Menstrual Cramps and Premenstrual Syndrome (PMS) Medication Guide

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Quick GuidePremenstrual Syndrome: A Visual Guide to PMS Symptoms, Causes and Treatments

Premenstrual Syndrome: A Visual Guide to PMS Symptoms, Causes and Treatments

What is the treatment for common menstrual cramps (primary dysmenorrhea)?

Treatment options vary and each woman needs to find a treatment that works best for her. Non-drug measures that may help include adequate rest and sleep, regular exercise (especially walking), and smoking cessation. Some women find that abdominal massage, yoga, or orgasmic sexual activity can help. A heating pad applied to the abdominal area may also relieve the pain.

For mild menstrual cramps, over-the-counter (OTC) aspirin and acetaminophen (Tylenol), or acetaminophen plus a diuretic (such as Diurex MPR, Midol, Pamprin, Premesyn) may help. However, aspirin has a limited effect in curbing the production of prostaglandin and is only useful for mild cramps. For moderate menstrual cramps, the nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful. The NSAIDs are more effective than aspirin in inhibiting the production and action of the prostaglandins. NSAIDs that are available OTC are:

  • ibuprofen (Advil, Midol IB, Motrin, Nuprin, and others);
  • naproxen sodium (Aleve, Anaprox); and
  • ketoprofen (Actron, Orudis KT).

For optimal control of menstrual cramps, a woman should start taking a NSAID before her pain becomes difficult to control. This might mean starting medication 1 to 2 days before her period is due to begin and continuing taking medication 1 to 2 days into her period. The best results are obtained by taking one of the NSAIDs on a regular schedule rather than on an as needed basis. Therefore, ibuprofen should be taken every 4-6 hours, ketoprofen every 4-8 hours, and naproxen every 8-12 hours for the first few days of the menstrual flow.

Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel).

Medically Reviewed by a Doctor on 11/23/2015

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