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Although birth control pills typically reduce or eliminate period pain, some people report cramping as a side effect. Cramping caused by oral contraceptives is usually temporary.
Most birth control pills are combination pills. This means that they contain synthetic forms of the hormones estrogen and progesterone.
These hormones help stop pregnancy by preventing ovulation, the development and release of an egg from your ovaries. The hormones also thicken your cervical mucus, making it more difficult for sperm to reach an egg. The lining of the uterus is also altered to prevent implantation.
The minipill only contains progestin, a synthetic form of progesterone. It also stops ovulation, alters the cervical mucus, and changes the uterine lining.
Taking your pills properly not only helps prevent pregnancy but can also help keep cramps at bay. If you miss pills or take them late, hormone levels may change and trigger breakthrough bleeding and mild cramping.
While some people only experience occasional menstrual cramping, others experience debilitating cramps every period.
Menstrual cramps are triggered by the secretion of prostaglandins from glands in the uterus. Prostaglandins are also the hormones that trigger uterine contractions. The higher your levels of this hormone, the more severe your menstrual cramps will be.
Birth control pills may be prescribed to help relieve painful menstrual cramping.
According to a literature review published by Cochrane Library in 2009, birth control pills are thought to reduce the amount of prostaglandins. This, in turn, is said to reduce blood flow and cramping. The pills also suppress ovulation, which prevents any related cramping.
A randomized controlled trial found that combination birth control pills taken cyclically, or 21 days on and seven days off, and those taken continually were both effective in treating primary menstrual pain.
Still, taking seven days off may lead to breakthrough bleeding and associated cramping. Taking the pills continuously offers better results in the short term.
Cramping may also be the result of an underlying medical condition. Conditions that cause painful menstrual cramping include:
- Endometriosis. Endometriosis is a condition in which the lining of the uterus implants outside the uterus. Learn more about it here.
- Fibroids. Fibroids are noncancerous growths in the uterine wall.
- Adenomyosis. In this condition, the lining of the uterus grows into the uterine muscle wall.
- Pelvic inflammatory disease (PID). This pelvic infection is often caused by sexually transmitted infections (STIs).
- Cervical stenosis. Not to be confused with cervical spinal stenosis, this is a narrowing of the opening of the cervix. This narrowing obstructs menstrual flow.
Most people adjust to birth control pills with few side effects. Side effects that may occur include:
- headaches
- irregular periods, which may or may not be accompanied by cramping
- nausea
- enlarged breasts
- breast pain
- weight loss or gain
Less common side effects of the birth control pill include:
Although some people report mood swings and depression while taking birth control pills, research hasn’t established a definite link.
Progestin-only pills are thought to have fewer side effects than combination pills.
Before using birth control pills to relieve cramps, you may want to try nonhormonal treatments such as:
- taking over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen
- placing a hot water bottle or heating pad on your pelvic area to relax muscles
- taking a warm bath
- performing gentle exercises, such as yoga or Pilates
Most people experience little to no cramping while taking birth control pills. Some have mild cramping for a cycle or two as their bodies adjust to hormone changes, but this often decreases or stops completely.
Call your doctor if you have sudden or severe cramping or pelvic pain. This is especially true if the pain or cramping is accompanied by:
- bleeding
- nausea
- vomiting
- dizziness
- a fever
These may be symptoms of ectopic pregnancy or a ruptured ovarian cyst.
A Chinese study found that birth control failure increases the risk of ectopic pregnancy. There’s also an increased risk of ovarian cysts while taking progestin-only pills.
It’s possible to get cramps on birth control, especially in the first cycle or so. For most people, however, birth control pills ease cramping or stop it altogether. When they’re taken properly, birth control pills shouldn’t cause cramping or make it worse.
You should talk to your doctor if you experience persistent or severe cramping.