Ask the doctor: I need a stronger painkiller for period pain. What can I take?
Got a medical question or need health advice? Dr Jennifer Grant has the answers
Dear Doctor, At the 'time of the month' I've always experienced some cramping, but lately it has amplified. I wake with pains in my legs and feel slightly achy. Is this normal or should I be worried? And is there anything stronger than ibuprofen that I can take for the pain?
Dr Jennifer's reply: It sounds like you are suffering with a condition called 'dysmenorrhea' or painful periods. Sometimes there are underlying reasons why this happens, such as fibroids, firm compact benign tumours in the womb or endometriosis, a condition where endometrial tissue or the lining of the womb is found outside the womb and causes pain. However in the majority of cases, no underlying condition is found and these are termed 'primary' dysmenorrhoea.
The pain typically starts one or two days before your period and can last up to 72 hours after and is usually confined to the lower abdomen. Some women describe low back pain or thigh pain, but it is unusual to travel any further down your leg.
Stronger NSAIDs (non-steroidal anti-inflammatory drugs) medication is available with a prescription from your GP. Mefenamic acid is the most commonly prescribed for dymenorrhea, but occasionally, if contraception is needed, a combined oral contraceptive pill works well to inhibit ovulation (egg release from the ovary) and induce a 'withdrawal bleed' or lighter period. If after about three months on one or both of these medications you do not feel adequate relief of your symptoms, it would be worthwhile getting investigated for secondary causes of dymenorrhoea.