What Causes Vaginal Cramps?

Is this cause for concern?

Cramps come in different types and intensities — from mild aches to sharp pain. The pain can also strike in different areas, from your abdomen down to your pelvis or vagina.

If you feel pain or discomfort in your vagina, the cause might be an infection or other problem with one or more of your reproductive organs. This includes your:

  • vagina
  • vulva
  • cervix
  • ovaries
  • fallopian tubes
  • uterus

1. Dysmenorrhea

Dysmenorrhea is pain that occurs during your menstrual periods. Between 16 and 91 percent of women have some cramping or pain during periods in their reproductive years. In up to 29 percent of these women, the pain is severe.

There are two types of dysmenorrhea:

  • Primary dysmenorrhea. This happens during your menstrual period, when your uterus contracts to push out its lining, without an underlying pelvic disease.
  • Secondary dysmenorrhea. This is caused by a reproductive disease, such as endometriosis, adenomyosis, or uterine fibroids.

The pain from primary dysmenorrhea usually starts one or two days before your period, or when you begin to bleed. You’ll feel it in your lower abdomen.

Other common accompanying symptoms include:

  • nausea
  • vomiting
  • fatigue
  • diarrhea

Pain from secondary dysmenorrhea starts earlier in your menstrual cycle, and it lasts longer than the typical period cramps seen in primary dysmenorrhea.

2. Vaginitis

Vaginitis is inflammation of the vagina commonly caused by bacteria, yeast, or parasites.

Types of vaginitis include:

  • Bacterial vaginosis. This is an infection that’s caused by an overgrowth of “bad” bacteria in the vagina.
  • Yeast infections. These infections are usually caused by the fungus Candida albicans.
  • Trichomoniasis. Trichomoniasis is a sexually transmitted infection (STI) caused by a parasite.

Both yeast infections and bacterial vaginosis are very common. Nearly 30 percent of women ages 14 to 49 in the United States have bacterial vaginosis. About 75 percent of women will get at least one yeast infection in their lifetime.

If you have one of these conditions, you may have vaginal irritation or pain when you urinate or have sex.

Other symptoms include:

  • white, greenish-yellow, or frothy discharge from the vagina
  • a foul-smelling discharge that may have a fishy odor
  • cottage cheese whitish discharge
  • vaginal itching
  • spotting

3. Vaginismus

Vaginismus is when your vaginal muscles tighten involuntarily as soon as something enters your vagina. It can happen during sex, pelvic exams, or when you insert a tampon. The muscle tightening causes pain that can be severe.

This condition is relatively rare. Between 0.4 and 6 percent of women have vaginismus.

The muscle tightness isn’t under your control. It’s thought to be linked to anxiety or fear — for example, if you had an unpleasant or painful experience during sex in the past.

Other symptoms of vaginismus include:

  • pain during sex or other forms of vaginal penetration
  • loss of sexual desire

4. Vulvodynia

Vulvodynia is pain involving the vulva — the external female genital area that contains the opening to the vagina — that’s typically chronic and lasts for at least three months. Although there’s no obvious cause, it may be due to:

  • an injury to nerves around the vulva
  • infections
  • sensitive skin

This condition affects over 8 percent of women from all age groups. The pain feels like a burning, stinging, or throbbing sensation. It can come and go, and it may be intense enough to prevent you from sitting down or having sex.

Other symptoms include:

  • itching
  • soreness
  • mild swelling of the vulva

5. Cervicitis

The cervix is the narrowed and lowest part of the uterus that contains the opening of the uterus into the vagina. Cervicitis is an inflammation of the cervix. It can be caused by bacterial infections and allergic reactions, but it’s most commonly caused by an STI, such as gonorrhea or chlamydia.

STIs are very common. Nearly 20 million new infections due to an STI are diagnosed each year.

Cervicitis often doesn’t cause any symptoms. Your doctor might discover it when you’re getting a Pap smear or another test on your cervix and other pelvic organs.

