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.
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.
What are some guidelines for the safe use of OTC products for menstrual cramps and PMS?
Always read the labels and know the ingredients in the
products. Never take more than the recommended doses
without checking with your doctor first.
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
surgeries 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
True aspirin allergy is rare. True aspirin allergy leads to hives, difficulty breathing, and/or shock within 3 hours of taking aspirin. Aspirin allergy is most common among individuals who have asthma,
hives, and nasal polyps. Individuals with true aspirin allergy should also avoid NSAIDs because they are chemically similar to aspirin.
Aspirin (and many other medications and some vitamins) can increase the blood thinning effect of the blood-thinning medication warfarin (Coumadin) and can dangerously increase the risk of bleeding. Patients taking
warfarin to prevent
strokes and other blood clots should not use prescription or OTC medications for menstrual cramps or PMS without first checking with the doctor supervising their
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.
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
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 should also avoid caffeine.
REFERENCE: MedscapeReference. Dysmenorrhea.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 9/14/2011