by Locke Hughes, Charlotte Hilton Andersen, Colleen de Bellefonds

First: don't freak. It turns out, there are tons of reasons you've got those tell-tale menstrual cramps, but no period.

Hormonal changes related to ovulation can affect some of the same pathways in your brain that might be affected by other medical conditions, causing mood swings that feel similar to your period but arent related to ovulation or menses, says Chailee Moss, M.D., an ob-gyn at <a href="https://www.hopkinsmedicine.org/" id="01eec23e-9aa9-31f3-a642-f87bf8f95e08"> Johns Hopkins Medicine </a> . Whats more, some physical abnormalities in your uterus and ovaries can also cause cramping that feels like PMS, she adds.

While skipping a period every now and then is usually nothing to worry about, if you have a fever, significant nausea or vomiting, or pain that you cant control with simple OTC medications or that doesnt improve within a week, check in with your doctor right away.

Otherwise, its time to see your doc if you skip more than three cycles in a row, suggests Chicago-based ob-gyn <a href="https://www.drjessicashepherd.com/" id="1670f95d-74b7-30fd-aa79-e7d0564d7f75"> Jessica Shepherd </a> , M.D.-here's what might be causing period-like cramps:

Every once in a while, your body goes through all of the hormonal changes associated with pre-menstrual syndrome (PMS), but if you didn't actually release an egg that month, you won't actually get your period. Known as anovulation, its more common than one might think. "Ten to 18 percent of all regular cycles are anovulatory, Shepherd adds. In case you're wondering, yes, that stat can make getting pregnant tricky!

If you've had unprotected sex in the last month, were a bit lax about taking your pill, or rely on the pullout method for birth control, it's worth taking a pregnancy test. Many of the <a href="https://www.womenshealthmag.com/life/a19969244/early-pregnancy-symptoms/" id="7b3d0ae1-c0f1-3c9d-af76-2a216c870115"> symptoms of early pregnancy </a> , including breast tenderness, mood swings, fatigue, and cramping, are the same ones that you were already experiencing month to month before and during your period.

Your <a href="https://www.womenshealthmag.com/health/a19932735/real-women-thyroid-horror-stories/" id="f1013cc4-e22a-30e4-aa53-af5fac79e23d"> thyroid </a> , a small butterfly-shaped gland in your neck, regulates many of your bodys functions, including your metabolism and menstrual cycles. If your thyroid gets out of whack, your cycles can become irregular, says Shepherd. The result: You may you go a long stretch without having your period while still experiencing period-like cramps, says Moss.

A missed period could be a possible symptom of ovarian cancer.

Because your thyroid regulates your brain function, mood swings that you thought were PMS may be related to your neurologic function, she explains. And spotting or cramping may occur because the lining of your uterus has built up but hasnt shed because youre not ovulating.

Be sure to check in with your doctor if youre experiencing other symptoms of a thyroid condition, including sudden unexplained weight loss or gain, shaking, heart palpitations, or significant fatigue.

One very common side effect of <a href="https://www.womenshealthmag.com/health/a19944755/iud/" id="1d6d31d5-747b-3bf0-afe8-dbdef6120153"> hormonal IUDs </a> is skipped periods. Thats because one of the ways the device prevents pregnancy is by thinning out the endometrial lining in your uterus so theres nothing to shed come that time of the month.

And, while they don't typically nix your flow altogether, birth control pills can result in super-light flows or spotting. So you might feel period symptoms, like cramps and breast tenderness, even without a heavy, full-blown period, says Shepherd.

Stress is a surprisingly common reason for <a href="https://www.womenshealthmag.com/health/a19915511/late-period/" id="8a25ecfb-46f3-3ff9-a5f9-b76fdd87344a"> missing your period </a> . Stress increases your cortisol levels, which affects your hormone balance, says Shepherd-including the hormones that regulate your ovaries and uterine lining.

Exams, deaths, and even breakups are all big-time stress-inducing events that can cause periods to go awry. But these life-changing biggies arent the only reasons you might be feeling the effects of stress.

