Cramps After Period Has Ended: 7 MAIN Causes, Treatment

Question: Is lower back pain and cramps after period normal or a sign of pregnancy?

During menstruation that occurs monthly for most women, pain in your lower abdomen may sometimes force you to change your routine daily work or planned activities.

This pain is common in women, and its nothing unusual. In fact, more than 80 percent of women will have experienced a mild to moderate sharp pain before and during menstruation. Different studies show that between 50–90% of women have some degree of period pain at some point in their life.

This pain occurs because your womb contracts and relaxes, and expels the endometrial lining that covers the inside of the uterus. As your uterus contracts, it temporarily blocks blood supply to your uterine muscle, resulting in dull or sharp abdominal pain.

While some women will notice severe abdominal cramps during their period, others may only get a mild to moderate cramps in their belly.

After period stops at the 5th to 7th day of bleeding, women get this relief from the emotional and physical PMS symptoms that you may experience. Therefore, if you now have cramps after your period, its normal you will be concerned.

The truth is, not all cramps mean a serious health concern. Some women will naturally experience pelvic pain after period when uterus “cleans itself” by expelling a small amount of “left-over” blood or endometrial tissues.

If this happens, you may experience light brown or dark spotting and mild cramping after your period; and in a few days time, symptoms will subside on its own.

Though cramping after period may not mean a serious health concern, in some women, it could be a sign of a medical issue.

Pelvic inflammatory disease, complicated vaginal infections, uterine fibroid, endometriosis, adenomyosis, ovarian cyst rupture may cause severe belly cramps after the end of menstruation.

This article explains the causes of spotting and cramping after menstruation ends, signs that indicate it could be pregnancy, and danger signs that signify something more serious.

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What causes cramps after period has ended?

If your period ended but still cramping, here are possible causes.

1. Uterine incapacity

Your uterus is made of muscle that works to contract and relax while you are having menstruation. This contraction helps to push out period-blood from your womb out through your vagina.

As contraction occurs, you will feel pain in your lower abdomen, pelvic region, and back.

If all endometrial blood is not expelled out of your womb, your body forces your uterus to contract after the end of period resulting in cramps in your abdomen.

During this time, you may experience a black, dark or brown spotting that occurs for a few days.

2. Pregnancy

Cramping after menstrual period may be due to implantation bleeding. Implantation bleeding is spotting by some pregnant women after the embryo is successfully attached to the uterus. During this process, it may cause you to feel stomach pain and also have brown or light pink vaginal spotting. Cleveland Clinic+1

The truth is, implantation cramps and spotting usually occurs around the 3rd–4th week of pregnancy, that is, about 10–14 days after conception and often around a week before your next menstrual period is due. Mayo Clinic+1

In women that experience implantation cramps, it’s mild, and will not be intense like your period pain.

Implantation bleeding is short-lived, and you may also experience other pregnancy symptoms like mood changes, feeling tired and unwell, urinating much more than normal, breast heaviness, and breast pain or nipple sensitivity.

If you’ve already had sexual intercourse, take a pregnancy test to determine if you are pregnant or not. This is especially vital if you are worried why you had a scanty period.

A blood test is the most accurate way to confirm pregnancy. Home urine pregnancy tests are also very reliable from the first day of a missed period when used correctly, but testing too early or using very dilute urine can give a false negative result. Mayo Clinic

3. Ovulation cramps

If you have cramps 2 weeks after period has ended, it’s likely to be ovulation cramps. In women with a short menstrual cycle, cramps 1 week after period is also a sign you are ovulating.

Ovulation means the release of an egg from your ovaries, and it’s normal that women between 13 and 50 years ovulate in each menstrual cycle. This is because, without regular ovulation, it’s difficult to conceive.

During ovulation, some women experience spotting and cramping in their lower abdomen. These cramps are short-lived, and within hours or few days, the pain will subside completely.

Apart from ovulation cramps, a clear watery and stretchy vaginal discharge is a way you can identify ovulation period. Other symptoms are back pain, abdominal bloating, increase sexual desire, excessive vaginal discharge due to elevated estrogen, and mid-cycle spotting.

4. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the uterus, fallopian tubes and ovaries that most commonly happens when sexually transmitted infections like chlamydia or gonorrhea spread upward from the vagina or cervix. NCBI+1

If you have pain in your vagina or pelvis with an abnormally foul-smelling discharge, it’s a sign you may have a vaginal or pelvic infection.

Like most women that catch sexually transmitted diseases (gonorrhea, chlamydia, trichomoniasis), symptoms will not always be apparent, and you may suddenly feel pain in your abdomen.

Persistent pain in your lower abdomen means something is wrong, and it could be due to pelvic infections.

