Q&A: Pharmacists Play Essential Role in Women' Health Care

Menstrual pain management has evolved to a comprehensive, patient-centered approach that empowers women through multiple treatment strategies. Pharmacists now recommend a holistic method combining lifestyle modifications, nonpharmacological interventions, and medical treatments, ranging from yoga and dietary changes to prescription medications. Joanna Lewis, PharmD, MBA, 340B program director at Baptist Health, discusses how social media is increasing awareness and encouraging women to explore various options like heating pads, specific yoga poses, magnesium supplements, and hormonal contraceptives. Pharmacists are playing a crucial role in this transformation, positioning themselves as key educators who can provide evidence-based guidance, help patients navigate complex health information, and destigmatize women's health issues. This progressive approach not only addresses menstrual pain but also represents a broader shift towards more comprehensive, personalized women's health care.

Pharmacists enhance menstrual pain management by integrating holistic strategies, empowering women with personalized care and evidence-based guidance for better health outcomes. | Image Credit: 9dreamstudio - stock.adobe.com

Drug Topics®: What are some of the nonpharmacological strategies pharmacists can recommend for managing menstrual pain? How can pharmacists integrate these into a patient counseling session?

Joanna Lewis, PharmD, MBA: The first thing I would ask my patient when they came to me asking for different modalities is, "what have you already tried? And did it work? Did it not work?" And then I would go from there. I would also ask about their diet and exercise as a starting point. There are a lot of different strategies people can try. Heating pads are a very easy thing to try. Regular exercise has been shown to help; yoga, especially Child's Pose, Cat-Cow, and Cobra, has been effective in reducing pain; stretching; magnesium-rich foods; or supplements—we've talked about that already. [Food] has been shown to mildly reduce cramps, and then overall, an anti-inflammatory diet with more fruits and vegetables and whole grains can help. I would also say less caffeine, which I know is hard for all of us [and] more hydration. Some people like tea, chamomile tea, and then acupuncture. Depending on how comfortable the patient is, acupuncture is also a nonpharmacological strategy that people can use so well.

Drug Topics: How can pharmacists counsel a patient who presents with severe, debilitating menstrual pain that has not responded to multiple OTC therapies?

Lewis: Often we have to try multiple therapies or a combination of therapies to really get the proper relief. If multiple modalities are not working, like if they're trying yoga plus supplements plus ibuprofen, and they're still not getting any relief, there are prescription-strength NSAIDs that we can try. These include higher doses of ibuprofen, higher doses of naproxen, and then there's another NSAID called mefenamic acid that's available with a prescription. Then some providers will actually prescribe birth control. This hormonal contraception works by thinning the uterine lining, and it reduces ovulation, which lowers prostaglandin production and cramp severity. So some people need to go on birth control. Then there are a few other prescription medications that are available for specific symptoms, like if you had a severe case that was linked to endometriosis, heavy bleeding, or even symptoms of irritability and sadness, all of these can be prescribed by your OB [obstetrician] or medical provider based on your individual need.

Drug Topics: How can pharmacists stay up-to-date on new guidelines, medications, and nonpharmacological treatments related to women's health conditions like dysmenorrhea, PCOS, or menopause?

Lewis: So my favorite resource for women's health is through ACOG, which is the American College of Obstetricians and Gynecologists. They publish guidelines, and they have a great online website that you can reference. The American Pharmacist Association also has CE and resources, as well as other pharmacy organizations. Also the Journal of Women's Health kind of hits all of those topics we just talked about, and then as far as online resources that most of us have access to in our practice, UpToDate and LexiComp are always good resources on the current guidelines.

Drug Topics: How do you see the role of the pharmacist evolving in the area of women's health, particularly with the growing number of OTC options and direct-to-consumer health care models?

Lewis: The good news about the world we live in today is that women are starting to speak out more and not suffer in silence. I think women used to just see menstrual pain as a cross to bear but now they realize that there are remedies available, and even on social media, there are a lot of influencers and just regular people bringing awareness to women and destigmatizing so that we don't suffer alone. I see this a lot too around perimenopause symptoms, and I'm glad that more people are speaking up about that because that will give us the awareness and the chance to develop more remedies in the future. So this is an exciting time to be a pharmacist because of all the social media content, though sometimes the consumer needs help sifting through the noise, so pharmacists really need to stay up to date on the current trends and remedies so that we can counsel on what works and what doesn't. I also see, in the future, pharmacists carving out more of a niche role around women's health. Our jobs are evolving so much, and there may be opportunities for us to be more involved in the public and women's health and perimenopause and menopause, so pharmacists can take a very active role in educating their patients and the public about these public health concerns.