Pharmacist Discusses NSAIDs in Relieving Menstrual Cramps

For many women, menstrual cramps are a monthly ordeal—sometimes mild, often disruptive, and occasionally debilitating. Despite their prevalence, effective management of menstrual pain remains a topic shrouded in misinformation and trial-and-error remedies. In this interview, Michelle Palmer, PharmD, FASCP, medication therapy management pharmacist at Consana Health, discusses the best over-the-counter strategies for menstrual pain relief and clarifies the science behind common treatments.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are household names, but few patients understand exactly how these medications work or how to use them most effectively. Palmer explains that NSAIDs target prostaglandins, the chemicals responsible for triggering uterine contractions and the resulting cramps.

“It’s really best to start these medications early, ideally a day or 2 before the period begins or at the onset of pain,” she said, emphasizing that timing and dosing are critical for optimal relief. She also notes that while acetaminophen is an option for those who can’t tolerate NSAIDs, it’s generally less effective for menstrual cramps.

Palmer’s guidance goes beyond simply recommending a pill. She highlights the importance of screening for contraindications—such as kidney disease, ulcers, or pregnancy—and discusses the common adverse effects, including gastrointestinal upset. Her practical tips, like taking NSAIDs with food and avoiding alcohol, are grounded in both pharmacological science and patient experience. For those seeking alternatives, Palmer addresses the limited evidence supporting herbal supplements and cannabis products for menstrual pain, urging patients to maintain realistic expectations and consult health care professionals about potential interactions.

"There are some studies that show potential benefit with some options, including ginger, fish oil, vitamin B1, zinc, or magnesium, but the data isn't strong enough to suggest this as a first-line treatment," Palmer said.