Pharmaceutical Risks

Pharmaceuticals are a poor option for the relief of menstrual cramps.

Both NSAID's and oral contraceptives have demonstrated various levels of success in reducing the severity of menstrual cramps. Unfortunately, these pharmaceutical options come with an extended list of risk factors and contraindications.

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NSAID's

Definition: a nonsteroidal anti-inflammatory drug (as Ibuprofen)

In July 2015, the FDA announced it would strengthen an existing label warning that NSAIDs increase the chance of a heart attack or stroke. Harvard Health Publications followed up this announcement stating "NSAID use comes with health risks. Use the lowest dosage possible for the shortest period necessary."

According to the website drugs.com "commonly reported side effects of [the popular NSAID] ibuprofen include hemorrhage, vomiting, anemia, decreased hemoglobin, hypertension, and eosinophilia. Other side effects include upper gastrointestinal hemorrhage, upper gastrointestinal tract ulcer, dizziness, and dyspepsia."

Further important risk factors may include kidney failure (primarily with chronic use), liver failure, ulcers and prolonged bleeding after injury or surgery. NSAIDs can [also] cause fluid retention which can lead to edema... most commonly manifested by swelling of the ankles."

Hormonal Disruption and Fertility

According to research conducted by the European League Against Rheumatism, recent findings suggest that readily available “non-steroidal anti-inflammatory drugs (NSAIDs) could have a harmful effect on fertility.”

NSAIDs and Miscarriage

A study of 1055 pregnant women, funded in part by the California Public Health Foundation and the National Institute of Child Health and Human Development (NICHD), studied the use of NSAIDs and miscarriage.

The research found “prenatal NSAID use was associated with an 80% increased risk of miscarriage (adjusted hazard ratio 1.8 (95% confidence interval 1.0 to 3.2)). The association was stronger if the initial NSAID use was around the time of conception or if NSAID use lasted more than a week.”

Conclusion

With the long list of contraindications that accompany the use of these readily available drugs, it is imperative that they should be regarded with the utmost caution.

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Oral Contraceptives, aka "the pill"

Definition: any of various preparations that usually contain both a progestin (as norethindrone) and an estrogen (as ethinyl estradiol,) are taken orally especially on a daily basis, and act as contraceptives typically preventing ovulation by suppressing secretion of gonadotropins (as a luteinizing hormone) —called also an oral contraceptive.

A non-contraceptive (or off label) benefit of "the pill" has been in the treatment of dysmenorrhea. Approximately three out of four women suffering from cramps report some relief when on estrogen-progestin contraceptives. The Int'l Agency for Research on Cancer has classified oral contraceptives as "carcinogenic to humans (Group 1)"

According to The National Cancer Institute "...studies have provided consistent evidence that the risks of breast and cervical cancers are increased in women who use oral contraceptives..." Unfortunately, oral contraceptives can cause further possible side effects and health risks as well, including:

-blood clots; nausea; breast tenderness; bloating; headaches; migraines; increased appetite; yeast infections; intermenstrual spotting; mood swings; brown facial spots; vaginal discharge; decreased libido.

According to the CDC, 30% of women that use the pill eventually quit because of side effects. According to an article published by the National Center For Biotechnology Information - NCBI, "the most commonly stated reason for discontinuation is depression."

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NSAIDs and Oral Contraceptives provide only limited relief

  • 31% of users experience pain reduction from Non-Steroidal Anti-inflammatory drugs - NSAIDs

According to a Cochrane meta-analysis of "80 good quality studies," NSAIDs "relieved pain in 31 out of 100 girls and women."

  • 33% of users experience pain reduction from oral contraceptives.

"Combined oral contraceptives have long been used off-label for dysmenorrhea, but a Cochrane review found only limited evidence for efficacy."

"On a verbal multidimensional scoring (VMS) system that rated pain as none, mild, moderate, or severe... one in three [women] moved down one category on the scale..."

 

Resources:

Harvard on NSAID's

FDA on NSAID's

What are the side effects of NSAID's?

Non-Steroidal Anti-inflammatory Drugs Inhibit Ovulation

Exposure to Non-Steroidal Anti-inflammatory Drugs During Pregnancy, and the Risk of Miscarriage

WHO on Oral Contraceptives

NCI on Oral Contraceptives Feb 2018

Johns Hopkins News-Letter - Birth Control Under New Scrutiny

Hormonal Contraceptives and Increased Risk of Brain Tumor