- Menstrual Cramps and Premenstrual Syndrome (PMS) Medication Guide Center
- Take the Menopause Quiz
- Essential Screening Tests Every Woman Needs Slideshow
- Surprising Benefits of Sex Slideshow
- Patient Comments: Menstrual Cramps and PMS - Medication
- Find a local Obstetrician-Gynecologist in your town
- Menstrual cramps and PMS medication facts
- What are menstrual cramps?
- What is the treatment for common menstrual cramps (primary dysmenorrhea)?
- What is premenstrual syndrome (PMS)?
- What treatments are available for PMS?
- What medications are used to treat PMS?
- What are some guidelines for the safe use of OTC products for menstrual cramps and PMS?
Menstrual cramps and PMS medication facts
- Menstrual cramps that occur in the absence of a known abnormality or cause are medically referred to as primary dysmenorrhea.
- Non-drug treatments for menstrual cramps include adequate rest and sleep, regular exercise (especially walking), and smoking cessation.
- Menstrual cramps are not the same as the symptoms experienced due to premenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced together.
- Premenstrual syndrome (PMS) is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation; and usually end with the onset of her menstrual flow.
- For moderate menstrual cramps, the nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil, Motrin, Nuprin, etc.] or naproxen [Aleve, Anaprox, Naprosyn, Naprelan]) are often helpful. The NSAIDs are more effective than aspirin in inhibiting the production and action of the prostaglandins that cause menstrual cramps.
What are menstrual cramps?
Menstrual cramps are abdominal and pelvic pains experienced by a woman around the time of her menstrual period. Menstrual cramps usually start shortly before the menstrual period, peak within 24 hours after their onset, and subside after a day or two.
Menstrual cramps can range from mild to severe. Mild menstrual cramps may be barely noticeable, short-lived, and are sometimes felt only as a sense of mild pressure in the abdomen and pelvis. Severe menstrual cramps can be so painful that they interfere with a woman's regular activities for several days. The discomfort can extend to the lower back or legs. Menstrual cramps are not the same as the symptoms experienced due to premenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced together. Many women suffer from both PMS and menstrual cramps.
Medical research of menstrual cramps has shown that they are often worse in women who began menstruating early and who have long menstrual periods associated with heavy menstrual flow. Smoking and a family history of severe menstrual cramps are also associated with severe dysmenorrhea.
What is the treatment for common menstrual cramps (primary dysmenorrhea)?
Treatment options vary and each woman needs to find the 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 the onset of her pain becomes difficult to control. This might mean starting medication 1 to 2 days before the onset of her period and continuing the medication for the first 1 to 2 days of 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.
Latest Women's Health News
Daily Health News
What is premenstrual syndrome (PMS)?
Premenstrual syndrome (PMS) is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation and normally end with the onset of her menstrual flow.
PMS remains a puzzle because of the wide-ranging symptoms and the difficulty in making a firm diagnosis. Several theories have been advanced to explain the cause of PMS. None of these theories has been proven and specific treatments for PMS largely lack a solid scientific basis. Most evidence suggests that PMS results from alterations in or interactions among the levels of sex hormones and brain chemical messengers known as neurotransmitters.
What treatments are available for PMS?
The treatment of PMS can sometimes be as challenging as diagnosing the condition. Some measures lack a solid scientific basis but seem to help some women. Other treatments with a sound scientific basis may not help all patients. General measures include:
- Exercise: Aerobic exercise for 30 minutes 3-5 times a week improves general health and helps relieve nervous tension and anxiety. Exercise also improves cardiovascular fitness and muscle tone, decreases weight and fluid retention, and improves self-esteem.
- Emotional support from family and friends.
- Stress reduction and stress management: Learning relaxation techniques, and developing coping mechanisms to reduce stress.
- Dietary changes: Reduce salt and refined sugar intake (too much salt and refined sugar exacerbates fluid retention).
- Avoid caffeine, as this may increase irritability
- Decrease the intake of animal fats.
- Avoid cigarettes and alcohol.
Research studies have linked a deficiency of calcium and magnesium to PMS; therefore, it may be beneficial for woman to try supplements of these nutrients at recommended dosages. Some women have reported relief of symptoms with these supplements. It is always important to follow recommended guidelines when taking vitamin supplements, since taking excess doses of some supplements may be harmful.
