Cramps are a common complaint during the menstrual cycle. A March 2014 "American Family Physician" article reports that as many as 9 out of 10 women experience menstrual cramps. The pain can be severe enough that some women miss work, school or social activities. Nonsteroidal antiinflammatory drugs, or NSAIDs, are generally the best medicines for cramps. They work well for cramps because they stop the uterus from producing inflammatory hormones called prostaglandins that can cause pain and cramps. Hormonal birth control medicines may also help relieve menstrual cramps.
Aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Menstridol) are NSAIDs available without a prescription. Acetaminophen (Tylenol) is another familiar over-the-counter pain reliever, but it is not an NSAID. A January 2010 systematic review study published by the Cochrane Library reported that NSAIDs are more effective than acetaminophen for relieving menstrual cramps. The study authors also noted there was no evidence indicating any particular NSAID was better than another at alleviating cramps. You may personally notice a difference in effectiveness among different NSAIDs for relieving your cramps, however.
Prescription NSAIDs -- such as ketoprofen, diclofenac (Voltaren, Cataflam) and indomethacin (Indocin, Tivorbex) -- are stronger than those you can buy over the counter. High-dose ibuprofen also requires a prescription. You may want to talk with your doctor about trying one of these medicines if over-the-counter NSAIDs have not given you adequate relief from your menstrual cramps.
Other Over-the-Counter Menstrual Medicines
Many over-the-counter products are available for premenstrual syndrome symptoms, including cramps, bloating and tiredness. Many of these products contain several ingredients to treat different symptoms. Common ingredients for menstrual cramps include acetaminophen, ibuprofen, naproxen and aspirin. Ingredients for other PMS symptoms include caffeine for tiredness and headache and pyrilamine or pamabrom for bloating. Read the medication label on the product to see what drugs it contains so you can avoid taking another product with the same ingredients.
Hormonal Birth Control
Hormonal birth control may help your cramps because it suppresses the release of an egg from the ovary, which is associated with menstrual cramps. Hormonal birth control is especially beneficial for women with endometriosis, a condition that occurs when uterine tissue grows outside the uterus -- often causing cyclic pain and cramps. Hormonal birth control can halt the growth of this abnormally located tissue, leading to less menstrual cramping. Hormonal birth control products typically contain a combination of estrogen and a progesteronelike drug called a progestin, or a progestin alone.
Side Effects and Cautions
Medicines that help menstrual cramps can have side effects. Side effects of NSAIDs include stomach pain, constipation, heartburn, dizziness and headache. If you have shortness of breath, chest pain, weakness on one or both sides of your body, slurred speech, or swelling of face or throat, seek immediate medical care.
Possible side effects of hormonal birth control include period changes, breast tenderness, nausea, spotting between periods, weight change and headache. Seek immediate medical attention if you have leg pain that will not go away, shortness of breath, sudden blindness, severe chest pain, severe headache, weakness in arms or legs, or yellowing of the skin or eyes.
- American Family Physician: Diagnosis and Initial Management of Dysmenorrhea
- Cochrane Database of Systematic Reviews: Nonsteroidal Anti-inflammatory Drugs for Dysmenorrhoea
- DailyMed: Seasonique - Levonorgestrel / Ethinyl Estradiol and Ethinyl Estradiol
- Food and Drug Adminstration: Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- DailyMed: Midol Complete - Acetaminophen, Caffeine and Pyrilamine Maleate Tablet
- DailyMed: Pamprin Max Menstrual Pain Relief - Acetaminophen, Aspirin and Caffeine Tablet
- Cochrane Database of Systematic Reviews: Oral Contraceptive Pill for Primary Dysmenorrhoea
- American Society for Reproductive Medicine: Noncontraceptive Benefits of Birth Control Pills
- American Family Physician: ACOG Guidelines on Noncontraceptive Uses of Hormonal Contraceptives