Cramps after menopause
Abdominal cramps during your reproductive years are usually a sign of your monthly menstrual period. For many women, cramps occur a couple of days before their period and during it. But what if you start feeling cramps after you’ve gone through menopause and your periods have stopped?
Abdominal cramps can be a symptom of many different conditions, from endometriosis to uterine fibroids. They can also be a symptom of a stomach virus or food poisoning.
Most of the time, cramps are nothing serious. You should pay attention to them, though, especially if they don’t go away. Here’s a guide to the various causes of cramps after menopause and what to do if you have them.
What is menopause?
Menopause is the time in a woman’s life when her monthly menstrual periods stop because their body stops producing the female hormone estrogen. Your doctor will tell you that you’re officially in menopause when you haven’t had a period for a full year.
Your periods will likely taper off in the months leading up to menopause. You may have symptoms such as hot flashes, night sweats, and vaginal dryness.
While you’re in the perimenopausal period, or the time when your periods are tapering off, you can still have symptoms like cramps and bleeding. These are signs you’re not quite through with your periods.
Once your doctor has told you that you are officially in menopause and your periods have stopped, your cramps are likely a sign of another condition. Along with the cramps, you may have:
- bleeding, which could be heavy
- swelling of the abdomen
- lower back pain
- pain during sex, urination, or bowel movements
- swelling or pain in your legs
- unexpected weight loss or gain
Cramps may also occur along with nausea, vomiting, and diarrhea if they’re the sign of stomach upset.
What are the causes of cramps after menopause?
A few different conditions can cause cramps after menopause.
Endometriosis is a condition in which tissue that’s normally found in your uterus grows in other parts of your body, such as in your ovaries or pelvis. Every time you get a period, this tissue swells up, just as it does in your uterus. The swelling can cause a cramping pain.
Endometriosis usually affects women who still get their period, and it stops at menopause. However, many women who’ve gone through menopause still report having endometriosis symptoms. If you take hormone therapy for menopause symptoms, the estrogen can make your endometriosis worse.
Uterine fibroids are growths that form in the wall of the uterus. They aren’t usually cancerous. Although most fibroids start earlier in life, women in their 50s can also have these growths. Fibroids typically stop growing or get smaller after menopause. Some women may still have symptoms after their periods end.
A stomach virus, food poisoning, irritable bowel syndrome, or another gastrointestinal ailment can cause cramps in your lower abdomen. These cramps usually occur with additional symptoms such as nausea, vomiting, or diarrhea. The symptoms may be temporary. They also may pop up in certain situations such as after you eat dairy foods or when you’re under stress.
Ovarian and uterine (endometrial) cancers
Cancer of the ovary or uterus can cause abdominal cramps. Your risk for these cancers increases in your 50s and beyond. Cramps alone aren’t reason to assume you have cancer. Women who have cancer usually have other symptoms along with cramps, such as:
- vaginal bleeding
- bloating in the belly
- unexplained weight loss
Any worrisome symptoms warrant a visit to your doctor just to make sure they’re not due to something serious.
What are the risk factors?
You may be more likely to get one of the conditions that causes cramps after menopause if you:
- took estrogen for menopause symptoms
- have a family history of ovarian or uterine cancer
- got your first period before age 12
- started menopause after age 52
- used an IUD to prevent pregnancy
Think about whether you have any of these risk factors. Then, discuss them with your doctor.
How are cramps after menopause diagnosed?
If you have cramps after menopause, make an appointment with your primary care doctor or OB-GYN so you can find out what’s causing them. Your doctor may do a pelvic exam to look at your uterus to see if there are any physical problems.
You might also need imaging tests to look inside your body at your uterus or ovaries. These tests can include:
- a CT scan
- an MRI scan
- a hysterosonography and hysteroscopy, which involve placing a salt and water solution, or saline, into your uterus so the doctor can examine it more easily
- an ultrasound, which uses sound waves to create pictures of the inside of your body
If your doctor suspects you have cancer, you may need to have a procedure to remove a piece of tissue from your uterus or ovaries. This is called a biopsy. A specialist called a pathologist will look at the tissue under a microscope to determine if it’s cancerous.
What treatments are available?
If you haven’t completely gone through menopause and your cramps indicate that your periods are tapering off, you can treat them as you would period cramps. Your doctor might recommend an over-the-counter pain reliever such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).
Warmth can also help soothe your discomfort. Try putting a heating pad or hot water bottle on your abdomen. You can also try exercise if you are not in too much pain. Walking and other physical activities help relieve discomfort as well as ease stress, which tends to make cramps worse.
When your cramps are caused by endometriosis or uterine fibroids, your doctor might recommend a medicine to relieve symptoms. Surgery can also be an option to remove the fibroid or endometrial tissue that’s causing you pain.
How cancer is treated depends on its location and stage. Doctors often use surgery to remove the tumor and chemotherapy or radiation to kill cancer cells. Sometimes, doctors also use hormone medicines to slow the growth of cancer cells.
What is the outlook?
If you have cramps, it could mean that you’re still getting your period. This can occur even if you thought you that you’ve gone through menopause. See your OB-GYN or primary care doctor if you have cramps that are accompanied by other symptoms, like heavy bleeding, weight loss, and bloating.
Your doctor can conduct tests to find out what’s going on. Then, they can prescribe a treatment that relieves your cramps and addresses the condition that’s causing them.