Experiencing Cramps After Menopause: What to Know

Medically Reviewed By Sanaz Ghazal, MD, FACOG

Cramps after menopause can be an expected part of the menopausal transition. Sometimes, however, cramps may indicate an underlying condition, such as uterine fibroids, endometriosis, or cancer. Many conditions can cause pelvic or abdominal cramps after menopause.

Talk with your doctor about your symptoms to determine your condition and create an effective treatment plan.

This article explains the possible causes of cramps after menopause, as well as symptoms, diagnosis, and treatment.

Causes and other symptoms

Someone holds a hot water bottle over their lower stomach.
Photography by Batuhan Toker/Getty Images

The following are possible causes of cramps after menopause.

Menopause

Some people may believe they have entered menopause if they stop having periods for a few months. However, menopause occurs only when you go 12 months Trusted Source National Institute on Aging Governmental authority Go to source in a row without a period.

It is possible to stop having periods for a few months before having a few more. As a result, you may not be in menopause yet, even if you have missed a few periods. In total, it can take up to 14 years to go a full 12 months without a period and reach menopause.

Menopause may cause symptoms such as cramps as well as:

Postmenopausal syndrome

Some people continue to experience symptoms through the perimenopausal period, when the body is transitioning to menopause, and after menopause. Doctors may refer to this as postmenopausal syndrome.

Uterine fibroids

Uterine fibroids are noncancerous growths around the uterus that comprise fibrous tissues and muscle.

While most people who have uterine fibroids do not have noticeable symptoms, it is possible to experience:

  • abdominal or lower back pain
  • discomfort or pain during sex
  • more frequent need to urinate
  • constipation

Uterine fibroids that develop before menopause often Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source get smaller or cause fewer symptoms after menopause. However, it is possible to develop uterine fibroids after menopause.

Endometriosis

Endometriosis is when tissue resembling the uterus lining grows outside the uterus. While it is rare Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for endometriosis to develop after menopause, it can affect people at any time.

Endometriosis can cause severe cramps or pelvic pain, as well as:

  • pain that is more noticeable during a period, sex, or when urinating or having a bowel movement
  • bleeding
  • bloating
  • nausea
  • fatigue
  • anxiety or depression

Sometimes, symptoms improve Trusted Source World Health Organization Highly respected international organization Go to source after menopause, although this may not happen for everyone.

Constipation and diarrhea

Sometimes, constipation or diarrhea causes cramps in the pelvic or abdominal area.

Constipation is a condition that may cause passing fewer than three bowel movements per week. You may also have dry, lumpy, or hard stools that feel difficult to pass.

By contrast, with diarrhea you may pass watery, loose stools three or more times in 1 day. Diarrhea can also lead to pelvic cramping, decreased control of bowel movements, and nausea.

Learn more about diarrhea and constipation, including their causes and symptoms.

Gastroenteritis

Gastroenteritis, or stomach flu, is inflammation of the gastrointestinal tract. Infections as well as exposure to irritating chemicals, medications, or food often cause gastroenteritis.

Apart from stomach cramping, gastroenteritis may also cause:

Usually, gastroenteritis is manageable at home. However, older adults may be more susceptible to complications from gastroenteritis.

If your symptoms are concerning to you or are not improving, contact a doctor for advice.

Cancer

Cancer in the pelvic area can cause pain or cramping after menopause. Uterine and ovarian cancers may be more common Trusted Source American Cancer Society Highly respected international organization Go to source in older people than younger people.

In addition to pain, these cancers may cause symptoms such as:

  • persistent bloating
  • difficulty eating or feeling full or nauseous very quickly
  • bleeding or spots of blood from the vagina
  • a change in vaginal discharge
  • a lump in the stomach around the pelvis
  • lower back pain
  • pain during sex
  • blood in the urine
  • more frequent urination

Risk factors

Some conditions that cause cramps after menopause may be more likely if you experience any of these risk factors:

When to see a doctor

Contact a doctor as soon as possible if you have persistent or recurring symptoms, such as cramps. Also talk with a doctor promptly if you experience cramps alongside other symptoms, such as vaginal bleeding.

Your doctor can work with you to provide a diagnosis and tailor a treatment plan.

Diagnosis

Your doctor will start the diagnostic process by asking questions about your symptoms and medical history. They will perform a physical exam.

If necessary, your doctor may order further tests, such as:

  • transvaginal ultrasound, whereby a small ultrasound probe placed in the vagina provides images
  • other imaging scans, such as an external CT or MRI scan
  • hysteroscopy, a procedure in which a doctor passes a thin camera through the vagina to look inside the uterus

Treatment and management

Treatment for cramps after menopause will depend on the underlying cause.

Examples of treatment options include:

  • Progestin medication: Progestins are hormones to treat Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source menopausal symptoms and endometriosis-related pain. Progestins can be in the form of pills, ointments, injections, or devices placed in the uterus.
  • Laparoscopy: Laparoscopy, or keyhole surgery, involves a small incision in the abdomen that allows doctors to use a camera and instruments to remove atypical tissue. This tissue includes the kind found with endometriosis.
  • Hysterectomy: A hysterectomy is a surgery to remove part or all of the uterus. Hysterectomy can treat some cancers and severe fibroids.
  • Pain relief medications: Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, can help manage pain.
  • Antibiotics or antivirals: For severe cases of gastroenteritis caused by infection, doctors may prescribe antibiotic, antiviral, or antiparasitic medications.

In addition to medical treatment, management options for cramps may include:

  • placing a hot water bottle or warm compress over the pelvis
  • staying hydrated
  • taking probiotics for gastroenteritis or upset stomach
  • getting regular, gentle physical activity
  • eating a balanced diet as your doctor recommends to help with digestive symptoms
  • asking your doctor about over-the-counter products, such as pain relief medications

Outlook

Outlook of cramps after menopause can vary per person and underlying cause.

Early diagnosis and effective treatment can often improve symptoms, outlook, and quality of life.

Talk with your doctor if you have questions about your outlook or treatment.

Summary

Causes of cramps after menopause include the menopausal transition, uterine fibroids, and endometriosis. In some cases, pelvic cancers such as uterine or ovarian cancer may also cause cramps.

While symptoms may differ based on the underlying cause, only a doctor can confirm your condition using tests such as ultrasounds.

Treatment options also vary depending on the underlying cause. Treatment may include hormone medications, surgery, or pain relief medications.

Contact a doctor promptly if you experience cramping or other persistent symptoms.

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Medical Reviewer: Sanaz Ghazal, MD, FACOG
Last Review Date: 2023 Oct 31
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