Cramps During Menopause: Causes, Treatment, and Prevention

Last updated 05.24.2024 | by Sabrina Johnson | 13 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Cramps go hand in hand with periods. But in the years leading up to menopause, cramps aren’t always a sign that it’s that time of the month again.

This type of pain can also be associated with hormonal shifts which cause inflammation and discomfort that feels similar to period pain. Plus, cramps can be a sign of an underlying condition. So, understanding the causes of cramps during menopause is essential in order to find the right treatment and relief.

I’ve been contacted by several readers who are experiencing cramping during their menopausal transition. Some of these women have suffered from menstrual cramps all of their adult lives, and now that they’re entering perimenopause, the pain they experience each month is getting worse. But for others, this is a brand new and very unwanted symptom of menopause, and they’re understandably concerned. 

Are you also struggling with menopause related cramping? Are you wondering if it’s a normal sign of menopause, or a possible indication of an underlying condition? You’re not alone. Cramping during this time can take us by surprise, but the sooner you find out the root cause of your pain, the sooner you can find relief.

So, in this post, I’ll delve into the connection between cramps and menopause. I’ll look at what causes the problem, how to ease the discomfort, and a few things to try that could prevent cramps from happening altogether.

Two Types of Perimenopause Cramps

Most of us associate cramps with periods. They’re unwelcome visitors who show up a few days before or during your monthly bleed.

This kind of cramping can continue for women in perimenopause who are still having periods. In fact, period cramping can get worse during perimenopause.

But cramps can show up whether we’re on our period or not.

Period Cramping Vs. Non-Period Cramping

Cramping while on your period is called primary dysmenorrhea. It’s caused by fluctuating hormones.

During perimenopause, your hormone levels are disrupted, and estrogen levels can rise and fall dramatically. If estrogen is high in the days after ovulation, this triggers your body to release chemicals called prostaglandins. Prostaglandins cause the muscles in your uterus to contract, resulting in menstrual cramping or primary dysmenorrhea.

Women who have experienced years of menstrual cramping are more likely to notice increased symptoms during perimenopause. And those who’ve never had much cramping might suddenly experience pain for the first time during their period.

But cramping isn’t always accompanied by your period. And when it isn’t, it’s secondary dysmenorrhea.

For perimenopausal women, this cramping without bleeding is often caused by hormonal shifts which affect the ovaries. The erratic nature of your cycle can lead to irregular ovulation, causing cramping and inflammation similar to period pain.

Other Causes of Cramping

Primary and secondary dysmenorrhea can be a normal part of perimenopause. But for some women, they are also symptoms of an underlying condition. Fibroids, endometriosis, and adenomyosis can all intensify cramping and cause other symptoms such as heavy bleeding, nausea, and fatigue.

How to Treat Perimenopause-Related Cramps

Treat Perimenopause-Related Cramps

Are perimenopause-related cramps making your life a misery? Don’t worry. There are several things you can do to ease the pain. And in some cases, you might even be able to avoid it completely.

Medication

Doctors prescribe two main types of medication for perimenopause-related cramping.

  • NSAIDs

Most doctors recommend nonsteroidal anti-inflammatories (NSAIDs) for treating perimenopause cramps. The most popular NSAIDs are ibuprofen and naproxen, sold under the brand names  Advil®, Motrin®, and Aleve®.

NSAIDs reduce the levels of prostaglandins in the body, those pesky chemicals that tell the uterus muscles to contract and cause cramping.

If you choose to use NSAIDs to tackle the pain of menstrual cramps, take the physician-recommended dose as soon as the pain begins. Severe cramping is harder to manage once the pain has passed a certain threshold. But catching the pain early on can make all the difference.

  • Hormonal birth control

Sometimes, your doctor may recommend a course of low-dose birth control pills or a ring. Birth control is used to manage many of the symptoms of menopause, including hot flashes, night sweats, and other hormonal issues.

So, it’s no surprise that it can also work to manage cramping during perimenopause.

However, birth control isn’t right for every woman. Finding the right dose can take time, and there are potential side effects to be aware of.

Exercise

Exercise might sound like a nightmare when you suffer from perimenopausal cramping. But if you can force yourself into the gym or even on a walk around the block, you might find that it helps more than other interventions.

