Have you ever been surprised by your period? Or more accurately, a period that’s MIA?
Whether you have a period tracking app to remind you or you’re running on vibes only, you probably have a good idea of what the start of your period feels like. Maybe your PMS manifests with crying at unlikely animal duo videos, or you just feel sort of tired and run down. Thanks to the unique stew of hormones that fluctuate during your monthly cycle, you will notice your body doing similar things every month, especially as you leave your teens.
But what happens if your period symptoms come, without the bleeding? Say your 3-5 week cycle putters along, and right on time you experience your usual hormonal acne, bloating, and cramping, but no period actually comes?
First, Don’t Panic
We know, we know—as first steps go, this one isn’t the easiest. But trust us! There are a host of reasons why you might have period symptoms but no period. And importantly, a lot of them aren’t cause for immediate concern.
Here are all the reasons you might have period symptoms, but no period:
Your Hormonal Birth Control
Hormonal birth control, whether the combination pill, mini-pill, implant, or ring, can disrupt your typical cycle. And that might mean getting period symptoms with no bleeding. You can read a bit more about this here, but it’s best to look up symptoms associated with your specific contraceptive medication.
Oh, stress. Whether it’s caused by exams, drama with your crush, or financial issues, this spike in cortisol is a serious disrupter of your cyclical hormone fluctuations. And missing your period is exactly the type of thing to make you even more stressed out. If other conditions can be ruled out, talk to your doctor about whether stress could be the cause of your disrupted cycle.
Anovulation means that no egg is released from your fallopian tubes. There are plenty of benign reasons for the occasional anovulatory cycle, and some not so benign. (You can read more about anovulation here.) In many cases you might still experience bleeding and not even realize that you didn’t ovulate, or it could cause lighter or no bleeding.
It’s a fun word, isn’t it? Basically this phenomenon—which happens to some 20% of people—refers to pain at ovulation. Ovulation occurs in the middle (mittel) of your period, around Day 14. This discomfort, including tender breasts and cramps, simply mean your period is still on its way.
Working out too hard as well as quickly losing or gaining a drastic amount of weight can all disrupt our periods. Even if you are on a medically-directed plan to gain or lose weight, absolutely always tell your doctor if you’ve missed your period.
PCOS—or Polycystic Ovary Syndrome—is a condition that affects 8-20% of menstruators worldwide. It is caused by a hormone imbalance, which is linked to an excess of androgen or insulin. PCOS causes irregular ovulation, and can also cause extremely heavy periods. As the name implies, it also causes cysts on ovaries, which can rupture or cause the ovary to twist. This results in pelvic pain that feels a lot like period cramps but isn’t related to oncoming bleeding. Keeping track of your symptoms and cycle can help when speaking with a healthcare professional about your symptoms if you’re experiencing pain, but aren’t sure about the cause. PCOS can also cause weight gain, acne, and facial hair, so keep track of those symptoms as well.
The thyroid is a small gland in your neck that regulates different bodily functions, including your metabolism and menstrual cycle. When it gets out of wack, it’s no wonder that these two things are affected.
There are a few different thyroid conditions. Hyperthyroidism is where the body produces too much thyroid hormone, and is more common in Black, Asian, or Pacific Islander people. The opposite condition, hypothyroidism, (also called Hashimoto’s Disease) is more common in white menstruators and causes fatigue and weight gain. If your cycle is out of wack, it’s worth getting your thyroid function checked.
Endometriosis is a condition where the tissue that normally lines your uterus starts growing outside of it. This can cause intense cramping that starts much earlier than your normal PMS cramps and last long after. It can be confused with a few other conditions, so read more about it here!
Look, this option has probably crossed your mind, right? Breast tenderness and cramping can be a symptom of pregnancy. (And if some spotting does come, that doesn’t totally rule out pregnancy—it could be implantation bleeding.) When in doubt, a drugstore pregnancy test is cheap and anonymous, so it’s the best option to give yourself some peace of mind and to help figure out what might actually be causing period symptoms with no bleeding.
Are There Other Reasons I’m Cramping Without a Period?
Thanks to the fairly central location of our reproductive organs, it’s pretty easy to mix up other cramp-causing conditions with your period. For example, a fairly serious cause of abdominal pain is appendicitis. You can check for this by pressing on the right side of your body, between navel and side, and then letting go. What you’re looking for is more pain in the ‘release’ than the press. That rebound tenderness and fever are two sure signs it’s time to get to the hospital ASAP!
With an urgent issue like appendicitis ruled out, several other things might be the culprit. It could be that certain penetrative sex positions have irritated your cervix, or that you have a urinary tract infection (UTI). Or, it’s a digestive issue like lactose intolerance, gluten sensitivity, an ulcer, or IBS.
This wide range of causes means that seeking medical attention if the issue persists is a pretty good idea. If you miss more than three periods, definitely seek medical care.
And as medical self-advocacy best practices suggest, you can bring a list of things you’ve ruled out or things you think it might be along with you. You might not know what is or is not significant, and a good doctor will understand that. It’s better if you tell them everything than leave something out!