You may have cramps before, during, and after your period. While they aren’t always a health concern, pelvic cramps may sometimes be a symptom of endometriosis or fibroids.

At some point in their lives, most people who get menstrual periods experience cramping and pain ahead of the menstrual flow and into the first few days of menstruation. Cramps may range from mild discomfort to severe pain, but several home remedies may help relieve them.

Symptoms of premenstrual syndrome (PMS) can vary widely by person, and while it’s not always the case, changes in estrogen and progesterone levels are usually the main cause of cramps and pelvic pain in the days ahead of a period.

Cramps associated with menstrual cycles are usually temporary and resolve with menstruation, or may come and go during a few days. They also respond to home remedies or over-the-counter pain relievers.

But having cramps a week before your period, or at any other time during your cycle, may also have a different cause. Here’s how to know if cramping before a period is a natural part of the cycle or may warrant a visit to a doctor.

Endometriosis

Endometriosis affects as many as 10% of people with ovaries during their reproductive years. Endometriosis means that tissue similar to that found in your uterus (endometrial tissue) grows outside your uterus on your ovaries, bowels, or abdominal cavity.

Hormonal changes during the menstrual cycle can affect the endometrial tissue, leading to pain and inflammation as much as a week before a menstrual period. In some cases, you may experience pain throughout the month, and not only ahead of your period.

Symptoms of endometriosis may include, but aren’t limited to:

Uterine fibroids

Uterine fibroids are abnormal growths in the muscle wall of your uterus. Fibroids may be small in size or grow enough to cause pain and other symptoms.

Many people who have fibroids have no symptoms, and others may feel pain or discomfort.

Symptoms of fibroids may include:

Cysts

Ovarian cysts develop on an ovary. Most cysts will resolve or go away without treatment, but some may reoccur or persist and could cause symptoms like:

  • feeling full or bloated
  • pressure around the abdominal area
  • cramps

Vomiting, fever, and severe pelvic pain require immediate medical care.

Implantation

If sperm fertilizes an egg, it’s possible to have cramps when that egg implants into your uterine wall. This usually happens close to the time a period is expected, but depending on when ovulation and conception occurred, the implantation cramping could happen as much as a week before your period.

Other symptoms of implantation may include spotting or bleeding.

Ovulation pain

Ovulation may not have any evident signs for many people, but some may feel a twinge of cramping when an egg is released.

Ovulation may also lead to watery discharge or spotting, with some ovulation pain.

Early period

Certain lifestyle changes and other factors may cause your period to come early. If your period is early, you may think you’re having cramps a week in advance, but it’s actually closer to the start of your cycle. You will likely experience other PMS symptoms too, like headaches or fatigue.

Factors that may cause a period to arrive early include:

  • weight loss
  • higher levels of stress
  • perimenopause
  • intense physical activity
  • sexual intercourse (rare)

What causes cramps?

Every month, the lining of your uterus sheds and passes through your vagina, and cramps are a result of this process.

If you’ve experienced cramps yourself, you know them when you feel them. It can feel like squeezing or intense pressure in your pelvic area, similar to a mild contraction. The medical term for period cramps is dysmenorrhea.

Some people experience intense cramping, enough to interfere with everyday activities, and others will deal with minor cramps monthly. Compounds called prostaglandins, which behave like — but are not — hormones can cause pain and inflammation as your uterus contracts, resulting in cramps.

Period cramps can be disruptive and debilitating at times, especially when they occur for as long as a week before your menstrual cycle arrives.

Here are some ways you can relieve cramps and pain using home remedies.

  • Use a heating pad or take a hot bath, which helps relax your uterine muscles.
  • Take an over-the-counter pain reliever like ibuprofen, or something specifically designed for menstrual cramps, like Midol.
  • Drink plenty of water and avoid excess salt, alcohol, and caffeine — anything dehydrating can intensify cramps.
  • Certain supplements, like calcium, magnesium, and zinc, may ease cramps.
  • Gentle movements and stretches may relieve cramps.
  • Specific yoga poses may relax your uterine muscles.

If home remedies do not help with menstrual cramps, consider asking a healthcare professional about other options like birth control pills, prescription medication, or other.

If your pain is accompanied by fever or vomiting, or if the pain is increasingly severe, you may need immediate care. It’s advisable not to wait for severe pain and vomiting to resolve itself.

If cramps are intense and persistent, or if you’re not sure if what you’re experiencing is routine menstrual pain or something else, it is highly advisable to talk with a medical professional like a primary care physician or a gynecologist.

Period cramps are caused by prostaglandins, which help your uterus contract but also cause cramping and pain in your pelvis. It’s possible to experience period cramps a week before your menstrual cycle is set to arrive, but these pelvic cramps could also be caused by something else, like endometriosis, fibroids, or ovulation pain.