During the two-week wait, many who are trying to conceive are on high alert waiting to feel the signs of implantation. Implantation is one of the most critical biological steps in pregnancy. Yet, surprisingly, this step often goes unnoticed.

When people aren’t trying to conceive, they’re unlikely to notice symptoms like cramping. Those actively trying to conceive are more likely to notice subtle symptoms like implantation cramping, because they’re focused on looking for them.

Identifying implantation cramping is even more challenging because the symptoms are very similar to premenstrual cramping and hormonal changes.

Even so, many women do notice twinges, sensations, cramping, and other implantation signs. Here are the most common questions about implantation cramps.

What is implantation?

After ovulation, if an egg is successfully fertilized, its cells begin to divide rapidly as it makes its way through the fallopian tubes and into the uterus. While the fertilized egg goes from a simple cell to a zygote and eventually a blastocyst, your body’s hormonal changes cause your uterine lining to thicken.

This all occurs during the luteal phase. This is the last phase in the menstrual cycle. It’s the stage that occurs after ovulation and before your period.

Be sure to read about the Luteal Phase – What Is It And How Long Does It Last? to understand more.

If the fertilized egg becomes a healthy blastocyst, it will continue its rapid growth and get ready to burrow into your uterine lining. This process is called implantation. The blastocyst quite literally implants into the lining of your uterus.

At this point, conception has occurred, and you are pregnant. However, it is still too early for any testing to pick up whether or not implantation has occurred. You will need to wait a few days longer for the very first early signs of pregnancy.

What are implantation cramps?

Throughout your menstrual cycle, you might notice twinges, sensations, and cramping. Some women notice these menstrual cramps quite often; others never have any noticeable cramping.

Some women experience cramping with ovulation and during the time before their period (premenstrual cramps). If you’re prone to PMS, you’re more likely to experience menstrual cramps.

What exactly are implantation cramps? They can be described as cramping felt around the time of implantation. However, because uterine cramping can be caused by a number of things, you can’t be sure, until later, whether the cramping is associated with the implantation of the fertilized egg. Also, many women feel very mild cramping or don’t feel any cramps at all.

When does implantation cramping occur?

If you feel implantation cramps about six or so days after ovulation, it is possible the cramping is associated with the implantation process, a sign of pregnancy. The timing of implantation, however, can vary. Many women report ongoing cramping, twinge sensations, and other early signs, as the fertilized egg burrows and continues to grow.

It’s hard to know for sure whether cramping is associated with implantation or with typical cyclical changes. Many women, for example, feel cramping around ovulation and again in the days leading up to their period.

If you feel cramps around 6-12 days post ovulation and you later have a positive at-home pregnancy test, you can assume those cramps were signs of implantation.

How long do implantation cramps last?

Each woman is unique and experiences different patterns of cramping and sensations that can vary throughout the cycles. Some women never experience cramping while others experience frequent or sporadic cramping.

Some women conceive and do not experience implantation cramps until they miss a period or have a positive home pregnancy test. Whether there really weren’t any implantation symptoms or they just weren’t as hyperaware of them as someone trying to conceive, we can’t know for sure.

If sensations are implantation cramps and not associated with other things, they are likely to last about 1-3 days. This can vary from woman to woman and even from pregnancy to pregnancy. If you’ve been pregnant in the past but weren’t actively looking for symptoms, you might not have noticed any cramping.

If you’re actively trying to conceive, you’re likely to notice your first and last twinge between ovulation and missed period or positive pregnancy test.

Implantation cramps can overlap with early pregnancy cramping, which also makes it difficult to know for sure how long they last.

As soon as implantation occurs, your body will begin to release hCG. This is a pregnancy hormone that tells your uterus to prepare for pregnancy. It can trigger stretching and growing cramps throughout early pregnancy.

You can read Cramps During Pregnancy – What You Need To Know to learn more about cramping.

What do implantation cramps feel like?

Every woman will feel implantation cramps differently. Some might not experience them at all. Those who notice implantation cramping are likely to experience a few different sensations, such as:

A light pricking or pulling feeling
Dull localized aching, felt in the lower abdomen/pelvic area
Premenstrual-like cramping and tenderness
A sensation similar to intestinal gas but felt within the pelvic region
They can also be accompanied by other signs of pregnancy, such as extreme tiredness or even morning sickness.

The feeling can vary significantly, from absolutely nothing to cramping with a bit of pain. Implantation cramping occurs very early, at a time when the egg that has been fertilized is super tiny – just the size of a pinhead. A localized sensation about the time of implantation is rarely a concern.

However, if you continue to have very localized pain early in pregnancy, be sure to get in touch with your midwife or provider. Cramping is very typical, but severe localized cramping could be indicative of an early ectopic pregnancy.

Some women just ‘feel’ they’re pregnant the moment they conceive and they don’t need pregnancy tests to know they’re pregnant. Pregnancy tests might help them by confirming something they already knew. There are some subtle signs of pregnancy some women feel before the level of human chorionic gonadotropin hormone (the one detected in pregnancy tests) rises.

Are implantation bleeding and cramping in early pregnancy normal?

If you’re in the ‘trying to conceive’ phase and joining forums and chat groups, you’re likely to be aware of implantation bleeding. As well as looking for implantation cramping, women trying to conceive often look for implantation bleeding.