Some people dont realize theyre so stressed, but once they talk about it they realize they are going through something, says Shepherd. If you think stress is messing with your periods, talk to your doctor; therapy, exercise, <a href="https://www.womenshealthmag.com/yoga/" id="5993f580-7f7e-37e2-a5c6-a045ccac3dd4"> yoga </a> , and meditation can all help get your stress under control and your periods back on track.

<h1> 6. Polycystic ovarian syndrome (PCOS) </h1>

Frequent skipped periods can be caused by PCOS. PCOS is a condition in which a patient has an excess of androgens, which are chemicals in the body that affect ovary function, hair growth, weight gain, and sensitivity to insulin, says Moss.

Up to 20 percent of women are affected by PCOS.

PCOS can result in anovulatory cycles and irregular spotting. It commonly causes cysts to grow on the ovaries, which, if they rupture or cause the ovary to twist, can cause pelvic pain that feels a lot like period cramps.

Up to 20 percent of women worldwide are affected by PCOS, and it's more common among women who are overweight or have a mom or sister with the condition, Moss says. If you think you might be suffering from PCOS, check in with your doctor. While there is no cure, <a href="https://www.womenshealthmag.com/content/birth-control/" id="076539e8-3dd9-3a38-a15b-97771f5dfdf2"> birth control </a> and other medications can help keep symptoms under wraps and get your periods back on track.

You might associate polyps with your colon, but the same small benign tumors can grow in your uterus. Its an overgrowth of lining of the uterus, says Moss. Polyps in your uterus can cause cramping and period-like discomfort, even when youre not on your period.

Because polyps can make it harder to get pregnant, and because there is a small risk they may develop into uterine cancer down the line, your doctor will likely want to remove them, most often with a relatively simple procedure known as a hysteroscopy. During a hysteroscopy, a doctor inserts a long tube up through the vagina and into the uterus. The doctor is able to use the scope to both see and cut out the polyps.

Every month, your ovaries make several cysts in preparation for ovulation, but only one cyst releases an egg. Although the others usually dissipate on their own by the time you get your period, sometimes one cyst or more sticks around.

Cysts can also occur if you have an anovulatory cycle (such as with PCOS). <a href="https://www.womenshealthmag.com/health/a19933465/ovarian-cysts/" id="6cafa4e7-2d2d-3d6b-ae32-07d02d6e63d0"> Ovarian cysts </a> often cause no symptoms at all, although they can sometimes trigger period-like pain when youre not on your period. So if youre experiencing irregular cramping, talk with your doctor.

Cysts in and of themselves arent usually a problem, says Moss. But if they get particularly large, they can cause the ovary to twist-a.k.a., an ovarian torsion-which is painful and requires an emergency procedure to save your ovary.

<h1> 9. Pelvic inflammatory disease (PID) </h1>

Cramping is a common symptom of PID, which is an infection of the uterus, fallopian tubes, or ovaries that typically occurs when sexually transmitted bacteria spread from your vagina to your reproductive organs.

Sexually transmitted infections such as chlamydia and gonorrhea are the typical culprits of this serious pelvic infection that can lead to pelvic pain and infertility, says , an ob-gyn and author of . Make sure youre getting regular STI checks between new sexual partners to ensure you are not a carrier of damaging STIs."

<h1> 10. Urinary tract infections (UTI) </h1>

One common symptom of a UTI is pelvic cramping, Ross says. Other symptoms include frequency, urgency, and pain and burning with urination, as well as bleeding with urination. If you think your cramps might be associated with a UTI, head to your ob-gyn or primary care physician ASAP; left untreated, a UTI could turn into life-threatening kidney infection.

If you've got PMS-like cramping, bloating, and breast tenderness but no period, one reason may be that it's not quite time for your period yet-but it's coming.

