What You Need to Know About Menopause Cramps

Perimenopause is the stage leading up to menopause, the time that marks 12 months since you last menstrual cycle, or period. Perimenopause can last for about two to eight years before you enter menopause. Typically affecting people with a uterus and ovaries in their 40s, perimenopause is caused by a gradual, natural decline in the hormone estrogen.

When this decrease in estrogen occurs, your menstrual cycle starts to change. You might either start having unusually light or heavy periods. You may have a period every two or three weeks or you may not have them for months at a time. Eventually, your periods will stop completely.

Physical changes may also happen as your body adapts to different levels of hormones. Common signs and symptoms of menopause include:

  • Hot flashes and/or night sweats
  • Trouble sleeping
  • Vaginal dryness
  • Mood swings
  • Trouble focusing

Cramps are common during menstrual periods. These cramps may intensify during the menopausal period and extend beyond menopause. This article discusses the causes of these cramps, available treatments, and when to see a healthcare provider.

Woman with menstrual pain

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Perimenopause and Cramping

Most research suggests perimenopause may increase general abdominal pain, including discomfort around the ovaries, during menstruation.

The glands in the lining of your uterus release hormones called prostaglandins. You produce more prostaglandins when your levels of estrogen are high—which often happens during perimenopause given your hormones spike irregularly. Simply stated, the higher your prostaglandin levels, the worse your cramps will be.

Ovarian Cysts

Ovarian cysts may also be a cause of abdominal pain in perimenopause. These are fluid-filled sacs that form on ovaries but usually don’t cause any problems.

If a cyst is large or if it ruptures, it can cause:

  • Pain in your abdomen on the side of the cyst
  • A feeling of fullness in your belly
  • Bloating

Could Cramping Be a Sign of a Cyst?

A cyst rarely causes cramping. If a cyst ruptures, it can cause sudden, severe pain.

Although most cysts are harmless, symptoms can indicate you have a larger cyst. Make an appointment with your primary care doctor or gynecologist if you suspect you may have ovarian cysts.

When to See a Doctor

Your risk for ovarian cancer increases as you get older. Ovarian cancer is rare in people under 40. Half of all ovarian cancers are found in people with a uterus and ovaries aged 63 years or older.

Symptoms of ovarian cancer include:

  • Feeling bloated
  • A swollen abdomen
  • Discomfort in your abdomen or pelvic area
  • Feeling full quickly when eating, or having a loss of appetite
  • Needing to urinate more often or more urgently than usual
  • Pain during sex
  • Fatigue
  • Weight loss
  • Constipation

Many noncancerous conditions can also cause these symptoms, so try not to worry too much if you experience something on the list. Still, if you have symptoms, it’s a good idea to see your doctor for an exam to rule out cancer.

Treating Perimenopausal Cramps

Home Remedies and Lifestyle 

Eating a balanced diet may help with cramps.

Research has found that diets with high levels of red meat, processed foods, sweets, dairy, and refined grains are associated with higher estrogen levels. These dietary patterns have also been associated with increased risks of breast cancer and obesity.

Try healthier eating, focusing on the following foods:

  • Whole grains: brown rice, whole-grain bread, oatmeal
  • Vegetables: broccoli, spinach, carrots, sweet potatoes, Swiss chard, Brussels sprouts
  • Legumes: beans, peas, lentils
  • Fruits: apples, mangoes, berries, oranges

You should also try to:

  • Avoid caffeine and alcohol.
  • Take a warm bath or place a heating pad on your lower abdomen or back to help alleviate the pain from severe cramps.
  • Incorporate physical activity into your day as exercise improves blood circulation and reduces cramps.

Over-the-Counter (OTC) Therapies

If home remedies aren't easing your cramps, try an over-the-counter pain reliever. These include:

Stronger medications like mefenamic acid (Ponstel) are available by prescription to treat more severe pain.

Birth Control Pills for Cramps

Taking birth control pills can also help control period pain. In perimenopausal people, oral contraceptives may be used for the improvement of various symptoms, including menstrual irregularity, heavy menstrual bleeding, and menstrual pain.

Menopause and Cramping

You may think that after your periods stop, the cramps will also go away. Unfortunately, cramping may still occur after menopause and can sometimes be a sign of an underlying condition, such as uterine fibroids, endometriosis, digestive problems, or cancer.


Uterine fibroids are common, noncancerous growths that can occur in the wall of the womb, or uterus.

Fibroids usually stop growing or they shrink after a person goes through menopause. However, some people may still experience symptoms of uterine fibroids, such as cramps or a feeling of pressure in the pelvis after their periods have stopped.

