How does ibuprofen reduce period pain?

Why do we get period pain?

So it’s that wonderful time of the month. But, have you ever took a second to think why am I actually popping ibuprofen for my period pain?! Well, read on to find out!

During our period, compounds known as prostaglandins are released from the uterine lining (endometrium) which triggers uterine muscle contractions (in order to expel the lining). Furthermore, it is thought that higher levels of prostaglandins can cause more severe cramping in some women.

What is ibuprofen and what has it got to do with period pain?

Ibuprofen is a nonsteroidal anti-inflammatory drug, also known as an NSAID. NSAIDs are often used to treat period pain. Moreover, NSAIDs inhibit the production of prostaglandins (via the inhibition of COX enzymes), the compounds responsible for period pain in many women (see below).

How ibuprofen treats period pain

Ibuprofen lessens period flow?

There has also been talk about how ibuprofen can lessen menstrual flow; if Cardi B can use it to delay her period for two days it must be true right? It turns out there might be some truth to it. Interestingly, a study found that taking NSAIDs can reduce menstrual flow by 28% to 49%. Although you shouldn’t really be using this method to ignore a potential underlying problem, in that case, a doctors visit would be advised.

Alternatives to NSAIDs

‘Natural’ methods

Although it has been shown that NSAIDs can reduce the levels of prostaglandins, these anti-inflammatory drugs can cause stomach problems (amongst other unpleasant side effects) for some people (and isn’t such a good idea for those with stomach ulcers) – so where possible – it is always best to relieve period pains through ‘natural’ methods (easier said than done, I know), such as those below:

  • Applying heat
  • Drinking more fluids
  • Massage
  • Exercise (I promise once you push past the pain it’ll help)
  • Or perhaps you have an increased sex drive right now? An orgasm can work wonders on your period cramps!

If you really can’t get on board with the more natural interventions then below are some potential ‘natural’ alternatives to NSAIDs that have a similar mode of action.

‘Natural’ alternatives to NSAIDs

Turmeric

Firstly, who here is a fan of turmeric? Well, you’d be wise to consume the spice during menstruation; in a recent study the spice has been shown to abate menstrual pain (to a similar extent as mefenamic acid – a prescription NSAID). Whilst a combination of turmeric and mefenamic acid gave the best outcome, use of turmeric alone wasn’t far behind mefenamic acid (alone) in terms of pain relief.

Curcumin, the primary bioactive compound in turmeric has been shown to be the main culprit for the pain-reducing effects of turmeric. As we saw earlier, the source of period pain often stems from the metabolism of arachidonic acid to prostaglandins. Curcumin affects arachidonic acid metabolism by blocking the cytosolic phospholipase phosphorylation, reducing the expression of cyclooxygenase-2 (COX-2). Remember COX enzymes were responsible for the conversion of arachidonic acid to prostaglandins, so if we reduce the expression of them, we reduce prostaglandin synthesis.

Zinc

There is evidence that zinc may also provide period pain relief – a study found that ingestion of zinc sulphate (a source of zinc) throughout the duration of menstruation reduced pain duration and severity (1.5 fold) by the third menstrual cycle, compared to the control group (placebo).

Disclaimer

This article hopes to provide relief (and information) to those suffering with primary dysmenorrhoea (period pain when there is no underlying medical problem). If you think your pain is abnormal or it is too severe that you can’t carry out daily tasks then you should consult a doctor in order to see if there is an underlying cause.

References

Hesami, S., Nooshabadi, M. R., Yousefi, M., Lalooha, F., & Haghighian, H. K. (2021). Randomized, double-blind, placebo-controlled clinical trial studying the effects of Turmeric in combination with mefenamic acid in patients with primary dysmenorrhoea. Journal of Gynecology Obstetrics and Human Reproduction, 50(4), 101840.

Zekavat, O. R., Karimi, M. Y., Amanat, A., & Alipour, F. (2015). A randomised controlled trial of oral zinc sulphate for primary dysmenorrhoea in adolescent females. The Australian & New Zealand journal of obstetrics & gynaecology, 55(4), 369–373.

Eby, G. A. (2007). Zinc treatment prevents dysmenorrhea. Medical Hypotheses, 69(2), 297-301.

Dawood, M. Y., & Khan-Dawood, F. S. (2007). Clinical efficacy and differential inhibition of menstrual fluid prostaglandin F2alpha in a randomized, double-blind, crossover treatment with placebo, acetaminophen, and ibuprofen in primary dysmenorrhea. American journal of obstetrics and gynecology, 196(1), 35.e1–35.e355.

Mazaleuskaya, L. L., Theken, K. N., Gong, L., Thorn, C. F., FitzGerald, G. A., Altman, R. B., & Klein, T. E. (2015). PharmGKB summary: ibuprofen pathways. Pharmacogenetics and genomics, 25(2), 96–106.

Matteson, K. A., Rahn, D. D., Wheeler, T. L., 2nd, Casiano, E., Siddiqui, N. Y., Harvie, H. S., Mamik, M. M., Balk, E. M., Sung, V. W., & Society of Gynecologic Surgeons Systematic Review Group (2013). Nonsurgical management of heavy menstrual bleeding: a systematic review. Obstetrics and gynecology, 121(3), 632–643. https://doi.org/10.1097/AOG.0b013e3182839e0e