A Research Review on the Effects of Ibuprofen on Menstrual Blood Flow

By: Kurt Ashley Mirano

Introduction
According to recent studies, menstrual symptoms, such as heavy periods, have been related to
approximately nine days of lost productivity per woman each year (Worley, 2021). A closer look reveals that
women who have heavy bleeding, and who experience painful periods, have elevated levels of hormones
called prostaglandins. As defined by the National Center for Biotechnology Information (NCBI),
prostaglandins are a group of lipids made at sites of tissue damage or infection. They assist the body to
remove the uterine lining by producing muscular contractions, which widen blood vessels and decrease the
clotting process. This delineates why having higher levels of these hormones can lead to heavier bleeding
and more severe cramping. As the field of gynecology progressed through the years, reviews on drugs that
could combat prostaglandin levels of women were preeminent — with a direct focus on the drug Ibuprofen.

Introduced as a better alternative to Aspirin in 1969, Ibuprofen was the first member of propionic acid
derivatives and is a popular domestic and over-the-counter painkiller and antipyretic for adults and children
(Bushra & Aslam, 2010). It is the most frequently used and prescribed NSAID which inhibits inflammatory
reactions and pain by decreasing the activity of cyclooxygenase, subsequently decreasing prostaglandin
synthesis. Relevantly, Ibuprofen is approved by gynecologists to be an effective first-line treatment option
for painful periods. Studies have shown that Ibuprofen reduces prostaglandin levels in the lining of the
uterus, which could be one way it reduces menstrual flow, though the exact mechanism remains uncertain.
This process is considered as the main reason why this drug, specifically, its variant Racemic Ibuprofen
and S(+) enantiomer, is mainly used in the treatment of mild to moderate pain related to dysmenorrhea.
This paper aims to direct a review on the effects of Ibuprofen on menstrual blood flow through a guided
perspective derived from the following: nursing considerations, management, and innovations.

Nursing Considerations
In administering Ibuprofen to any patient with or without heavy menstrual blood flow, the first nursing
consideration is assessment. The nurse must assess if the patient has a history of allergy to ibuprofen,
salicylates, or other NSAIDs; CV dysfunction, hypertension; peptic ulceration, GI bleeding; impaired hepatic
or renal function; pregnancy; lactation. A physical examination is also imperative, with a keen eye on skin
color, lesions; T; orientation, reflexes, ophthalmologic evaluation, audiometric evaluation, peripheral
sensation; P, BP, edema; R, adventitious sounds; liver evaluation, bowel sounds; CBC, clotting times,
urinalysis, LFTs, renal function tests, serum electrolytes, stool guaiac. It is also important to conduct
interventions with respect to some warnings. Patients must be monitored accordingly as they may be at
increased risk of CV events, GI bleeding. The drug should also be administered with food or after meals if
GI upset occurs and an arrangement for periodic ophthalmologic examination during long-term therapy.
Ibuprofen should be discontinued if eye changes, symptoms of hepatic impairment, or renal impairment
occur. If an overdose occurs, institute emergency procedures must be applied: gastric lavage, induction of
emesis, and supportive therapy.

Management
Although most commonly used and prescribed for regulating menstrual blood flow, Ibuprofen must only be
used as suggested to avoid overdosage. IF GI upset occurs, the drug should be taken with food or after
meals. It is also important to avoid over-the-counter drugs for the reason that many of these drugs contain
similar medications, and serious overdosage can occur. There are also certain side effects such as nausea,
GI upset, dyspepsia, drowsiness, dizziness, vertigo, and insomnia. If sore throat, fever, rash, itching, weight
gain, swelling in ankles or fingers, changes in vision, black or tarry stools occur, immediately advise the
patient to report it to medical professionals.

Innovations
Presently, Ibuprofen is usually available over the counter as tablets or capsules in doses of 200–400 mg
and can be taken up to three times a day after food. Aside from tablet type Ibuprofen, another innovation of
this drug is administering it through a syringe. Further research suggests that in the future, people can take
Ibuprofen via a skin patch (Felton, 2020). According to British researchers, the technology they developed
in collaboration with Medherant, a bioadhesives firm, might revolutionize the way over-the-counter pain
relievers are sold. Despite the fact that medical patches and gels are not new, Medherant claims that their
technology improves their effectiveness and design: The translucent, "highly-tacky" patches linger on the
skin all day long yet are nonetheless easy to remove. They also give a larger (but constant) dosage of
medicine than comparable products—five to ten times more. This might be applied to women's lower
abdomens as patches for more convenient and pleasant pain treatment.
References:
1. Pulkkinen, M., & Csapo, A. (1979). Effect of ibuprofen on menstrual blood prostaglandin levels in
dysmenorrheic women. Prostaglandins, 18(1), 137–142. https://doi.org/10.1016/s0090-
6980(79)80031-3

2. Bushra, R., & Aslam, N. (2010). An Overview of Clinical Pharmacology of Ibuprofen. Oman
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3. P. (n.d.). Ibuprofen. PubChem. Retrieved September 14, 2021, from

https://pubchem.ncbi.nlm.nih.gov/compound/ibuprofen

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menstrual-flow

5. NURSING CONSIDERATIONS FOR IBUPROFEN . (2020, September 14). Histotechnology Group

of Queensland. https://www.hgq.org.au/blog/eo9h6.php?id=6a9489-nursing-considerations-for-
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6. ibuprofen Nursing Considerations & Management . (2019, February 13). RNpedia.

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7. Felton, K. (2020, September 3). In the Future, You Might Be Able to Take Ibuprofen Via a Skin

Patch. Health.Com. https://www.health.com/condition/rheumatoid-arthritis/ibuprofen-skin-patch