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How to Distinguish an Irritable Uterus From Real Labor Contractions

Feeling twinges and light cramps down there? Here’s what could be causing your discomfort, plus what to do next.
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Updated August 31, 2024
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Expecting a little one can come with a newfound focus on everything happening in and around your belly. And, if you happen to feel twinges or cramping, it’s understandable to wonder what could be going on in there.

Before you panic and assume you’re in early labor, know this: It’s possible to have an irritable uterus. This can happen for various reasons—and it could easily be correctable or require potentially medical intervention. Here’s what you should know about uterine irritability, including how to get relief.

What Is an Irritable Uterus?

An irritable uterus is exactly what it sounds like. “Uterine irritability can feel like a slight cramping or tightening of the abdomen,” explains Megan Bernstein, MD, a health sciences clinical instructor of obstetrics and gynecology at the University of California, Los Angeles School of Medicine. “It typically feels much weaker than a contraction, and some women may not feel it at all.”

Anitra Beasley, MD, MPH, an associate professor of obstetrics and gynecology at Baylor College of Medicine, describes uterine irritability as “very low-level contractions.” She adds that symptoms of an irritable uterus are worthy of a check in with your doctor.

What Causes Uterine Irritability?

There are a few potential reasons why you might be dealing with an irritable uterus. “We’re not always sure why it happens,” says G. Thomas Ruiz, MD, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “But we know that there are a lot of situations that tend to be associated with it.”

Ruiz points out that uterine irritability is “especially common” in the heat and is linked with mild dehydration. But uterine irritability can also be associated with a urinary tract infection, like a bladder infection, he says. “The uterus can respond to the bladder infection by getting irritable,” Ruiz explains.

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There are other potential causes of uterine irritability, says Bernstein:

  • Stress
  • Physical overexertion
  • Vomiting
  • Diarrhea

“However, some patients may notice uterine irritability throughout their pregnancy without those risk factors,” she adds.

Symptoms of Irritable Uterus

Symptoms of an irritable uterus can vary from person to person. The best way to describe it is 15-second mild uterine contractions, Ruiz says. “They tend to come one after another.” Ruiz says that these contractions can be “uncomfortable, but not usually painful.”

Irritable Uterus vs. Labor Contractions

While it may be easy to confuse the two if you’ve never been in labor, an irritable uterus isn’t the same as having labor contractions. Doctors say that the big difference between the two is what’s happening with your cervix. “A labor contraction is associated with cervical changes,” Ruiz says.

Labor contractions also don’t go away, Beasley says. “Uterine irritability—what I am seeing on the monitor—most often doesn’t lead to cervical dilation,” she adds.

Irritable Uterus vs. Braxton Hicks

It can be tricky to tell the difference between an irritable uterus and Braxton Hicks contractions, Bernstein says. In case you’re not familiar with them, Braxton Hicks contractions often last between 15 and 30 seconds and may to go away or lessen when you change positions.

“Uterine irritability is more likely to be described as a light cramping sensation, whereas Braxton Hicks may feel like a whole abdominal tightening, with or without pain, similar to a labor contraction,” Bernstein says.

How to Get Relief

If you suspect that you’re dealing with uterine irritability, it’s a good idea to drink some water and then see how you feel, Ruiz says. Taking a warm shower may also help calm things down, he adds.

If you’ve been physically exerting yourself, Bernstein recommends resting, if you can. Getting plenty of sleep may also help lower the odds you’ll have uterine irritability in the future, she adds.

When to Reach Out to Your Doctor

If you’re concerned about uterine irritability, it’s a good idea to reach out to your doctor. “I cannot figure out if a patient is in labor or if there’s something else going on without talking to the patient or seeing them in person,” Beasley says. “If I can’t do that, I certainly don’t expect patients to be able to do it.”

Your doctor will likely want to give you an evaluation, monitor your uterine activity and do a urine analysis to look for signs of a bladder infection, Ruiz says. If they determine that you have a bladder infection, you may need antibiotics.

In the meantime, if you’re experiencing some mild discomfort, try to take it easy and see if some relaxation helps.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Sources

Anitra Beasley, MD, MPH, is an associate professor of obstetrics and gynecology at Baylor College of Medicine. She earned her medical degree from Baylor College of Medicine.

Megan Bernstein, MD, is a health sciences clinical instructor of obstetrics and gynecology at the University of California, Los Angeles School of Medicine. She earned her medical degree from the University of California, Irvine School of Medicine.

G. Thomas Ruiz, MD, is the lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California. He received his medical degree from University of California Irvine School of Medicine.

Learn how we ensure the accuracy of our content through our editorial and medical review process.

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