What to Know About Cramps During Menopause

What to Know About Cramps During Menopause

Wondering why you’re getting cramps during menopause?

There’s a whole variety of reasons why things might be acting up down there.

You might be feeling surprised—and a little bit annoyed.

Surely your days of period pain are over?!

Unfortunately, cramps during menopause can and do happen.

Sometimes, the cramps are due to the hormonal fluctuations in the body that happen at this time of life.

But sometimes, they’re a sign that you need to be seen by a doctor.

In this article: 📝

  • Why do menstrual cramps happen in the first place?
  • What is menopause, and what is perimenopause?
  • Why do I have cramping during (or leading up to) menopause?
  • Can menstrual cramps during menopause be treated?
  • Menopausal cramps: the bottom line

Why do menstrual cramps happen in the first place?

As anyone who experiences them can tell you, menstrual cramps are not fun, at all.

Still, while you’re curled up with a hot water bottle and your favorite box set, your body is doing incredible things.

Who said a duvet day wasn’t productive?

Your period (and, for some people, the cramping that comes with it) marks the first few days of your menstrual cycle.

Your uterus is shedding its lining to make room for a new one (and possibly a fertilized egg).

But all the muscular contractions needed for these renovations can cause pain.

What is menopause, and what is perimenopause?

When your periods stop due to lowered hormone levels, it’s called menopause.

Most often, this happens between the ages of 45 and 55, but it can happen earlier or later.

Technically, menopause is defined as 12 months after you’ve had your last period.

But your hormone levels fluctuate in the years leading up to this time, which can lead to symptoms such as hot flashes, irregular periods, night sweats, and vaginal dryness.

This time leading up to menopause is called perimenopause.

Why do I have cramping during (or leading up to) menopause?

That’s a good question.

No period = no cramping, right?

Well, not quite.

The levels of the sex hormone estrogen can actually rise significantly during perimenopause before they ultimately fall.

And this triggers higher levels of prostaglandins.

Prostaglandins are hormone-like chemicals that can help out with many important bodily processes, including ovulation.

Unfortunately, their role in muscle contraction means they can also spark period pain.

The higher the levels of prostaglandins, the worse cramps tend to be.

Ovarian cysts can also cause perimenopausal cramping.

These cysts are fluid-filled sacs that are very common—and often don’t cause any issues.

But sometimes, ovarian cysts can cause painful cramping, bloating, and abdominal pressure.

And cramps happen after menopause too.

Although your body is no longer experiencing a menstrual cycle, cramps can occur for other reasons.

These include:


These are benign growths that can grow in or around the uterus.

They tend to be rare once someone has reached menopause.

But if they do grow, they can cause abdominal pain.


The tissue that lines the uterus is called the endometrium.

Sometimes, this tissue can break away and start growing in other places, such as the ovaries and the fallopian tubes.

Endometriosis is more common than many think and affects up to 5% of postmenopausal women.

Those who do experience endometriosis after menopause can have pelvic pain, ovarian cysts, and intestinal issues.

Gastrointestinal (GI) causes

Cramping during menopause can be caused by that pesky estrogen again, as this hormone can affect the gastrointestinal tract.

Research has found that IBS symptoms can be worsened by menopause too.

Uterine and ovarian cancers

Unfortunately, certain types of cancer can be behind abdominal and pelvic cramping, and increased age is one known risk factor.

Uterine and ovarian cancers can cause other symptoms, too, such as bleeding, abdominal bloating, unexplained weight loss, and extreme fatigue.

Can menstrual cramps during menopause be treated?

Yes, there are quite a few treatment options for the cramps you might experience around menopause.

However, the exact route depends on the underlying cause.

That’s why it’s important to reach out to your doctor if you have any symptoms that worry you, especially any unexplained bleeding.

Understanding what’s causing your pain is the first step to getting the right treatment.

Treatment options for perimenopausal cramps

Cramps due to raised estrogen levels can be treated as you might do for monthly menstrual cramps.

A heating pad and over-the-counter NSAID medication such as ibuprofen can go a long way.

NSAID medications are particularly effective in treating period pain because they target a specific biological pathway that leads to the production of prostaglandins.

Some think there are also lifestyle changes that you can make to lower your level of prostaglandins and, hopefully, help ease painful cramps.

These include exercise and swapping out highly processed foods for whole foods and healthy fats.

Of course, if these options aren’t doing the job, don’t be afraid to reach out to your healthcare provider—no one should have to suffer in silence.

If an ovarian cyst is causing you pain, that’s something that needs to be seen by a medical professional.

This is especially true if you have symptoms of a ruptured cyst (which is considered a medical emergency) or if you have ovarian cysts that develop after menopause, as the risk of ovarian cancer is higher.

Treatment options for post-menopausal cramps

Here again, the right treatment very much depends on what’s causing your pain. We’ll take you through the various possibilities:


Fibroids can be treated in various ways, including medication, procedures to shrink the fibroid size (myolysis), a hysterectomy, and hormone treatment.


Endometriosis treatment often involves surgery, but other treatments, such as hormone therapy, may also be used. In some cases, your doctor may suggest a hysterectomy.

GI issues

GI issues can be helped in several ways, including medication and surgery.

There’s also a procedure called a fecal-microbiome transplant, which is designed to restore healthy microbe diversity.

Menopausal cramps: the bottom line

Cramps at any time during your life are uncomfortable—and sometimes downright debilitating.

But cramps during menopause can be especially frustrating.

And because there are quite a few potential causes, it can be difficult to get to the bottom of it.

That’s why it’s crucial that you get the help you need.

If you’re in pain or at all worried, reach out to a health professional so you can get the right treatment for your symptoms.

And remember, you’re not alone—we’re here to support you.

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