From the Guidelines
Naproxen can be used to reduce menstrual bleeding when taken at a dose of 500 mg twice daily, starting 1-2 days before the period and continuing for 3-5 days, as it inhibits prostaglandins that cause uterine contractions and increased blood flow during menstruation. According to the U.S. selected practice recommendations for contraceptive use, 2024 1, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen can be considered as a treatment option for bleeding irregularities, including heavy menstrual bleeding. The recommended treatment duration for NSAIDs is 5-7 days 1. It is essential to note that while naproxen may help reduce menstrual bleeding, it is crucial to explore underlying health conditions that may be contributing to heavy bleeding, such as interactions with other medications, sexually transmitted infections, pregnancy, thyroid disorders, or new pathologic uterine conditions 1. Some key points to consider when using naproxen for menstrual bleeding include:
- Starting the medication 1-2 days before the period and continuing through the heaviest days of bleeding
- Taking the medication with food to minimize stomach upset
- Being aware of potential side effects, such as stomach irritation, and avoiding its use if you have a history of stomach ulcers or kidney problems
- Consulting your doctor before using naproxen if you're already taking blood thinners or have bleeding disorders
- Seeking medical attention if heavy bleeding persists despite naproxen use, as it could indicate an underlying condition requiring different treatment.
From the Research
Dosage and Administration
- Naproxen can be used to reduce menstrual bleeding in women with heavy menstrual bleeding (HMB) 2.
- The dosage of naproxen used in the study was 1250 mg/day for 5 days or 500-mg loading dose, then 750 mg/day for 5 days 2.
- Naproxen was taken during 2 consecutive menstruations, and the treatment was found to be effective in reducing menstrual blood loss by 22% and 32% with low- and high-dose naproxen, respectively 2.
Efficacy of Naproxen
- Naproxen was found to be more effective than placebo in reducing HMB, but less effective than tranexamic acid, danazol, or the levonorgestrel-releasing intrauterine system (LNG IUS) 3, 4, 5, 6.
- There was no clear evidence of a difference between naproxen and other medical treatments such as oral luteal progestogen, ethamsylate, or the oral contraceptive pill (OCP) 3, 4, 5, 6.
- Naproxen was found to reduce HMB when compared with placebo, but the evidence quality was low to moderate due to risk of bias and imprecision 3, 4, 5, 6.
Comparison with Other Treatments
- Naproxen was compared with other non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid, and no evidence of a difference was found between them in reducing HMB 3, 4, 5, 6.
- Danazol was found to cause a shorter duration of menstruation and more adverse events than NSAIDs, but this did not appear to affect the acceptability of treatment 3, 4, 5, 6.
- Tranexamic acid, danazol, and LNG IUS were found to be more effective than naproxen in reducing HMB, but with more adverse events 3, 4, 5, 6.