I Thought I Was Done! Cramps After Menopause

Women's Health | | Natasha Weiss
5 min read

You made it through the woods. The years of bleeding through pants, hormonal weeks, hot flashes, and the dreaded…cramps.

Or so you thought.

Your days of periods are over, you’ve traversed your way through menopause. You’re pretty positive that *that period* of your life is over, and then BAM! Cramps. In your uterus.

If this is you, let’s take a look at what could be causing cramps after menopause, and what you can do about them. 

What Causes Cramps After Menopause?

You probably don’t need a reminder, but you’re officially post-menopausal after you haven’t had a period for a full year. 

If you’ve fully exited menopause, or are at the tail end of it, sudden uterine cramps may take you by surprise and leave you a little worried.

The good news is unless they are severe or ongoing it’s probably nothing to worry about. That being said, any sort of pain is a warning signal or type of communication from your body and is something to pay attention to. 

Here’s what those cramps could mean:

You’re Still Menopausal

Maybe it’s been nearly a year since your last period, but you’re not quite there. 

Then all of a sudden – cramps! You might have guessed this one, but one possibility is that you’re having another period. This one will be easy to figure out and resolve after the end of this cycle. 

Gastrointestinal Issues

You’ll most likely be able to tell the difference between uterine and abdominal cramps, but sometimes things get mixed up in there.

That being said, if you have ongoing stomach issues, that’s something to get checked out. Although you’ll most likely want to go to your primary care provider or a gastroenterologist instead of an OB-GYN.

Vaginal Atrophy

During menopause, estrogen levels drop. This can cause vaginal changes like dryness, as well as a loss in strength and elasticity – otherwise known as vaginal atrophy.

This can cause pain with intercourse, cramping, and can increase your chance of developing yeast infections and bacterial vaginosis.  

Pelvic Organ Prolapse

A decrease in estrogen can also cause the pelvic floor to weaken, sometimes leading to pelvic organ prolapse

This is when the ligaments and muscles that make up the pelvic floor weaken enough so that the bladder, uterus, and rectum bulge.

Here are a few pelvic organ prolapse symptoms to watch out for:

  • A lack of sensation or discomfort during sex.
  • Heaviness or dragging in your pelvic area.
  • Bladder or bowel incontinence
  • Bulging outside of the vagina or in the front or back wall of it.
  • And of course…cramping. 

Endometriosis and Uterine Fibroids

Endometriosis is when the endometrial or uterine lining grows outside of the uterus like on the ovaries, intestines, and fallopian tubes. 

Fibroids are typically benign growths in the uterine wall.

Both of these disorders usually stop growing or get smaller after menopause, but not always.

Symptoms usually disappear after you stop getting your period, but it’s not uncommon to still experience cramping after menopause from endometriosis or uterine fibroids. 

Hormone replacement therapy (HRT) is often used as people transition through menopause to balance symptoms. The use of estrogen however can exacerbate symptoms of endometriosis and uterine fibroids after menopause.

If you have a history of one of these disorders before menopause it’s important to see your doctor. If you’re on HRT they may want to reevaluate your medications.

Cancer of The Reproductive System

The c-word can be scary. But the earlier you catch any potential cancer, the easier it usually is to treat. 

Your risk of reproductive cancers increases in your 50s and older age, especially after menopause.

Cancer in the reproductive system can appear in the:

  • Ovaries
  • Cervix
  • Uterus
  • Vagina
  • Vulva

It’s especially important to stay on top of your reproductive health if you have a family history of cancer, whether or not they’re reproductive cancers.

Cramps After Menopause: Your Next Steps

If you’ve ruled out gastrointestinal issues and the possibility of menstruating, it’s time to seek some professional guidance and get some answers. 

You’ll want to give your OB-GYN a visit as your first step. 

Before you see your provider, be sure to write down any other symptoms you’ve been experiencing, even if they seem unrelated, as well as any possible questions you might have. 

Some diagnostic measures your practitioner may use are:

  • Pelvic exam: This is a physical and visual examination to see if your doctor notices anything before getting further imaging. 
  • Biopsy: If they suspect cancer, your provider will take a tissue sample to examine for cancerous cells. 
  • Ultrasound: This will probably be the first kind of scan that your doctor would order. Ultrasounds use high-frequency waves to create images of the inside of your body.  
  • MRI Scan: These use a large magnet and radio waves to look at structures in the body, including organs. 
  • CT Scan: Similar to an MRI scan, but using X-rays to create images.
  • Hysterosonography and Hysteroscopy: These involve using a saline or saltwater solution into your uterus to make examination easier.

If anything is going on your provider will be able to outline what potential treatment options are.

In the meantime to help ease the discomfort, you can try an over-the-counter pain medication like ibuprofen or acetaminophen, a heating pad, taking a warm Epsom salt bath, and resting. 

It can be anxiety-inducing to not know what’s going on in your body. The fact that you’re reading this means you’re taking the steps you need to figure out what’s going on in your body.

Take a deep breath and one step at a time.

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