Let’s not beat around the bush: Period cramps are the worst. Just hearing the word “cramps” conjures up images of heating pads, over-the-counter pain medication, and lethargic afternoons on the couch. Unfortunately, these kinds of cramps are extremely common: About 80% of women will experience period pain at some point during their lifetime.
But menstruation isn’t always the cause of abdominal cramps. In fact, cramping can occur during the early stages of pregnancy, specifically during implantation. This is when a fertilized egg, also known as a blastocyst, nestles deep into the lining of the uterus. While some patients do experience cramping during implantation, it’s far less common than period cramps. “Most women do not experience any bleeding or cramping [during implantation],” says Callum Potts, MBBS, Practice Director, founding physician, and reproductive endocrinologist at CCRM Fertility of Miami. “When they do, it is usually just for a couple of days.”
The good news is, that there are several major differences between implantation cramps and period cramps, which can help you determine what exactly you’re dealing with whenever those nasty pains flare up. Every case is different, though, so it’s always a good idea to contact your medical provider for additional guidance if you’re experiencing any kind of cramping.
Implantation cramps vs. period cramps: What’s the difference?
Timing
It depends on where you are in our cycle, says Ila Dayananda, MD, MPH, a board-certified OB/GYN and Chief Medical Officer at Oula Health in New York City. “Implantation cramps typically occur 6-12 days before a missed period, while period cramps occur just before and/or during menstruation.”
This won’t be the case for everyone though: “Figuring out the timing of what should be happening can be particularly difficult for women with irregular cycles,” says Dr. Potts. “Even in women with regular cycles, ovulation can vary by a couple of days each month, so implantation symptoms can occur when premenstrual symptoms are expected to start, and vice versa.”
Pain scale
Pain intensity can also help determine if you’re about to start your time of the month – or if pregnancy may be imminent. “Generally speaking, implantation cramps are less painful and might feel shorter in both length and duration,” says Dr. Dayananda.
Bleeding
While bleeding is of course expected during menstruation, implantation can cause light bleeding or spotting as well.
Location
“Implantation cramps will typically be confined to the lower abdomen,” says Dr. Dayananda. “Whereas period cramps can be felt in the back, thighs, etc.”
Why do implantation and menstruation cause cramping?
Implantation
“The causes of implantation cramping are unclear,” says Dr. Potts. “But may be related to the inflammatory and hormonal changes that occur during implantation.
Menstruation
Although the cramps may not be as severe during implantation, the uterus is certainly put through its paces during menstruation. “As the uterine lining prepares to shed, it releases inflammatory hormones called prostaglandins,” explains Dr. Potts. “The uterus is a muscle, and in response to the prostaglandins, it contracts to help the uterine lining shed during menses. These contractions can cause painful cramping just before menses start and last for days, though it tends to improve after the first few days of a period.”
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How to alleviate implantation and period cramps
Pain is pain, so there usually isn’t a difference in treatment whether you’re dealing with implantation cramps or period cramps. According to OB/GYN Himali Maniar Patel, MBBS, these at-home remedies will work on both types of cramping:
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Taking an over-the-counter pain reliever such as ibuprofen or acetaminophen
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Applying a heating pad to the abdominal area
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Getting regular exercise
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Practicing relaxation techniques such as deep breathing or yoga
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Eating a nutritious diet and avoiding salty, sugary, and processed foods
What if I’m having cramps, but no period? Should I take a pregnancy test?
“One consistent event among all women, whether cycles are regular or irregular, is that menses should start about two weeks after ovulation unless a pregnancy has started,” says Dr. Potts. “This is also around the time when home pregnancy tests start becoming positive, so this is a great time to check if a period hasn’t started.”
When should patients see a doctor for abdominal cramps?
“Just because cramping is common doesn’t mean we shouldn’t do something about it,” says Dr. Potts. He recommends over-the-counter medications like NSAIDs to treat period pain, but if cramps are, well, cramping your day-to-day life, then it’s worth making an appointment with your physician. Specifically to determine if your (menstrual) cramps are caused by secondary dysmenorrhea, which is due to a disorder in the reproductive organs. (Primary dysmenorrhea is caused by menstruation itself.) Dr. Potts also advises contacting your doctor if you think you may be pregnant and are having abdominal cramping or pain. “It is essential to see a doctor to rule out miscarriage or ectopic pregnancy, as these can be dangerous,” he says. An ectopic pregnancy is a pregnancy that occurs outside of the uterus; most commonly, in the fallopian tube, and it can become life-threatening if not treated in a timely fashion.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.
