Cramps During Menopause: Causes, Treatment, and Prevention

Last updated 07.31.2023 | by Sabrina Johnson | 7 Minutes Read

The information provided by Simply Menopause may not apply to your specific circumstances. Please consult your healthcare provider for personalized guidance. Learn more.

Cramps go hand in hand with periods. But when you arrive at perimenopause (the transitional time before you reach menopause), cramps aren’t always a sign that it’s that time of the month again.

Whether you’ve been getting menstrual cramps all your adult life or they’re a new unwanted symptom of perimenopause, you probably want to get rid of them quickly. Luckily, there are several ways to find relief.

This post delves into the connection between cramps and menopause. We’ll look at what causes them, how to ease the discomfort, and a few things to try that could prevent them 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.


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 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.

Exercise has been shown to decrease the pain of cramping by releasing mood-boosting chemicals called endorphins. But 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.


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 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.

You can buy thyme tea or supplements over the counter from your local health food shop. Alternatively, you can use fresh or dried thyme to make a soothing infusion to sip on when cramping pain begins.

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.


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)


Cramping is common during perimenopause. Many women 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.



  • 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.