German for "middle pain," mittelschmerz happens about half-way through your menstrual cycle-around day 14 when you ovulate, says <a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__iuhealth.org_find-2Da-2Ddoctor_physician_71932_&amp;d=DwMFaQ&amp;c=B73tqXN8Ec0ocRmZHMCntw&amp;r=znTStS2jECCLk6SZT4VqFylz6ofACowzTBVwFeR4DR4&amp;m=L1dRnUQol8nJkWDcsoCp21aUICAPdcxtc1A_dPOEIdQ&amp;s=vk2PyKaRICzx3DJIbMEs1ahKmip129rEdfJR6f4o71s&amp;e=" id="458917bb-bfbe-3591-a162-917ec521f88b"> Nicole Scott </a> , M.D., an ob-gyn at IU Health. It's a totally normal experience-affecting about 20 percent of women-and it doesn't mean anything is wrong, she says. Since it's just your ovaries doing their thing, there's not much you can do to prevent it and the symptoms should go away within a day or two but if it's extremely painful or comes with any sign of infection, call your doc, she adds.

Hitting the gym on the regular is one of the best things you can do to help deal with PMS, but working out too hard or too often can actually mess up your cycle and in some cases make you miss your period all together, Scott says.

All that physical stress, especially if you lose a lot of body fat, can make your period go AWOL and cause abnormal fluctuations in your hormone levels. These fluctuations can cause moodiness, irregular spotting, acne, and other PMS-like symptoms. If you miss your period for three cycles or more in a row, talk to your doctor.

Its ironic that something so pleasurable can also lead to pain. Experiencing cramping or pain after sex is completely normals, says Ross.

The culprit? Some sexual positions are known to be anatomically harder on the vagina and female organs including the uterus and ovaries, she says. For example, doggie style allows deeper penetration but can cause discomfort for many women, while missionary position tends to be easier and more comfortable for women. Experiment with your partner to figure out which positions are best for your body.

This painful bladder syndrome, which affects women more often than men, can also cause cramping in the lower abdominal area, Ross says.

Also known as painful bladder syndrome, other symptoms of interstitial cystitis are similar to a urinary tract infection, including pelvic pain, pain between the vagina and anus in women, pain during intercourse, and a continual strong urge to urinate. The exact causes of this condition arent known, but it may be associated with a defect in the protective lining (epithelium) of the bladder, an autoimmune reaction, infection, or allergy. It may also be hereditary.

Miscarriages are much more common than you might thing-every pregnant woman has a 25 percent chance of having a miscarriage, says Ross.

Signs of a miscarriage can include severe menstrual-like cramping. If you're pregnant and are experiencing severe cramping, contact your doctor immediately.

Endometriosis occurs when tissue that typically grows inside of the uterus, grows outside of it-typically in the pelvic area, which can cause significant cramping, says Ross.

Pelvic pain associated with endometriosis differs from regular PMS pain in that it often shows up days or weeks earlier than typical PMS cramping, and may last for days even after your period is done (so, basically, you have very few pain-free days throughout your cycle). <a href="https://www.womenshealthmag.com/health/a19995748/endometriosis-stories/" id="03730666-d922-36dd-af02-e362c1abdd50"> Endometriosis cramping </a> also comes without those other PMS symptoms like mood swings.

<h1> 17. Irritable bowel syndrome (IBS) </h1>

Lower abdominal cramping is a common complaint in women suffering from IBS, Ross says.

The intestinal disorder is associated with recurring abdominal pain or discomfort along with altered bowel habits over a period of at least three months. These can include constipation, diarrhea, or the double whammy-both constipation and diarrhea, Ross says, which, yes, is totally possible.

Ovarian cancer is relatively rare, affecting only about 22,000 women a year in the U.S., but it's one of the deadliest cancers for women, killing about 14,000 women a year. A big part of this is because it often shows no, or very subtle, symptoms, Scott says.

