Is Post-Period Cramping Normal?

Cramping before and during a period is a common experience for many menstruators. Approximately 90 percent of women report experiencing premenstrual symptoms, which include cramping, according to the U.S. Department of Health and Human Services Office on Women's Health.

Additionally, more than half of women who menstruate experience pain for one to two days each month during their period, according to the American College of Obstetricians and Gynecologists (ACOG). This is called dysmenorrhea. For many women, the pain exhibits as cramps that begin in their lower abdomen and sometimes radiate to the back and lower thighs.

For some women, cramping doesn't stop when their period is over. While cramping before and during your period is normal, getting cramps after your period isn't as common, according to Mary Jane Minkin, M.D., clinical professor in the department of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in New Haven, Connecticut.

"Indeed, most women who have cramps experience them with their menses; some cramping can occur afterwards, too, but in general, most of those women will have had cramps during their periods, too," Minkin explained.

If you're someone who experiences cramping after their period, you should learn more about why it happens and what to do about it.

What causes cramps, anyway?

Cramping during a period is actually the result of uterine contractions caused by chemicals called prostaglandins. Your uterus contracts to expel its lining. If the contractions are too strong, the uterine muscles won't get enough oxygen. The result is a painful cramp.

Minkin said cramps can be broken down into two categories. The first is primary dysmenorrhea, usually caused by prostaglandins. The muscle contractions occur not only in the uterus, but also in the intestines and stomach, according to Minkin.

Primary dysmenorrhea is more common in women younger than 30 and women with heavier periods. These cramps can be minimized with the use of medications that inhibit the prostaglandins, such as nonsteroidal anti-inflammatory drugs (NSAIDs), including Motrin, Aleve and Advil.

"Take them early as soon as cramps are felt—you want to block the making of more prostaglandins," Minkin advised.

In addition to over-the-counter medication, exercise, massage and a heating pad or hot water bottle are common methods used for relief.

However, not all cramping is related to prostaglandins. The second category of cramps is secondary dysmenorrhea, which is not related to prostaglandins alone and may be associated with endometriosis or, occasionally, fibroids or infections, Minkin said. In some cases, intrauterine devices (IUDs) have been noted to cause secondary dysmenorrhea.

Why you might get post-period cramps

If you get cramps after your period, they may be caused by one of the conditions associated with secondary dysmenorrhea, or another underlying condition.

"It could be endometriosis, adenomyosis…an infection, pelvic inflammatory disease or it can be caused by a sexually transmitted infection," explained Christine Greves, M.D., an Orlando-based gynecologist.

Here's a deeper look into possible causes of cramping after your period:

Ectopic pregnancy

"If you are menstruating and have pain after your period, it's important to make sure you aren't pregnant," Greves advised.

Lower abdominal pain and vaginal bleeding can be symptoms of ectopic pregnancy.

In a healthy pregnancy, the fertilized egg attaches to the lining of the uterus. In an ectopic pregnancy, the fertilized egg instead attaches somewhere outside the uterus, usually in a fallopian tube. Though this condition is rare, it's important to seek immediate medical care if you suspect an ectopic pregnancy, as it is a life-threatening condition.

Endometriosis

Endometriosis is a condition where endometrium-like tissue similar to the lining of the uterus grows outside the uterus. This tissue can cause painful cramping throughout your cycle, including after your period. Symptoms of endometriosis include painful cramps at any point in your cycle, back pain, pain during or after sex, painful bowel movements, infertility, fatigue, bloating and nausea.

Generally, endometriosis is more common in young adults. Some estimates suggest 70 percent of women with endometriosis experience symptoms before turning 20.

"Mind you, endometriosis is not going to appear out of nowhere in a 30- to 40-year-old woman," Greves said. "If you're in your 30s, the pain could be because of something different."

Medications, hormone therapy, lifestyle changes and surgeries are common treatment options for endometriosis.

Fibroids

Fibroids are noncancerous growths on the uterus. They can cause pressure on the abdomen and pelvic pain. In some cases, fibroids can be the culprit for after-period cramping.

Fibroids are often found during a pelvic exam or medical imaging. Greves noted having a family history of fibroids puts you at greater risk for developing them.

Fibroid growth slows as you approach menopause. While some healthcare practitioners suggest waiting it out if you suffer from fibroids, this isn't an option for everyone. Medical treatments include painkillers and hormone treatments. In some cases, surgery or hysterectomy is needed.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is caused by a bacterial infection that can spread from the vagina to other parts of the reproductive organs, such as the uterus, ovaries and fallopian tubes. Lower abdominal pain is a sign of PID. Sometimes PID is caused by a sexually transmitted infection (STI). Antibiotics are commonly used to treat the infection.

Mittelschmerz

Mittelschmerz is a German word for "middle pain" and describes the pain some women experience around ovulation.

"Mittelschmerz pain is a very sharp, shooting pain on one side which can last up to 48 hours," Greves said.

Mittelschmerz pain occurs in the lower abdomen, typically mid-cycle. About 40 percent of reproductive-age women report experiencing this pain.

Women who regularly have ovulation pain can begin to recognize it and note it as part of their cycle, Greves said.

Constipation

Sometimes abdominal pain can be unrelated to your reproductive organs. Constipation and diarrhea are both common causes of abdominal pain.

"Constipation is a cause for pain in the left lower quarter of the abdomen," Greves said.

Eating a high-fiber diet can help combat constipation.

What helps ease after-period cramping?

Although pain after your period is less common, it does respond to many of the same treatments as regular period cramps. Physical exercise, OTC medications, massage, heat pads, baths and herbal teas are all home remedies people use to help alleviate cramping.

"If someone is experiencing cramps, it's almost always reasonable to try some Motrin or Aleve, and take it early and with some food, [because] they can bother the stomach," Minkin advised.

"If that doesn't help, then it's quite reasonable to check in with your GYN care provider to see what else could be going on," she continued. "Your provider will want to see you, do an exam, maybe do an ultrasound or do some cultures, depending on what exactly they think is going on."

You are your body's biggest advocate, so if you suspect an underlying health issue, it's important to see a healthcare professional.

"If they're at all concerned, come see us. That's what we're here for," Greves concluded.