Although some women report cramping as a side effect of birth control pills, the pills typically help reduce or eliminate period pain. When cramping occurs, it’s usually temporary and related to hormone changes. Learn why this happens and what you can do about it.

How Birth Control Pills Work

Most birth control pills are combination pills. These pills contain synthetic forms of the female hormones estrogen and progesterone. These hormones help stop pregnancy by preventing the development and release of an egg from your ovaries, or ovulation. The hormones also thicken your cervical mucus. This makes it more difficult for sperm to reach an egg. The lining of the uterus is also altered to prevent implantation.

A progestin-only pill known as “the minipill” also stops ovulation, alters 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.

The Connection Between Birth Control Pills and Cramps

While some women only experience occasional menstrual cramping, others experience debilitating cramps every period.

The secretion of prostaglandins from glands in the uterus triggers menstrual cramps. These are hormones that trigger uterine contractions. The higher the levels of this hormone, the more severe your menstrual cramps will be.

Home Remedies for Menstrual Cramps

Birth control pills may be prescribed to help relieve painful menstrual cramping. According to a review published in Cochrane Library, birth control pills are thought to reduce the amount of prostaglandins. In turn, this 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 withdrawal bleeding and associated cramping. Taking the pills continuously offers better results in the short term.

Can Anything Else Cause Cramps?
Cramping may also be the result of an underlying medical condition. Conditions that cause painful menstrual cramping include:

  • endometriosis, which is a condition in which the lining of the uterus implants outside the uterus
  • fibroids, or noncancerous growths, in the uterine wall
  • adenomyosis, which is a condition in which the lining of the uterus grows into the uterine muscle wall
  • pelvic inflammatory disease, which is a pelvic infection often caused by sexually transmitted diseases
  • cervical stenosis, which is a narrowing of the cervical opening that obstructs menstrual flow

Other Side Effects of Birth Control

Most women 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:

  • blood clots
  • a heart attack
  • a stroke

Although some women 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.

How to Treat Cramping

Before using birth control pills to relieve cramps, you may want to try non-hormonal treatments such as:

  • taking over-the-counter 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

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When to Worry About Cramping

Most women 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. One report found the incidence of ectopic pregnancy increases slightly with oral contraceptive use. There’s also an increased risk of ovarian cysts while taking progestin-only pills.

The Takeaway

It’s possible to get cramps on birth control, especially in the first cycle or so. For most women, birth control pills ease cramping or stop it altogether. When they’re taken properly, birth control pills shouldn’t cause cramping or make cramping worse. You should talk to your doctor if you experience persistent or severe cramping.

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