1. Impending episode of breakthrough bleeding--this would be confirmed by the onset of spotting.
2. Ovarian cyst--while less common in birth control pill users they still can arise. Pain with intercourse/exercise is classic for an ovarian cyst.
3. Pain from a pelvic infection (eg chlamydia or gonorrhea)--if you are both monogamous this is not likely.
4. Cramps from the bowel---there are a number of bowel infections which will prompt cramping (eg diverticulitis, gastroenteritis, etc.)
If the cramping persists or escalates see your GYN or clinic for an evaluation.
Yours,
Jane
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