Like cramping, implantation bleeding isn’t something everyone experiences. Bleeding during the luteal phase can also occur for a variety of reasons.

Bleeding at this time can’t be confirmed as implantation bleeding until after a positive pregnancy test. In fact, some research suggests the bleeding isn’t necessarily from implantation at all and could be coincidental.

Whatever the reason, you can rest assured that light bleeding, or lack of bleeding, doesn’t rule pregnancy in or out. You needn’t worry; these are very early signs that only some women experience.

As hard as it is, just wait until you can confirm pregnancy via a test; it’s the only way to know for sure if you’re actually experiencing pregnancy symptoms.

That’s easier said than done. We all know it’s hard not to speculate. Still curious?

You can read Early Signs Of Pregnancy – 9 Signs You May Be Pregnant to learn more.

Implantation cramps vs ovulation cramps

Both types of cramping might feel very similar. They could even feel similar to period cramps.

The main difference is the timing; ovulation cramps happen around ovulation. If you experience ovulation cramps you should be familiar with them. Implantation cramps, if noticeable, are felt between 6 and 14 days after ovulation.

On the other hand, if you hardly ever experience ovulation cramps but you experience cramps (mild cramping or intermittent cramping) in your lower abdomen around the time you should get your period this could very likely be implantation pain or cramps.

Implantation cramps or menstrual cramps?

One of the most challenging things about the two-week wait is wondering what any twinges or symptoms could mean. During a normal luteal phase, your hormones rise and then slowly drop. In a luteal phase when conception occurs, hormones rise but don’t drop down; there’s also the added hormone, hCG.

Whether you are pregnant or not, the end of your luteal phase will consist of hormonal fluctuations.

In both cases you might experience:

Light to moderate cramping
Spotting or light bleeding
Breast tenderness
Mood swings
Appetite changes
Nausea.

There might also be other symptoms. How can you tell the difference between implantation cramps and menstrual cramps? Usually, the only way to know is to have a pregnancy test around the time of your expected period.

Women who are very aware of their cycles might also chart and track their basal body temperature and notice some subtle differences.

For example, if cramping occurs in the time frame for implantation (about 6-12 days after ovulation) and there hasn’t been a dip in their basal body temperature, they might assume their cramps are from implantation.

Some women who have never had premenstrual cramping experience some kind of cramping during cycles in which they conceive. If you’re very familiar with your body and your cycle, you might be able to tell the difference between your typical follicular phase symptoms and those that often occur days before your period during those cycles where you conceive.

There are some who say that implantation cramps feel more localized. Their premenstrual and period cramps, on the other hand, are more generalized, and felt all over their uterus, and even include pelvic muscle discomfort.

Implantation cramps on one side

Implantation pain can sometimes be felt on only one side. This can happen because the uterus is slightly tilted, which is completely normal and is influenced by the different thicknesses of the uterine muscles and their distribution around the uterine wall. It might also mean that one side of your body is more sensitive than the other.

Although it’s normal for implantation cramps to happen on one side, we need to be aware of the possibility of an ectopic pregnancy.

The main difference between implantation cramps and an ectopic pregnancy is the pain. Implantation cramps feel like… well, cramps, but the pain experienced in an ectopic pregnancy is very intense.

If you think you might be in your early pregnancy and you feel severe cramping on one side, probably accompanied by heavy bleeding (this bleeding might also appear as light bleeding because most of the bleeding is concealed in the abdomen), make sure you contact your healthcare provider straight away, as an ectopic pregnancy requires emergency treatment. An ectopic pregnancy accompanied by severe pain usually means the bursting of a fallopian tube.

Implantation cramping and bleeding

When the fertilized egg attaches to the endometrium, the inner uterine lining, there could be some vaginal bleeding. This can range from light spotting to mild bleeding. Although we can consider implantation bleeding normal, heavy bleeding isn’t usually one of the signs of implantation.

Heavy bleeding around the time of implantation is more likely caused by an early miscarriage. Make sure you seek professional medical advice if you consider you’re bleeding too much, compared with your normal menstrual cycle bleeding.

When can I confirm implantation cramps?

Unfortunately, at the time you’re experiencing implantation cramps, you won’t be able to know for sure. On the days before your period is due, a pregnancy test is the only way to confirm that the sensations you felt were an early sign of pregnancy: implantation cramps.

Given that there are many potential causes of cramping – even if it occurs around the time of expected implantation – it’s hard to confirm the real cause.

If you have your period and a negative pregnancy test, chances are all the twinges and cramps you felt were typical of the hormonal changes during your luteal phase. If you’re trying to conceive and feel like you’ve noticed a lot of signs and symptoms, a negative test can be a bit upsetting.

Rest assured that it takes a healthy couple 6-12 cycles to conceive. Although that might sound daunting, it’s typically your body just waiting for the perfect fertilized and mature egg to implant properly.

Wondering how soon you can take a pregnancy test? Be sure to read When To Take A Pregnancy Test For An Accurate Result to learn more.

Resources:

Harville, E.W., et al. “Vaginal Bleeding in Very Early Pregnancy.” OUP Academic, Oxford University Press, 1 Sept. 2003, academic.oup.com/humrep/article/18/9/1944/708284.

Hasan, Reem, et al. “Patterns and Predictors of Vaginal Bleeding in the First Trimester of Pregnancy.” Annals of Epidemiology, U.S. National Library of Medicine, July 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2884141/.