From the FDA Drug Label
For the treatment of dysmenorrhea, beginning with the earliest onset of such pain, ibuprofen tablets should be given in a dose of 400 mg every 4 hours as necessary for the relief of pain. Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. In controlled analgesic clinical trials, doses of ibuprofen tablets greater than 400 mg were no more effective than the 400 mg dose
The best treatment for dysmenorrhea (menstrual cramps) is ibuprofen. The recommended dose is 400 mg every 4 hours as necessary for relief of pain. This is based on the drug label information for ibuprofen tablets 1.
- Key points:
- The dose of ibuprofen for dysmenorrhea is 400 mg every 4 hours.
- Doses greater than 400 mg were not more effective than the 400 mg dose in controlled clinical trials.
- Ibuprofen tablets may be given at the earliest onset of pain for relief of dysmenorrhea. 1
From the Research
The best treatment for dysmenorrhea (menstrual cramps) is nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium (Aleve) at 440 mg, which has been shown to be more effective than acetaminophen in providing significant, long-lasting pain relief. According to a double-blind, randomized, single-dose, crossover study published in 2019 2, naproxen sodium was more effective than acetaminophen in reducing pain intensity and providing relief from menstrual cramps.
Key Findings
- Naproxen sodium (440 mg) was found to be more effective than acetaminophen (1000 mg) in providing pain relief over 12 hours 2.
- The study found that naproxen sodium was significantly more effective than acetaminophen in reducing pain intensity, with a least-squares mean difference of 4.31 (p < 0.001) 2.
- Naproxen sodium was also found to be more effective than acetaminophen in providing relief from menstrual cramps, with 70.6% of subjects rating naproxen sodium as good-to-excellent compared to 63.1% for acetaminophen (p = 0.002) 2.
Treatment Options
- NSAIDs such as ibuprofen (Advil, Motrin) at 400-600 mg every 6-8 hours or naproxen sodium (Aleve) at 220-550 mg every 12 hours, started at the first sign of menstrual pain or bleeding and continued for 2-3 days as needed.
- Hormonal contraceptives like birth control pills, patches, or hormonal IUDs can also provide long-term relief by thinning the uterine lining and reducing prostaglandin production.
- Non-medication approaches that may help include applying heat to the lower abdomen, regular exercise, stress reduction techniques, and dietary changes such as reducing caffeine and salt intake.
Safety and Efficacy
- While NSAIDs are generally effective in reducing menstrual cramp pain, they can have side effects such as stomach irritation and should be taken with food to minimize this risk.
- Acetaminophen (Tylenol) at 500-1000 mg every 6 hours can be used as an alternative, though it may be less effective.
- It's essential to consult a healthcare provider if pain remains severe despite these treatments to rule out underlying conditions like endometriosis or uterine fibroids.