When symptoms do occur, they can include:

  • pain during sex
  • green, brown, or yellow vaginal discharge
  • foul-smelling discharge
  • bloody discharge
  • frequent urination
  • pain when you urinate (if the urethra is also infected)
  • bleeding after sex that’s not caused by a menstrual period

6. Pelvic floor dysfunction

The pelvic floor muscles support the organs of the pelvis — the bladder, uterus, and rectum. Pelvic floor dysfunction is a group of disorders involving these muscles that interfere with your ability to urinate or have a bowel movement. Injuries, childbirth, and other damage to the muscles of your pelvic floor can cause this condition.

Between 2005 and 2010, up to 25 percent of U.S. women had at least one pelvic floor disorder.

In addition to pain in the pelvis and vagina, pelvic floor dysfunction can cause:

  • constipation or straining with bowel movements
  • a frequent need to urinate
  • hesitant or intermittent urine stream
  • pain during urination
  • pain during sex
  • pain in your lower back

7. Endometriosis

Endometriosis occurs when the tissue that lines the surface inside your uterus, called endometrial tissue, grows outside of the uterine cavity on other parts of your pelvis, like the ovaries, fallopian tubes, or on top of the outside surface of the uterus.

Each month, the uterine lining swells up and then is shed during your period. When this tissue is in other parts of your uterus, it can’t escape in the way that normal endometrial lining is shed. The swollen tissue causes pain wherever it grows.

More than 11 percent of women ages 15 to 44 have endometriosis. In addition to painful menstrual cramps, it can cause:

  • pain during sex
  • pain during urination or bowel movements when one’s period is occurring
  • bleeding between periods
  • back pain
  • difficulty getting pregnant
  • diarrhea, constipation, and bloating that are worse during periods

8. Adenomyosis

Adenomyosis occurs when tissue that normally lines your uterus, called endometrial tissue, occurs and grows into the muscular wall part of the uterus.

Every month during your period, this tissue swells up just as it would in the uterus. With nowhere to go, the tissue expands the uterus and causes severe cramping pain during periods.

It’s not clear exactly how many women have this condition. Some research suggests that anywhere from 20 to 36 percent of women who undergo a hysterectomy for noncancerous conditions have adenomyosis.

Adenomyosis isn’t the same as endometriosis. However, some women have both conditions simultaneously. Other symptoms include:

  • heavy bleeding during periods
  • blood clots during periods
  • pain during sex
  • an enlarged uterus, which may cause the belly to bulge

9. Urinary tract infection (UTI)

You get a urinary tract infection (UTI) when germs like bacteria multiply in and infect your urinary tract — including your urethra, bladder, ureters, or kidneys.

UTIs are much more common in women than in men. Between 40 to 60 percent of women will get a UTI at some point in their lifetime. In most of these women, the infection is in the bladder.

With a UTI, the pain is commonly centered in the middle of the pelvis and near the pubic area.

Other symptoms include:

  • burning when you urinate
  • cloudy or smelly urine
  • red or pink urine
  • an urgent or constant need to urinate

10. Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs. It’s typically caused by STDs like chlamydia or gonorrhea. More than 1 million women in the United States are diagnosed with PID each year.

In addition to pain in the lower abdomen, it can cause:

  • an unusual, foul-smelling vaginal discharge
  • pain or bleeding during sex
  • pain or burning during urination
  • fever
  • chills
  • nausea
  • vomiting
  • bleeding between periods

11. Ovarian cyst

Cysts are fluid-filled sacs enclosed in a membrane that can form in or on many parts of the body — including the ovaries. Between 8 and 18 percent of women have ovarian cysts.

Cysts usually don’t cause any symptoms and they eventually go away on their own. However, a large cyst or one that ruptures can cause significant pain. The pain from ovarian cysts is often centered in your lower belly on the side the ovarian cyst occurred on. It can feel dull, or sharp and achy.

