NSAIDs for Painful Periods—How They Work and The Impact On Your Health
If you struggle with moderate to severe period pain, you’re most likely familiar with a variety of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen. These substances are widely used in branded pain relievers that many women rely on for period cramps since they can easily be found over-the-counter.
NSAIDs work well to alleviate pain, like the kind we experience during a period, while also reducing fever and inflammation.
In this post, you’ll learn exactly how NSAIDs work to reduce period cramps and the underlying consequences that menstruating women face with prolonged use.
Skip ahead to part two for my path to pain-free periods and the practical diet, exercise, and lifestyle changes I’ve implemented along the way.
Short on time? Here are the key takeaways ↓
The sudden change in hormones that occurs before and during your period can bring undesirable symptoms including cramping, headaches, and body aches. NSAIDs provide quick, reliable relief.
NSAIDs are widely used to relieve pain and inflammation by blocking the COX enzyme which is a key player in gut health.
Your gut, revered as the “second brain” and the “gateway to health,” supports everything from your immune system and stress management to mood and brain function. Chronic use of NSAIDs can increase intestinal permeability which damages gut health.
NSAIDs can reduce menstrual flow and prolong pain during your period because they interfere with prostaglandins via the inhibition of the COX enzyme.
NSAIDs can actually reduce menstrual flow and prolong pain. This means, when the medicine wears off, the pain wears on.
How Do NSAIDs Reduce Pain?
NSAIDs work by inhibiting a specific enzyme whose primary function is to protect the lining of the stomach and maintain healthy kidney function. This enzyme, called cyclooxygenase (COX), is also produced when inflammation or injury occurs to help create prostaglandins. We will discuss the role of prostaglandins in period pain next, but it’s helpful to know that these hormone-like chemicals are produced when tissue damage or infection occurs to signal inflammation, pain, and fever which are part of the body’s natural healing process.
Eliminate prostaglandins and you temporarily eliminate your pain symptoms.
Takeaway ➞ NSAIDs are widely recognized for effectively blocking both forms of the COX enzyme to eliminate pain and inflammation. The collateral damage on the stomach and other organs however, often flies under the radar.
The Root Causes of Period Pain and Why NSAIDs Provide Quick Relief for Menstrual Malaise
A Sudden Drop in Hormones
Period pain is largely a function of the inflammation and stress that occurs when hormones take a nosedive at the end of your cycle. The sharp decline in estrogen and progesterone signals the release of the uterine lining and the production of prostaglandins which are hormone-like substances that help the uterus contract and relax to promote period flow.
Higher levels of prostaglandins can lead to more painful periods.
The drop in estrogen levels around your period can also bring headaches and other symptoms like nausea and fatigue. With lower estrogen, levels of the feel-good hormone serotonin decrease. When you have less feel-good hormones, you might experience the mood disruptions that many women associate with PMS and their period.
Blood Stagnation and Decreased Flow
In Traditional Chinese Medicine, painful periods may indicate blood stasis or improper circulation in and around the pelvis. If you experience moderate to severe cramps before the onset and during the first few days of your period, it may be the result of stagnation in the uterus where the lining gets “stuck” and causes pressure and inflammation. You might also experience bloating and lower back pain when circulation is sluggish with large clots and a slow-to-start menstrual flow.
Anecdotally, this was my experience for many years—very strong cramps with scant flow until my full bleed broke through. Once the pressure was released and I moved into heavy flow, the pain improved significantly.
Increased Inflammatory Response
In addition to rising hormone levels in the second half of the cycle, inflammation tends to flare up during the luteal phase when your immune system comes back online after taking a short break during ovulation.
The body downregulates immune function when you are most fertile to lower your guard against potential foreign invaders, namely sperm. If fertilization does not occur, your immune system returns to its regular state of defense, which can cause inflammation.
When the body is inflamed, more prostaglandins are produced which worsens PMS and intensifies period cramps. (1,2) This is one of the primary causes of painful periods.
NSAIDs to the Rescue
The bottom line? With their two-fold assault on inflammation and pain, NSAIDs address many of the symptoms women experience around their periods, making them a go-to for menstruators who might otherwise be sidelined during this hormonally turbulent time.
