From the Guidelines
To alleviate dysmenorrhea, consider using hormonal birth control methods, such as combined oral contraceptive pills (COCs), which can reduce the thickness of the uterine lining and decrease prostaglandin production, thereby reducing pain and discomfort 1.
Methods to Alleviate Dysmenorrhea
- Take over-the-counter pain relievers like ibuprofen (Advil, Motrin) 200-400mg or naproxen sodium (Aleve) 220-440mg at the first sign of discomfort, and continue every 4-6 hours as needed throughout your period.
- Apply heat to your lower abdomen using a heating pad or hot water bottle for 15-20 minutes at a time.
- Stay physically active with light exercise like walking or yoga, which releases endorphins that counteract pain.
- Stay hydrated by drinking 8-10 glasses of water daily and reduce salt, caffeine, and alcohol intake, which can worsen bloating and discomfort.
- Consider dietary changes like increasing anti-inflammatory foods (fruits, vegetables, omega-3 fatty acids) and reducing processed foods.
Hormonal Birth Control Methods
- COCs can be started on the same day as the visit (“quick start”) in healthy, nonpregnant adolescents, and patients should be counseled to use a backup method (ie, condoms or abstinence) for at least the first 7 days for contraceptive efficacy 1.
- Extended or continuous cycles of COCs may be useful for treating medical conditions such as severe dysmenorrhea, endometriosis, and dysfunctional or heavy menstrual bleeding 1.
- Other hormonal birth control methods, such as the contraceptive vaginal ring and transdermal patch, may also be effective in reducing dysmenorrhea symptoms.
Selective Progesterone Receptor Modulators (SPRMs)
- SPRMs, such as ulipristal acetate (UPA), have been shown to be effective in improving quality of life, decreasing menstrual blood loss, and achieving amenorrhea in patients with uterine fibroids 1.
- UPA has been recommended in clinical practice guidelines as an option for preoperative management of uterine fibroids, and its use has been associated with a reduction in fibroid volume and symptoms 1.
From the FDA Drug Label
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. The method to alleviate dysmenorrhea is to take ibuprofen tablets in a dose of 400 mg every 4 hours as necessary for the relief of pain, starting from the earliest onset of pain 2.
- The recommended dose is 400 mg every 4 hours.
- Treatment should begin with the earliest onset of pain.
- Ibuprofen tablets are the specified medication for this treatment.
From the Research
Methods to Alleviate Dysmenorrhea
The following methods can be used to alleviate dysmenorrhea:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (COX-2)-specific inhibitors to inhibit prostaglandin production 3, 4, 5, 6
- Oral contraceptives to improve pain control 3, 4, 5
- Hormonal manipulation or surgery for endometriosis 3, 5
- Alternative treatments such as:
- Surgical treatment in rare cases of severe dysmenorrhea refractory to treatment 4
Pharmacological Treatments
Pharmacological treatments for dysmenorrhea include:
- NSAIDs (e.g. ibuprofen, etoricoxib, celecoxib) 3, 4, 5, 6
- COX-2-specific inhibitors (e.g. etoricoxib, celecoxib) 3, 6
- Oral contraceptives (e.g. combined oral contraceptives) 3, 4, 5
- Gonadotropin-releasing hormone (GnRH) agonists 5
- Danazol 5
- Aromatase inhibitors 5
- Elagolix (a new oral GnRH antagonist) 5
Non-Pharmacological Treatments
Non-pharmacological treatments for dysmenorrhea include: