Period pains: Can anti-inflammatory drugs help?

Anti-inflammatory drugs like acetylsalicylic acid or ASA (ASS in German), diclofenac, ibuprofen and naproxen can help relieve severe period pain. These drugs occasionally have adverse effects like headache or indigestion.

Period pains or menstrual cramps (dysmenorrhea) are a common problem that affects nearly half of all women. Some women become too unwell for everyday activities, including work or school, on 1 to 3 days each month.

In women with period pains, too much of the hormone prostaglandin is produced in the womb tissue. This leads to painful cramps in the abdomen that can sometimes also radiate into the back or thighs. Period pain may already start a few hours before menstrual flow.

In some cases, period pain is associated with other conditions such as endometriosis (where the endometrium also grows outside of the womb). You can find more information on endometriosis here.

Anti-inflammatory drugs block prostaglandin production

Anti-inflammatory drugs are commonly used for period pains and include drugs like acetylsalicylic acid or ASA (ASS in German), diclofenac, ibuprofen and naproxen. These drugs are also called non-steroidal anti-inflammatory drugs (NSAIDs). They inhibit prostaglandin production and aim to reduce menstrual cramps. Many NSAIDs are available at pharmacies without prescription.

To see whether they can help and how well tolerated these drugs are, researchers from the Cochrane Collaboration looked for clinical trials of these medications. The Cochrane Collaboration is an international network of researchers that investigates the benefits and harms of therapies. The trials compared NSAIDs with other treatments, with a dummy tablet (a placebo) or with one another. The researchers found 73 relevant trials with more than 5100 women aged between 12 and 47 years. The trials included women with and without endometriosis.

Current research proves that NSAIDs can relieve period pain

The trials show that NSAIDs were more effective than placebos at relieving period pain: For example, only 3 out of 10 women (30%) who took naproxen were unable to go to work or school due to the pain, compared with nearly 7 out of 10 women (67%) who took a placebo. So the drug helped 4 out of 10 women (40%).

Some trials compared NSAIDs with paracetamol. They suggested that NSAIDs were a little more effective at relieving period pain than paracetamol. There was not enough evidence to know whether any particular NSAID might be more effective than others.

Regarding adverse effects, the trials showed that NSAIDs can sometimes lead to stomach problems, nausea or headaches. Most women tolerate them well, however.

You can find more information on period pains and other treatment options, as well as information for girls in our feature.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)