Menstrual cramps affect millions of women worldwide, causing significant discomfort and disruption to daily life. Joanna Lewis, PharmD, MBA, 340B program director at Baptist Health, highlighted comprehensive strategies for managing menstrual pain, focusing on medication, supplements, and patient education.
Non-steroidal anti-inflammatory drugs (NSAIDs) emerge as the primary treatment for menstrual cramps, according to Lewis. Medications like ibuprofen (Advil) and naproxen (Aleve) work by reducing prostaglandins, the chemicals responsible for uterine contractions. These medications not only alleviate pain but also address associated symptoms like inflammation. Dosage recommendations are critical. Ibuprofen is typically prescribed at 400 mg every 6 hours, while naproxen is recommended at 220 milligrams every 8 to 12 hours. She stressed the importance of taking medication at the first sign of cramps, and some patients even begin treatment one to two days before their expected period.
However, NSAIDs aren’t without risks. Potential adverse effects include stomach upset, nausea, heartburn, and, in some cases, increased bleeding risk. Patients with kidney disease, heart failure, or active ulcers, or those on anticoagulants, should consult health care professionals before use. Complementing pharmaceutical interventions, certain supplements show promise in managing menstrual pain. Magnesium can help relax uterine contractions, while omega-3 fatty acids reduce prostaglandin production. Vitamins B1 and E, along with zinc, have demonstrated potential in alleviating menstrual discomfort. Lewis cautions that supplements require consistent daily intake and may take 1 to 2 menstrual cycles to show significant results. Alternative OTC options include combination products like Midol Complete and Pamprin Multi-Symptom, which address multiple menstrual symptoms, including fatigue and irritability. Lidocaine patches offer another localized pain relief method.
“The first thing a pharmacist needs to do is educate the patient on how to take the medication,” Lewis said. “It’s best for these NSAIDs to take the medication as soon as you feel the first sign of cramps. It really works better when you get ahead of the pain.”