Not only do women have to deal with periods, but now there is a phantom period. For many women, being able to predict their period is an essential aspect of their monthly planning routine. Whether it’s for family planning or wanting to know whether we need to pack tampons for vacation (VIP detail), having a regular period can be an important timestamp.
However, more women are reporting what’s being unofficially called a “phantom period” — meaning, they’re experiencing the signs of an upcoming period, but the period itself never comes. What does this strange phenomenon mean for your health? We’re uncovering the potential causes of having cramps but no period and what you should do about it.
What is a Phantom Period?
During your period, the lining of your uterus, known as the endometrium, is shed (as long as you’re not pregnant). This process is a part of the menstrual cycle, which is a regular, monthly series of changes that occur in a woman’s body in preparation for the possibility of pregnancy. At least, this is what happens during the normal, expected process of having a period.
The phantom period, on the other hand, is described as having pretty much all the symptoms of PMS without the period itself. Many women report experiencing the things they would normally expect before menstruation actually occurs, like:
In other words, there’s every reason to believe that Aunt Flo is coming to town that month. But for whatever reason, she ends up driving right by, leaving you confused, annoyed and perhaps concerned.
Potential Reasons Behind Having Cramps but No Period, The Phantom Period
Okay, so you’ve got cramps but no period. What gives? According to women’s health experts, there could be a few things going on.
It’s important to get to the bottom of recurring irregular periods, as the menstrual cycle is considered the “fifth vital sign” for evaluating women’s health, along with blood pressure, body temperature, heart rate, and respiratory rate. The most likely underlying culprits of phantom periods may be physical, psychological, or both.
Your period is a complicated dance of hormonal fluctuations that tell your body what to do every month. But if something is disrupting the flow of things, then it can quite literally disrupt the flow of things. Some of the underlying physical triggers of a phantom period can include:
Lack of Ovulation
Not ovulating, a condition known as anovulation, can indeed explain the presence of period-like symptoms without the occurrence of actual menstrual bleeding. During ovulation, an egg is released from the ovary, which is followed by other phases of the menstrual cycle, like estrogen and progesterone production. However, when ovulation doesn’t happen, this can lead to hormonal imbalances that appear as period symptoms without bleeding.
Hysterectomy with Ovarian Preservation
Women have hysterectomies for a number of reasons. A hysterectomy with ovarian preservation involves the surgical removal of the uterus while leaving the ovaries intact. The uterus is responsible for menstruation, so when you don’t have one, you won’t have a period anymore. However, when the ovaries are preserved, the hormonal function continues so that menopause doesn’t start immediately. This explains why you might have similar symptoms with no period.
Effects of Hormonal Medications
The use of birth control in the form of intrauterine devices (IUDs) or oral contraceptives can lead to an irregular period when you first begin using them. The irregular levels or imbalances of estradiol and progesterone can cause a lack of ovulation and therefore no period, despite other symptoms.
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by an excess of androgens (male hormones) like testosterone, and it often involves insulin resistance. The hormonal imbalances associated with PCOS can result in period-like symptoms without the typical menstrual bleeding.
Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. While the primary symptom of endometriosis is pelvic pain, it can also lead to period-like symptoms but without bleeding.
Perimenopausal Hormonal Changes
If you’re approaching the age of perimenopause, it’s possible that your lack of period could be a sign that your hormones are starting to shift in that direction. During perimenopause, estrogen levels may rise and fall irregularly, leading to changes in the menstrual cycle.
Progesterone, another hormone involved in the menstrual cycle, may also become erratic. The relationship between estrogen and progesterone becomes imbalanced, contributing to irregular periods.
Eating disorders like anorexia nervosa or bulimia can have significant effects on hormonal balance. Changes in body weight and nutritional status can disrupt reproductive function, potentially causing period-related symptoms even if menstruation is irregular or absent.
Pregnancy can cause all sorts of weird symptoms, especially in the beginning. Plus, you’re not going to have a period if you’re expecting. The hormonal changes associated with pregnancy, particularly the presence of hCG (Human Chorionic Gonadotropin), prevent the drop in progesterone levels that would typically lead to a period.
This hormonal environment helps maintain the uterine lining and sustains the conditions necessary for the successful development of the embryo and fetus. If you think you might be pregnant, take a test to confirm.
It should come as no surprise that we’re living in a high-stress time that seems to value busyness and full schedules. With this way of living can come a heavy mental and emotional burden. The mind is a powerful thing. Left unmanaged, chronic stress, anxiety, and depression can ultimately affect physiological processes like menstruation.
Stress and Anxiety
High levels of stress and anxiety can impact your endocrine system, including the release of hormones that regulate the menstrual cycle. Chronic stress may lead to irregularities in ovulation and the menstrual cycle. This might result in symptoms like bloating, cramping, and breast tenderness without actual menstruation.
Emotional Distress or Depression
Grief, trauma, or significant life changes, can disrupt the regularity of the menstrual cycle. Depression and emotional upheaval may affect hormonal balance and lead to period-like symptoms with a period.
What To Do
When you’re experiencing a phantom period, it’s important first not to panic. Missing a period, or experiencing irregular periods from time to time, is not uncommon for most women. If it continues, further digging may be warranted.
First, if it’s possible you could be pregnant, taking a pregnancy test makes sense. If that confirms you’re not pregnant, then it’s a good idea to speak to your healthcare provider, especially if you continue to experience phantom periods in subsequent months.
There could be several underlying factors involved, such as the physical and psychological triggers discussed above, as well as potential endocrine conditions to consider. Your provider can help you evaluate what might be contributing to your phantom periods.
In the meantime, there are things you can do as part of your everyday routine to help support your reproductive health and menstrual regularity. Consider the following ideas:
- Practice stress management. Things like yoga, stretching, mindful meditation, journaling, art, nature walks, and listening to calming music can help alleviate stress and prevent it from building up.
- Seek mental health support. Therapy can be an invaluable tool for working through emotional distress, anxiety, depression, and grief that can manifest into physical symptoms. Leaning on your community is great too, but professional therapists can help you make sustainable changes to support your mental wellness.
- Eat a healthy diet. Eating a nutrient-dense diet that emphasizes fruits, vegetables, whole grains, legumes, nuts, seeds, and lean proteins (and minimizes added sugars and processed meats) is one of the best things you can do for your health. These foods provide an array of vitamins, minerals, fiber, and antioxidants that help you thrive and support premenstrual symptom management and regularity.
- Move your body. Regular exercise is important for reproductive and overall health. While the mechanisms aren’t well understood, physical activity has metabolic and hormonal benefits that likely support a healthy menstrual cycle.
- Supplement. Adding certain supplements to your daily routine is an easy way to help support menstrual health. For example, HUM Private Party® is a potent vaginal probiotic + cranberry supplement to help balance the vaginal microbiome and promote optimal urinary tract function. Another option is HUM SOS PMS Gummies, which combine clinically-tested chasteberry extract, agnusides, vitamin B6, and cranberry for PMS symptom relief, healthy hormonal balance, and urinary tract health.
Phantom Period Takeaway
Talking about our periods is no longer taboo, thankfully. With more women reporting phantom periods, it helps normalize talking about the abnormalities many of us experience at any given month. While missing your period occasionally isn’t uncommon, that doesn’t mean it’s not worth investigating.
If you continue to have phantom periods, there could be many factors involved. Confirm first that you’re not pregnant, consult with your healthcare provider, and be sure to incorporate everyday lifestyle habits that support menstrual regularity and overall health.