Cramps After Your Period: Causes and When to Worry

Cramps after your period can be the last of your normal period cramps, ovulation pain about a week or two later, or a sign of a condition such as endometriosis, adenomyosis, an ovarian cyst or an infection. A mild ache as your bleeding tails off is common. Cramps that are strong, keep coming back, or come with a fever or unusual bleeding need a doctor.

When the cramps start, where you feel them and what comes with them give the best clues. This guide goes through each cause, the signs that need help straight away, and what to write down for your doctor. It is general information. Your own doctor decides what is right for you.

Get urgent help for these signs

Call 911 in the US, or 999 in the UK, or go to the emergency department if you have cramps with any of these signs:

• A sharp, sudden and intense pain in your tummy, often low down on one side
• You feel very dizzy, you faint, or you look very pale
• Pelvic pain that is severe, getting worse, or hurts when you move or touch the area
• Pelvic pain with heavy bleeding from your vagina
• Pelvic pain with a very high temperature, or you feel hot, cold or shivery

If you could be pregnant, one-sided pain low in your tummy with bleeding or a brown watery discharge needs advice the same day. It can be a sign of ectopic pregnancy. Contact a doctor, urgent care or NHS 111 even if you have not had a positive pregnancy test.

How to tell the causes apart

The timing and the feel of the cramps point to different causes. Use this table as a guide, not a diagnosis.

If your cramps come with no bleeding at all, our guide to cramps but no period covers that pattern.

Causes of cramps after a period

Your period cramps are easing off

Period pain happens when your womb tightens during your period. Natural chemicals called prostaglandins make the muscle of the womb contract. Their level is high on the first day and goes down as bleeding continues, so the pain tends to ease after the first few days.

Normal period pain usually lasts for up to 3 days. A mild ache on the last day of light bleeding fits this pattern. Strong cramps, or cramps that come back days after the bleeding has stopped, fit it less well and are worth tracking.

An intrauterine device (IUD) can also cause period pain, mostly in the first 3 to 6 months after it is put in.

Ovulation

Ovulation pain comes about 14 days before your next period. In a 28-day cycle, that is about a week after a 5-day period ends. In a shorter cycle, it comes sooner. The pain lasts from a few minutes to 1 or 2 days. It feels like a dull pain or sharp, sudden twinges, and it is usually on one side of your lower tummy.

Pain around ovulation that is severe or keeps coming back can have another cause, such as endometriosis. Our guide on ovulation pain vs endometriosis explains how the two patterns differ.

Endometriosis

In endometriosis, tissue similar to the lining of the womb grows in other places, such as on the ovaries, behind the womb or on the bladder. This tissue breaks down and bleeds when your hormones change, which causes pain, mostly around your period. Scar tissue can form and make organs stick together, which causes pain too.

Pain from a condition like this is called secondary dysmenorrhea. It tends to get worse over time and to last longer than normal cramps. It may start a few days before your period, get worse as the period goes on, and not go away after it ends. For a side-by-side look, read endometriosis vs normal period cramps and our list of 20 symptoms of endometriosis.

Adenomyosis

In adenomyosis, the tissue that lines the womb grows into the muscle wall of the womb. It is another cause of secondary dysmenorrhea, so its pain can follow the same longer pattern. It is more common in older women who have had children. Endometriosis and adenomyosis are both on the list of conditions that make periods more painful. Read more about adenomyosis symptoms.

Ovarian cysts

Most ovarian cysts are functional cysts that form as part of the menstrual cycle. They are usually harmless and go away on their own. A cyst usually causes symptoms only if it bursts, is very large, or twists. The pain can range from a dull, heavy feeling to a sudden, severe and sharp pain. Other signs are pain during sex, bloating, and changes to your periods. Endometriosis can cause cysts too.

Get an urgent appointment or call NHS 111 if you have sudden, severe pelvic pain, or tummy pain with nausea or vomiting. Our guide to what ovarian cyst pain feels like covers the dull kind and the sudden kind.

Pelvic inflammatory disease (PID)

PID is an infection of the womb, fallopian tubes and ovaries. It is usually caused by sexually transmitted infections such as chlamydia and gonorrhoea. Not everyone with PID has symptoms. If you do, they can include:

• Pain low in your tummy or pelvis
• Pain deep inside during sex
• Heavy or painful periods that are unusual for you
• Bleeding between periods or after sex
• Vaginal discharge that looks, smells or feels unusual for you

Ask for an urgent appointment if you think you have PID. It is usually easy to treat with antibiotics if it is found early. Without early treatment, it can cause long-term pelvic pain and problems getting pregnant.