What medications are used to treat PMS?
Medications used to treat the different symptoms of PMS include taking:
- Diuretics, which are medications that increase urine production, thereby eliminating excess fluid and relieving weight gain, bloating, and swelling. Ammonium chloride, caffeine, and pamabrom are mild diuretics that are ingredients in nonprescription OTC products such as Diurex PMS, Lurline PMS, Midol PMS, Pamprin Multisymptom, and Premesyn PMS. Spironolactone (Aldactone) is a prescription diuretic that has been used to treat premenstrual swelling of the hands, feet, and/or face.
- Nonsteroidal anti-inflammatory medications (NSAIDs) that are commonly used for menstrual cramps, headaches, and pelvic discomfort. NSAIDs are available as both prescription and non-prescription products. Examples of NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox), ketoprofen (Orudis), and mefenamic acid (Ponstel).
- Oral contraceptive pills (OCPs) that are sometimes prescribed by doctors to decrease fluctuations in ovarian hormone levels. While older studies failed to provide evidence that OCPs can consistently provide relief for symptoms of PMS, the newer low-dose birth control pills, with their improved hormonal formulations, seem to be more beneficial.
- Ovarian suppressors such as danazol (Danocrine) have been prescribed by doctors to suppress ovarian hormone production. Danocrine cannot be used over long periods because of side effects.
- Gonadotropin-releasing hormone (GnRH) analogs, which cause the complete suppression of ovarian function, and have been found to be helpful in treating some women with PMS. These GnRH analogs are not prescribed long term (more than 6 months) because of their adverse effects on bone density and an increased risk of bone thinning (osteoporosis).
- Antidepressants which are prescribed by doctors to treat the mood disturbances related to PMS. Antidepressants appear to work by increasing brain chemical (serotonin and others) levels that are affected by the ovarian hormones.
- Fluoxetine (Prozac) and paroxetine (Paxil). These are examples of antidepressant medications that have been found to be effective in treating the mood changes associated with PMS.
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 first checking with your doctor.
- 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.
- 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.
- 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 thrombocytic diseases should not use prescription or OTC medications for menstrual cramps or PMS without first checking with the doctor supervising their warfarin dosages.
- 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 liver disease.
- 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.
Health Solutions From Our Sponsors
Top Menstrual Cramps and PMS Medication Guide Related Articles
Abdomen PictureThe abdomen (commonly called the belly) is the body space between the thorax (chest) and pelvis. See a picture of the Abdomen and learn more about the health topic.
Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility.
Treatment of endometriosis can be with medication or surgery.
Fibrocystic Breast Condition (Changes)Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually pain, tenderness, and discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort.
Some women with fibrocystic breasts have mile breast tenderness or pain. Other women with the condition may have very painful and tender breasts with lumpy areas that can be felt. Fibrocystic breast condition is most common in women after age 30, which continues through perimenopause and menopause. Women with the condition often have fewer problems after menopause (postmenopause).
Fibrocystic breast condition that involves hyperplasia is associated with a slightly increased risk of developing breast cancer. Atypical hyperplasia is associated with a moderately increased risk of developing breast cancer compared to women with fibrocystic without fibrocystic changes.
Natural and home remedies to help relieve breast pain include NSAIDs like aspiring, Aleve, and Advil. Prescription medication also may help relieve symptoms of fibrocystic breasts.
25 Hormone Imbalance Symptoms and SignsHormone imbalance including abnormal levels of estrogen, testosterone, cortisol, progesterone, and other hormones may lead to symptoms like weight gain, fatigue, and mood swings. Hormonal imbalance may be due to natural states, like menopause, or other conditions. See your doctor for suspected imbalances in hormonal systems.
IUD (Intrauterine Device for Birth Control)
An IUD (intrauterine device) is a birth control method designed for a woman. The IUD is a small "T" made of molded polyethylene plastic coated with barium so that, if need be, it can be seen on X-ray.
There are two types of IUDs 1) Intrauterine contraceptive device (IUCD) including the ParaGard, Copper 7, and Mini-7; and 2) Intrauterine system (IUS) including Progestasert and Mirena.
