Best Painkillers for Period Cramps: What 80 Trials Found
PeriodsArticleAnti-inflammatory painkillers like ibuprofen and naproxen have the strongest trial record for period cramps. Across 80 trials, about half of women got moderate or excellent relief on them, against 18% on placebo, and no single brand stood out. The combined pill also eased cramps, at the cost of more irregular bleeding. Here is what the reviews found and when cramps need a closer look.
In this article
Most women reach for a painkiller on the first day of a bad period. Two Cochrane reviews show what the trials found.
Anti-inflammatory painkillers (NSAIDs)
NSAIDs include ibuprofen and naproxen. A review of 80 trials with 5,820 women found:1
| Placebo | NSAIDs | |
|---|---|---|
| Moderate or excellent pain relief | About 18 in 100 | 45 to 53 in 1001 |
| Side effects | About 10 in 100 | 11 to 14 in 1001 |
- No single NSAID was clearly better or safer than another.1
- NSAIDs appeared more effective than paracetamol (acetaminophen), in three small trials.1
- The evidence was rated low quality, mainly from poor reporting, and most trials were company-funded.1
So NSAIDs help about half of women a lot, and leave the other half needing something more. A cramp that outlasts the pill isn’t you doing something wrong.
The combined pill
A 2023 review of 21 trials with 3,723 women found the combined birth control pill gave a moderate reduction in period pain.2 The trade-offs:2
- Irregular bleeding rose from about 18% to between 39% and 60%.
- Headaches and nausea were probably more common.
- Taking the pill continuously, without the break week, may relieve pain better than the usual regimen.
There wasn’t enough data to say whether NSAIDs or the pill work better.2
Other things that help
Heat on your belly, a warm bath and gentle exercise are all on UK self-help advice.3 See heat pads and patches and exercise for cramps.
When cramps need a closer look
See a doctor if:3
- Periods become more painful, heavier or irregular
- Pain stops your usual activities
- You have pain during sex or when peeing or pooing
- You’re bleeding between periods
These can point to conditions like endometriosis or fibroids. See why your cramps are so bad and what endometriosis is.
Try: “Ibuprofen takes the edge off my cramps but I still miss a day of work every month. What should I try next?”
Period, Handled covers this in Chapter 7, “Cramps That Stop You,” in a section called “What the Trials Support.” Its Pain Kit plans what you’ll reach for, and when, before day one arrives. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Anti-inflammatory painkillers aren't safe for everyone, including people with some stomach, kidney, heart or bleeding conditions, asthma triggered by these drugs, or those on blood thinners; ask a pharmacist first and follow the label. Get urgent help for sudden severe pelvic pain, fainting or fever. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- Cochrane Database of Systematic Reviews, NSAIDs (via PubMed Central), 2015Nonsteroidal anti-inflammatory drugs for dysmenorrhoea (opens in a new tab)abcdef
- Cochrane Database of Systematic Reviews, combined pill (via PubMed Central), 2023Combined oral contraceptive pill for primary dysmenorrhoea (opens in a new tab)abc
- NHS, 2025Period pain (opens in a new tab)ab
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