Lower abdominal pain or cramps are often challenging to interpret, as they could be due to several conditions and have nothing to do with the female reproductive system. Abdominal pain, relating to the upper part of the trunk, and pelvic pain, which instead concerns the lower part, represent two different signals of what could be a possible pathology.
Still, it is only sometimes so simple to understand what the exact location of what you are feeling is. In fact, these pains are also accompanied by other symptoms such as nausea, exhaustion, mood swings, musculoskeletal pain, and headaches, which can often confuse the identification of the illness.
Period Pain Without Menstrual Flow: Not Just Pregnancy
Menstrual pain (dysmenorrhea) can be of various degrees, and although they are part of the menstrual phase, it should not be underestimated if it severely affects a woman’s daily life.
For convenience, they are called “period pain,” but in reality, we must always keep in mind that the menstrual cycle is the period that goes from the first day of menstruation to the first of the following one. In contrast, the menstrual flow is the set of days of the month in which the blood loss appears.
Pelvic pain without the appearance of classic bleeding due to menstruation is usually linked to the possible onset of pregnancy. In fact, in the first phase, women often suffer from this type of pain, which can be either acute ( cramp-like ) or intermittent. Sometimes, there is also a combination of the two types, but, in any case, if limited in time, they are not a cause for concern for the treating gynecologist since they are due to the natural processes of tension of bones and ligaments that take place to prepare to welcome the fetus.
In case of persistent and abnormal pain, however, it is always advisable to contact a specialist for an in-depth medical consultation. Below, we see some hypotheses of alternative diagnoses to pregnancy that could be associated with this symptomatology.
Period Pain Without Menstruation: Some Pathologies
Pathologies Of The Abdomen
Pelvic pain is not only a symptom of a gynecological disorder but could be linked to some pathologies of the digestive system. As already mentioned, in fact, pain in the abdominal and pelvic areas is not easy to distinguish. Among the most common ones are:
- Appendicitis: the pain is concentrated at the navel and in the upper part of the abdomen with a possible localization on the right and other related symptoms, including nausea, diarrhea, and bloating ;
- Irritable bowel syndrome (IBS): a multifactorial pathology that leads to severe cramps (intestinal colic) and consequent abdominal swelling, the need for a sometimes tricky evacuation with diarrhea and constipation ;
- Intestinal blockage: the obstruction causes a blockage in the progression of the intestinal contents to be expelled, causing crampy abdominal pain, feelings of nausea and vomiting, bloating, and loss of appetite.
Premenopause
Premenopause (or perimenopause ) is a transition period towards actual menopause and can occur in women between the ages of 40 and 50, about ten years earlier than the canonical starting period. This anticipation of the physiological condition that a woman faces, typically from the age of 50 onwards, has various repercussions on her mature age. It manifests itself with multiple symptoms, such as:
- Irregular sleep;
- Mood instability;
- Decrease in libido;
- Vaginal dryness;
- Difficulty remembering and concentrating;
- Generalized tiredness with possibly musculoskeletal pain.
Another vital symptom, however, is pelvic pain, which can worsen compared to the normality that the woman has always experienced, even appearing in the phase of ovulation or anovulation ( ovulation without expulsion of eggs ). This discomfort is often associated with an alteration of the menstrual cycle, which initially appears irregular, with a delay in menstruation, and then reaches the state of amenorrhea ( the total absence of menstruation ) since the ovulation phase is unable to complete, the progesterone level drops and the estrogen level fluctuates.
Gynecological Complications
One of the natural conditions of the menstrual cycle that could be associated with pelvic pain is linked to premenstrual syndrome. Many women, in fact, often, when taking oral contraceptives, experience more significant pain in this phase of the cycle rather than at the time of blood loss. The pain experienced is not only linked to the pelvic area but also to other areas of the body and the psychological sphere. In fact, we experience:
- Feeling of depression;
- Nervousness;
- Abdominal swelling;
- Breast and nipple pain;
- Physical fatigue;
- General exhaustion.
Furthermore, various gynecological pathologies have often, especially in recent years, been underestimated by specialists because there was not yet sufficient scientific literature, research, and clinical cases available from which to learn how to recognize and treat them, such as:
- Endometriosis: a chronic benign disease that is still very difficult to diagnose since it is not easy to have a close-up view of the endometrial tissue. It brings with it several collateral symptoms, such as both abdominal and pelvic pain, pain during sexual intercourse (dyspareunia), vulvar pain/burning (vulvodynia), and intestinal disorders ;
- Benign tumors ( fibroids or myomas ): diagnosable by means of pelvic ultrasound; these are neoformations, which are delivered from the uterine muscle tissue, which cause pelvic agony during the period and the remainder of the feminine cycle ;
- Ovarian cysts are generally benign formations close to the ovaries, which can remain unchanged in size or enlarge and which, in some cases, cause intense pelvic pain during menstruation.
Losses
In conjunction with severe menstrual pain without a period, you may also experience some losses of various kinds. For example:
- Spotting: small blood losses so called because they appear in the form of darker spots than menstrual ones. This phenomenon is of concern precisely because it occurs in intermenstrual periods when there should be no blood loss. In the presence of pain, if it increases in intensity or occurs even after sexual intercourse, it should be investigated in depth by the referring gynecologist;
- Ovulation: this is the moment of maximum fertility in a woman, which, in a regular cycle, occurs approximately 14 days before the arrival of the next menstruation. It is a period in which some more or less abundant white discharge may occur and which may lead to premenstrual pain with abdominal tension, pain in the ovaries, swelling of the belly, and the possible presence of spots. Often, women who have ovulation-related disorders may have thyroid problems or polycystic ovary syndrome ;
- Cystitis/candidiasis: when you have pelvic pain similar to period pain but without menstruation and abnormal discharge, there may be a bacterial infection of the urinary tract ( cystitis ) or a fungal infection of the vaginal mucous membranes ( candidiasis ).
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