Period pains: Can anti-inflammatory drugs help

Anti-inflammatory painkillers like diclofenac, ibuprofen and naproxen can help relieve severe period pain. These medications sometimes have side effects such as stomach problems.

Period pain and cramps (dysmenorrhea) are common. Most girls and women have pain of varying intensity at some point during their period. In some women the pain is so bad that they're unable to carry out their usual daily activities, like going to work or school, on one to three days every month.

In women who have bad period pains, the womb often produces too much of the chemical messenger prostaglandin. This leads to painful cramps in the lower abdomen that might also radiate into the back or thighs. Benign (non-cancerous) growths such as fibroids sometimes play a role too. Very severe period pain can also be a symptom of endometriosis, where the type of tissue that lines the womb grows outside of the womb.

Painkillers block prostaglandin production

Anti-inflammatory painkillers are often used to relieve period pain, especially the drugs diclofenac, ibuprofen and naproxen. These medications are all non-steroidal anti-inflammatory drugs (NSAIDs). They inhibit the production of prostaglandins and can relieve period pain in that way. Many NSAIDs are available from pharmacies without a prescription.

Researchers at the Cochrane Collaboration – an international network of researchers – looked for clinical studies of these drugs to find out whether they help and how well they are tolerated. The researchers found 80 good-quality studies involving more than 5,800 girls and women between the ages of 12 and 47. These studies compared the effectiveness of the painkiller with that of a placebo (fake drug) or other medications. The studies included women with and without endometriosis.

The research shows: NSAIDs can relieve period pain

The studies show that NSAIDs were more effective than placebos at relieving period pain:

• 82 out of 100 girls and women who didn't take NSAIDs still had severe pain after a few hours.
• 51 out of 100 girls and women who took NSAIDs still had severe pain after a few hours.

So the painkillers relieved pain in 31 out of 100 girls and women.

Some studies compared NSAIDs with acetaminophen (paracetamol). They suggest that NSAIDs are a little more effective than acetaminophen at relieving period pain. There's not enough good research to be able to say whether some NSAIDs are more effective than others.

The studies also show that NSAIDs can sometimes have side effects: 2 to 3 out of 100 girls and women experienced stomach problems, nausea, headaches or drowsiness.