In this article, you will be provided with the information of what cramps before period are, how to know if the premenstrual cramps are signs of menstruation or pregnancy and proper therapies to comfort your cramps.
Cramps before period or pre-period cramping is the abdominal pain that happens to many women before their period. Most of time, it is completely natural as a sign of the beginning of a menstrual cycle. However, the pain may come from other reasons as well. While the early period cramps can be a signal of many situations, the most frequently asked question is when it is an early symptom of pregnancy. Let’s go through the causes of cramps in menstruation and pregnancy to see the differences. By that, having a comprehensive answer to the question.
Causes and symptoms of menstrual cramps
What causes menstrual cramps and why do you get cramps on your period?
Menstrual cramps before period usually happen about one to two days before your period. It is a result of the uterine endometrium desquamation (endometrium is the inner lining of uterine) and the uterine muscle contractions.
As you know, a menstrual cycle is counted by the number of days between two first bleeding days of two consecutive cycles. The average duration is 28 days long, but it can be as short as 20 days or as long as 45 days in some women.
During the latter half of the monthly cycle, after the ovulation, two ovarian hormones progesterone and estrogen are secreted in large amount. These hormones lead to the significant proliferation of uterine endometrium with highly tortuous blood vessels, in order to make uterine cavity a high nutrient environment, which is rich in blood cells and mucous to prepare for pregnancy if the ovum is fertilized by a sperm.
However, if the ovum remains unfertilized after the ovulation (about two days before the end of a monthly cycle), the ovarian hormones fall to low levels of secretion, leads to the decrease in nutrients to the endometrium and initiate the necrosis of it, especially of the blood vessels. As a result, the hemorrhagic areas grow rapidly in 24 to 36 hours.
About 48 hours later since the ovulation happened without fertilization, all the superficial layers of the endometrium have desquamated. This is when the menstrual cramps occur, followed by the menstruation. The mass of desquamated tissue and blood in the uterine cavity, together with the contractile effects of prostaglandins in the decaying desquamate initiate uterine muscle contractions to expel the uterine contents.
The uterine cramping before period is probably caused mainly by the decrease in oxygen supply to the uterine muscle, resulting from compression of the blood vessels in the uterus, which is felt by local sensory nerves. At the same time, prostaglandins which is released by the necrosis tissues, increases the intensity of muscle contraction in uterus, may lead to severe cramps before period.
Other reasons may lead to stomach pain before period is the movement of desquamated endometrial pieces or the presence of blood clots. The menstrual fluid is normally non-clotting because an enzyme fibrinolysin which dissolves clots, is released along with the necrotic endometrial material.
If excessive bleeding occurs from the uterine surface, the amount of fibrinolysin may not be efficient to prevent clotting. When the size of desquamated mucosa and clots are large enough, they can cause pelvic pain and vaginal pain before period while passing through the narrow cervical canal.
What do menstrual cramps feel like?
Menstrual cramps are pains in a woman’s lower abdomen that occur when her menstrual period begins (or just before) and may continue for two or three days. The intensity, severity, and frequency of pain are very various. While some women may experience it as a mild, dull cramp, the others must seek for medication to get over their sharp throbbing pains which are very annoying and prevent them from participating in daily activities. For other women, they even do not experience cramps before period, or their cramps are too light to be noticed.
Though the most frequently reported cramp is lower abdominal pain, sometimes cramping can be described as a pulling, pulsing pain felt all over the abdominal area. For some women, the pain does not only restrict to a particular place but also moves to other parts of body, such as thighs, waist, hips, lower back and causes cramps there. All of these make the menstrual cramps very discomfort to handle. The intensity of pain in different parts of body is very diverse as well, from very light to very strong.
Then, how long do period cramps last? Or how many days do you have cramps before your period?
The menstrual cramps can come before, during or even after period. Usually, menstrual cramps come before and last one to two days before the period begins, called premenstrual cramps. In some cases, they can happen during the period. Sometimes, menstrual cramps come after period, though this is very rare.
As discussed above, severe cramps before period are likely accountable to the high level of prostaglandins. Suffering severe premenstrual cramps is a signal to show that your prostaglandins concentration is higher than usual, causing very painful contractions to occur. Depending on the level of prostaglandins in the body, the uterine muscle contractions may continue, which leads to ongoing menstrual cramps during the period.