Missing your period isn't the most common symptom of ovarian cancer-those are abdominal bloating, urinary problems, weight loss, and pain-but it is a possible symptom, according to the <a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cancer.org_cancer_ovarian-2Dcancer_detection-2Ddiagnosis-2Dstaging_signs-2Dand-2Dsymptoms.html&amp;d=DwMFaQ&amp;c=B73tqXN8Ec0ocRmZHMCntw&amp;r=znTStS2jECCLk6SZT4VqFylz6ofACowzTBVwFeR4DR4&amp;m=L1dRnUQol8nJkWDcsoCp21aUICAPdcxtc1A_dPOEIdQ&amp;s=KjP7TM3f1P3fVzJaBN1lKL4YODJJ1sZ6_Rg3YFNHJzo&amp;e=" id="50b34e72-c86f-3e13-a590-7aadae6742c0"> American Cancer Society </a> . So if you've missed your period for three months or more or you have other concerning symptoms, call your doc STAT.

Cysts-such as those caused by PCOS, an anovulatory cycle, or simply your ovaries-are fluid-filled sacs that are often symptom-less, according to the <a href="https://medlineplus.gov/ency/article/001504.htm" id="c411f48d-6ea5-33e2-a7b7-7c3c13873ecd"> National Library of Medicine </a> (NLM). That being said, they can lead to pressure, bloating, swelling, and (ding, ding, ding) period-like pain sans-menstruation.

Cramping or stomach pain sans-period could hit at the possibility of a ruptured cyst.

Although cysts are typically not a problem, they can get rather large and potentially rupture, causing sudden, sharp cramps, often in tandem with nausea and vomiting, per the <a href="https://medlineplus.gov/ency/article/001504.htm" id="843c6e45-d294-3de8-a8cb-0974b43cef1a"> NLM </a> . Because it depends on which ovary has (or had) the cyst, theres no hard-and-fast rule as to where in your abdomen you might experience this pain.

<h1> 20. Pelvic floor muscle dysfunction </h1>

The pelvic floor is a group of muscles and other tissues that form a sling across the pelvis, which holds together the vagina, uterus, bladder, rectum, and other pelvic organs, according to the <a href="https://medlineplus.gov/pelvicfloordisorders.html" id="5323006c-a8de-363b-afdd-b7ed47aa7b5e"> NLM </a> . Just like any other part of your body, <a href="https://www.womenshealthmag.com/health/a19725028/pelvic-floor-therapy/" id="69fa22d6-9900-388c-a25d-d776af9376cd"> your pelvic floor can become weak or injured </a> , particularly after pregnancy and childbirth, and cause symptoms such as pelvic pain, lower back pain, and sensations of pelvic pressure or fullness that are akin to those during your period. Standout difference from menstruation discomfort? If you can feel a bulge inside the vagina or, in more extreme cases, you can organs start to push out of the vaginal opening, per the <a href="https://www.acog.org/~/media/For%20Patients/faq012.pdf" id="184226e7-b173-3b6a-acd7-44eb8b3b6f59"> American College of Obstetricians and Gynecologists </a> (ACOG).

Other symptoms include pain during sex, burning feeling in the vagina and while peeing, leaking urine when you cough, laugh, or exercise, and leaking stool or hard time making it to the bathroom in time. To determine whats going on, <a href="https://www.acog.org/~/media/For%20Patients/faq012.pdf" id="f1dc4a7c-75a8-3c8d-a196-ca796393a10f"> ACOG </a> says that your health care provide will typically conduct vaginal and rectal exams in which you may be asked to cough or strain to see if you leak.

Simply put: an ectopic pregnancy is when a fertilized egg-ultimately, a baby or fetus-grows outside the uterus, about 90% of the time in a fallopian tube, according to <a href="https://www.acog.org/Patients/FAQs/Ectopic-Pregnancy?IsMobileSet=false#what" id="9e56ab93-a395-3833-a78d-bf288ff6f568"> ACOG </a> . As the pregnancy grows, it can cause the tube to burst, potentially causing life-threatening internal bleeding that warrants immediate surgery.

