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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What are some guidelines for the safe use of OTC products for menstrual cramps and PMS?

  1. Always read the labels and know the ingredients in the products. Never take more than the recommended doses without first checking with your doctor.
  2. Aspirin and NSAIDs can cause ulcers and should be avoided by patients with known peptic ulcer disease or reflux esophagitis. They can also increase the risk of bleeding and should be avoided by women with certain blood diseases. Women who are scheduled for elective surgery should inform their doctors that they are taking aspirin or NSAIDs. The doctor may ask them to withhold these medications for a period of time prior to the procedure.
  3. True aspirin allergy is rare. However, it may lead to hives, difficulty breathing, and/or shock within three hours of ingestion. Aspirin allergy is most common among individuals who have asthma, hives, or nasal polyps. Individuals with true aspirin allergy should also avoid NSAIDs because they are chemically similar to aspirin.
  4. Aspirin (and many other medications and some vitamins) can increase the anti-coagulant effect of the blood-thinning medication warfarin (Coumadin) resulting in an increased risk of bleeding. Patients taking warfarin to prevent strokes and other throbocytic diseases should not use prescription or OTC medications for menstrual cramps or PMS without first checking with the doctor supervising their warfarin dosages.
  5. Most healthy adults tolerate aspirin and NSAIDs well, but some may develop side effects such as headaches, dizziness, upset stomach, heartburn, poor appetite, constipation, or diarrhea. Taking these drugs with food can decrease the stomach upset and heartburn.
  6. Ammonium chloride, an OTC diuretic, is an acid that can cause stomach upset in high doses. It can also cause an excess accumulation of acid (acidosis) in the blood of patients with kidney and liver disease.
  7. Caffeine is a diuretic and a stimulant. It can cause restlessness, anxiety, and insomnia. Nervousness, irritability, and nausea can occur if caffeine-containing foods and beverages are consumed concurrently. Women taking certain asthma medications such as aminophylline or theophylline (Respbid, Slo-Bid, Theo-24, Theoair) should also avoid caffeine.

Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology

REFERENCE:

MedscapeReference. Dysmenorrhea.

Medically Reviewed by a Doctor on 11/23/2015

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