While the level of prostaglandins needs blood test to be confirmed, there are other factors that affect the cramps and are much easier to see. They are emotional stresses, overweight or obese, frequently smoking or alcohol drinking, heavy bleeding, never been pregnant or had the first period at early age (younger than eleven years old). Basically, women in above circumstances are more likely to experience menstrual cramps before period .
Other menstrual symptoms
Besides premenstrual cramps, there are other early signs of period that you should also pay attention to. Cramp before period is just one of many symptoms of a syndrome called premenstrual syndrome (PMS). The syndrome is a group of symptoms linked to your menstrual cycle.
PMS symptoms usually happen one to two weeks before your period and stop after your period begins, including period symptoms such as abdominal pains, breast tenderness or breast pain, irritability or mood changes, lower back pain, leg pain, nausea or vomiting, diarrhea, fatigue. All of these are the signs you are about to get period.
The PMS symptoms can be very similar to the early pregnancy symptoms and may cause confusions sometimes. We will discuss about the similarities and differences in the following parts.
Causes and symptoms of pregnancy cramps
Pregnancy cramping is the abdominal discomfort that women may experience in the early stage of pregnancy. The cramps may come very soon, even before the urine test confirms positive result. As they usually happen around the time that menstrual cramps take place, they are often mistaken and unnoticed by many women.
Is cramping a sign of pregnancy?
To answer this question, we need to know where these cramps come from. They are related to the ovulation, the fertilization and the implantation of embryo in uterus. Ovulation in a woman who normally has 28-day menstrual cycle takes place on the 14th day. If the ovum is not fertilized by a sperm, the two ovarian sex hormones estrogen and progesterone will decrease rapidly and the menstruation will happen, leads to the menstrual cramps.
In another hand, if the fertilization occurs, which means a sperm has entered the ovum, estrogen and progesterone level are maintained thanks to the continuous secretion of placenta. Under the influence of these hormones, the inner lining of uterine keeps on being nourished and uterus becomes an ideal environment with full of nutrients for the embryo to grow. As a result, there is no hemorrhage and the monthly menstruation will not happen. That’s why the pregnancy cramping is also mentioned as period cramps but no period.
An additional three to five days is normally required for transport of the fertilized ovum to the uterine cavity. While the fertilized ovum is moving to the uterine cavity, it also conducts cell division. At the time it enters uterus, it has reached the number of one-hundred cells from a single cell, now called blastocyst. During this period, there may be sudden cramps which only last in a few minutes.
Implantation is when the blastocyst attaches itself to the uterine endometrium. After reaching the uterus, the developing blastocyst usually remains in the uterine cavity an additional one to three days before it implants in the endometrium. So that, for the whole process, the implantation happens on about the fifth to seventh day after ovulation. This is when implantation cramping occurs.
At the attaching point, the blastocyst will develop over its surface a structure called placenta. It is a connecting channel between the mother and the baby. The fetus gets nutrients from mother’s body and metabolizes through the channel, serving for its growth. Because of this role, the implantation and the presence of placenta are essentially important for pregnancy.
When the implantation begins, from the surface of blastocyst releases a special chemical called proteolytic enzymes that help to “digest” the uterine lining and make the attachment easier to achieve. During this process, some endometrial vessels get dislodged. This causes abdominal discomfort, known as implantation cramps. The blood cells and other blood components that come from dislodged vessels then go out through the vagina. They are seen as the pink or light brown vaginal discharge, typically to the implantation bleeding and implantation symptoms.
After implantation, uterus has to extend its cavity to make room for the fetus to grow inside. This extension frequently occurs in order to respond to the rapid and continuous growth of the fetus, which may cause the early pregnancy cramping as well.
What do pregnancy cramps feel like?
As explained above, the cramps in early stage of pregnancy are usually linked to the ovulation, the fertilization and the implantation. Because there are different causes, the pains are somehow different too.
This is an abdominal discomfort which is felt when an ovum is released. Only a single ovum is normally released from one of the two ovaries each month, so normally only a single fetus will begin to grow at a time. There are cases that more than one single ovum is released, but they very rarely occur.
The cramping is mild and can be easily distinguished from premenstrual cramps base on the time it happens, usually around the ovulation day which means around the 14th day or two weeks before the 1st period day of 28-day menstrual cycle.