I used to suffer from regular cramping before and during my periods, and I found that yoga was particularly useful in alleviating my pain. There are all kinds of yoga poses which can help to reduce this type of cramping. My personal favorites are Cobbler’s pose, which helps to open up the pelvic region, and Cat-Cow, which stimulates blood flow in the uterus and loosens tense muscles in the lower back region.

But don’t worry if yoga isn’t your thing. All forms of exercise can help to decrease the pain of cramping by releasing mood-boosting chemicals called endorphins. Endorphins don’t just make you feel good on an emotional level. They also have pain-relieving properties, which can banish the symptoms of perimenopause cramps.

Regularly hitting the gym may also help stave off perimenopause cramping before it begins. According to research, women who exercise regularly experience fewer menstrual cramps overall.

Heat

Applying heat, for example, a hot water bottle, to your lower abdomen and lower back can provide sweet relief from cramping.

Heat relaxes the contractions in your uterus, which dials down the pain. It also helps open the blood vessels and send oxygen and nutrients to your cells. It can calm inflammation, especially when used with other treatments, such as NSAIDs.

Thyme

Thyme is something you might be used to seeing in the kitchen. But this culinary herb has also been shown to help relieve the symptoms of menstrual cramps. One study even found it to be as effective as NSAIDs.

I’ve found thyme to be one of the most effective remedies for my own period pain during perimenopause. To utilize its healing properties, I like to make a soothing infusion with fresh or dried thyme and hot water. Personally, I like the flavor of thyme on its own, however, you might want to add a spoonful of honey to sweeten the taste.

You can also buy thyme tea or supplements over the counter from your local health food shop.

What Else Cause or Increase the Risk of Cramps after Menopause?

During your periods, you know that the reason behind your cramps is prostaglandins; however, cramps after menopause are a different story.

Since you’re no longer menstruating, uterine contractions shouldn’t be the reason. So, what’s going on down there?

Let’s know some of the common causes:

Uterine Fibroids

These are noncancerous growths in the uterine wall. They’re pretty frequent, affecting many women by age 50. Fibroids can cause cramping, heavy bleeding, and pelvic pressure.

Endometriosis

This is a condition in which tissue similar to your uterine lining grows outside your uterus, like on your ovaries or fallopian tubes. It is very painful and causes cramps throughout your cycle, even after menopause.

Endometriosis affects an estimated 10-15% of all women of reproductive age, and some women continue to experience symptoms after menopause.

Pelvic Inflammatory Disease (PID)

This is an infection of the reproductive organs. While PID is more common in younger women, it can occur at any age. Symptoms include cramping, pelvic pain, and abnormal vaginal discharge.

Urinary Tract Issues

Urinary tract infections (UTIs) and interstitial cystitis (IC), a chronic bladder condition, can mimic cramping sensations in the pelvic area.

Digestive Trouble

Our digestive system works with our reproductive organs, so constipation or irritable bowel syndrome (IBS) can sometimes feel like cramping.

I know this might not be exactly your experience, but a friend of mine actually went through this. She had always had pretty bad cramps during her periods, and to her surprise, they continued after menopause. It turned out she had undiagnosed endometriosis.

So, if you’re experiencing cramps after menopause, it’s definitely worth getting checked out by a doctor. Early diagnosis and treatment are key for managing any underlying conditions.

Risk Factors for Cramps After Menopause

Experiencing cramps, even after hitting menopause, can be frustrating. Why is it still happening, though? Well, while menopause itself eliminates the possibility of menstrual cramps, it doesn’t erase the risk of other conditions that can cause pain.

Some of the factors that might increase your chances of post-menopausal cramps are:

Early Periods: Women whose periods started before the age of 11 might be more prone to developing fibroids later in life. Fibroids are a common reason behind postmenopausal cramps.

Heavy Periods: Heavy periods during your reproductive years can also be a risk factor for fibroids.

Family Matters: Genetics play a part in many health conditions. Fibroids and endometriosis are a few concerns that can be passed down and cause severe cramps. If you have a close relative with either condition, your risk is higher.

The Age Factor: While menopause typically occurs between 45 and 55, there’s some variation. If you enter menopause later in life, you might have a slightly increased risk of developing fibroids.

