Ibuprofen or Naproxen for Period Cramps: Which and When

Ibuprofen works well for period cramps, and naproxen works about as well. Trials have not shown that one of them is clearly better, so the main difference is how long a dose lasts: you take ibuprofen every 4 to 6 hours and naproxen every 8 to 12 hours.

Both work best if you take them at the first sign of your period or pain. This guide puts the two side by side and gives the doses from the over-the-counter label. It also lists who should not take them and explains when cramps that do not ease can be a sign of endometriosis or adenomyosis. It is general information and not medical advice.

Quick answer: ibuprofen vs naproxen for period cramps

Choose the one that suits your day. With naproxen, one or two doses can cover a school day, a workday or a night. With ibuprofen, you can start with one tablet and take the next dose sooner. If one of them has worked for you before and your stomach is fine with it, that is a good choice.

How ibuprofen and naproxen ease period cramps

Before and during your period, the lining of your womb (uterus) makes chemicals called prostaglandins. They make the muscles and blood vessels of the womb squeeze, and their level is highest on the first day of your period. That squeeze is the cramp.

Ibuprofen and naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs). They reduce the prostaglandins your body makes, so the cramps get less severe. In trials, about 18% of people on a dummy pill got moderate or excellent pain relief, compared with 45% to 53% on an NSAID.

NSAIDs have side effects. Stomach upset, headache and drowsiness were more common on NSAIDs than on a dummy pill: where about 10% of people on the dummy pill had a side effect, 11% to 14% on an NSAID did. If painkillers make you feel sick, our guide to nausea during your period has tips.

Is ibuprofen or naproxen better for period cramps?

Neither one wins. A review of 80 trials compared 20 different NSAIDs for period pain. It found little evidence that any single NSAID gave better pain relief or was safer. Most of the head-to-head trials were small, so a small difference could still exist. For most people, the practical points matter more:

• How often you want to take a dose. Naproxen lasts longer, so you need fewer doses.
• How your stomach feels. Both carry the same stomach bleeding warning. If either one upsets your stomach, take it with food or milk.
• What has worked before. Your own record over a few periods is a better guide than any general rule.

Do not take ibuprofen and naproxen together, and do not take one straight after the other to get more relief. Taking two NSAIDs raises the chance of stomach bleeding. Also check the ingredients of cough and cold products, because some of them contain an NSAID. Do not take an over-the-counter NSAID with any other medicine for pain unless your doctor tells you to.

How to take them: the dose on the label

These are the directions for adults and children 12 and older on the over-the-counter Drug Facts label. Always follow the label on your own pack, because tablet strengths can differ. A pharmacist can check the dose with you and tell you if it is safe with your other medicines.

Ibuprofen 200 mg tablets. The label directions are:

• Take 1 tablet every 4 to 6 hours while the pain lasts.
• If 1 tablet does not help, you can take 2 tablets.
• Do not take more than 6 tablets in 24 hours unless a doctor tells you to.

Naproxen sodium 220 mg tablets. The label directions are:

• Take 1 tablet every 8 to 12 hours while the pain lasts, with a full glass of water.
• For the first dose, you can take 2 tablets within the first hour.
• Do not take more than 2 tablets in any 8 to 12 hour period, or more than 3 tablets in 24 hours.

For both medicines, use the smallest dose that works, and take it with food or milk if it upsets your stomach. Stop and ask a doctor if the pain gets worse or lasts more than 10 days. For children under 12, ask a doctor.

If the label dose does not help, do not take more. Talk to a doctor. The pain may need a different treatment, and it may have a cause that is worth finding.

Why starting at the first sign of your period helps

NSAIDs work best if you take them at the first sign of your period or pain, and you usually need them for only 1 or 2 days. Prostaglandin levels are high on the first day and go down as your period goes on. If you take an NSAID early, it can lower prostaglandins before the cramps build up. If you wait until the pain is at its worst, the medicine has more to catch up on.

