There is a lot of misinformation out there about menstruation and especially period pain. As I was researching for this guide to see what questions were out there, I came across one that asked “what does a period without cramps mean?”
At this point, nothing surprises me about how patriarchal standards of living have normalized miseducation about our bodies, but it did remind me just how conditioned we are to believe that we are meant to be in pain.
To answer the question: A period without cramps means you have a healthy period! Pain is a symptom of hormonal imbalance, and anything more than *mild* cramping, especially if it’s happening consistently, should be looked into. Your menstrual phase should not be unbearable.
To get an understanding of what a healthy menstrual cycle looks like, and how your period actually works, read this post.
Types of period pain
Painful menstruation is known in the medical world as dysmenorrhea, which is characterized by throbbing pain in the lower abdomen (if you’ve found your way here on purpose, you know this all too well!). This can be accompanied by many other PMS symptoms, but we’re just going to focus on the pain today (see this post for recommendations on dealing with PMS as a whole).
What causes period cramps? That depends.
There are two types of dysmenorrhea:
The most common type of period pain, occurring in the luteal or menstrual phases of your cycle. It is not associated with any medical conditions.
It happens when there is an imbalance of chemicals known as prostaglandins, which causes the uterus to contract (meaning to continuously tense and relax) in order to expel blood and shed its lining. There are three types of prostaglandins (PgE 1, 2, and 3) — one that actually stimulates that uterine contraction and pain (PgE 2), and the other two that work to counteract that pain (PgE 1 and PgE 3).
Your inner technology is pretty smart! As you can see, if there are too many 2s and not enough 1s and 3s, that’s where the pain can come from (and also migraines, vomiting, and diarrhea).
Speaking of diarrhea, want to know why that happens during your period? The uterus is pretty close to your intestines, so its contractions can also stimulate the bowels, too. Fun fact!
Hormonal imbalance can be caused by a number of things. The most common factor I see with clients is stress (primarily the stress of resisting the natural ebbs and flows of our cycles). Take a look at this post for more information.
Secondary dysmenorrhea is a type of period pain that’s caused by other reproductive disorders, such as:
- Ovarian cysts
- Pelvic inflammatory disease (typically caused by an STI)
- Tipped uterus
- and more.
The pain may increase over time as well.
How do you know which type of period pain you have?
If it’s severe and unbearable, bad enough that you miss work, can’t relieve it easily, and it interferes with your daily life, you should speak with your doctor to explore the possibility of the above conditions.
What if I have cramps but no period?
Cramps can occur in the luteal phase, which is the premenstrual phase where PMS symptoms tend to pop up. If you track your cycle and know you’re not due for a while, there could be a few reasons you’re experiencing pain if you’re not already experiencing any of the above conditions mentioned in secondary dysmenorrhea:
- Digestive issues: Remember that the uterus and intestines are neighbors, so it’s possible you may be experiencing symptoms of constipation or an inflammatory bowel disorder. Where you feel the pain depends on which issues you’re dealing with.
- Ovulatory pain: Mild discomfort is normal when you’re ovulating. You may feel a sudden twinge or a dull ache, and it will only happen on one side (whichever side released an egg this cycle).
- Burst ovarian cyst: It may feel like sharp cramps on one side (whichever ovary had the cyst). Ruptured cysts don’t always cause pain.
- Early pregnancy: Implantation pain may feel like slight cramping and can happen before you start to experience other typical symptoms of first-trimester pregnancy, like nausea.
- Miscarriage: The pain may gradually increase and you may or may not experience bleeding. If you are pregnant, call your doctor ASAP.
These are not the only potential causes of cramps without a period, but some of the more common.
Things that make period cramps worse
There are a few things we may be doing during our period that actually aren’t helping the pain situation. Also, because we’re trained to resist the natural ebbs and flows of our cycle on a daily basis, we may be contributing to that pain weeks before it even happens.
Here are a few factors that can make your cramps worse:
- Painkillers: Don’t shoot the messenger! They may work in the short-term, and it’s okay if you need them, but long-term use may stress out your liver, which is a key part of our hormone health and balance. If you are expecting cramps, you may want to take some ibuprofen at the first sign so you can try to avoid more severe pain later on as well as the need for more pills.
- Tampons: Some people may be sensitive to sticking anything up there at this time. Temporarily switching to pads, cups, or period underwear may be helpful until the cramps subside.
- Intense exercise: As we near menstruation, our energy levels naturally take a dip. Since this isn’t common knowledge, we still try to keep up our normal exercise routines, praying to goddess that the floodgates don’t give way every time we try to do a jump squat, and feeling frustrated that we couldn’t do as many burpees as we could two weeks ago. This doesn’t mean you *can’t* exercise around your period, but switching up the types of exercises you do to better align with each phase of your cycle may make your next period easier to deal with.
- Caffeine, alcohol, and not drinking enough water: All of your muscles need water to be able to relax. Drinking things that dehydrate you and not rehydrating enough can cause muscle cramping, and remember, your uterus is a muscle!