Weight Gain: Being overweight or obese increases your risk of developing fibroids. This is because fat cells produce estrogen, and fibroids are sensitive to estrogen.

Hormone Replacement Therapy: HRT uses hormones to manage menopausal symptoms. While it is used to manage symptoms of menopause, there are some forms that can cause side effects, which can eventually lead to menopausal cramps.

If you have one or more of these risk factors, it doesn’t mean you’ll experience post-menopausal cramps. It varies from person to person.

How to Prevent Perimenopause Cramps

Preventing perimenopause cramps isn’t possible for everyone. But several lifestyle changes can help reduce their severity or lower your chances of ever getting them in the first place. 

  • Exercise regularly. Women who have a regular workout routine or play sports have less frequent and less severe cramping.
  • Avoid inflammatory foods such as sugar, refined carbohydrates, and processed foods.
  • Eat anti-inflammatory foods like leafy green vegetables, berries, nuts, seeds, and extra virgin olive oil.
  • Get at least 7-9 hours of sleep per night. It reduces inflammation in the body and helps to relieve pain.
  • Drink plenty of fluids. Dehydration can make perimenopause-related cramps more painful. So, be sure to keep your body topped up with fluids.
  • Cut down on coffee. Research suggests that your morning cup of joe can raise your risk of primary dysmenorrhea. One study showed that women who don’t drink coffee are 88% less likely to suffer from menstrual cramping.

What Tests May be Required to Make a Diagnosis?

If you’re experiencing cramps after menopause, instead of sitting and wondering what’s causing the discomfort, you should first visit your doctor.

They will likely use a combination of tests to understand the reason behind your cramps.

However, before the tests, your doctor will ask detailed questions about your symptoms, medical history, and lifestyle. This also includes things like the frequency and severity of your cramps, past menstrual experiences, etc.

Physical Exam: The doctor might perform a pelvic exam to check for any abnormalities in your reproductive organs. It is a crucial step in the diagnosis process.

Other Tests: Depending on your symptoms, they might recommend some tests to get a clearer picture:

  • Transvaginal Ultrasound: It is a painless procedure and uses sound waves to create detailed images of your uterus, ovaries, and fallopian tubes. It helps to identify fibroids, ovarian cysts, or any other issues.
  • Hysteroscopy: In this procedure, a thin tube with a camera is inserted through your vagina to directly view the inside of your uterus. It can be used to diagnose polyps, fibroids, or scar tissue.
  • MRI or CT Scan: This is not a common method of diagnosing post-menopausal cramps, but it might be used if more serious conditions are suspected.

There’s no one specific test for post-menopausal cramps. Getting a diagnosis can feel overwhelming, but it is essential to understand the reason behind the condition.

FAQs

When do menopause-related cramps usually occur?

Most women who suffer cramps during their menopausal transition will start to notice them as they enter perimenopause. It could be as early as your late 30s or well into your 40s.

How long do menopause-related cramps last?

Perimenopause cramps usually only last for a few days. However, they can come and go along with your cycle for several years. The less frequent your periods are, the less frequent the cramping will be.
Once you reach menopause and have gone 12 months without a period, you can say goodbye to this cramping for good.

When should I worry about menopause-related cramping?

Cramping is a relatively common symptom of perimenopause. So, a slight increase in discomfort around your period or ovulation dates is normal.
That said, if your cramping pain becomes severe or the following symptoms accompany it, be sure to book an appointment with your doctor. It could be a sign of an underlying condition that needs attention.
See your doctor if you experience:
Heavier than usual blood flow
Blood clots larger than a quarter in diameter
Pain during sex
Spotting after sex or in the days following your last period
Periods that occur less than 21 days apart
Vaginal bleeding or cramping after menopause (12 months after your last period)

Conclusion

Cramping is common during perimenopause. Many women, myself included, find their usual menstrual cramping gets worse during this transitional time. But the good news is that several medical interventions, natural therapies, and lifestyle changes can help relieve or prevent your symptoms.

And remember, your perimenopausal cramping won’t be around forever. When you reach menopause and your periods finally stop, the cramping that goes alongside them stops, too.

If you notice any cramping or bleeding after reaching menopause, contact your doctor immediately. Sometimes, it could be a sign of a serious underlying condition.

References:

Author

  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.