NSAID’s & Endometriosis – A Brief on a Scientific Study

I stumbled upon this in the medical databases last night while searching for any current research or information on endometrios my readers would find interesting. There were two articles that jumped out, and one of which I will highlight in today’s blog post. The first article covered the popular use of NSAID’s (namely Naproxen) as a popular treatment for endometriosis and whether or not it was an effective medical treatment. This interested me because, and I don’t know about you gals, but Naproxen doesn’t even touch my pain – especially when it’s cystic pain! Yet, gynecologist’s repeatedly swear by the stuff and refuse to prescribe anything worth my copay.

Unfortunately, all I could access was the abstract and not the full article (some have full articles, and some don’t), but it was an excellent abstract to work from. The study: Non-steroidal anti-inflammatory drugs for pain in women with endometriosis ; conducted by Allen C., Hopewell S., Prentice A., Gregory D. for Cochrane Database of Systematic Reviews (Online), 2009, Oxford, United Kingdom.

The study objectives were to: “To assess the effects of NSAID’s used for the management of pain in women with endometriosis compared to placebo, other NSAID’s, other pain management drugs, or no treatment” (Allen C., Hopewell S., Prentice A., Gregory D. 2009). The study showed that, when they compared Naproxen to a placebo, it produced no positive pain relief for women with endometriosis. They also found “inconclusive evidence” to suggest that these women, women who are prescribed Naproxen for their endometriosis pain, often have to seek further medication with other analgesics.

Another interesting note about their research – “There is no evidence on whether any individual NSAID is more effective than another” (Allen C,. et all 2009). I would like to note that when I was prescribed Naproxen and found no relief, I was then prescribed Cataflam (according to my doctor, a “stronger NSAID”). This didn’t help my cystic pain either. Eventually, I just learned to deal with the pain. After all, after I read through the side effects list that accompanied my prescription of Cataflam from Walgreens, I was not about to take any more than the first three days I had already taken. Cataflam, unlike Naproxen, required me to remain upright for 30 or 60 minutes (can’t remember how long, it’s been a long time since I’ve taken it) after I took it. When I read this in my pamphlet, “This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use Cataflam,” I just about hit the deck. I don’t like stuff that could cause heart attacks and strokes when I have stroke-like migraines!

And wow, even scientists acknowledge that NSAIDS are not good for us. “As shown in other Cochrane reviews, women using NSAIDs need to be aware of the possibility that these drugs may cause unintended effects” (Allen C., et all 2009).

Unintended effects??? You mean to tell me I can get “unintended effects” from a medication my doctor prescribes that’s 1) not even helping me and 2) he’s just giving me to shut me up and get me out of his office? Great, because I don’t have enough going against me right now! So, Mr. Scientist, what are these “unintended effects”? You know, other than it can kill me!
Side-effects:
– nausea
-vomiting
-headache
-drowsiness
-constipation
-decreased appetite

And now it gets serious:
-Kidney Failure
-Liver Failure
-Ulcers

I know, you are thinking “Endochick, those ‘serious’ things are only for people who abuse NSAID’s or take them long term.” Well, which category do you think endometriosis and chronic pain patients fall into? My doctor wanted me to take Naproxen and Cataflam for over two years, but I never refilled the prescriptions. The stuff made me feel icky and gross. And it never relieved my pain completely, so why bother.

How about you? Has NSAID’s helped your endometriosis? Or, like the study results, have you found they don’t really do much for your pain?

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22 responses to “NSAID’s & Endometriosis – A Brief on a Scientific Study

  1. autoimmunelife

    NSAIDs are NO help for my endo – tramadol barely even touches it – though it helps some….

    They help my lupus some by keeping the inflammation down, but I don’t want to be on them long term (at this point I take 2 alleve every 12 hours or so…..I hate that!)

    I can’t take most other NSAIDs – my body doesn’t react well with them – probably because of long term use in the past….. I actually end up with more inflammation in my legs… 😦

    So although I take alleve, I’m not a fan of NSAIDs at all…..

    J – http://autoimmunelife.wordpress.com

  2. I was given Naproxen when I was going through the diagnosis for Endo and for back pain. The drug was harsh on my stomach but did take away the pain, for a short period of time. I was given a drug called Tramadol(Relivia?) for my recent herniated disc problem and have found that it helps with the Endo spasms I get.
    Tramadol is habit forming and very expensive but I have found I need one pill to stop spasms and if I take the pill in the morning it will help throughout the day, it does last much longer then Naproxen or other over the counter pain relievers. Since I am newly diagnosed Endo patient I am trying to judge my pain levels and decide what is bareable and when I need to take a painkiller.

