Period pain is one of the most common health issues for women.¹ 

 Period pain refers to pain in the lower abdomen which can occur just before or during a woman’s period, usually lasting for around two to three days.^1,2 The severity of period pain varies between women; from a mild annoyance to severe pain which can interfere with normal day-to-day activities.

What causes period pain?

Period pain can occur when chemicals called prostaglandins are released from the lining of the uterus (womb). The release of prostaglandins causes the muscles in the uterus to contract which may cause pain in some women. Although it’s not entirely clear why some women experience stronger period pain than others, women with higher levels of prostaglandins may experience stronger cramps and pain.

Anti-inflammatory medicines

Anti-inflammatory medicines can provide period pain relief for many women by stopping the body from producing prostaglandins. There are several OTC anti-inflammatory medicines that can be used to relieve period pain. These medicines contain the following active ingredients:

• Ibuprofen (eg, Nurofen and Advil)
  
• Mefenamic acid (eg, Ponstan)
  
• Naproxen (eg, Naprogesic)
  

Speak with your pharmacist which one is the best option for you. Some of these medicines are only available from pharmacies.

Anti- inflammatory medicines may not be suitable for everyone

Anti-inflammatory medicines can irritate the stomach and interact with other medicines. So not everyone can take them. If you have a history of the following medical conditions, it’s important that you talk with your doctor or pharmacist before starting anti-inflammatory medicines.³

• Stomach ulcers
  
• Reflux
  
• Asthma
  
• Kidney, heart or any other health problems.
  

Paracetemol and other options

Pain relief medicines containing the active ingredient paracetemol (eg, Panadol) can be helpful for women experiencing mild period cramps. When taken as directed on the packet, paracetamol is generally well tolerated by most people.

Some women also benefit from non-medicine options such as heat packs, exercise, transcutaneous electrical nerve stimulation (TENS) or acupuncture.^1,2 

Low-dose codeine medicines (eg, Panadeine and Nurofen Plus) were formerly available over the counter, but from 1 February 2018, all medicines containing codeine require a prescription. This is because of changes made by the Therapeutic Goods Administration (TGA).

Why has codeine become prescription-only?

OTC medicines containing low-dose codeine provide very little extra pain relief when compared to other OTC pain relief medicines. There are serious risks associated with taking medicines containing codeine. Some people can become dependent on these medicines and develop withdrawal symptoms such as headaches and insomnia when they stop taking them.

For more information on codeine containing medicines and the changes made by the Therapeutic Goods Administration see: Medicines with codeine - what you need to know and Codeine rescheduling FAQs.

If you are experiencing period pain that interferes with day-to-day activities, consider discussing alternative treatment options with your doctor. Some women find that the combined contraceptive pill (the pill), or other hormone treatments, can help with period pain, however, this is not suitable for everyone. Your doctor or healthcare professional can advise on what’s best for you.

Rarely, period pain can be caused by an underlying medical condition. If you are experiencing severe pain or have symptoms that are unusual or persist longer than expected, it’s important that you seek help from a doctor, nurse or sexual health practitioner. This is because you may need tests to rule out other causes.

For information on medicines you can phone the NPS Medicines Line on 1300 MEDICINE (1300 633 424), Monday to Friday, 9 am to 5 pm AEST (excluding NSW public holidays).

For more information on reproductive and women’s health, visit:

• Family Planning Alliance Australia
  
• Jean Hailes for Women’s Health
  

References

1. Therapeutic Guidelines. Endocrinology- Menstrual disorders. West Melbourne: Therapeutic Guidelines LTD, 2017  (accessed 18 September 2017).
   
2. Australian Medicines Handbook. Menstrual symptoms. Adelaide: AMH Pty Ltd, 2017.  (accessed 18 September 2017).
   
3. Pfizer Australia. Ponstan Capsules Consumer Medicine Information. 2015 (accessed 18 September 2017).