November 27, 2015
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Menstrual Cramps and PMS Medication Guide (cont.)

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What is the treatment for common menstrual cramps (primary dysmenorrhea)?

Treatment options vary and each woman needs to find a treatment that works best for her. Non-drug measures that may help include adequate rest and sleep, regular exercise (especially walking), and smoking cessation. Some women find that abdominal massage, yoga, or orgasmic sexual activity can help. A heating pad applied to the abdominal area may also relieve the pain.

For mild menstrual cramps, over-the-counter (OTC) aspirin and acetaminophen (Tylenol), or acetaminophen plus a diuretic (such as Diurex MPR, Midol, Pamprin, Premesyn) may help. However, aspirin has a limited effect in curbing the production of prostaglandin and is only useful for mild cramps. For moderate menstrual cramps, the nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful. The NSAIDs are more effective than aspirin in inhibiting the production and action of the prostaglandins. NSAIDs that are available OTC are:

  • ibuprofen (Advil, Midol IB, Motrin, Nuprin, and others);
  • naproxen sodium (Aleve, Anaprox); and
  • ketoprofen (Actron, Orudis KT).

For optimal control of menstrual cramps, a woman should start taking a NSAID before her pain becomes difficult to control. This might mean starting medication 1 to 2 days before her period is due to begin and continuing taking medication 1 to 2 days into her period. The best results are obtained by taking one of the NSAIDs on a regular schedule rather than on an as needed basis. Therefore, ibuprofen should be taken every 4-6 hours, ketoprofen every 4-8 hours, and naproxen every 8-12 hours for the first few days of the menstrual flow.

Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel).

Medically Reviewed by a Doctor on 11/23/2015


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