In practice, this means:

• Keep your NSAID with you in the days before your period is due.
• Take the first dose when the bleeding or the first cramp starts. Do not wait to see if it gets bad.
• On day one and day two, if the cramps go on, take the next dose when the label time gap allows.

A cycle record makes this easier, because it shows you when your period is likely to start.

Who should not take ibuprofen or naproxen, or should ask first

People with bleeding disorders, asthma, an aspirin allergy, liver damage, stomach disorders or ulcers should not take NSAIDs unless a doctor says it is safe. The same warnings apply to ibuprofen and naproxen.

Stomach ulcers or bleeding. NSAIDs can cause severe stomach bleeding. The chance is higher if you:

• Are 60 or older
• Have had stomach ulcers or bleeding problems
• Take a blood thinner (anticoagulant) or a steroid medicine
• Take another NSAID, such as aspirin
• Have 3 or more alcoholic drinks every day
• Take more, or for longer, than the label says

Asthma triggered by aspirin. Ibuprofen and naproxen can cause a severe allergic reaction, especially in people who are allergic to aspirin. Wheezing is one of the signs. If you have asthma, and more so if you also have nasal polyps or a stuffy or runny nose most of the time, tell your doctor before you take an NSAID.

Kidney disease, heart disease or high blood pressure. Ask a doctor first if you have high blood pressure, heart disease, liver cirrhosis, kidney disease or asthma, have had a stroke, or take a water pill (diuretic). NSAIDs other than aspirin raise the risk of heart attack, heart failure and stroke, and the risk is higher if you take more or for longer than the label says. Do not take them right before or after heart surgery.

Blood thinners and some other medicines. Tell your doctor or pharmacist if you take a blood thinner, a steroid, or an SSRI or SNRI antidepressant. If you take low-dose aspirin for your heart, ask first, because ibuprofen and naproxen can reduce this benefit of aspirin.

Pregnancy. If you are pregnant or breastfeeding, ask a health professional before you take an NSAID. It is especially important not to use them at 20 weeks of pregnancy or later unless a doctor tells you to, because they can cause problems for the baby or during delivery.

If you cannot take NSAIDs: acetaminophen

Acetaminophen (paracetamol) is a different kind of painkiller. It changes the way the body senses pain. In trials it gave less relief for period pain than NSAIDs, but it can still help when an NSAID is not safe for you. Ask a doctor or pharmacist if it suits you.

Take it safely:

• Follow the label, and do not take more than 4,000 mg in a day from all products. Too much can cause serious liver damage.
• Take only one product that contains acetaminophen at a time. Many cold and flu products contain it, and labels can shorten its name to APAP.
• Do not take it if you have 3 or more alcoholic drinks every day, and tell your doctor if you have liver disease.

Heat on your lower belly, such as a heating pad or a hot water bottle, can also be soothing.

When NSAIDs do not help: endometriosis or adenomyosis

Most period cramps come from prostaglandins alone. Sometimes a condition in the pelvis causes the pain. Doctors call this secondary dysmenorrhea. Endometriosis, adenomyosis and fibroids are common causes.

This pain tends to get worse over time and often lasts longer than normal cramps. It may start a few days before your period, get worse as the period goes on, and not go away when it ends. Look out for these signs:

• NSAIDs at the label dose, taken at the first sign of your period, do not ease the pain
• The pain stops you from going to school, work or your usual activities
• Your periods get more painful over the years
• The pain goes on after your period ends
• You also have pain during sex, or when you pee or poo

If this sounds like you, read how endometriosis pain differs from normal period cramps and the symptoms of adenomyosis. If medicines do not relieve your pain, treatment should focus on finding the cause, for example with an ultrasound or a laparoscopy. Our guide to getting diagnosed with endometriosis explains the steps.

