I have been on methyldopa for 5 years and 2 pregnancies and have high blood pressure so I feel for you. As for the meds causing the cramping, it is probably not the problem. I don't believe that is one of the side effects, I never had any problems with it during either pregnancy or in between them. I would call your ob and tell him/her what is going on. A few things to look for on this medicine though (off topic but might be useful to you), its common to feel a little light headed for a minute after standing up from sitting or lying down, if you start to feel dizzy or light headed or more tired than usual then check your blood pressure because it could be low. Likewise if you are hotter than normal, start getting headaches a lot or feel like its a little harder to breath it may be high. Methyldopa isn't exactly the best med for controlling high blood pressure but its pretty much the only one we can use and it does the job. Don't be suprised if further on your doctor adjusts your meds a few times..blood presssures change naturally at different stages of pregnancy so they'll have to adjust to that. One wonderful bonus of having a high risk blood pressure related pregnancy (gotta look for that silver lining right?!) is that you'll get a lot of extra ultrasounds to check the babies growth :) Anyway, sorry that was so long but I hope it helps you some!