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.
Most Effective Medication for Dysmenorrhea:
- Ibuprofen is the most effective medication for dysmenorrhea, as it has been shown to be more effective than propoxyphene in relieving symptoms of primary dysmenorrhea 1.
- Key Benefits: reduces prostaglandin activity, intrauterine pressure, and frequency of uterine contractions.
- Comparison to Mefenamic Acid: while mefenamic acid was also shown to be effective in treating primary spasmodic dysmenorrhea, the direct comparison between ibuprofen and mefenamic acid is not provided in the given drug labels 2.
From the Research
For severe menstrual pain, diclofenac potassium is the most effective medication, as evidenced by a 2014 study 3 that showed significant reduction in menstrual pain intensity across 24 hours. The study found that diclofenac potassium, administered at a daily recommended dose of 150 mg, significantly reduced menstrual pain intensity compared to placebo, with no woman requiring rescue medication when taking diclofenac potassium. Some key points to consider when using diclofenac potassium for severe menstrual pain include:
- Taking the medication at set intervals across the first 24 hours of menstruation
- Starting with a dose of 50 mg and taking additional doses as needed, up to a maximum of 150 mg per day
- Combining diclofenac potassium with other treatments, such as heat therapy or gentle exercise, for optimal relief
- Consulting a healthcare provider if pain remains severe despite treatment, as it could indicate underlying conditions like endometriosis or fibroids. Other studies, such as those on ibuprofen 4, 5 and naproxen 6, also support the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for severe menstrual pain, but the 2014 study on diclofenac potassium 3 provides the most recent and highest-quality evidence. Additionally, a 1990 study on transcutaneous electrical nerve stimulation (TENS) 7 found that TENS can be an effective non-medication method for managing primary dysmenorrhea, but this treatment may not be as widely available or convenient as NSAIDs like diclofenac potassium.