From the Guidelines
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most effective treatment for relieving menstrual pain, with ibuprofen and naproxen being the most commonly recommended options. According to the most recent evidence, NSAIDs such as ibuprofen (400-600 mg every 6-8 hours) or naproxen sodium (220-550 mg every 12 hours) should be started at the first sign of menstrual pain or bleeding and continued regularly for 2-3 days during menstruation 1. These medications work by inhibiting prostaglandin production, which are hormone-like substances that cause uterine contractions and pain during menstruation.
Some key points to consider when using NSAIDs for menstrual pain relief include:
- Taking them with food to minimize stomach irritation
- Starting them at the first sign of menstrual pain or bleeding for maximum effectiveness
- Continuing them regularly for 2-3 days during menstruation
- Considering alternative options, such as hormonal contraceptives like birth control pills, patches, or hormonal IUDs, if NSAIDs do not provide adequate relief
It's also worth noting that hormonal IUDs, such as the levonorgestrel IUD, can be an effective alternative for relieving menstrual pain, as they reduce the buildup of the uterine lining and decrease prostaglandin production 1. However, NSAIDs remain the first-line treatment due to their high efficacy and relatively low risk of side effects. If over-the-counter medications do not provide sufficient relief, it's recommended to consult a healthcare provider for prescription-strength options or to rule out underlying conditions like endometriosis.
From the FDA Drug Label
Controlled studies have demonstrated that ibuprofen tablets are a more effective analgesic than propoxyphene for the relief of episiotomy pain, pain following dental extraction procedures, and for the relief of the symptoms of primary dysmenorrhea In patients with primary dysmenorrhea, ibuprofen tablets have been shown to reduce elevated levels of prostaglandin activity in the menstrual fluid and to reduce resting and active intrauterine pressure, as well as the frequency of uterine contractions. Dysmenorrhea: 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.
Ibuprofen is the best medication for relief of dysmenorrhea (menstrual pain), as it has been shown to be effective in reducing symptoms of primary dysmenorrhea. The recommended dose is 400 mg every 4 hours as necessary for the relief of pain 2 2.
From the Research
Medications for Menstrual Pain Relief
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium, ibuprofen, and acetaminophen are commonly used to relieve menstrual pain 3, 4, 5, 6, 7
- A study comparing naproxen sodium and acetaminophen found that naproxen sodium was more effective in relieving menstrual pain over 12 hours 3
- Ibuprofen has also been shown to be effective in relieving primary dysmenorrhea, with a significant decrease in pain intensity after 48 hours of treatment 5
- NSAIDs work by inhibiting the production of prostaglandins, which are hormones that cause cramping abdominal pain 4, 6, 7
Comparison of Medications
- A systematic review of 80 randomized controlled trials found that NSAIDs were more effective for pain relief than placebo, but were associated with more adverse effects 7
- The review also found that NSAIDs were more effective than paracetamol for pain relief, but there was no evidence of a difference in adverse effects 7
- There is insufficient evidence to determine which individual NSAID is the safest and most effective for the treatment of dysmenorrhea 7
Safety and Efficacy
- NSAIDs are generally considered safe and effective for the treatment of menstrual pain, but women should be aware of the potential risk of adverse effects such as gastrointestinal and neurological problems 7
- The quality of the evidence for the effectiveness and safety of NSAIDs for menstrual pain relief is generally considered low due to poor reporting of study methods 7