What to track

A short record over two or three periods shows which medicine works for you. It also gives a doctor facts instead of "the painkillers don't work". Note:

• The cycle day and time the cramps start
• Which medicine you took, how many tablets, and the time of each dose
• Your pain from 0 to 10 before the dose and 1 to 2 hours after it (our period pain scale can help you pick a number)
• Side effects, such as stomach pain or heartburn
• How many days you needed pain relief, and days you missed school, work or plans
• Other symptoms, such as heavy bleeding, back pain, nausea or pain during sex

Endolog lets you log pain, medicines and symptoms next to your cycle and share a report with your doctor. Our pain diary for your doctor shows what to bring to an appointment.

When to see a doctor

See a doctor if:

• NSAIDs at the label dose, taken early, do not ease your cramps over two or three periods
• The pain keeps you from your usual activities
• Your periods have become more painful over time, or the pain lasts after your period ends
• Your pain lasts more than 10 days or gets worse while you take an NSAID
• NSAIDs give you stomach pain or heartburn
• You have one of the conditions above and you are not sure which painkiller is safe for you

Severe period pain is a medical problem, and you deserve treatment for it. If you want help to put the pain into words, see how to describe period pain.

Get urgent help

Stop the NSAID and get medical help right away if you have signs of stomach bleeding:

• You feel faint
• You vomit blood, or vomit that looks like coffee grounds
• You have bloody or black, tarry stools
• You have stomach pain that does not get better

Call 911 in the US, or your local emergency number, if you have signs of a severe allergic reaction, such as facial swelling, hives or wheezing. Also call if you have chest pain, shortness of breath, weakness in one part or side of your body, or slurred speech. Go to the emergency department if you have sudden, severe pain in your belly or pelvis, and more so if you could be pregnant.

FAQ: ibuprofen and naproxen for period cramps

Is ibuprofen or naproxen better for period cramps?

Neither is clearly better. Trials found little evidence that any single NSAID works better or is safer. Naproxen lasts longer, so you take fewer doses. Ibuprofen lets you start with one tablet and adjust sooner.

How much ibuprofen can I take for period cramps?

The over-the-counter label for 200 mg tablets says to take 1 tablet every 4 to 6 hours, or 2 if 1 does not help, and no more than 6 tablets in 24 hours unless a doctor tells you to. Check the label on your own pack, and ask a pharmacist if you are not sure.

How long does naproxen last for period cramps?

One dose of naproxen sodium lasts 8 to 12 hours, so the label allows up to 3 tablets in 24 hours. That makes it a good choice if you want to cover the night or a long day with fewer doses.

Can I take ibuprofen and naproxen together?

No. Both are NSAIDs, and taking more than one NSAID raises the chance of stomach bleeding. Pick one. If it does not help at the label dose, talk to a doctor or pharmacist.

What can I take for period cramps if I can't take ibuprofen?

Acetaminophen (paracetamol) is an option when NSAIDs are not safe for you. It gave less relief than NSAIDs in trials, but it can still help, and heat on your lower belly can help too. If cramps come back every month, ask a doctor about hormonal birth control, which can treat painful periods.

Why doesn't ibuprofen help my period cramps?

The dose may have come too late, since NSAIDs work best at the first sign of your period or pain. If early doses at the label amount still do not help, a condition such as endometriosis or adenomyosis may cause the pain. If medicines do not relieve your pain, the next step is to find the cause, so see a doctor.

Related articles

• Endometriosis Pain vs. Normal Period Pain: Key Differences
• Back Pain During Period: Causes, Relief and When to Worry
• Where Are Period Cramps Felt? A Map of Period Pain
• Nausea During Your Period: Why It Happens and What Helps
• Adenomyosis Symptoms: Heavy Periods, Pain, and What to Track
• Free Printable Pain Diary for Your Doctor: What to Track

This article is for general information. It is not medical advice and does not replace advice from your own doctor or pharmacist, who can tell you which medicine is right for you. If you think you have an emergency, call 911.