Before you call your gynecologist, read this.
BY ALEXANDRIA GOMEZ May 15, 2017
Cramps are, to put it lightly, the absolute worst. That stabbing pain can leave you breathless, and so desperate you’d do almost anything for a heating pad. But what’s the deal when those aches arise and you’re not on your period? Before you fall down the Googling-your-symptoms rabbit hole, know that these sensations are normal.
“Cramps are a very common complaints amongst my patients and they can occur at any time,” says Niket Sonpal, M.D., assistant clinical professor at Touro School of Osteopathic Medicine in New York City. Of course, they are more pronounced in some women during their cycles, but there are other factors that can trigger cramps at any time.
It can sometimes be helpful to determine the cramp’s cause based on where it’s located. Cramps in an exact location, like the lower left abdomen, are often associated with the organs in that area, says Sonpal. However, if the cramps are on both sides, the problem may be affecting the entire colon, which could indicate gas or a food-related illnesses.
One thing to keep in mind is that cramping is different from pain. Cramps come and go while pain stays constant. If you have constant pain, see an M.D. as soon as you can. If you think it could be another cause, these seven things could be the culprit:
“Most people with irritable bowel syndrome (IBS) find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week or the first weeks on a new job,” says Sonpal. But, while stress may aggravate symptoms, it doesn’t cause them. The exact mechanism is not known, but experts think stress hormones may make the gut more sensitive to stimuli, thus responding with either diarrhea or constipation, he says. Additionally, this hyperactivity makes the muscles in your gut more likely to contract, possibly with intensity. This leads to the cramps and pain associated with IBS and stress. In fact, IBS used to be called “spastic colon,” says Sonpal. If your symptoms don’t calm down, see a G.I. doc to determine if a different diet or meds could help ease the problem.
Not all cramps and abdominal pain are due to the bowel, says Sonpal. Sometimes it’s as simple as a pulled abdominal muscle. This can result from exercises like Pilates moves or even from performing your daily activities and making a sudden motion. An injury like this will leave yourabs feeling sore and, in turn, they’ll cramp up. Rest and hydration can help with this, he says. Take it easy on the planks for a while. (Kick-start your new, healthy routine with Women’s Health’s 12-Week Total-Body Transformation!)
Constipation leads to waves of pain in various regions of the colon, says Sonpal. In fact, the pain is constantly relocating because the muscles of the colon contract to push hard stool forward. If it takes a lot of pressure to move stool forward, the colon swells and causes cramping. Adding more water and fiber to your diet can help you avoid constipation, says Sonpal. For further help, supplements could aid in clearing out your colon, but be sure to see an M.D. before you start taking one.
This is an autoimmune condition in which antibodies attack the GI tract and cause ulcers, diarrhea with or without blood, and cramping, says Sonpal. This chronic disease must be treated aggressively (mostly with antibiotics) to be put in remission. Your physician can help figure out if this is the cause with a blood test, colonoscopy, endoscopy, or a mix of these.
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German for “middle pain,” mittelschmerz, the lower abdominal pain associated with ovulation, occurs about 14 days before the next menstrual period, says Sonpal. Many PMS issues have one thing in common: the release of prostaglandins (hormones your body releases to deal with pain) by the uterus and various other organs, says Mary Jane Minkin, M.D., a board-certified ob-gyn and a clinical professor at Yale University School of Medicine.
When you ovulate, you can release a bit of prostaglandin, which can lead to contraction of the smooth muscle of the uterus and the intestine. This is the same reason why some women experience intestinal cramping and diarrhea when they get their periods. Birth control pills do help in general with cramping because they stop ovulation and cause you to produce significantly less prostaglandins, says Minkin. Another option is to take anti-inflammatory medication, like ibuprofen and naproxen, which blocks the production of prostaglandins. Just make sure to take it preventatively, otherwise the hormones are still produced and the cramping won’t stop until they’re broken down.
One of the most common reasons for cramps is developing gas, and this can be due to bacterial overgrowth or simply not letting it out. “As Shrek says, ‘Better out than in,'” says Sonpal. Although it may be a bit embarrassing, flatulence is very common and normal. If you hold it in, it swells your colon and causes it to cramp up, says Sonpal. So go ahead and let it rip.
“Many women do experience pain in their abdomens and assume it is gynecological in nature when it is really related to the intestines, because they occupy the same areas,” says Minkin. “I have ended up diagnosing many women with diverticulitis, because they come in to see me with abdominal pain and cramping, assuming it’s related to their reproductive organs.” In this case, what it’s really coming from is their digestive tract. This inflammation of diverticula pouches in your digestive tract lining causes intense abdominal cramping, along with fever and nausea. A mild case can be treated with rest, minor diet changes, and antibiotics. However, severe or recurring diverticulitis could require surgery.