Depending on the released ovum comes from which ovary that the pain sometimes locates on that side. For example, if the ovulation comes from the left ovary, you will have the left ovarian pain before period and you will feel discomfort on the left side of abdomen. However, sometimes the pain may switch sides.
This happens while the fertilized ovum is moving toward the uterine cavity. As mentioned above, an additional three to five days is normally in need for the transportation. The fertilization cramps are quite similar to the ovulation ones. The pain may be felt pulsing and sharp or dull and continuous, and is generally localized at one side of abdomen.
This is the most common pregnancy cramping. It occurs when the blastocyst attaches itself to the uterine endometrium. The causes and the mechanism of it were discussed earlier. Now we will talk about what implantation feels like and how long implantation cramping last?
Normally, the implantation cramps usually happen on around the fifth to seventh day after ovulation. The implantation cramps are usually localized and felt in the uterus and the cervix so that the pain will be in the center of lower abdomen, below the belly button. The pains are slight and may go on for one or two days, but usually stop as suddenly as they start.
Besides, the early pregnancy cramping may be result of the extension of uterine cavity as mentioned above and this progress will be felt as constant pulling pains in the center of abdomen.
So, is it normal to have cramps in early pregnancy? At this point of the article, I believe you are able to give yourself the answer. However, only the cramps themselves are not yet complete. There are other signs that you should take care of as well.
What are the first symptoms of pregnancy?
Besides early pregnancy cramps, you may find yourself feeling sick, having unusual tastes, breast tenderness or fullness, nausea and vomit regularly. Most of them are results of the hormonal changes in the body in order to adapt and prepare for baby growing inside, especially the presence of HCG – Human Chorionic Gonadotropin.
HCG is produced by placenta during the pregnancy and is a crucial factor for a normal pregnancy. This hormone is secreted rapidly as double level every 48 hours in early pregnancy. The increasing of this hormone starts causing pregnancy symptoms in which the breast tenderness is one of the most recognizable. But it might be mistaken for regular breast pain before period. Breast tenderness can be a big sign for those women who do not usually experience in their menstrual cycle.
Otherwise, the high HCG level can bring fatigue, nauseous and vomiting and these statuses happen very often. Unusual taste is a prominent symptom in the early pregnancy. Some women may become very fond of fishy food while others may very afraid of it, and many other flavors like sourness, sweetness, spiciness. Some women like eating a lot while others do not. Another common taste is a sudden taste of metal in mouth. This can all happen as soon as the implantation happens.
Besides cramping, there are accompanying symptoms to help you identify whether you are suffering PMS cramps or pregnancy cramps.
- Breast tenderness: Breast tenderness usually come at the second half of your menstrual cycle. You may feel the pain ranges from slight to heavy, especially right before your period. The tenderness will decrease in your period as the progesterone level falls down. In early pregnancy, your breasts may feel sore, sensitive, or tender. You may feel fuller and heavier and this feeling lasts longer as your progesterone level rises during the pregnancy.
- Bleeding: In premenstrual syndrome, you do not have bleeding or spotting. It only appears in your period. In early pregnancy, there may be vaginal bleeding or spotting, around ten to fourteen days after implantation. They are seen as pink or light brown discharge with a small amount, not enough to fill pads or tampons and normally lasts for several days. So the bleeding is shorter than a monthly period which usually lasts for a week.
- Mood changes: Before period, you may feel more anxious, irritable or emotional than usual. But these feelings will quickly go away once your period begins. If you are pregnant, the mood changes will last until your delivery. Getting some exercise and plenty of sleep may help you recover.
- Fatigue: Like mood changes, this symptom is common but it will go away once your period begins. If you are pregnant, fatigue can last during your pregnancy. Getting some exercise, eat well and lots of rest will help you cope with it.
- Nausea: This does not usually happen in your menstrual cycle while it is one of the most typical symptoms of pregnancy, known as morning sickness. Vomiting may come along with nausea. Though it names morning, it actually can happen at any time, not only morning time. However, not every woman experiences this symptom.
- Unusual tastes: This is not very noticeable during your menstrual cycle but it is a very prominent symptom when you are pregnant. During your pregnancy, you may have craving for certain foods, at the same time you may also be afraid of specific smells and tastes, even foods you liked before. You can also find yourself addicted to eat nonsense items like ice, dirt, wall or pieces of metal…, things with no nutrients. If you have cravings for these kinds of food, please consult a doctor.