Takeaway ➞ The sudden change in hormones that occurs before and during your period can bring undesirable symptoms including cramping, headaches, and body aches. NSAIDs provide quick, reliable relief for period pain and can soothe inflammation during the luteal and menstrual phases.
A Band-Aid With Consequences
The trouble with NSAIDs is that they do not address the root cause of period pain and inflammation. Instead, they merely inhibit the production of prostaglandins for quick relief—like a band-aid.
Short-Term Relief Can Prolong Period Pain
The immediate relief provided by NSAIDs is reversible (with the exception of aspirin) and declines rapidly between doses as a result of a short half-life. (3)
Not to mention that by halting the production of the chemicals that facilitate uterine contraction, NSAIDs can actually reduce menstrual flow. This may initially sound like a plus, but in slowing the flow, your period might last longer and prolong your pain.
When the medicine wears off, the pain wears on.
Takeaway ➞ NSAIDs can reduce menstrual flow and prolong pain during your period.
NSAIDs Can Also Wreak Havoc on Your Gut
As mentioned above, the COX enzyme is responsible for maintaining the stomach lining.
When this enzyme is repeatedly blocked with the chronic use of NSAIDs, increased intestinal permeability allows larger toxins and bacteria to prematurely enter the bloodstream, which compromises your gut function.
This not only produces more inflammation and discomfort, but may affect your ability to extract energy from food and can be the precursor to other diseases.
Your gut is a powerhouse of immune function and feel-good hormones—it produces 70–80% of your immune system and 95% of mood-boosting serotonin. (4)
So while a few days of around-the-clock Advil during a painful period may not cause leaky gut or immediate consequences, your intestinal lining can become “injured” with repeated use which chips away at your gut health over time.
Poor gut health can lead to symptoms of hormone imbalance because your hormones are largely produced in your stomach.
The bottom line? We need a healthy gut in order to have happy periods. If you already struggle with hormone symptoms or an imbalance of good bacteria in your gut, relying on NSAIDS for period pain may be standing in the way of healing.
Takeaway ➞ Your gut, revered as the “second brain” and the “gateway to health,” supports everything from your immune system and stress management to mood and brain function. While not immediately dangerous, chronic use of NSAIDs can increase intestinal permeability which damages gut health.
Other Health Concerns You Should Be Aware Of
In addition to negatively impacting gut health, these pain relievers have wide-ranging side effects with frequent use. NSAIDs interfere with the kidneys’ natural filtration process which can be problematic for your immune system and kidney function. They’ve also been linked to heart disease and liver damage.
What To Use Instead
Again, you’re not likely to experience organ failure with one cycle of NSAID use, but if you’re popping pain relievers just to get through the day during repeated painful periods, it may be worth looking into alternatives.
Which is why I’m excited to share what has worked for me in part two of this blog post: Why I Ditched NSAIDs for Period Pain ➞
Ready to get started on the path to pain-free periods with cyclical movement as medicine?
Join lunae on YouTube to get access to a growing catalog with hundreds of phasic workouts and practices to support your cycle all month long.
Bertone-Johnson, E. R., Ronnenberg, A. G., Houghton, S. C., Nobles, C., Zagarins, S. E., Takashima-Uebelhoer, B. B., Faraj, J. L., & Whitcomb, B. W. (2014). Association of inflammation markers with menstrual symptom severity and premenstrual syndrome in young women. Human reproduction (Oxford, England), 29(9), 1987–1994. https://doi.org/10.1093/humrep/deu170
Gold, E. B., Wells, C., & Rasor, M. O. (2016). The Association of Inflammation with Premenstrual Symptoms. Journal of women's health (2002), 25(9), 865–874. https://doi.org/10.1089/jwh.2015.5529
FitzGerald G. A. (2003). Parsing an enigma: the pharmacodynamics of aspirin resistance. Lancet (London, England), 361(9357), 542–544. https://doi.org/10.1016/S0140-6736(03)12560-3
Carpenter, S. (2012, September). That gut feeling. Monitor on Psychology, 43(8). https://www.apa.org/monitor/2012/09/gut-feeling