- Not getting enough sleep: This can increase your cortisol levels. Cortisol is typically high in the morning. It’s what makes you feel awake, alert, and ready for the day. Sleep deprivation can have your body pumping out more and more of this stress hormone, and chronically high cortisol is no bueno for long-term hormone balance.
- Stress: Mental stress, physical stress, emotional stress — all of it! As I explain in this post, your body prioritizes stress hormones above all else. So when you’re in a state of stress, it’s your body’s #1 goal to cope with that and put everything else on the back burner, including proper regulation of your reproductive hormones.
Exercises to relieve cramps
I’m a nutritionist, not a personal trainer, so this is not my area of expertise. However, I do know a thing or two about the menstrual cycle and what the body typically needs in each phase. As our hormones fluctuate throughout the month, so do our stamina and energy levels.
Thirty minutes of aerobic exercise three times a week can help improve period pain over time. Aerobic exercise is basically just any steady cardio, and luckily there are different intensities available for you to work with through your cycle.
Anaerobic exercise is more short bursts of high-intensity work that leave you out of breath, like burpees, sprinting, or heavy weight lifting.
Below is a list of the types of exercises that may feel good in each phase, honoring your cycle and creating less physical stress on the body.
Follicular phase (inner spring, waxing moon)
Estrogen and energy start low and then quickly rise in this phase, so incorporating different types of fun cardio may feel good. Remember energy is growing, not at its peak. Don’t burn yourself out.
- Stair climbing
- Elliptical training
Ovulatory phase (inner summer, full moon)
Estrogen and energy hit their peak, along with testosterone, so you’ll likely feel super motivated and strong. This is a social phase too, so group classes can give you a boost in stamina.
- Any of the above at a higher intensity
- Strength training
- HIIT circuits or bootcamp-style classes
- Kickboxing (like Kick It By Eliza!)
Luteal phase (inner fall, waning moon)
This is a longer phase, where energy is high at the beginning and slowly wanes, just like the light of the moon. You may want to start with more intense workouts (like during ovulation) and then taper off into more solo exercises or slower forms of movement as you move through this phase.
- Vinyasa yoga
- Sculpt classes (I love Walter’s classes on obe fitness)
- Strength training
Menstrual phase (inner winter, new moon)
Hormone levels drop to their lowest in this phase, which means your energy takes a dive too. Slow movement, or even no movement, might feel best now. Rest is restorative and helps you perform at your best the rest of your cycle. Don’t feel bad about it!
- Restorative or yin yoga
- Foam rolling
- Deep breathing and meditation
And here are a couple of YouTube videos with poses that may help you out more immediately with cramps:
Foods that help with period cramps
Eating for your cycle all month long can help you avoid period cramps in the long-term (you can sort through the recipes on my site by cycle phase, in case you were wondering!), there are a few things that might help a bit more quickly:
- Foods rich in Vitamin E, which is known to reduce period pain: Nuts and seeds (particularly almonds, hazelnuts, and sunflower seeds), avocado, olive oil, leafy greens, whole grains, broccoli, asparagus, berries, mango, and salmon.
- Foods high in magnesium, a known muscle relaxant that can help reduce prostaglandins: Nuts and seeds (particularly pumpkin seeds, cashews, almonds, and chia seeds), edamame, cacao, fennel, black beans, leafy greens, seaweed, salmon, banana.
- Foods with linoleic acid (polyunsaturated omega-6 fatty acid), which helps make prostaglandins, including the pain-killing kind!: Pumpkin seeds, flax seeds, sesame seeds, and sunflower seeds (seed cycling, anyone?), chia seeds, hemp seeds, edamame, avocados, oats, walnuts, peanuts, almonds, eggs, cashews, salmon, beef, chicken, and pork.
You can see there’s some overlap here, since foods are complex and contain multiple nutrients. Kind of makes it easier, IMO! To keep it simple, at the very least you’ll want some nuts, seeds, leafy greens, and salmon if that’s part of your diet.
Dairy and menstrual cramps
Keep in mind that conventional dairy and animal products may potentially exacerbate cramps due to their arachidonic acid content. It’s an essential nutrient, but it can be inflammatory in high amounts, and dairy is also a common trigger for inflammation (especially if you’re a C-section baby).
Not to spoil the fun of wanting to put cheese on everything right now, but it’s worth experimenting with removing for a while to see if it changes anything. Another reason for this is because of a type of casein found in cow’s milk (A1 casein) that is known to cause inflammation as well.
One workaround? Sticking to A2 casein dairy made with goat’s, sheep’s, or buffalo’s milk. This includes goat cheese (obv), feta, halloumi, manchego, pecorino, ricotta, roquefort, and buffalo mozzarella.