Other symptoms include:

  • a bloated abdomen
  • a feeling of fullness
  • irregular periods
  • nausea and vomiting

12. Uterine fibroids

Fibroids are growths that form in the uterus. They’re very common, affecting up to 70 percent of women.

Fibroids can be so tiny that they’re barely visible, or large enough to stretch out the uterus. Fibroids aren’t cancerous, and they typically don’t increase your risk for cancer. Often times, women with fibroids don’t even have any symptoms unless the growths are large or they press on the ovaries or other nearby structures.

In addition to pressure and pain in the pelvis, fibroids can cause:

  • heavy or prolonged menstrual bleeding
  • bleeding in between periods
  • a frequent need to urinate
  • trouble emptying the bladder
  • pain during sex
  • constipation
  • lower back pain
  • leg pain

13. Ectopic pregnancy

An ectopic pregnancy is when a fertilized egg implants outside of the uterine cavity — for example, inside the fallopian tube. It will still turn a pregnancy test positive, but the pregnancy isn’t viable.

The first sign of an ectopic pregnancy may be pain in the pelvis or abdomen. Other signs include:

  • spotting
  • cramps that feel like an urge to have a bowel movement
  • dizziness or fainting
  • pain in the shoulder

An ectopic pregnancy can become a medical emergency. A fertilized egg can’t develop into a viable fetus outside the uterus. If the pregnancy continues, it could rupture the fallopian tube and lead to life-threatening bleeding and other complications in the mother.

Thanks to accuracy in diagnostic tests like blood testing and ultrasound, most ectopic pregnancies are diagnosed before the fallopian tube ruptures. However, as of 2012, ectopic pregnancy still caused 4 to 10 percent of all pregnancy- related deaths.

14. Miscarriage

Miscarriage is the loss of a fetus before the 20th week of pregnancy. About 10 to 20 percent of all pregnancies end in miscarriage. The number may be even higher because most miscarriages happen in the first trimester, in which a miscarriage may occur before a woman even knows she’s pregnant.

Symptoms that you’re having a miscarriage include:

  • period-like cramps
  • spotting or bleeding coming out of the vagina
  • intense pain in the abdomen

These symptoms don’t always mean you’re having a miscarriage. Still, you should see your OB-GYN for tests to check that your pregnancy is healthy.

15. Premature labor

A pregnancy is considered full-term at 37 weeks. Going into labor before that time is called premature (preterm) labor. About 1 out of every 10 babies born in the United States in 2016 was premature.

Preterm labor can lead to many complications. Babies who are born too early may not be developed enough to survive on their own.

Symptoms of preterm labor include:

  • pressure, cramps, or pain in your lower belly
  • a dull low backache
  • a change in the consistency or color of your vaginal discharge
  • contractions that come regularly
  • water breaking

If you have any of these symptoms, call your OB-GYN right away.

When to see your doctor

Call your doctor if you experience any new or unusual pain in the vaginal area. You should see your doctor within the next day or two if you’re also experiencing:

  • unusual vaginal odor or discharge
  • itching
  • an urgent or frequent need to urinate
  • cloudy or foul-smelling urine
  • bleeding in between periods or after your periods have stopped

Get medical help right away for more serious symptoms like these:

  • heavy bleeding
  • fever
  • chills
  • sudden or severe pelvic pain
  • dizziness or fainting

You should also call your doctor right away if you’re pregnant and you have symptoms like:

  • cramps
  • bleeding
  • regular contractions before your due date

Your doctor will do a pelvic exam to check the health of your vagina, cervix, uterus, fallopian tubes, and ovaries. A transvaginal ultrasound can help your doctor look for problems with the pelvic organs by going through the vagina. Treating conditions that cause vaginal cramps can be simple, or more complex. The sooner you’re treated, the more likely you won’t experience any complications.

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