Muscle cramps and pelvic pain are often high on the list of uncomfortable health issues—but when these symptoms combine with vaginal cramps, you may start to worry. While cramps can be completely normal, there are a variety of potential causes for this type of discomfort—that may or may not be cause for concern.
Vaginal cramps are a type of broader pelvic pain that relates to the pelvic floor muscles and possible pelvic floor dysfunction. While vaginal cramps may be related to period cramps or uterine cramps, they can also be described as a “spasm, tightening, or a ‘charley horse’ in the vagina itself,” explains Khara Simpson, M.D., assistant professor at the Johns Hopkins department of obstetrics and gynecology. “They can occur during or after sex, following certain exercises, or after a pelvic exam with your provider.” Vaginal cramps often feel “sharp” and can even present as abdominal or rectal pain, Dr. Simpson adds.
Vaginal cramps can often be considered “normal,” especially when related to the menstrual cycle, explains Sherry Ross, M.D., women’s sexual health expert, author of she-ology and the she-quel. However, “even under ‘normal’ conditions, it’s helpful to see a healthcare professional to ensure all the symptoms you are experiencing are, in fact, normal.”
Ahead, experts share the most common reasons for vaginal cramps—plus, when to go ahead and schedule a visit with your doctor.
1. Period or menstrual cramps
A very common cause of vaginal cramps is dysmenorrhea, or period cramps.“Your uterus is basically one big muscle (the shape of a pear) which starts to contract to shed the lining during a period,” Dr. Ross explains. These totally normal contractions often cause cramping.
2. Pelvic floor dysfunction (PFD)
Pelvic floor dysfunction, or myalgia, refers to a weakened pelvic floor (the muscles that support your bladder, bowel, and uterus). “PFD is more common in women with other pain-causing conditions such as endometriosis as well as following psychological trauma,” Dr. Simpson says. “It is also common following pregnancy and following vaginal deliveries.” Pelvic floor dysfunction is often the root of many types of vaginal cramping or pelvic discomfort.
3. Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is a “severe pelvic infection caused by sexually transmitted infections in the reproductive organs,” Dr. Simpson explains. Symptoms beyond pelvic severe pain and cramping include fever and foul-smelling vaginal discharge
The term vaginitis refers to inflammation of the vagina, explains Dr. Simpson, and is a common cause of vaginal cramping. Vaginitis is often caused by vaginal infections, including vaginal yeast infections and bacterial vaginosis—which can also cause vaginal discharge and vaginal cramps in addition to swelling, Dr. Ross adds.
Both experts agree that endometriosis is a possible cause of vaginal cramping. Endometriosis is a condition in which the uterine tissue grows outside (rather than inside) the uterus, causing “pain and inflammation in the pelvis during a period and with sex,” explains Dr. Ross.
6. Uterine adenomyosis
Similar to endometriosis, adenomyosis “is a condition where the tissue and glands that normally line the uterus grow into the muscle wall,” explains Dr. Ross. “This tissue responds by thickening, breaking down, and bleeding during each menstrual cycle, leading to painful periods.”
The cervix is located at the lower part of the uterus, connecting the uterus to the vagina. Cervicitis occurs when this tunnel-like organ gets inflamed and can cause vaginal cramping in addition to abnormal discharge as well as vulvar or vaginal irritation. It is most commonly due to sexually transmitted infections such as gonorrhea, chlamydia, and trichomonas, Dr. Simpson explains.
8. Genitourinary Syndrome of Menopause (GSM)
Oftentimes the vagina changes during menopause—resulting in Genitourinary Syndrome of Menopause (GSM), which refers to the decrease in estrogen in the vagina, making the tissue dry and pale. In addition to vaginal cramping GSM can cause “vaginal dryness, burning, lack of lubrication, pain with sexual intercourse, and urinary urgency, frequency, and pain,” Dr. Ross explains. “As a result, intercourse and other forms of vaginal contact become painful and often impossible.”
Vulvodynia, or painful vulvar syndrome, refers to “pain in the vagina or vulva (which can include the clitoris, labia, vestibule-vaginal opening, and urethra) that lasts at least three months with no other identifiable cause such as infection,” Dr. Simpson explains. The pain, which may be constant or occasional, can include cramping, soreness, burning, itching, or painful intercourse.
10. Uterine fibroids
Fibroids, also known as leiomyomas or myomas, are common benign pelvic tumors that vary in size, shape, and location, anywhere in and around the uterus. “Symptoms include pelvic pain and cramps, pressure on the bladder and bowel, irregular and heavy bleeding, difficulty urinating, miscarriage, and infertility,” Dr. Ross explains.
11. Central sensitization syndrome
Central sensitization syndrome refers to a group of pain-related disorders including pelvic pain syndromes (in addition to irritable bowel syndrome, fibromyalgia, chronic headaches, and more), according to the National Library of Medicine. Central sensitization and its syndromes refer to changes in the central nervous system that “alter its processing of pain and other sensory stimuli,” often causing “unexplained pain” that manifests in various disorders, per the Cleveland Clinic.
When to see a doctor for vaginal cramps
It’s likely a good idea to schedule an appointment with your provider if you experience severe pain, sustained cramping, pain persisting despite treatment (such as ibuprofen, a heating pad, or a warm bath), or if the pain you are feeling affects your overall quality of life, according to Dr. Simpson. However, “It’s always okay to make an appointment with your provider to discuss things even when it doesn’t meet this criteria,” Dr. Simpson adds.
If you’re feeling hesitant about seeing your doctor, it may be okay to monitor your symptoms at home for a period of time—but when in doubt, get it checked out. “If symptoms are mild in severity, intermittent, and go away without intervention, there is a role for a wait-and-see approach,” according to Dr. Simpson.
Shannen Zitz is an Assistant Editor at Prevention, where she covers all things lifestyle, wellness, beauty, and relationships. Previously the Editorial Assistant at Prevention, she graduated from the State University of New York at Cortland with a bachelor’s degree in English. If she’s not reading or writing, you can probably find her frequenting the skincare and makeup forums on Reddit or hogging the squat rack at the gym.
Gynecologic Surgeon and Assistant Professor in the Department of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine
Angela Chaudhari, M.D., is an associate professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine. She received her M.D. from Northeastern Ohio Universities, completed her obstetrics and gynecology training at Washington University in St. Louis in 2004, and then completed a fellowship in minimally invasive gynecologic surgery at Florida Hospital, Celebration. She serves as the chief of gynecology and gynecologic surgery at Northwestern Medicine, overseeing surgical quality and patient safety. She is also the founder and director of the P2P Network, a physician peer support program, that provides emotional first aid for physicians experiencing professional burnout at Northwestern Medicine. She is an executive leadership coach certified through Northwestern’s School of Education and Social Policy, Organizational and Leadership Coaching Certificate Program.Clinically, Dr. Chaudhari focuses on providing individualized, equitable care for patients needing minimally invasive gynecologic surgical approaches for gender affirmation, abnormal uterine bleeding, uterine fibroids, and endometriosis. Her research interests are in surgical education, simulation and coaching, physician well-being and burnout, and leadership coaching for physicians and healthcare leaders.