From the Guidelines
For menstrual cycle-related vomiting, the most effective treatment option is ondansetron (Zofran) 4-8mg every 8 hours, as it has been shown to be effective in reducing nausea and vomiting in various studies, including those related to menstrual cycle vomiting 1.
Medication Options
When considering medication options for menstrual cycle-related vomiting, it's essential to prioritize those that have been shown to be effective in reducing nausea and vomiting. Some options include:
- Ondansetron (Zofran) 4-8mg every 8 hours, which has been shown to be effective in reducing nausea and vomiting 1
- Metoclopramide (Reglan) 10mg three times daily, which can help regulate gastrointestinal motility and reduce nausea and vomiting 1
- Promethazine (Phenergan) 12.5-25mg every 4-6 hours, which can help reduce nausea and vomiting, but may have more sedating side effects
Additional Considerations
For those whose vomiting is linked to menstrual pain, NSAIDs like ibuprofen (Advil) 400-600mg every 6 hours or naproxen (Aleve) 500mg initially followed by 250mg every 6-8 hours can help by reducing prostaglandins that cause both pain and nausea. Hormonal birth control pills may provide long-term relief by regulating hormonal fluctuations that trigger these symptoms 1. It's crucial to start medication at the first sign of symptoms rather than waiting until vomiting is severe and to stay hydrated with small sips of clear fluids. If vomiting persists for more than 24 hours, causes dehydration, or occurs with severe pain, seek medical attention as this could indicate a more serious condition.
From the Research
Medications for Menstrual Cycle Vomiting
- Menstrual cycle vomiting can be managed with various medications, including oestrogen therapy 2 and ondansetron 3, 4.
- Oestrogen therapy has been shown to be effective in treating catamenial cyclic vomiting syndrome, a condition characterized by stereotypical vomiting attacks occurring in every menstrual period 2.
- Ondansetron, an antiemetic medication, has been found to reduce the incidence and intensity of postoperative nausea and vomiting in women undergoing surgery during their menstrual cycle 3, 4.
- Metoclopramide is another antiemetic medication that has been studied as a potential treatment for nausea and vomiting in pregnancy, although the results are inconclusive 5.
- The choice of medication for menstrual cycle vomiting may depend on the individual woman's symptoms and medical history, as well as the phase of her menstrual cycle 4.
Factors Influencing Medication Effectiveness
- The phase of the menstrual cycle can affect the incidence of nausea and vomiting, with some studies suggesting that the luteal phase is associated with a higher risk of vomiting 4.
- The timing of surgery within the menstrual cycle can also impact the risk of postoperative nausea and vomiting, with some studies suggesting that surgery during the periovulatory and premenstrual periods may be associated with a higher risk 3.
- Individual differences in symptom severity and response to treatment can also influence the effectiveness of medications for menstrual cycle vomiting 6.