Asking for a female friend. a week prior to her period she has cramping with no blood and the cramp pain is a stabbing pain that lasts for a few minutes at a time. 5/10 pain with slight spotting . should she be concerned?

If that described pain occurs almost every month and it subsides or resolves when cycle starts, there is nothing to concern if this pain does not have much impact on her quality of life. She can use local warm compress or ibuprofen for that pain as needed. She should see a GYN doctor if pain becomes prolonged and unbearable.

Pain is a matter of concern but that can be determined by the patient. Her doctor can prescribe pills that can limit her period to once a year and may be an option if the pain is interfering with the life.