WITH new research finding that menstrual issues are often normalised or trivialised and undermanaged in young people, the study's lead author says pharmacists are ideally placed to advise on pain management.
The research team from the Murdoch Children's Research Institute in Melbourne worked directly with adolescents and their parents to better measure the impact of menstruation and identify ways to reduce stigma and ignorance among medical professionals and the wider public.
One of the major themes to emerge was around pain and pain management, and another related to the physical and psychological impact of pain and bleeding.
Many of the participants reported unsympathetic GPs, inexperienced in providing appropriate strong pain relief to young people, while parents described difficulties getting appointments with gynaecologists.
Lead author Dr Courtney Munro (pictured) has previously worked as a hospital and consultant pharmacist, including spending time in community pharmacy, and spoke to Pharmacy Daily about the role pharmacists can play in menstrual pain management.
Dr Munro said previous research with 1,800 12-18 year-olds found that 85% reported painful periods, but only half took medication, and half of those took paracetamol.
"People will often come into a pharmacy looking for a medication, maybe on the advice of the doctor or maybe independently.
"And while paracetamol is good for most things, for primary dysmenorrhoea, or period pain, which is inflammation based, your first call is really an anti-inflammatory - and I'm not sure that message is clear at the community level," Dr Munro told Pharmacy Daily.
"Obviously there are cases where you wouldn't use an NSAID, but for most people who don't have precautions or contraindications, this is the best option," she said.
"The other thing with NSAIDs is that they reduce bleeding, perhaps by 30% if people have heavy bleeding," she added.
Dr Munro also stressed the importance of early and adequate dosing, pointing out that the pain is worse the day before the period starts and for the first few days.
"And a single daily dose is not enough for those with severe dysmenorrhoea - they should be taking whatever the package says is the maximum daily dose if it's over the counter."
Dr Munro says no one NSAID is better than another, whether ibuprofen, mefenamic acid or naproxen sodium, as long as the dosing is appropriate.
"And if they've got heavy bleeding, they should really be having a chat with the GP because there are other things that we can do to treat it, such as tranexamic acid or oral contraceptives, which will need a prescription."
Read the research paper HERE. KB
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