Managing Menstrual Pain: Safe Painkillers and Stomach Health Tips

Q: Managing Menstrual Pain: Safe Painkillers and Stomach Health Tips

Dear Miss Chen：<br>1. <br>I would like to inquire whether the following ingredients are harmful to the stomach： acetaminophen 500mg and the other excipients (the manufacturer did not specify the dosage)： hydroxypropyl cellulose, polyvinylpyrrolidone, polyethylene glycol 6000, sod

Inquiring about whether painkiller ingredients harm the stomach & methods to alleviate menstrual pain?

Hello Dr.
Hsiao,
I experience severe menstrual cramps almost every month, to the extent that I vomit if I drink water or eat anything (I previously consulted a gynecologist who mentioned it might be due to elevated prostaglandin levels).
The pain usually starts when my period begins, but I take painkillers before the pain starts, which sometimes leads to taking them on an empty stomach.
Additionally, I read online that painkillers containing acetaminophen are more effective when taken before meals.
1.
I would like to ask if the following ingredients are harmful to the stomach: acetaminophen 500mg and the other excipients (the manufacturer did not specify the dosage): hydroxypropyl cellulose, polyvinylpyrrolidone, polyethylene glycol 6000, sodium starch glycolate, magnesium stearate, magnesium aluminosilicate, and tartrazine.

2.
Can painkillers containing the above ingredients be taken on an empty stomach?

3.
Is it true that taking them before meals enhances their efficacy?

4.
If they should not be taken on an empty stomach, can they be taken with antacids in such a situation?

5.
Is it acceptable to take 1-2 tablets of the above painkillers each month?

6.
Are there any methods to alleviate severe menstrual cramps? (I have previously tried birth control pills, herbal remedies like Si Wu Tang, and other traditional Chinese medicine without success, and eventually gave up and only took painkillers.)
Thank you for patiently reading my questions.

Miss Chen, 20~29 year old female. Ask Date: 2023/12/11

Dr. Xiao Yongxun reply Family Medicine

Dear Miss Chen:
1.
I would like to inquire whether the following ingredients are harmful to the stomach: acetaminophen 500mg and the other excipients (the manufacturer did not specify the dosage): hydroxypropyl cellulose, polyvinylpyrrolidone, polyethylene glycol 6000, sodium starch glycolate, magnesium stearate, magnesium aluminosilicate, and tartrazine.

Answer: Theoretically, they should not harm the stomach; however, since acetaminophen is metabolized by the liver, an overdose can still cause liver damage or toxicity.
2.
Can pain relievers containing the above ingredients be taken on an empty stomach?
Answer: Yes, they can.
3.
Is it more effective to take them before meals?
Answer: Theoretically, if there is no food interference, most medications are better absorbed when taken before meals or on an empty stomach.
4.
If it is not advisable to take them on an empty stomach, but one must, can they be taken with stomach medication in that situation?
Answer: It depends on the specific medication being taken.
Some medications are more effective when taken after meals, while others may have reduced efficacy on an empty stomach.
Whether or not to take stomach medication also depends on the specific drug, and there is no definitive answer.
5.
Is it acceptable to take 1-2 tablets of the above pain reliever each month?
Answer: Theoretically, as long as it is within the body's capacity to metabolize and eliminate, it should not be a problem.
6.
Are there any ways to alleviate severe menstrual pain? (I have previously tried birth control pills, herbal remedies, and other methods without success, and have since given up and only take pain relievers.)
Answer: It would be best to discuss this issue with your primary care physician or visit a gynecologist.
There are many causes of menstrual pain, and the treatment methods vary accordingly.

Reply Date: 2023/12/11

More Info

Managing menstrual pain can be challenging, especially when it becomes severe enough to cause nausea and vomiting. Your situation, where you experience intense pain due to high levels of prostaglandins, is not uncommon. Prostaglandins are hormone-like substances that can cause the uterus to contract, leading to pain during menstruation. Here are some insights and recommendations regarding your questions about pain management, particularly concerning the use of acetaminophen and its effects on stomach health.

1. Acetaminophen and Stomach Health
Acetaminophen (also known as paracetamol) is generally considered to be gentler on the stomach compared to nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin. While NSAIDs can irritate the gastric mucosa and potentially lead to ulcers or gastrointestinal bleeding, acetaminophen does not have the same level of gastrointestinal side effects. However, it is important to note that taking any medication on an empty stomach can sometimes lead to discomfort, although acetaminophen is less likely to cause this compared to NSAIDs.

2. Taking Painkillers on an Empty Stomach
While acetaminophen can be taken on an empty stomach, it is usually recommended to take it with food to minimize any potential stomach discomfort. If you find that you need to take it on an empty stomach due to the severity of your pain, it is generally safe, but you should monitor how your stomach reacts.

3. Efficacy When Taken Before Meals
Taking acetaminophen before meals can help in managing pain effectively, as it allows the medication to enter your system before the onset of pain. However, the timing of the medication should be based on your pain pattern. If your pain typically starts with the onset of menstruation, taking it beforehand can be beneficial.

4. Combining with Stomach Medications
If you must take acetaminophen on an empty stomach and are concerned about potential stomach discomfort, you can consider taking an antacid or a proton pump inhibitor (PPI) alongside it. This can help protect your stomach lining and reduce the risk of discomfort. However, it’s essential to consult with a healthcare provider before combining medications to ensure safety and efficacy.

5. Frequency of Use
Taking acetaminophen 1-2 times a month for menstrual pain is generally considered safe, provided you do not exceed the recommended dosage (typically 3000-4000 mg per day for adults). However, if you find yourself relying on it frequently, it may be worth discussing with your healthcare provider to explore other long-term management strategies.

6. Alternative Pain Management Strategies
Since you have tried various methods without success, here are some additional strategies that may help alleviate menstrual pain:
- Heat Therapy: Applying a heating pad or hot water bottle to your abdomen can help relax the muscles and reduce pain.

- Exercise: Regular physical activity can help reduce the severity of menstrual cramps for some women.

- Dietary Adjustments: Maintaining a balanced diet rich in omega-3 fatty acids, fruits, and vegetables may help reduce inflammation and pain.

- Herbal Remedies: Some women find relief with herbal teas such as ginger or chamomile, which may have anti-inflammatory properties.

- Mind-Body Techniques: Practices such as yoga, meditation, or deep-breathing exercises can help manage stress and reduce pain perception.

If your menstrual pain continues to be severe and unmanageable, it may be beneficial to revisit your healthcare provider for further evaluation. They may suggest other treatment options, such as hormonal therapies or alternative medications that could provide better relief without compromising your stomach health.

In conclusion, while acetaminophen can be a safe option for managing menstrual pain, it’s essential to consider your overall health and any potential interactions with other medications. Always consult with a healthcare professional for personalized advice tailored to your specific health needs.

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