Cramps During Menopause: Causes, Symptoms, and Treatments

Written by Giuliana Castellucci, medically reviewed by Sophia Yen, MD, MPH.

TL;DR: Cramps During and After Menopause
Cramps can occur during perimenopause and even after menopause due to hormonal changes, fibroids, endometriosis, or ovarian cysts. While mild cramps may be normal, persistent or severe pain postmenopause should be checked by a doctor. Treatment depends on the cause and may include medication or hormone therapy.

Why Do Menopausal Women Have Cramps?

Menopause marks the end of menstrual cycles, typically occurring between the ages of 48 and 55. However, many women experience cramping during perimenopause, menopause, and even postmenopause. These cramps can be surprising, especially when menstruation has ceased. Understanding why these cramps occur is crucial for effective management and relief.

During perimenopause—the transitional phase before menopause—hormonal fluctuations, especially in estrogen and progesterone, can cause uterine contractions, resulting in cramping. These hormonal shifts can also lead to irregular periods, heavier or lighter menstrual flow, and symptoms like bloating and pelvic discomfort.

During menopause, defined as when periods stop for 12 consecutive months due to no more eggs being released, uterine cramps may happen. This is often due to residual hormonal activity or conditions like fibroids or endometriosis that continue beyond menstrual cycles. These uterine cramps generally get better after the ovaries stop producing hormones to stimulate them.

Postmenopause is defined as the period after menopause has officially begun. While cramps typically subside, some women still report experiencing them. This can be a sign of underlying gynecological conditions that require medical attention.

Are Cramps After Menopause Normal?

Experiencing lower abdominal cramps after menopause is not normal and may indicate underlying health concerns. Gynecological conditions such as uterine fibroids, ovarian cysts, or even endometriosis can persist or emerge after menopause. It’s important for women experiencing postmenopausal cramping to consult with their healthcare provider to rule out conditions such as:

• Uterine Fibroids: Non-cancerous growths that can cause pain and cramping. Generally gets smaller after ovaries stop producing hormones, but can grow with HRT/MHT (estrogen treatment).
• Endometriosis: Although it primarily affects women of reproductive age, it can continue to cause issues post-menopause, especially if hormone therapy is used.
• Ovarian Cysts: Fluid-filled sacs that form on the ovaries and lead to pain. 5-17% of postmenopausal women may get this.
• Pelvic Inflammatory Disease (PID): Usually a sexually transmitted infection of the reproductive organs that may cause cramping.

What Causes Cramping After Menopause?

Several factors can contribute to cramping during and after menopause:

• Hormonal Imbalance: Estrogen levels drop significantly, but small fluctuations can still trigger cramps.
• Menopause Hormone Therapy (MHT): While MHT can relieve many symptoms of menopause, it may also contribute to cramping as the body adjusts to hormones. This symptom should go away but if it persists, speak to your doctor.
• Digestive Issues: Bloating, constipation, and gastrointestinal changes during menopause can sometimes be mistaken for menstrual cramps.
• Gynecological Conditions: As mentioned earlier, fibroids, cysts, and endometriosis can persist after menopause, causing discomfort.
• Adhesions or Scarring: Surgical procedures or past infections can lead to scar tissue that triggers cramps in the uterus or outside the uterus.

How to Treat Cramps Before and After Menopause

Treatment for menopausal cramps depends on the cause but may include:

• Over-the-Counter Pain Relievers: Ibuprofen or acetaminophen can help alleviate mild discomfort.
• Heat Therapy: Applying a heating pad to the lower abdomen can relieve muscle tension and pain.
• Stress Management: Techniques like yoga, meditation, and deep breathing can reduce overall tension in the body, easing cramps.

For persistent or severe cramps, a consultation with a gynecologist is recommended to explore additional options like physical therapy, prescription medications, or even surgical intervention if needed.

Conclusion

While uterine cramps are more commonly associated with menstruation, they can still affect women during perimenopause, menopause, and postmenopause. Understanding some of the possible underlying causes can lead to effective treatment and relief. If you experience severe or persistent cramping, it’s crucial to consult with your healthcare provider to rule out underlying gynecological conditions.

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. Always consult with a healthcare provider for personalized medical guidance.