Nonprescription medications for the treatment of pelvic pain

Nonprescription medications may effectively control chronic pelvic pain. They also reduce menstrual cramping caused by endometriosis and adenomyosis.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, reduce menstrual cramps and relieve pain by reducing swelling (inflammation) and lowering the level of the hormone prostaglandin within the uterus. High levels of prostaglandin have been found in the menstrual blood of women with painful periods.¹

• Start taking the recommended dose of pain medication as soon as your discomfort begins or one day before your menstrual period is scheduled to start.
• Take the medication in regularly scheduled doses to keep the pain under control. Pain medication is more effective if you take it at regularly scheduled intervals around the clock. You may wish to take your pain medication in the morning, at lunch, before dinner, and when you go to bed. Taking the medication only when your pain is "really bad" is not an effective method for pain control.
• Try acetaminophen, such as Tylenol, if NSAIDs do not relieve your pain.

Before you take any nonprescription medications for the first time, be sure to carefully read the information on the package. It is important to understand how much of the medication you should take and when you should take it, as well as reasons not to take the medication. As with all medications:

• Do not exceed the maximum recommended dose.
• If you have been told to avoid these medications (nonsteroidal anti-inflammatory drugs), call your health professional before taking them.
• If you are or could be pregnant, call your health professional before using any medication.
• Do not give aspirin to anyone younger than age 20 because of the risk of Reye's syndrome.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Ibuprofen, such as Advil or Motrin

Initial dose: 400 mg

Following doses: 200 mg every 4 hours or 400 mg every 8 hours

Naproxen, such as Aleve

Initial dose: 220 mg

Following doses: 220 mg every 8 to 12 hours

Do not take more than 3 capsules in 24 hours unless directed by a health professional.

Side effects with NSAIDs are usually mild. Stomach upset or discomfort is the most common side effect. Taking the medication with food may help.

Reasons not to use NSAIDs (contraindications)

• Pregnancy or trying to become pregnant
• Stomach ulcers or gastrointestinal bleeding
• Nasal polyps
• Allergic reactions to aspirin or related drugs
• Kidney or liver disease
• Anemia
• Blood-clotting disorders

Do not take NSAIDs if you are taking any of the following medications:

• Blood thinners (anticoagulants), such as heparin or warfarin
• Corticosteroids, such as prednisone or dexamethasone
• Lithium
• Oral antidiabetic medication

Citations

1. Mishell DR Jr, et al. (2001). Endometriosis and adenomyosis. In MA Stenchever et al., eds., Comprehensive Gynecology, 4th ed., pp. 531–564. St. Louis: Mosby.