Other symptoms include:

  • Enlargement of the lower abdomen
  • Frequent urination
  • Pain during sex
  • Lower back pain

Hormone Therapy and Uterine Fibroids

The use of hormone therapy after menopause is associated with a greater risk for a fibroids diagnosis, as reported in a 2017 peer-review article of most studies to date. The risk of surgically confirmed fibroids increased up to sixfold in people using estrogen or combined estrogen-progestin therapy compared with nonusers.


Endometriosis is a condition in which the tissue that lines the uterus starts to grow in other parts of the body. Most often, endometriosis is found on the:

  • Ovaries
  • Fallopian tubes
  • Tissues that hold the uterus in place
  • The outer surface of the uterus

Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum.

Endometriosis more commonly occurs in people under 45 years old than in older people. Although rare, symptoms can still occur postmenopause.

Symptoms of endometriosis may include:

  • Pelvic pain and cramping
  • Pain in the lower back
  • Pain during or after sex
  • Pain when urinating or during bowel movements

Undergoing hormone therapy for menopausal symptoms may make the pain of endometriosis worse.

Gastrointestinal Issues

A wide range of digestive symptoms can arise during menopause, including:

  • Excessive gas
  • Bloating
  • Belching
  • Nausea
  • Abdominal discomfort

These symptoms may be caused by irritable bowel syndrome (IBS) or another gastrointestinal ailment that can cause cramps in your lower abdomen

One systematic review of fluctuating hormone levels and gastrointestinal (GI) symptoms in people with a uterus with and without IBS revealed that there was an increase in GI symptoms—including abdominal pain—during menopause.

Treating Cramps After Menopause

Treatment for postmenopausal cramps will vary depending on the underlying cause. Some possible treatment options may include:

Fibroids: If you do have pain caused by fibroids, painkillers will usually be recommended first.

There are medications available to help shrink fibroids. If these prove ineffective, surgery, such as a myomectomy or hysterectomy, may be recommended.

Endometriosis: There's no cure for endometriosis and it can be difficult to treat. Treatment aims to ease symptoms so the condition does not interfere with your daily life.

  • Medication: Pain medication may be prescribed to ease discomfort.
  • Surgery: Surgery is usually reserved for severe symptoms when hormones are not providing relief. During the operation, the surgeon can locate the sites of your endometriosis and may remove the endometrial patches.

Irritable Bowel Syndrome: Treatment for IBS can include changes to diet and lifestylemind/body therapies (including psychotherapy, meditation, and acupuncture), and medications. Often, a combination of treatments will provide the most relief. There is still much that is not understood about IBS, so it may take some experimentation with different therapies to achieve positive results.

When to See a Doctor

Occasionally, endometrial cancer can cause abdominal cramps. Your risk for endometrial cancer increases in your 50s and beyond. Cramps alone aren’t a reason to assume you have cancer. People with a uterus who have cancer usually have other symptoms as well as the cramps, such as:

  • Vaginal bleeding, particularly if it's been more than one year since your last period
  • Abdominal bloating
  • Fatigue
  • Unexplained weight loss
  • Changes in bowel or bladder habits
  • Feeling full quickly

Postmenopausal Bleeding

If you experience postmenopausal bleeding, speak to your healthcare provider as soon as possible.

Frequently Asked Questions

What causes cramps after menopause?

Menstrual cramps are common but cramping after menopause is more unusual. It can often be the sign of an underlying condition such as:

  • Uterine fibroids
  • Endometriosis
  • IBS
  • Ovarian or endometrial cancers

How do you get rid of menopause cramps fast?

According to the American College of Obstetricians and Gynecologists (ACOG), over-the-counter pain relievers like ibuprofen, naproxen, and aspirin are effective treatments for cramps.

If you are looking for nonmedicinal help, try using a heating pad or a heated patch or wrap on your abdomen to help relax the muscles of your uterus. Heat can also boost circulation in your abdomen, which may help reduce pain.

When should you make a doctor's appointment for heavy bleeding with cramps after menopause?

Any vaginal bleeding that starts 12 months or more after your last period is considered abnormal and requires evaluation by your primary care doctor or gynecologist. This is especially true if the bleeding is accompanied by cramping, bloating, and unintentional weight loss.

A Word From Verywell

If you think you're menopausal and have cramps, it could mean that you’re still getting your period. Cramps can occur even if you think that you are postmenopausal.

Make an appointment with your gynecologist or primary care doctor if you have cramps that are accompanied by other symptoms, like weight loss and bloating. You may be worried about cancer but many noncancerous conditions can also cause cramping.

Your doctor can perform tests to find out what’s going on and prescribed a treatment that relieves your cramps and addresses the underlying condition.

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14 Sources
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