Many women experience severe pain with their periods. Pharmacist Diana Helfrich explains which medications or other active ingredients help best and why women shouldn’t just endure the pain.
Dear women and especially dear young girls, you often suffer from period pain! Don’t just accept this. It’s not normal to practically stop working during your period because of the pain, no matter how many times you may have heard that that’s just the way it is with the pain. It is always possible that there is something behind it that can be treated, such as endometriosis. More on that in a moment. Of course, a pharmacist column first has to be about what you can do with over-the-counter remedies for period pain.
The good thing is: A very clear recommendation can be made here. Almost ten years ago, in 2015, the renowned Cochrane Collaboration took on the topic of ‘painkillers for period pain’ and evaluated the studies available up to that point. What came out of it: The so-called non-steroidal anti-inflammatory drugs (NSAIDs; ibuprofen, naproxen, acetylsalicylic acid or ASS and others) are more effective than paracetamol.
The latter has been out of the game since 2015, because no one can get past Cochrane. And which NSAID should it be? The 80 studies evaluated in the review did not provide sufficient data to answer this question, says Cochrane. So I’m trying this: ASA is not an option because it could increase bleeding due to its anticoagulant effect, even if it is of course not a wound that needs to be closed to stop bleeding. I find naproxen, on the other hand, very suitable because of its long duration of action of 12 hours. After all, the moment it starts again, it is clear to the women affected that the whole thing will take longer. You only need to take naproxen twice a day.
And then there is the active ingredient butylscopolamine, which is an option if cramps are the main problem. Because butylscopolamine is an antispasmodic that is also used, for example. B. is used for irritable bowel syndrome. But be careful, if you have cardiac arrhythmias, angle-closure glaucoma or muscle weakness, you should not take it. The drug is also available in combination with paracetamol – which in my opinion makes little sense for period pain since the Cochrane study. The monopreparation is better in combination with a naproxen or ibuprofen tablet.
Period pain: Magnesium can help
And otherwise? For some women, simply magnesium is enough, although another Cochrane review (from 2012) describes it as “unlikely” that the mineral will prevent muscle cramps. You can try omega-3 fatty acids; a small study from Iran showed that they can reduce the need for ibuprofen. Doesn’t sound so unlikely, because they could regulate the body’s own production of pain messengers (prostaglandins). So eat a lot of fatty fish and maybe try a nutritional supplement. There is also anecdotal evidence that acupuncture can relieve period pain.
And plant medicine is also popular, especially antispasmodic plants. Phyto-Pope Heinz Schilcher, whose lectures I sat in, left posterity his “Guide to Phytotherapy,” a kind of bible of herbal medicine. In it, he recommends a cup of goose cinquefoil tea with its special tannins several times a day (pour 150 milliliters of boiling water over a teaspoon of finely chopped, dried goose cinquefoil, let it steep for ten minutes, strain), in combination with sitz baths with chamomile flower and yarrow herb extracts. Just the warm water on the abdomen is beneficial for menstrual pain.
Start the phytotherapy in good time before the days
Chamomile tea is also good, after all, chamomile flowers are a classic for cramping stomach pains. Important: If you want to try the “Phytos”, you should not just start when the pain is there, but rather drink the first tea a few days before your expected menstrual period. Reason from the phytotherapists: It is easier to keep the uterus supple than to relax a tense organ.
Or you can try to positively influence the system cycle with plant power in the long term. So don’t start the treatment again month after month, but rather change something fundamentally. However, you really need patience; most remedies only work after weeks or even months. That’s why I would always discuss such a therapeutic attempt with a gynecologist who is interested in phytotherapy – so that I actually make all the effort with the plant that is most promising for me personally. But I can already say which ones might be suitable. These are mainly monk’s pepper (also called chaste mud or Vitex agnus castus), black cohosh (Cimicifuga racemosa), lady’s mantle (Alchemilla vulgaris) and also here yarrow (Achillea millefolium) and cinquefoil (Potentilla anserina).
All in all, most women get along somehow with all of these resources, supplemented by a hot water bottle and a sofa, because cramps are simply easier to bear when lying down. A type of hot water bottle that you can walk around with are heat patches that you can stick into your panties at the height of the pain. But women tend to put up with a lot. Too much to bear.
A test for endometriosis provides clarity
That’s why I definitely want to say something about endometriosis. Fortunately, a lot of awareness has arisen about this disease in recent years; in September it was even debated in the Bundestag, here you can listen to the speeches from the debate. But it will still be a while before we live in a world where everyone has this treacherous disease on their hands, in which cells similar to those in the uterine lining are located somewhere else in the abdomen.
The tissue in the wrong place behaves in the same way as the tissue in the right place: it builds up under the influence of the cycle hormones and bleeds during the period. Not only does this cause excruciating pain (depending on where it is, including during sex or bowel movements…), it also affects fertility. That’s why women who are diagnosed and treated early are better off. There are hormone therapies that relieve cyclic pain. You should try that first. In about one in ten cases an operation is recommended. Because if you operate on the tissue, not only does the pain stop, family planning is also open again.
I would recommend that all young women who are constantly struggling with period pain take a look at this site endometriose-liga.eu to go and there the so-called Endo test close. After twelve questions, it gives an assessment as to whether the illness seems “unlikely”, “less likely” or whether “clarification is necessary”. That’s five minutes that can be very worthwhile. Because it is simply tragic when a woman endures period pain for twenty years and only realizes that she has endometriosis when she runs out of time to get pregnant.
That’s why the following applies: go to your gynecologist. Because of course the test (like everything on the internet, let me say) does not replace a medical diagnosis. And of course there are numerous other tangible reasons for period pain, such as fibroids, inflammation or cysts. And this can only be discovered with a careful medical examination. Apart from that, your doctor can prescribe the pill. And it has been proven to reduce period pain. Incidentally, the third generation is a little better than older estrogen-progestogen combinations. By the way, you can also take the pill continuously, and if there is no bleeding, there will be no period pain. But as I said, discuss this with your trusted gynecologist.
Note: The column cannot provide individual advice Pharmacy replace the package insert or the medical diagnosis and treatment.