For some people, just imagining the pinching, aching, piercing abdominal pangs that come with their period is enough to make them want to assume the foetal position and sleep until it's over. If this is you, sure, you could pop a couple of Advil or Motrin, but is that actually going to do anything? Actually, it might, but the type of over-the-counter painkiller that you choose matters when you're treating period cramps.
If you want to make an informed decision, it's helpful to understand what causes period cramps in the first place: Chemicals called prostaglandins, which are created in a person's uterine lining, cause the muscles of the uterine wall to contract, and you feel a cramp, says Margaret Polaneczky, MD, FACOG, an Ob/Gyn at NewYork-Presbyterian/Weill Cornell Medicine. Luckily, your first line of defence against period cramps is an over-the-counter medication, Dr. Polaneczky says. But not all OTC meds are created equal.
"Medications that interfere with prostaglandins-production or activity are the best treatments," Dr. Polaneczky says. Non-steroidal anti-inflammatory drugs (NSAIDs), for example, target and reduce the amount of prostaglandins that your body makes, which will make your cramps less severe, according to the American Congress of Obstetrics and Gynecologists (ACOG). According to Dr. Polaneczky, Motrin, Advil, or Aleve will probably be effective for most people, but you might have to try a few different types of NSAIDs to find one that works for you. "You can switch to a different class and you might have more efficacy, because they all act on different spots in the prostaglandin-production pathways," she says.
And if you can't take NSAIDs (because they upset your stomach, for example), then acetaminophen can also help to decrease the pain, according to the Mayo Clinic. There are some OTC medications, such as Midol, that contain a combination of acetaminophen, caffeine, and antihistamines, Dr. Polaneczky says. "The idea is that caffeine is augmenting the pain relief activity of acetaminophen," she says. "And the antihistamines might somehow be acting on the calcium channels in the uterine muscles, which would prevent the cramps." So, the cocktail of substances might be more effective at treating some people's menstrual cramps than just a plain NSAID would.
So, when should you take a painkiller? Most people experience cramps right before their period starts, because that's when prostaglandins levels are highest, according to ACOG. It's best to start taking medication right when you experience symptoms, and you can continue taking it for up to three days, according to the Mayo Clinic. As you get your period, and the lining of your uterus sheds, the prostaglandins levels — and cramps — typically go away.
There are also a few ways that you can manage the pain without using medication, according to Dr. Polaneczky. "Exercise can certainly help, unless you're totally debilitated by your cramps," she says. Using a hot water bottle or getting a lower back massage certainly doesn't hurt, either.
If none of these treatments work, then the next step for you would be to figure out if you want to prevent your period, which is typically done using birth control pills. "Anything that suppresses ovulation will also help with cramps," Dr. Polaneczky says. Birth control pills (both combination pills and progesterone-only ones), IUDs, or injections tend to work well at preventing cramps, according to ACOG. And if you're already on the pill, you might want to consider skipping your inactive pills to prevent getting your period each month, she says.
Period cramps are no joke, and if you feel like yours are interfering with your daily life, then talk to your doctor. In the meantime, you may want to take an OTC painkiller and remember that this too shall pass.