    • autoimmunelife

      If you get your tramadol at any of the pharmacies that do the $4 generics it’s just $4 for a 30 day supply… my husband gets 90 pills at a time and it’s only $13…. just to let you know.
      J

  3. NSAIDs, a drug I have come to loathe. I’ve been given Naproxyn on and off since my teens for my “period pain” saying that it would make me better. Sometimes it would make me sleepy, but what it did do for me was to create a lot of problems! I learned I am allergic to NSAIDs, not that I cry much over it since they didn’t help in the least, the hard way. When I took the Naproxyn orally, my mucousal linings broke out in little sores. I remember that my gums hurt so bad that I could barely chew, and drinking shakes were torture to my throat.

    One doctor gave me toradol through a IV, I broke out in welts all over my body.

    It was then thought, let’s give this chick some Indomethacin rectally. Well, it went okay for the first few suppositories, and then it felt like acid had been poured into open wounds in my stomach.

    My old pain doc’s wise idea, if oral Naproxyn didn’t work for me, let’s give me rectal Naproxyn since it isn’t processed by the body first. Well let’s just say that I couldn’t sit or move my buttocks for a full two weeks due to welts, and that I had to use lidocaine gel just to attempt to keep from screaming.

    Even when yesterday my high-risk suggested I could take ibuprofen for some pain, I had to tell her that something as simple as an Advil makes me develop small bruises all over my body. The last time I took an Advil out of desperation, I ended up with 40-50 said bruises. What is that doing to my body?!

    Not a single one of these was beneficial to my pain, aside from the horrible reactions.

    Thanks for the note on NSAIDS!

    Melissa

    • you poor thing, nsaids don’t work and are brutal as it is but what you went through with welts and pain and the dopey doctor gives them to you anally….pardon my french but what an azz-hole “-) hope you found something beeter to control your endo pain..xo

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  5. I’ve found most NSAIDS make my endo worse because my endo seems so linked into my stomach and GI system. No adhesions there (yet) but NSAIDS make my stomach hurt, cramp, bloat, etc and that doesn’t help the endo pain!
    for low to moderate pain, constant tylenol or tylenol with caffeine is okay. tramadol helps for worse pain, but it makes me feel stupid.

  6. NSAIDs… What a joke! I have been diagnosed with endo. All I keep hearing is take Motrin. I was given tramadol to no avail. I have reached the point where I just want a hysterectomy! Take it out if you won’t help in any other way. I have had the lap done. Pain free for about 3 months. Here we go again…

  7. NSAIDS suck…..plain & simple, woman with Enodmetriosis need narcotics to relieve the really bad pain and the stupid doctors are only worried about addiction which makes no sense & makes us suffer. I got a bleeding ulcer on top of the Endo from taking these glorified asprin for to many years for my Endo, now I take narcotics & pain is pretty much relieved if only for a little while!

  8. I tried a NSAID I can’t remember the name of a year ago. The doctor didn’t properly explain to me (if at all) the importance of taking it with food, I didn’t know (how was I supposed to) took it without and was pain-free for half a day – then sick and had bad diarrhea, which naturally brought on endometrial cramps. I tried mefenamic acid with an assurance from my doctor that it would definitely sort out pain. Seemed to work at first, now nothing – in fact I suspect it’s made me a little bloated and gassy which seems to be inviting more frequent pains.

  9. Blah, NSAIDs.

    I used to take the doctor-prescribed amount of Naproxen as soon as the bleeding started. Later it was called Anaprox, and later still it became over the counter in Aleve form, but it never worked for me for very long.
    I started taking more than the recommended doseage like I had previously done with ibuprofen, just to try to dent the pain. That’s when my doctor told me that taking more than recommended can lead to heart attack and/or stroke.
    Plus, after a four-day hospitalisation for pancreatitis and gallstones in 1993, I was told I was a high candidate for developing stomach ulcers, and put on meds to counter that. Naproxen (Aleve) is also really bad for people with G.I. issues.

