Cramps while on birth control but no period

Top things to know

• As many as 90% of people who menstruate have cramps or period pain.

  Table of Contents Show

  • Top things to know
  • Can hormonal contraceptives help my cramps and period pain? 
  • Combination contraceptive pills
  • Progestin-only contraceptive pill
  • Hormonal IUD
  • Injection/birth control shot
  • Vaginal ring
  • Non-hormonal options for managing cramps and period pain
  • Non-steroidal anti-inflammatories (NSAIDs)
  • Exercise 
  • Transcutaneous electrical nerve stimulation (TENS)
  • Dietary supplements & herbal medicine
  • Are my period cramps a sign of a problem?
  • Is it normal to have cramps but no period on birth control?
  • Why am I having period symptoms but no period?
  • How would you know if you were pregnant while taking the pill?

• In general, research shows that hormonal contraceptives can help with period pain.

• Other medications, heated pads, lifestyle changes, and low intensity electrical currents (yup, you read that right) can also help with period pain. 

• If cramps are getting in the way of your ability to live your life, you should check in with a healthcare provider. 

Many of us experience cramps when we get our periods. The pain (called dysmenorrhea by healthcare providers) usually starts in the pelvis and, for some people, radiates to the lower back and thighs. In this article, we’ll go over some different options for managing period pain, as well as conditions that could be causing it. 

Download Clue to track your menstrual pain.

Can hormonal contraceptives help my cramps and period pain? 

Yes, research shows that hormonal contraceptives (containing only progestin or a combination of progestin and estrogen) can help with period pain. 

Keep in mind that when you are on a hormonal contraceptive, you are not experiencing a "real" period as part of a menstrual cycle. Monthly bleeding on most hormonal contraceptives is caused by different processes in your body, and is called "withdrawal bleeding." We refer to the pain you'd experience during monthly bleeding as "period pain" below.

Combination contraceptive pills

Birth control pills that contain both estrogen and progestin relieve period pain more effectively than placebos (1). Taking extended-cycle combination pills (without a break, with fewer breaks, or with shorter breaks) might improve pain better than taking pills on a regular cycle (21 days of active pills, with a 7-day break) (2). 

Progestin-only contraceptive pill

At this time, it looks like no research has studied whether progestin-only birth control pills affect period pain. That being said, medications that contain the progestin dienogest and are used to treat the gynecologic condition endometriosis are associated with a decrease in period pain (3). 

Hormonal IUD

Studies suggest that, compared to no treatment or copper IUDs, progestin-releasing intrauterine devices decrease period pain (4,5). 

Implant

Using the hormonal implant, which is inserted under the skin and releases progestin, is associated with a decrease in period pain over time, in several studies (6).

Injection/birth control shot

For people with endometriosis, injectable contraception containing the progestin medroxyprogesterone acetate might reduce period pain as well as the implant or other medications used to manage endometriosis-related pain (7,8).  

Vaginal ring

One study showed that people who use the progestin-releasing vaginal ring experience less period pain compared to their previous contraceptive method (9). 

Keep in mind that it’s hard to know what type of hormonal contraception works best for period pain, and how these treatments compare to other medical and non-medical treatments. Even if a treatment works for some or most people, it might not improve pain for you. 

Non-hormonal options for managing cramps and period pain

There are many options beyond hormonal birth control for managing cramps and period pain. Read more here about cramps and how to manage them.

Non-steroidal anti-inflammatories (NSAIDs)

These medications, like acetylsalicylic acid, reduce period pain and seem to work better than acetaminophen (10). 

Heat

Studies show that heated pads and patches work better than a placebo for improving pain and might work as well as certain NSAIDs (11). 

Exercise 

Regular low intensity or high intensity exercise reduce menstrual pain compared to no exercise (12). We’re still waiting on evidence about resistance training!

Transcutaneous electrical nerve stimulation (TENS)

High-frequency TENS involves stimulating the skin on the lower abdomen with electrical currents, specifically with 50 Hz to 120 Hz pulses delivered at a low intensity. This treatment works better than a placebo for reducing period pain (13). 

Dietary supplements & herbal medicine

It looks like fenugreek, fish oil, vitamin B1, ginger, valerian, zataria, zinc sulphate, and Chinese herbal medicine might help relieve period pain (14,15). More research will help us understand better understand the relationship between these treatments and period pain better. 

Are my period cramps a sign of a problem?

As many of 90% of people who menstruate experience some period pain (16). For many people, period pain is not caused by another condition; for others it might be caused by an underlying condition like endometriosis or adenomyosis (17). 

Either way, if cramps are stopping you from doing your daily activities or you want to try a new treatment for your period pain, you should check in with your healthcare provider. Tracking your pain symptoms with Clue before the appointment can help you and your healthcare provider create a care plan that is right for you. 

Is it normal to have cramps but no period on birth control?

Why am I having period symptoms but no period?

How would you know if you were pregnant while taking the pill?