Early pregnancy

Bleeding that you took for a period can sometimes be a sign of an ectopic pregnancy. An ectopic pregnancy grows outside the womb, usually in a fallopian tube. Its symptoms usually start between the 4th and 12th week of pregnancy and can include one-sided tummy pain, vaginal bleeding or a brown watery discharge, pain in the tip of your shoulder, and discomfort when you pee or poo.

If you have had sex since your last normal period, take a pregnancy test. If you have these symptoms and could be pregnant, get advice the same day, even with a negative test.

What helps cramps after your period

For mild cramps, the same steps that ease period pain can help. You can use a heat pad or hot water bottle, have a warm bath, massage your tummy, try gentle exercise, or take paracetamol or ibuprofen.

Anti-inflammatory painkillers such as ibuprofen and naproxen lower prostaglandins. They work best at the first sign of pain. People with asthma, stomach problems or ulcers, liver damage, a bleeding disorder or an aspirin allergy should not take them. Ask a pharmacist if you are not sure.

These steps treat the pain, not the cause. If the cramps come back every cycle, finding the cause matters more. For a fuller look at the options and the evidence behind them, read what helps period cramps.

What to track

A record over 2 or 3 cycles shows your doctor what a single visit cannot. It helps to separate cramps that belong to the end of your period from cramps that come later in the cycle.

Each day, note:

• Your pain from 0 to 10, and 0 on pain-free days so the gaps show
• Your cycle day, and whether you are bleeding, spotting or not bleeding
• Where the pain is: the middle, the left side or the right side
• What it feels like: a dull ache, cramps in waves, or a sharp stab
• How long it lasts, and what you took for it and whether it helped

Also note any fever, unusual discharge, pain during sex, bleeding after sex, a new IUD or other change in contraception, and any pregnancy test result.

After 2 or 3 cycles, look at which cycle days the pain falls on. Cramps that fade on the last day of bleeding look different from pain that goes on for days after it, or a twinge that comes back mid-cycle. Our guide to a pain diary for your doctor shows how to share the record.

Endolog is a pain and symptom diary app for this. You log pain on any day of your cycle, with or without bleeding, and your doctor sees the pattern instead of relying on your memory.

When to see a doctor

Ask for an urgent appointment, or call NHS 111 in the UK, if your pelvic pain or period pain is severe or worse than usual, and painkillers have not helped.

See a doctor soon if:

• Cramps after your period come back every cycle, or last for days
• Your periods become more painful, heavier or irregular
• The pain stops you doing your usual activities
• You have pain during sex, or when you pee or poo
• You bleed between periods or after sex
• You have a swollen tummy, lose your appetite, or lose weight without trying

Your doctor will ask about your symptoms and your cycle, and may suggest a pelvic exam. If painkillers do not help, the next step is to look for the cause. That can mean an ultrasound scan, and sometimes a laparoscopy, which is keyhole surgery to look inside the pelvis.

Frequently asked questions

Is it normal to have cramps after my period ends?

A mild ache as your bleeding tails off is common, because normal period pain usually lasts for up to 3 days. Cramps that are strong, last for days after the bleeding stops, or happen every cycle are not the usual pattern. See a doctor about them.

Why do I get cramps a week after my period?

A week after your period can be close to ovulation, which comes about 14 days before your next period, especially in a shorter cycle. Ovulation pain is usually on one side and lasts from minutes to 1 or 2 days. Pain that is severe or keeps coming back needs a check for other causes, such as endometriosis or an ovarian cyst.

Can endometriosis cause cramps after my period?

Yes. Pain from endometriosis may begin before a period, get worse during it and not go away after it ends. It also tends to get worse over time.

Could cramps after my period mean I am pregnant?

If you have had sex since your last normal period, take a pregnancy test. One-sided pain with bleeding or brown discharge can be a sign of ectopic pregnancy, so get advice the same day if you could be pregnant.

This article is for general information. It does not replace care from a doctor. If you think you have an emergency, call 911 in the US, or 999 in the UK.

Related articles

• Cramps but no period: causes and when to see a doctor
• Ovulation pain vs endometriosis
• Endometriosis vs normal period cramps
• What ovarian cyst pain feels like
• One-sided pelvic pain during your period