Disease: Menstrual Cramps
and
Premenstrual Syndrome (PMS) Medication Guide

    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 and short-lived, sometimes felt just as a sense of light heaviness in the belly. 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 with heavy menstrual flow. Smoking and a family history of severe menstrual cramps are also associated with painful menstrual cramps.

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

    Treatment options vary and each woman needs to find a treatment that works 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:

    Learn more about: Tylenol

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

    Learn more about: Orudis

    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).

    Learn more about: Ponstel

    What medications are used to treat PMS?

    Medications used to treat the different symptoms of PMS include:

    • Diuretics are medications that increase urine production, thereby eliminating excess fluid and relieving weight gain, bloating, swelling, and a full feeling. 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, or face.
    • Nonsteroidal anti-inflammatory medications (NSAIDs) 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) 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 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, have been found to help 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 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) are examples of antidepressant medications that have been found to be effective in treating the mood changes associated with PMS.

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

    Treatment options vary and each woman needs to find a treatment that works 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:

    Learn more about: Tylenol

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

    Learn more about: Orudis

    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).

    Learn more about: Ponstel

    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 still 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: Learn relaxation techniques, and develop coping mechanisms to handle stress.
    • Dietary changes: Reduce salt and refined sugar intake (too much salt and refined sugar aggravates fluid retention).
    • Avoid caffeine, which increases irritability
    • Decrease 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:

    • Diuretics are medications that increase urine production, thereby eliminating excess fluid and relieving weight gain, bloating, swelling, and a full feeling. 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, or face.
    • Nonsteroidal anti-inflammatory medications (NSAIDs) 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) 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 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, have been found to help 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 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) are examples of antidepressant medications that have been found to be effective in treating the mood changes associated with PMS.

    Source: http://www.rxlist.com

    Treatment options vary and each woman needs to find a treatment that works 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:

    Learn more about: Tylenol

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

    Learn more about: Orudis

    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).

    Source: http://www.rxlist.com

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