What Are Implantation Cramps?

For most women, especially those who aren't sexually active, twinges below the navel tend to signal the beginning of their menstrual cycle. This prickling sensation can feel painful, irritating and inconvenient.

Did you know that similar twinges could indicate you might be pregnant?

Learn why and when implantation cramps occur, where they are felt, and how to tell the difference between typical menstruation and implantation cramps.

What is implantation cramping?

Since conception typically occurs two weeks after your last period, the sperm and egg won't meet until week three of your pregnancy. Once the sperm and egg unite, they create a one-celled entity, or zygote. The zygote heads along the fallopian tube to the uterus and forms new cells.

The zygote divides again, forming a group of cells, or a morula. The fast-dividing, dynamic ball of cells, or blastocyst, begins burrowing into the nutrient-rich and sustaining uterine lining. The inner cells become the embryo, while the outer cells of the blastocyst form the placenta. This burrowing during week four may result in implantation cramps.

Implantation cramps occur to tell you that you have officially become pregnant, explained Monte Swarup, M.D., an OB-GYN based in Arizona and the founder of Vaginal Health Hub. But where are implantation cramps located? The intensity of the discomfort ranges from a dull ache to sharp twinges in your abdomen or lower back. These cramps may be felt for up to three days.

Should bleeding with implantation cramps cause concern?

A small amount of bleeding can accompany implantation, but it is not as heavy as a typical menstrual flow. This blood may be mixed with other bodily fluids, such as cervical mucus or other discharge. It could also be different shades of color, just like during your period. Implantation cramping does not cause heavy bleeding or clotting.

How do I know if it's implantation or menstruation?

Implantation cramps don't fall within the same timeline as your menstruation cramping. In general, period cramps feel different than implantation cramping. For one thing, implantation cramps are more of a dull ache or brief, sharp pain.

How common is implantation cramping? Roughly 30 percent of women experience implantation cramps. If you have painful cramping or cramps that don't go away, or you notice heavy bleeding, call your doctor.

What other symptoms accompany implantation cramps?

Aside from light bleeding, implantation cramps may also be accompanied by more obvious physical signs of early pregnancy, said Gregory Marchand, M.D., an OB-GYN with Marchand Institute for Minimally Invasive Surgery in Mesa, Arizona. The early signs of pregnancy can include nausea, malaise and even a sudden sensitivity to or dislike of certain foods and odors.

In addition, people in this early stage of pregnancy may experience more breast tenderness than they usually have during their periods, along with mood swings, bloating, more frequent urination and digestive issues. Marchand explained that signs such as frequent urination and breast tenderness could occur before cramping and other symptoms.

When to call your doctor

Cramping can be part of the entire pregnancy experience. It can be hard to know when you are experiencing typical cramping or when it's something else. If you aren't sure, you should always speak with your doctor.

If your pain is intense and accompanied by heavy bleeding, if you have prolonged and one-sided pain, or have previously experienced an ectopic pregnancy, don't hesitate to call your healthcare professional.

The bottom line

Implantation cramping is a little different from the usual period cramps. They may or may not be accompanied by light bleeding or spotting and occur in week four of pregnancy. If you can't distinguish between menstrual blood or spotting, or have heavier bleeding and painful cramping, don't hesitate to call your doctor.

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