Menstrual cramps (primary dysmenorrhea) are usually managed at home: an over-the-counter NSAID like ibuprofen or naproxen plus heat and gentle activity relieves pain in most people. See a clinician if cramps are severe, getting worse, or don't respond to painkillers, since they can occasionally signal an underlying condition.
Available without a prescription — follow each label.
Advil, Motrin NSAID (nonsteroidal anti-inflammatory drug) | First-choice OTC option. NSAIDs lower the prostaglandins the uterus makes, which both ease the cramping pain and often reduce bleeding. Works best if started as soon as pain or bleeding begins. Avoid if you have ulcers/stomach problems, bleeding problems, liver disease, or an aspirin allergy; take with food. |
Aleve NSAID (nonsteroidal anti-inflammatory drug) | Another effective OTC NSAID; longer-acting than ibuprofen so it needs fewer doses per day. Same cautions as ibuprofen (avoid with ulcers, bleeding disorders, liver disease, or aspirin allergy). |
Bayer NSAID (salicylate) | An OTC NSAID that can relieve cramps, though it is generally less convenient than ibuprofen or naproxen. Not for anyone with bleeding problems or aspirin sensitivity. Do not give aspirin to teens or children because of the risk of Reye's syndrome. |
Tylenol analgesic (non-NSAID) | An option if NSAIDs aren't suitable (e.g., stomach ulcers or NSAID allergy). Because acetaminophen isn't anti-inflammatory, it generally relieves period pain less effectively than an NSAID, but it is gentler on the stomach. |
A doctor may prescribe these — not for self-treatment.
combined hormonal contraception the pill, patch, or ring estrogen-progestin contraceptive | A doctor may prescribe hormonal birth control (pill, patch, or vaginal ring) to thin the womb lining, making periods lighter and less painful — useful when cramps are recurrent or NSAIDs alone aren't enough. |
levonorgestrel intrauterine device hormonal IUD progestin-releasing IUD | A doctor may place a hormonal IUD, which can lighten periods and reduce cramping over time; it's a longer-term option for managing painful periods. |
prescription-strength NSAID (e.g., mefenamic acid) Ponstel (mefenamic acid) prescription NSAID | For severe cramps, a doctor may prescribe a stronger anti-inflammatory such as mefenamic acid, flurbiprofen, or prescription-dose naproxen — do not exceed OTC dosing of any NSAID on your own. |
treatment of an underlying condition condition-specific therapy | If cramps are due to a condition (secondary dysmenorrhea) such as endometriosis or fibroids, a doctor treats the cause — which may involve specific medications or, in some cases, surgery — rather than just symptom relief. |
For most people, start with an OTC NSAID — ibuprofen or naproxen — taken as soon as pain or bleeding begins, and pair it with heat (a hot water bottle or warm bath) and gentle movement like walking or yoga; this combination relieves cramps in the large majority of cases. Naproxen lasts longer so it needs fewer doses. If you can't take NSAIDs (ulcers, bleeding problems, liver disease, or aspirin allergy), acetaminophen is a gentler-on-the-stomach fallback, though it's generally less effective for cramps because it isn't anti-inflammatory. If cramps come back every cycle, are severe, or NSAIDs aren't enough, a clinician can discuss hormonal options (the pill, patch, ring, or a hormonal IUD) or check for an underlying cause. Hormonal contraception and stronger prescription NSAIDs are prescription-only — talk to a doctor rather than self-treating with them.
See a clinician if your period pain is severe, worse than usual, or getting worse over time, and painkillers haven't helped; if pain stops you doing day-to-day activities or doesn't improve within a few weeks; or if periods become heavier or more irregular. Also see a doctor if severe cramps start for the first time after age 25, cramps suddenly worsen, you have a fever with the pain, or you have pain outside of your period. Other red flags warranting evaluation include bleeding between periods, pain during sex or with urination/bowel movements, abdominal swelling, loss of appetite, or unexplained weight loss. Seek urgent care (in the US, your doctor or local urgent care; in the UK, NHS 111) if pelvic or period pain is severe or worse than usual and painkillers have not helped.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.