Our Health Information Line receives calls and emails from women on a broad range of health issues. This regular column features answers to some of them.
Q I am 22 and take ibuprofen for period pain and always thought that you should take it with food. Recently, I read that this is not the case - that it is best to take on an empty stomach. Can you clarify?
A Previously the advice in Australia was to take ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) with food or milk as it was thought that this would reduce the impact the medication had on the lining of the stomach. Long term use of NSAIDs can cause gastric ulcers. However, recently, the Australian Medicine’s Handbook changed its advice, stating that ibuprofen can be taken with water alone.
The reason for this change is that when ibuprofen is taken with food it slows the absorption of the drug, meaning that people don’t receive pain relief as quickly. For example, if people take ibuprofen with food, the peak concentration in the blood (which is related to pain relief) occurs between 1.5 to 3 hours afterwards. If they take the ibuprofen with just water, the peak blood concentration occurs after just 45 minutes. The delay in pain relief that occurs when people take ibuprofen with food can lead to people taking more doses over time, which in fact increases their risk of damaging their stomach lining. In addition, people were often left in pain while waiting to take ibuprofen with a meal.
The new advice is for people who do not have a history of stomach problems such as a gastric ulcer. These people should consult their doctor for specific advice. Some people experience more side effects when they take ibuprofen on an empty stomach such as nausea, vomiting, diarrhoea or stomach upsets. If you experience these side effects, it might still be best to take the ibuprofen with food.
Ibuprofen helps with period pain by decreasing the production of prostaglandins in the body. Prostaglandins cause inflammation and help the uterus to contract during menstruation so that the uterine lining can be expelled. They are, therefore, associated with the pain and cramping associated with period pain. For ibuprofen to be most effective at treating period pain, it needs to be taken before the prostaglandins are produced. If your cycle is quite regular taking the ibuprofen the day before your period is due is ideal. Otherwise take it at the first sign of bleeding or when you first experience the period pain.
If your period pain is causing you to take time off from work, study or social activities, you should visit your doctor as you might have endometriosis. Endometriosis is a condition where tissue similar to that which normally lines the uterus grows in other parts of the body. Symptoms of endometriosis can include period pain, pelvic and abdominal pain outside of menstruation, heavy periods, pain during sexual intercourse, painful bowel motions and difficulty in getting pregnant. For more information on endometriosis, please see our Endometriosis fact sheet.
Last updated: December 2016
© Women’s Health Queensland Wide Inc. This article was written by Kirsten Braun and reviewed by the Women’s Health Queensland Wide editorial committee. It was published in Health Journey 2016 Issue 4.