*Content reviewed by HotPause Health Medical Advisor & Board-Certified OB/GYN Dr. Beverly Joyce

What Are Perimenopause Cramps?

Perimenopause is the transitional phase leading up to menopause, marked by significant hormonal fluctuations. While cramps are commonly associated with the menstrual cycle, many women experience cramps during perimenopause. These perimenopause cramps can be unexpected, occurring even when periods become irregular or less frequent. Learn why cramps happen and how you can manage the symptom from HotPause Health Medical Advisor & Board-Certified OB/GYN Dr. Beverly Joyce.

Why Do Cramps Happen During Perimenopause?

Perimenopause cramps primarily result from fluctuating estrogen levels. During this phase, estrogen levels can unpredictably rise and fall. An increase in estrogen prompts the uterus to produce more prostaglandins—hormone-like substances linked to inflammation and pain. Prostaglandins cause the uterus to contract during menstruation, leading to cramps. Elevated production of prostaglandins during perimenopause can therefore increase both the likelihood and intensity of cramps, even when you’re not on your period.

How Long Do Perimenopause Cramps Last?

The duration and frequency of perimenopause cramps can vary widely among women. Some may experience mild discomfort occasionally, while others might have more intense cramps that persist. As hormone levels continue to fluctuate throughout perimenopause, cramps can come and go unpredictably until hormone levels stabilize post-menopause.

What Can You Do About Perimenopause Cramps?

Managing perimenopause cramps involves a combination of lifestyle adjustments, natural remedies, and medical treatments. Here are some effective strategies to alleviate discomfort:

Lifestyle Modifications

• Heat Therapy: Applying a warm heating pad or hot water bottle to your lower abdomen can relax uterine muscles and provide soothing relief.
• Regular Physical Activity: Engaging in exercise improves blood circulation and can lessen cramp severity. Yoga and stretching are particularly beneficial for relaxing muscles.
• Healthy Diet and Hydration: Consume a diet rich in omega-3 fatty acids, magnesium, and vitamin B. Stay hydrated and consider reducing caffeine, alcohol, and sugar intake, which may exacerbate cramps.
• Stress Management: Techniques like deep breathing exercises, meditation, and mindfulness can reduce stress levels, potentially decreasing cramp intensity.

Over-the-Counter Remedies

• Non-Prescription Pain Relief: NSAIDs like ibuprofen, naproxen, or Midol can effectively reduce inflammation and alleviate pain associated with perimenopause cramps.

Medical Treatments

• Menopause Hormone Therapy (MHT): MHT can help regulate hormone levels by supplementing estrogen and progesterone, reducing cramps and other menopausal symptoms like hot flashes and mood swings. Consult your healthcare provider to determine if MHT is suitable for you.
• Birth Control Pills: Low-dose contraceptives can regulate menstrual cycles and diminish cramps, and are beneficial for managing heavy bleeding and irregular periods during perimenopause.
• Progestin Therapy: For women who cannot, or prefer not to, take estrogen, progestin-only medications can help control heavy bleeding and alleviate cramps.
• Intrauterine Device (IUD): A progestin-releasing IUD can reduce menstrual bleeding and cramping, offering localized hormone therapy as an alternative to systemic treatments.
• Pelvic floor physical therapy can help some women who have perimenopausal pelvic pain. 

Alternative Approaches

• Acupuncture: Some women find relief from perimenopause cramps through acupuncture, which may help balance the body’s energy and reduce pain.
• Herbal Supplements: Certain herbal remedies, like black cohosh or evening primrose oil, are believed to alleviate menopausal symptoms. Always consult with a healthcare provider before starting any new supplement to ensure it’s safe for you.
• A TENS Unit:  Transcutaneous Electrical Nerve Stimulation can also reduce perimenopausal cramps and back pain. These are available over-the-counter and online, and may be covered by FSA or HSA funds.

When to Seek Help

While perimenopause cramps are often a normal part of the menopausal transition, it’s important to consult with your healthcare professional if:

• Cramps are severe or disrupt your daily life.
• You experience heavy bleeding or spotting between periods.
• There’s a sudden change in your symptoms.

A medical evaluation can rule out other potential causes of abdominal pain and ensure you receive appropriate treatment.

Conclusion

Understanding why they occur and how to manage them can make a significant difference in your quality of life. By incorporating lifestyle changes, exploring natural remedies, and consulting with your healthcare provider about medical treatments, you can find relief and navigate this transition more comfortably.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.