Drugs & Updates

Effect of Birth Control Pills on Cramping

A few women complain about developing cramps as a side effect of taking birth control pills. However, the pills typically help in reducing cramps. Cramps occur as a result of hormonal changes and are therefore temporary.

How do birth control pills work?

Most birth control pills are combination pills. They contain synthetic forms of hormones like estrogen and progesterone. These hormones are responsible for preventing ovulation, development and release of an egg from the ovaries. These hormones thicken the cervical mucus, thus preventing the entry of sperms into the egg. The lining of the uterus is altered to avoid pregnancy.

Taking the birth pills in time helps to prevent pregnancy and also helps to keep the cramps at bay. However, if one misses the tablets or takes them late, hormonal levels may get disturbed, leading to breakthrough bleeding and mild cramping.

How can birth control pills affect cramps?

Some people may experience menstrual cramping occasionally, while others experience debilitating cramps every period. Menstrual cramps are triggered by the secretion of chemicals like prostaglandins from the uterus. Prostaglandins trigger uterine contractions. The severity of the menstrual cramps increases with the concentration of prostaglandins.

Birth control pills may be prescribed to provide relieve painful menstrual cramps. According to a literature review published in Cochrane Library in 2009, it was concluded that birth control pills could reduce the secretion of prostaglandins in the body. This, in turn, reduces the blood flow and onset of cramps. In addition, the medications suppress ovulation and thus prevent the onset of cramps. Similarly, a randomized control trial concluded that birth control pills are taken cyclically, or 21 days on and seven days off. Those taken continuously were equally effective in treating primary menstrual pain.

Still, taking seven days off can cause breakthrough bleeding and cramps. Taking the pills continuously can offer better results in the short term.

Other causes of menstrual cramps

Cramps can occur as a result of several underlying medical conditions. A few examples are:-

  • Fibroids: Fibroids are benign growth in the uterus.
  • Endometriosis: Endometriosis is a condition in which the lining of the uterus implants outside the uterus.
  • Adenomyosis: In this condition, the uterine lining lies in the uterine muscle wall.
  • Pelvic inflammatory disease It is usually caused by sexually transmitted diseases
  • Cervical stenosis In cervical stenosis, the opening of the cervix becomes narrow. This narrowing obstructs menstrual flow.

Side effects of birth control

A few side effects associated with birth control pills are:-

  • Headache
  • Irregular menstrual cycle
  • Nausea
  • Enlargement of breasts
  • Breast pain
  • Weight loss

Less common side effects are:-

  • Blood clots
  • Heart attack
  • Stroke

Treatment of cramps

To treat menstrual cramps, one need not use birth control pills as the first step. Non-hormonal treatments that can be started are:-

  • Take over-the-counter pain relievers like acetaminophen or ibuprofen.
  • Place a hot water bottle or heating pain in the pelvic area
  • Take a warm bath
  • Perform gentle exercises like yoga or pilates.

When should you worry about cramping?

One should inform the doctor if they experience any of the following symptoms:-

  • Bleeding
  • Nausea
  • Vomiting
  • Dizziness
  • Fever

These may be the symptoms of ectopic pregnancy or ruptured ovarian cyst.

A Chinese study found that birth control failure increases the risk of ectopic pregnancy. There is also an increased risk of ovarian cysts while taking progestin-only pills.


One may experience cramps after taking birth control pills, especially in the first cycle. However, for most women, birth control pills ease cramping. One should talk to the doctor if one experiences persistent or severe cramping.


Tuhina Mishra

Dr. Tuhina Mishra completed her MBBS from Grant Government Medical College in the year 2021. She has published several research papers in Indian and international journals. Tuhina is a recipient of the ICMR-STS award in the year 2019. She is a staunch believer in making research an integral part of the medical curriculum. She has volunteered in several NGOs, healthcare startups, and awareness programs.

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