Supplements for cramp relief
While I always recommend diet first as a means of prevention, you probably want to slap me right now just to redirect your pain. You can find a list of herbs for period pain here, and below are a few recommended supplements to consider:
- Vitex, or chaste berry: You can get this in herb form but you can also buy it as a tincture to drop in a glass of water, or as a pill. Used medicinally, it stimulates the pituitary gland to regulate hormones and the menstrual cycle, improving the estrogen:progesterone ratio. Thus, it can help with painful PMS symptoms.
- Magnesium: You probably already know that this has a relaxing effect on muscle tissue, but there are so many options out there — which form of magnesium is best for cramps? Magnesium L-threonate is best tolerated and taken orally and magnesium sulfate (epsom salt) is a nice way to supplement topically when you add them to a warm bath. Magnesium citrate and magnesium oxide may be stimulating on the bowels, so you might not want to add that potential burden right now.
- Vitamin B6: B6 increases progesterone, so if you are deficient, it can trigger PMS symptoms like cramping. A B-complex vitamin may be a good option as well because B vitamins are also important for blood flow and circulation, nerve signaling, and general hormone regulation.
- Fish oil: Fish oil capsules contain those anti-inflammatory omega-3s that we know and love. This is the type I use. Pro tip: keep them in the freezer, you won’t get the fish-burps that way (I know, gross. You’ll thank me.)
- Curcumin: Curcumin is the active component in turmeric, which I’m sure you know is a lovely anti-inflammatory herb. Chronic inflammation can impair estrogen detoxification and the production of progesterone. This can lead to estrogen dominance, which is a major contributor to period cramps. So you can load up on turmeric in your meals, or consider this supplement.
Important to note: Don’t just buy everything on this list and start popping pills. Like I said, diet is foundational to hormone balance, these aren’t magic pills. The imbalance will still be there when you’re done with the bottle if you’re not doing anything else to address the pain.
Speak with your doctor or a trained health care practitioner before taking any of these supplements to make sure that 1. You actually need them (test, don’t guess), 2. They won’t interfere with any medications you’re currently on, and 3. You don’t waste your money.
Other ways to relieve period cramps naturally
The menstrual phase is all about YOU. Pamper yourself! Do what makes you feel good. Take a hot shower, put on a face mask, stay in bed all day — whatever feels good to you. Here are some extra tips:
- Wear loose clothing: The last thing you need is tight yoga pants or leggings constricting your abdominal area. Do yourself a favor and throw on some cozy sweats or PJ pants.
- Hydrate: As you read above, drinking beverages that dehydrate you can lead to muscle cramping, so you obviously want to do the opposite and load up on the water! Herbal tea, infused water, seltzer, broth — all can count towards your water intake for the day (the general rec is half your body weight in ounces per day). You might also want to try a chia fresca. Chia seeds can hold up to 10x their weight in water, and are high in fat in fiber, so they digest slowly and keep you hydrated for longer.
- Have an orgasm: It might be the last thing you’re in the mood for when you’re in pain, but you can totally DIY instead of trying to muster up interest in the whole shebang. You know how great you feel afterwards, and that’s because orgasms release neurotransmitters like oxytocin and dopamine, which lowers your cortisol levels too. This can also improve circulation in your pelvic area since blood rushes to the area during arousal.
- Make a castor oil pack: When applied topically, castor oil has been found to reduce pain and inflammation. I haven’t personally tried this, so I’ll leave this one to my girl Samatha of Holistic Wellness. As she likes to say, you can apply this stuff “from boobs to pubes” for calming relief from cramps, cysts, fibroids, and more. Follow her instructions here.
- Curl up with a heating pad or hot water bottle: Make sure you wrap the hot water bottle in a towel or t-shirt so you don’t burn yourself. Studies show heat therapy can be as effective as ibuprofen. The warmth can offer some relief and help relax your muscles. Place it on your pelvic area wherever you’re feeling the pain.
- Make your partner read up: Having a partner who doesn’t understand what you’re going through, while doesn’t directly cause physical pain, definitely makes everything worse. I was going to write a little bit about how to deal with it, but honestly, if you’re a person who doesn’t menstruate and you’re reading this, just be nice to us and feed us. And read this Reddit thread. This one too. (CW: gendered language.)
- Align with your cycle: Each phase of your cycle comes with changes in your energy, productivity, creativity, mood, immune health, fertility, social interest, libido, and more. Understanding the fluctuations in your body can help you work with them instead of against them, which creates less stress and brings a LOT more flow in life.
Are you still with me? Thanks for making it this far! I hope this information will help you find relief for your next cycle.
If you want to learn more about aligning with your cycle and all of the gifts that are waiting for you on the other side of this pain, I’d love for you to check out my private members community, Superpower Your Natural Cycle.
Each month, we cover a topic of health and life that helps you work through obstacles and start living a cyclically guided life free from cramps and other debilitating PMS symptoms.
Membership reopens in early 2021, but you may want to sign up for the waiting list now in case there’s a Black Friday surprise… 😉