It is important to identify whether you are pregnant or not. Because if you are pregnant, the sooner you find out, the sooner you can access to proper care. Those symptoms above are just some suggestions for you to identify your cramping. The most accurate way to have conclusion is the pregnancy test. It is also necessary to take care of your menstrual symptoms regularly so that you can tell when a change happens. If you have questions or concern, do not hesitate to tell your doctor.
What can you do to ease the cramps before period?
If you usually experience cramps before period, these suggestions below may be useful for you to cope with it  .
- Exercise: Getting some exercise like yoga, walking, cycling will help to increase your blood circulation, by that it helps improve your PMS symptoms a lot. Besides, premenstrual cramps are usually worsened by stress, which is easily dispelled by exercise in a natural way so that you may not feel your symptoms much at all.
- Foods and drinks: Staying hydrated actually can help your body avoid painful, especially warm water helps improve cramping before period by increasing blood flow to the skin and relaxing muscle. Always bring with you a bottle of water with some pieces of cinnamon or ginger inside is a good idea. You should also bring watery fruits such as cucumber, watermelon, and berries as you can eat them raw or make delicious salads.
Bananas, avocados, sweet potatoes are rich in potassium which helps boost up your moods, improve your sleep quality and support your bowel movements. Put a banana in your bag for a snack or a few slices of avocado to your lunch or dinner are also great ideas.
Fishes like salmon or tuna are rich in omega 3 and other unsaturated fatty acids which are effective in relaxing muscles that may decrease the severity of your premenstrual cramps.
You can refer to how to prepare these foods into delicious dishes in the following video:
- Clothing: You should avoid tight clothes, especially at the waist during and a week before your period. They will cause further compression to your abdomen and make the cramps more severe. Actually, you should choose dresses or skirts instead of jeans when going out on these days.
- Heat: Try a hot bath or a heating pad when you are having cramping before period is very effective to relieve the cramps. Get it bed, relax and put something hot over your abdomen will make you more comfortable. You can buy heating pads and hot water bottles at local drugstore, or you can make your own too. It is very simple. Firstly, you boil water. After that, you pour the boiled water into a bottle very carefully, check the heat to make sure it will not burn your skin, then rolling the bottle all over your abdomen and you’ll see, the cramps will go away.
- Acupuncture and massage: There are certain acupuncture points which are believed to have effect of regulating blood flow through abdominal cavity and relax the nervous system, by that can help ease the premenstrual cramps. Studies also show that acupuncture is as effective as other pain killer medicines in reducing pain.
If you are afraid of needles, massage therapy may be a better choice. Lay down comfortably and slowly move your palms over belly button in small circles for around one minute, after that, begin to apply some pressure. You will find sensitive spots around the belly button and with appropriate pressure, the cramps will be relieved.
- OTC medication: For many women, the cramps are so intense that they have to take OTC medication and delayed their works for a few days. OTC stands for over-the-counter, which means the medicine you can easily buy without a prescription.
The most effective medication nowadays is NSAIDs (Non-Steroid Anti Inflammatory Drugs) as they directly block the effects of prostaglandins, the main cause of pre period cramping as mentioned in the early of article. There are many types of NSAIDs but you should choose Ibuprofen, Ketoprofen and Naproxen to treat your cramps. These drugs work better if taken before the start of menstruation and can be continued as long as needed.
However, NSAIDs are harmful to your stomach. If you have medical history of kidney problems or stomach problems, you should consult your doctor in advance.
If one type does not relieve the pain, try another, because these medications do not work the same for everyone. Remember not to take two different NSAIDs at the same time as many studies have shown it does not increase the effectiveness of treatments but doubles the side effects.
It is normal to have cramps before period. Do not be panic, calm down and help yourself get over the pain with our suggestions. You will feel much better.
However, if you are experiencing unusual cramp or this is the first time you have ever had, you need to calculate the chances of pregnancy. If you had unprotected sex within six to twelve days after ovulation, there is a high chance that the abdominal discomfort is blamed for the implantation. You should take care of your body and wait a week or two before taking a urine test to confirm your doubt.
If your cramps before period become abnormal like non-stop severe pain for 24 hours or if you have symptoms like heavy vaginal bleeding, high fever, smelly discharge, strong headaches, non-stop vomiting, fainting and burning sensations when passing urine, these symptoms definitely have to be investigated, which means it’s time to meet a doctor.
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