Detailed guides to painful problems, treatments & more

Treating menstrual cramps with pain-killers

 •  • by Paul Ingraham

Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

In my last post, I announced a new article, a users’ guide to the common pain-killers. I left something out of that article, a truly forehead-smacking oversight. It’s a great tip for uterus-havers, and it’s delivered with a cute personal story too. I sheepishly, belatedly added it to the article, and I’m sharing it here too.

Menstrual cramps are powered by prostaglandin, a molecule produced by the womb during menstruation. Prostaglandins are everywhere in physiology, and are also found in inflamed tissues. All of the non-steroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin production, which is a big part of what makes them “anti-inflammatory. And so NSAIDs are particularly effective for menstrual cramps, especially compared to the other common pain-killer, acetaminophen.

Think of the NSAIDs as truly effective muscle relaxants for one specific muscle. 😉

My wife credits me with teaching her about this, and she was quite impressed by the upgrade. She had been taking whatever medication was handy, oblivious to any difference — a good example of why people need a guide like this. It was a revelation to discover that one type of pain medication is truly superior for this purpose. But, amusingly, she never remembers which one, just that there is a better choice. And so, for well over a decade now, we have the same conversation regularly:

“Which one is it again for the cramps? Ibuprofen, right? But I always get this backwards, so it must be acetaminophen?”

“Rewind! Back to your first impression. You want me to write it on the bottle? Or make a chart?”

“Don’t you dare make a chart.”

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