Do you take painkillers for period pains every month?

Once a month, the vast majority of women suffer menstrual cramps.

The intensity varies – for one in five, it can be as painful as a heart attack. 

Consequently, most women resort to popping a few doses of over-the-counter painkillers, sometimes up to seven days every month, in order to dispel the pain and keep working as normal.

It makes sense: other natural options – like an ancient Chinese massage or hot compresses – are less practical in, for example, an office context. 

However, Mayo Clinic gastroenterologist Dr Sahil Khanna warns overdoing this regular pill-popping could set you up for some uncomfortable health issues down the line, including stomach ulcers, acid reflux and digestive problems.

UCLA gynecologist Aparna Sridhar, MD, insists it is not a black and white situation – pain management is incredibly individualized, and women who have unbearable cramps can often see results using a combination of natural methods and painkillers.

Here, we run through the risks of painkillers and the alternative methods that women could try.  

Most women resort to popping over-the-counter painkillers, sometimes up to seven days every month in order to dispel the pain to keep working as normal. A gynecologist and a GI explained why that’s risky – and how to alleviate the risks with natural methods

WHAT ARE THE RISKS OF REGULAR PAINKILLERS?

According to Dr Khanna, anything more than two is risky, especially if it’s repeated day after day, month after month.

‘We [gastroenterologists] like to avoid Advil-like medicines as much as possible,’ he told Daily Mail Online.

‘The maximum is four 250mgs a day – three is better, two is even better.

‘Taking them so much can have serious gastrointestinal side effects.

‘It is particularly risky for patients who are also taking aspirin or ibuprofen, or they smoke or drink alcohol.’ 

Common side effects include acid reflux, constipation and diarrhea – though patients may not realize it is stemming from their painkiller use.

The biggest thing to be concerned about, though, is an ulcer on the stomach or small intestines, which can be incredibly painful, Dr Khanna warns.

Ulcers can go unnoticed for months or years. If they don’t heal of their own accord, they can bleed through the intestines into the patient’s stool, which can be alarming, dangerous and, again, painful.

Over time, regularly popping nonsteroidal anti-inflammatory drugs (known as NSAIDs, like Advil) can also dangerously lower blood pressure and hemoglobin levels, which, Dr Khanna warns, is not something to be easily ignored.

‘Sometimes this can result in hospital visits or even ICU visits because very quickly these patients can bleed without much notice.’ 

Dr Khanna insists that each patient must weigh their own risks with their doctor to decide how to handle the situation. 

Some doctors, he says, may consider prescribing medications to balance out their patient’s acid levels, such as omeprazole, which is used to treat acid reflux.  

Unfortunately, he said, there aren’t many other options from a GI standpoint – aside from cutting smoking, drinking, and anything else that plays with your acid levels. 

Dr Sridhar, who treats patients and trains medical students in obstetrics and gynecology, said she does not avoid prescribing NSAIDs, but she checks that patients have exhausted all other options first.

‘Usually, by the time patients are coming to the doctor for treatment, they have tried everything else,’ she told Daily Mail Online. 

When it comes to dosing, ‘the lesser the better’ but ‘as long as it’s within the recommended limit, it should be ok,’ she says, adding: ‘Will anyone really have to take 3,200mg of ibuprofen per day [which is the limit]? Probably not.’

WHAT ARE THE ALTERNATIVES?

There is one enduring issue underlying this whole conundrum of how to treat menstrual pains: surprisingly little research and funding has been invested in studying the cramps that affect more than half the world’s population. 

As a result, any natural treatments outside of general painkillers are largely untested.

While this is the case for many areas of medicine, Dr Sridhar admitted that she does balk at some of the roundabout ways to ‘help’ women without pursuing better treatments. 

‘I recently read an article about somewhere giving women days off work during their period, and people seemed to think that was a good thing. I thought “this is wrong, these women need help, not time off!”‘ 

That doesn’t mean people haven’t tried to find alternatives. 

‘There are a lot of things that aren’t completely proven by science but seem to work,’ Dr Sridhar explains. 

Hot compresses – i.e.: placing something warm on the pelvic area – have been touted as a surefire way to ease pains (although, as Dr Sridhar pointed out, ‘that’s not very practical to fit into working life’). 

Another option is focusing on diet to increase your intake of vitamins like B1, Dr Sridhar says, though that strategy is based more on anecdotal evidence than scientific proof. 

The most effective alternative treatment that has been tested in clinical settings is exercise – and it’s something Dr Sridhar has seen work quite well in patients. 

‘There’s a good amount of evidence that being active helps with pain,’ she explains.  

‘If nothing works and they are in pain that is disrupting their daily activities, then you can try painkillers, but always start with non-pharmacological options first, then the lowest dose, then, if nothing else, you can explore changing birth control.

‘For a lot of women, doing exercise can help lower their dose of painkillers, if they still need them.’



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