Other symptoms of pelvic inflammatory disease are

• Fever that may be persistent throughout the day

• Painful sexual experience

• Painful urination

• Upper abdominal pain

• Smelly vaginal discharge (with green or yellow color)

• Bleeding between periods or after sex

• Body weakness and fever Mayo Clinic+1

If you have cramps all the time after your period is finished, it could be due to infections if you have these symptoms too.

For best treatment, it’s vital you inform your doctor for tests. Usually, after swabs or urine tests and culture, your doctor will start you on antibiotics and pain relief medications. Treating your sexual partner is also important to prevent re-infection. MedlinePlus+1

5. Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb (endometrium) is found outside the uterus, for example on the ovaries, fallopian tubes or pelvic walls. It is estimated to affect about 1 in 10 women of reproductive age worldwide. World Health Organization+1

Within your womb is the endometrium that builds-up before the start of a period. When your period begins, your uterus contracts and expels your endometrium as bright red period blood.

Normally these endometrial tissues are located inside the uterus; if they become displaced and found in other parts of your body, it may cause severe pain during and after period.

Other symptoms of endometriosis (apart from pain) are longer than usual menstrual period now lasting more than seven days, severe cramps in your back, pain while having sexual intercourse, infertility, spotting between periods, heavy menstrual bleeding during periods, and chronic pelvic pain that continues even when you are not on your period (see ACOG FAQ: https://www.acog.org/womens-health/faqs/endometriosis and WHO fact sheet: https://www.who.int/news-room/fact-sheets/detail/endometriosis). ACOG+2Office on Women’s Health+2

If you persistently get severe lower or upper abdomen pain, either on the right or left side of your abdomen, talk to your doctor. Endometriosis can affect your quality of life and future fertility if not treated.

Endometriosis can be managed with pain relief medications, hormonal treatment (such as some contraceptive pills or hormonal IUDs) and sometimes surgery, though a complete cure is not currently possible for many women. ACOG+1

6. Adenomyosis

Just like endometriosis, adenomyosis involves endometrial tissue in the wrong place, but this time, endometrial tissues are located within the muscle of the uterus itself.

This is more common in women that have previously had children and those who have had uterine surgery such as cesarean section or fibroid surgery. It can also occur after procedures that open the uterine cavity. Adenomyosis may cause heavy menstrual bleeding and cramping that can continue after your period. MSD Manuals

7. Other causes of pelvic pain after a period

Other causes of pelvic pain after a period are hormone imbalance, stress and emotional factors, birth control pills (especially when recently started or changed), and ovarian cyst rupture. Conditions affecting the bowel or urinary tract can also cause pain that feels like period cramps. MedlinePlus+1

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How to ease cramps after period

If you have cramps that are mild and due to ovulation or implantation, within hours to a few days, you will usually start feeling better.

However, some women will experience a severe pain after the end of period that will require urgent treatment.

These are easy ways to feel better:

1. Use painkillers

Most pain medications block the synthesis and release of prostaglandins, a substance that stimulates the uterus to contract and cause pain.

Drugs like naproxen and ibuprofen (NSAIDs) and acetaminophen can help. Avoid aspirin if you are younger than 18 or if you have bleeding problems, stomach ulcers, kidney disease, or are on blood thinners. If you’ve confirmed pregnancy, it’s important you see your doctor before taking any medications, because some drugs are contraindicated in the first trimester. Medscape+1

2. A warm bath and heating pads

Take a warm bath to ease off the pain. If you have a heating pad, you can also apply to your lower abdomen or back to relieve your cramps.

3. Get physical, have sex and exercise

Women that routinely exercise will notice a reduction in menstrual cramps. Gentle stretching, walking or yoga can also help. Some women also feel better after orgasm because of the natural release of endorphins. Women’s Health Concern+1

4. Talk to your doctor

Some cramps in your belly may require further testing and treatment you cannot apply at home. See your doctor for help, especially if:

• Pain is suddenly very severe or getting worse

• You have fever, chills, vomiting or feel very unwell

• You have heavy bleeding, large clots, or bleeding after sex

• You have a positive pregnancy test with pain or bleeding (possible ectopic pregnancy)

• Pain continues for weeks and interferes with work, school or sleep

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Cramps 2 days after period

If you start getting cramps 2 days after period, it is also likely your endometrium that was left over is being expelled. Cramps 3 days after period or cramps 4 days after period may be due to the same reason.

Nevertheless, a smelly vaginal discharge, severe pain, pain with fever, or pain that does not improve may signify something more serious like infection, endometriosis or an ovarian problem. In these cases, you should see a doctor or visit the hospital for proper examination and tests. MedlinePlus+1