At first, this pregnancy might appear and feel just like any typical pregnancy thanks to signs such as missed period, tender breasts, and an upset tum. You might also experience lower back pain, abdominal pain, or pelvic pain (think: cramping)-all of which still make it hard to tell if youre <a href="https://www.womenshealthmag.com/life/a19959067/what-is-ectopic-pregnancy/" id="c6dda0c9-52fa-348f-abd6-5ee55034bc36"> experiencing an ectopic pregnancy </a> or a typical one. But as the fetus grows, more serious, defining symptoms may start to develop, such as sudden and severe abdominal or pelvic pain, shoulder pain, weakness, dizziness, or fainting, per <a href="https://www.acog.org/Patients/FAQs/Ectopic-Pregnancy?IsMobileSet=false#what" id="9e56ab93-a395-3833-a78d-bf288ff6f568"> ACOG </a> . If you experience any of these, you should visit your doc or the ER stat.

This painful scenario happens when one end of the appendix gets blocked by a foreign object such as poop. Yup, you read that right: poop. Blockage inside this small tube-like organ can cause pain around your belly button that gradually gets sharper and moves towards the right, lower part of your abdomen, per the <a href="https://medlineplus.gov/ency/article/000256.htm" id="24926ce6-1993-3214-a9b3-38af2b85e1f6"> NLM </a> .

Heads up: the cramps can get made fast and may be even worse when you cough, sneeze, or even walk. Other non-period-like signs? Fever, nausea, and vomiting-all of which mean you should head to the doc or ER as soon as possible for treatment hopefully before the appendix bursts.

<h1> 23. Inflammatory bowel disease (IBD) </h1>

Different from IBS, IBD is a term for two conditions-Chrons Disease and ulcerative Colitis-that are characterized by chronic inflammation of the GI tract. While the exact cause is unknown, IBD is the result of a faulty immune system that responds incorrectly to environmental triggers, causing inflammation, according to the <a href="https://www.cdc.gov/ibd/what-is-IBD.htm" id="a94307e8-0747-3230-a9be-671c694892da"> Centers for Disease Control and Prevention </a> (CDC).

The cramping and pain associated with IBD differs depending on the diagnosis. For <a href="https://www.womenshealthmag.com/health/a19811083/crohns-disease-condition-confession/" id="9a5d044e-eb65-341f-a7ac-548cca778392"> patients with Chrons </a> , its typically localized to the lower, right side of the abdomen and for those with ulcerative colitis, the left, according to ChronsandColotis.com. [NOTE: tried to find descriptions of pain/cramping from a .gov or one of our typical sites but was having difficulty. found on these two pages, but not sure how you want to link since it's technica lly two separate site pages? https://www.crohnsandcolitis.com/ulcerative-colitis/symptoms // https://www.crohnsandcolitis.com/crohns/disease-symptoms + some info from cleveland clinic here: https://my.clevelandclinic.org/health/articles/9669-ibd----ibs-q--a thanks /eb]

A.k.a. when you cannot digest foods with lactose, the sugar found in milk and milk products, and when you do, youre left feeling with gas, diarrhea, bloating, and pain. This sick to your stomach sensation might mimic period symptoms, particularly cramping, but they should dissipate within a few hour, per the <a href="https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/symptoms-causes" id="08592581-6be6-3127-a3d0-afe5c4ffa7bf"> National Institute of Diabetes and Digestive and Kidney Diseases </a> . Not sure whats going on? Think back on what you just ate and if it continues, keep a food journal to help determine a pattern.

Stomach cramps, particularly in your upper belly? Indigestion or dyspepsia, often during or right after eating, might be to blame. Other symptoms include heat, burning, or pain in between the belly button and the lower part of the breastbone, an unpleasant sensation of fullness during or right after a meal, bloating, and nausea, according to the <a href="https://medlineplus.gov/ency/article/003260.htm" id="480929de-b653-3709-ab97-7b8ced27275a"> NLM </a> . Most of the time, indigestion is not a sign of a serious health problem (might want to slow down your eating)-that is unless it occurs with bleeding, trouble swallowing, or weight loss, which might be a sign of another health condition.

Youve been seriously bloated, moody, and tired. Youve got monster cramps, and your face is as pimply as a 17-year-old boys. In other words, youre suffering from all of the classic period symptoms-but your period is totally MIA.

25 Reasons Why You've Got Cramps But No Period

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25 Reasons Why You've Got Cramps But No Period