into the lining of the uterus.
However, bleeding and pain early in pregnancy can also be a sign of miscarriage. If an individual is experiencing pain and bleeding, and is pregnant, they should speak with a healthcare professional.
What is a phantom period?
Factors like stress and endometriosis can cause phantom periods. This is when a person experiences many of the symptoms of menstruation without bleeding.
Cramps that follow a period are often not a cause for concern.
In some cases, cramps may be a sign of pregnancy or an underlying condition, such as endometriosis. Treatment depends on the cause.
If cramps are severe, do not improve, or appear with other symptoms, consult a healthcare professional.