Which is better for period cramps ibuprofen or tylenol

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.

Sources

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Dysmenorrhea (painful periods) is a very common condition that affects more than half of all women who are actively having their menstrual cycle. Some women experience only mild discomfort, while others have severe menstrual cramps preventing them from going about their everyday lives. 

This article will discuss ways to relieve pain and menstrual cramps, including medications such as Tylenol and other lifestyle modifications.

What are the symptoms of dysmenorrhea?

Most women experience at least some period pain during their menstrual cycle. This is often present with a dull with or without throbbing pain in the lower abdomen and lower back. The pain and period cramps may be accompanied by other symptoms such as headache, dizziness, breast tenderness, mood changes, nausea, vomiting, upset stomach, and loose stools.

Why does menstrual pain happen?

The painful cramps (period pain) that typically occur before and during a period are called primary dysmenorrhea. These period cramps happen because of natural body chemicals called prostaglandins. Prostaglandins are responsible for the pain and inflammation that causes uterine contraction. When the uterus contracts, its lining sheds, which is how the menstrual bleeding occurs. 

Levels of prostaglandins are high during the first 1-2 days of a period, which is why many women experience more severe stomach cramps during this time. As the uterine lining is shed with menstrual bleeding, the prostaglandins levels decrease, causing period cramps to lessen.

Dysmenorrhea can also occur due to problems with the reproductive organs. This is called secondary dysmenorrhea. Possible causes include endometriosis, uterine fibroids, adenomyosis, and others. Period cramps associated with secondary dysmenorrhea tend to last longer. Also, period pain may worsen as the period progresses instead of improving.

What is the best medication for severe cramps?

Pain medicines, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), can effectively treat painful menstrual cramps in the lower belly. These pain medications target prostaglandins and lessen their effects. So, if you suffer from period cramps, you can try taking an over-the-counter medicine such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn).

NSAIDs work best to reduce pain if taken at the first sign of menstrual cramps. Most women need to take NSAIDs for 1-2 days only. 

Note that NSAIDs are not appropriate for women with a bleeding disorder, kidney disease,  stomach ulcers, and severe asthma. You may react to an NSAID if you have a true aspirin allergy. You should consult your doctor if any of these conditions apply to you.

Does Tylenol work for severe menstrual cramps?

Acetaminophen (Tylenol) is an effective pain reliever that can treat a wide array of painful conditions, including menstrual cramps (period pain). While both NSAIDs and Tylenol treat pain and fever by reducing the level of prostaglandins, each drug class uses different pathways or mechanisms of action. Regarding efficacy, some people find NSAIDs are more helpful in relieving cramps than Tylenol. One important fact to remember is that if you have kidney problems, NSAIDs are your enemy, and if you have liver disease, Tylenol is not your number one choice. That does not mean you have to suffer through pain and cramps; your doctor can help you choose the most appropriate drug agent for you.

What are the other treatment options for period cramps and period pain?

If an over-the-counter pain reliever does not help relieve your menstrual cramps, you should obtain professional medical advice from a healthcare provider. Your OB/GYN may want to perform a pelvic exam or order other tests to rule out problems with the reproductive organs that might be causing menstrual cramps. 

If over-the-counter pain relievers are insufficient to manage your symptoms, your doctor may prescribe a prescription-strength NSAID to help ease period pain. This can allow you to stay comfortable and continue normal activities during your menstrual cycle.

Doctors can also prescribe hormonal birth control, such as the pill, ring, or patch, which contains estrogen and progestin and can treat period pain. Progestin-only injections and implants may also be used to treat menstrual cramps.

An intrauterine hormonal device (IUD) can also reduce menstrual cramps, relieve pain, and make menstrual bleeding lighter. This is an option if you are not planning a pregnancy in the near future and are looking to get on birth control.

Certain vitamins and supplements like vitamin B1 and magnesium may help some young women who feel pain and experience cramps during their period. Still, more research is needed to support their use.

What are some home remedies for menstrual cramping?

• Aerobic exercise, such as walking, swimming, and biking, can help with period pain by producing pain-blocking chemicals such as serotonin and endorphins.
• Heat can help soothe period cramps. You can apply heat with a heating pad or hot water bottle or take a warm bath.
• Getting enough rest and sleep before and during your period is important to prepare your body for the discomfort of severe menstrual cramps. 
• Relaxation through meditation or yoga is also effective in helping you cope with period pain.

References:

1. https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

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