    Celebrex makes me dizzy, gives me stomach pain and GI issues, gives me heart palpitations/panic attacks, and led to weight gain.

    I used to take up to 1200mg at a time of Advil as soon as the bleeding started – nothing less than 1200mg worked to dent the pain, and taking that much only worked for a few years. My body got used to the dosage and I plateaued, and taking more would not have any further effect, I was told.

    Nowadays, I still take Ibuprofen, but only in addition to Tylenol 3, which seems to be the only pain med to dent the pain without also giving me really nasty side effects. Nowadays I only take 600-800mg of Ibuprofen at a time, and only a couple of times per day as needed. The ibuprofen still does a good job as an anti-inflammatory and diuretic for me, but just does not cut it alone to dent the pain at all.

    Thanks for posting the research report! I will post this over on my blog, too.

  10. took 800mg 2 hours ago when pain/ period began… Now pain is so intense (about my 8/10) and just want to rip uterus out! nothing helps!!!! GAHHHH

  11. I have gotten the same answer from my doc, “we dont prescribe narcotics for that” ‘take Naproxin’. Its like UH HELLO DOC, you try having ENDO and see if you dont prescribe yourself a weak NSAID. I found relief with Tramadol and the use of “another” type of drug, (which i am no longer using) I had the surgery and the dr didnt even remove it due to the fact that my colon is attached to my uterus. I also had the “pre-meano” shot and that did not change anything for me, i still had pain during that time, and since the pain seems to have increased….. good luck ladies with your doctors…..

  12. I used to take NSAIDs for endometriosis pain, which they (any of them) did nothing for. Still, I’d take it as often and as much as I was allowed to (during periods) and it resulted in the worst Crohn’s flare I’ve ever had in my life. I lost so much blood I was hospitalized and needed a blood transfusion. Doctors STILL want to prescribe me NSAIDs to manage the endo pain. Such arrogance, such lack of compassion.

    Thank you for this post. Doctors need to LISTEN to patients, and really understand that NSAIDs are ineffective and potentially dangerous. Endo patients have REAL pain and it needs EFFECTIVE treatment.

    • They do! I just sat in a research meeting discussing expanding my research into the hospital’s pain management department for just this reason. While addiction is a real concern with people asking for narcotics (or anything stronger than Tylenol Advil), there are chronically ill patients in need of pharmaceutical therapy. These women are not drug seekers or addicts. In general, they are an population that would rather be pain free then pop a pill.

      • you are absolutley right Endochick (love the name “-) nsaids suck, are NO help and can hurt you more than help you, I have ulcers from taking annprox for 5 years in my teens, male OB/GYN doctor said if Endometriosis was male disease there would have been a cure already! good luck all!

      • Thanks, JoJo!
        Yes, NSAIDS are terrible on the stomach and an easy out for the doctors. They added to hesitant to prescribe pain medication anymore because of malpractice claims, and whatnot. I do wish all male gynos could get this disease for one day and feel our pain. Maybe experience the monthly hell… a cure would be fast tracked.

  13. I just finished a week’s round of 800 mg ibuprofen. Nothing. No relief! I don’t have insurance so my doctor said she is limited on what testing/surgeries she can do. I had a lap to get my tubes tied, but she was unable to complete surgery due to all the adhesions. She said from the lap, i have severe endometriosis with adhesions connecting my bowel,bladder,and uterus. Any suggestions? Can i possibly get medicaid or something!? *edited: I don’t suggest giving private emails on here since this isn’t a message board or forum, but a private blog)

    • Hi, Erica,
      Depending on your income, and a well-written letter and prepared documentation from your physician, you can apply for medicaid. But it’s difficult to get. I’ve helped women apply with only one getting a temporary card for Lupus. With the US’s new Affordable Healthcare Act, or Obama Care, you’ll have more hoops to jump through. I’d get started now, though, if you’re serious. Phone your doctor and ask her to prep a packet and address why you need surgeries and medication that’s TOO EXPENSIVE for out-of-pocket. Then get crackin’ on a well-formed letter. Explain your disease — they won’t Google it, and don’t expect them to — it’s history pattern, treatments so far and any inability to hold or find employment that provides insurance. Good luck.

  14. For those of you that haven’t found relief using NSAIDs, my understanding is that you have to start taking them 24 hours *before* the pain begins, and then keep taking them at least every six hours, otherwise they won’t work.

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