Side effects of the IUD include spotting, infection, infertility, pelvic inflammatory disease, and heavy menstrual bleeding. Risks and complications of the IUD are miscarriage, ectopic pregnancy, pelvic inflammatory disease, and increased menstrual bleeding.
Menstruation (Menstrual Cycle)Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack of a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
PerimenopausePerimenopause is the time in a woman's life when she is approaching menopause. During this time a woman starts to develop symptoms of declining estrogen levels that may include mood swings, painful sex, night sweats, hot flashes, and weight gain. Every adult woman eventually will experience perimenopause.
Pelvic Pain SlideshowThere are many causes of pelvic pain in women including cysts, PMS, appendicitis, and bladder infections. Pelvic pain has uncomfortable symptoms, but luckily there are treatments for pelvic pain.
PMS vs. Pregnancy (Differences and Similarities)Many women have difficulty figuring out if they are pregnant, have PMS, or are about to start their period. The most common signs and symptoms of early pregnancy, PMS, and the start of your period include mood swings, back pain, increased urination, and tender breasts. These three conditions also share other similar signs and symptoms, but there are unique differences between each. Moreover, there are symptoms that only occur if you are pregnant. Early pregnancy symptoms, PMS, and the start of the menstrual period all have common signs and symptoms like mood swings, back pain, and breast pain. Symptoms and signs between the three conditions that may seem similar, but are slightly different include the following: Pelvic or abdominal cramping before or during your menstrual period is normal; however, the cramping of early pregnancy is mild. If you are pregnant, nausea and vomiting, or morning sickness, is common. They are not common symptoms of PMS. Fatigue is common in both, but PMS usually goes away once your period begins. Food cravings or aversions to certain foods are common in both pregnancy and PMS, but if you are pregnant, the cravings or aversions to foods are more specific and intense. You may have spotting or bleeding if you are pregnant or suffering from PMS. When the embryo inserts itself into the uterus (implantation bleeding), you may mistake it as your menstrual period. However, implantation bleeding is much lighter (not enough to soak a pad or tampon) than the heaving bleeding experienced at the beginning of your period. Signs and symptoms that you may have only if you are pregnant include, implantation cramping and bleeding, a white, milky vaginal discharge, and your areolas or nipples darken. The only way to find out if you are pregnant is with a pregnancy test. Home pregnancy test kits are available without a prescription at pharmacies and most grocery stores. Contact a doctor or other health care professional if you think you may be pregnant.
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder (PMDD) is considered a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, and hot flashes.
Treatment for PMDD is with medication to treat the symptoms of PMDD.
Premenstrual Syndrome (PMS)Premenstrual syndrome (PMS) is a combination of physical and emotional disturbances that occur after a woman ovulates and ends with menstruation. Common PMS symptoms include; depression, irritability, crying, oversensitivity, and mood swings. For some women PMS symptoms can be controlled with natural and home remedies, medications, and lifestyle changes such as exercise, nutrition, and a family and friend support system.
25 Ways to Relieve Menstrual CrampsMenstrual cramps happen when prostaglandins force the uterus to contract. Dysmenorrhea, or period pain, may be relieved by heating pads, ibuprofen, and other measures. Endometriosis may cause severe cramps during the menstrual cycle. Luckily, women have many options for period pain relief.
Spotting vs. PeriodMenstruation (a female's "period") occurs due to the shedding of the lining of the uterus. Menstrual bleeding lasts about three to five days, and the bleeding is heavy the first couple of days and then it lessens. Spotting is vaginal bleeding between periods.
Vaginal Pain (Vulvodynia)Vulvodynia or vaginal pain, genital pain is a condition in which women have chronic vulvar pain with no known cause. There are two types of vulvodynia, generalized vulvodynia and vulvar vestibulitis. Researchers are trying to find the causes of vulvodynia, for example, nerve irritation, genetic factors, hypersensitivity to yeast infections, muscle spasms, and hormonal changes.The most common symptoms of vaginal pain (vulvodynia) is burning, rawness, itching, stinging, aching, soreness, and throbbing. There are a variety of treatments that can ease the symptoms of vulvodynia (vaginal pain).