Dear Dr. Craig,
Right from when I had my first period, I’ve always experienced serious menstrual pain, so bad that on the first few days I’ll be unable to do any activity for the first few hours, after which it would be bearable.
Since I started working, I’ve been fortunate that the first day of my period would often fall on a weekend. On one fateful day however, I had a very important presentation to give when my menstrual pain started. Fortunately, a colleague had a drug (Flevin) and when I took it, I noticed the pain was gone in 15 minutes and thereafter no pain. I was elated. No more menstrual pain, or so I thought.
My usual periods are heavy and the flow lasts four days but I noticed when I took the drug, my flow was so light that the period was over in 2 days. I haven’t taken the drug again and I noticed my flow (and the pain!) has come back to normal.
I’m worried that taking drugs for menstrual pain might affect my fertility since my flow actually reduced. It’s my desire to have children of my own in the earliest future (by God’s grace). Am I being paranoid? If Flevin isn’t a good drug to take, can you recommend any?
Thank you very much,
Dear Miss Painful-Periods,
Thank you for sending in your question but before I answer the specifics of ‘Felvin and Fertility’, allow me to briefly explain what happens when you have a period.
Every part of the female reproductive system is specially designed to perform a specific role in the reproductive process. The ovaries produce eggs for fertilization, the fallopian tubes are the courier service that transports the eggs, the vagina is the collector of the partner’s sperm and the womb is the incubator. The womb’s function is to provide a soft and plush cocoon for the fertilized egg to grow and the lining of the womb is made up of a special tissue called the endometrium which acts as a thick blanket where the fertilized egg is nourished and fed.
When the egg is released from the ovaries on the 14th day of a woman’s cycle, the body sends a message to the womb lining (endometrium) to begin to prepare for the possibility that the egg will be fertilized. This message is in form of a spike in the female sex hormone progesterone, which signals to the endometrium to set things in motion. Over the next few weeks the lining of the womb begins to thicken and fills with blood as it lays out the red carpet and fluffs up the pillows, stocks up on fresh food and fruits and puts up a welcome banner in anticipation of the arrival of a very special guest. If by a certain point the egg is not fertilized, the body instructs the uterus to pull down the welcome banners, roll up the red carpet and put away the blankets. All of these have to be discarded and they find their way out of the body through the vagina. The resulting flow of blood containing clumps of endometrial lining is what we know as menstruation and this happens every month as long as a woman is not pregnant, until she reaches menopause.
When the endometrial lining breaks down it releases a chemical compound known as Prostaglandin which is coincidentally one of the chemicals involved in pain perception and is produced when you get a burn or are pricked with a needle. This prostaglandin causes the uterus to squeeze and relax rhythmically to push out the shed lining and this is often painless in about 30-50% of women. In the other 50-70% of women, studies have shown that they either produce more prostaglandin than normal or are more sensitive to it. The drug Felvin™ (Piroxicam) belongs to a class of medicines called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) which were developed specifically to target Prostaglandins and counteract their action and this is probably why Felvin worked so effectively.
To answer your question, NSAIDs are not know to have any negative effects on future fertility. However, they are known to have serious side effects which may include diarrhea, hematemesis (vomiting blood), haematuria (blood in urine), blurred vision, skin rash, itching and swelling, sore throat and fever. NSAIDs have also been associated with acute liver damage.
Unfortunately Piroxicam (also known as Feldene™, Felvin™) has one of the lower safety profiles of the NSAIDs, with increased reports of side effects including ulcers, skin reactions and gastrointestinal bleeding. Safer alternatives include Ibuprofen and Diclofenac, both of which also have the tendency to cause ulcers and stomach irritation.
Sometimes your doctor may decide that the benefits of taking NSAIDs outweigh the risks and could prescribe an additional drug to protect the stomach lining. It is important to have a talk with your family doctor or gynaecologist to discuss this further so as to determine what is best for you.
Alternatively, you can try some exercise, a cup of chamomile tea, a hot water bottle, or soaking in a warm bubble bath, all of which are natural and safe means of reducing the intensity of period pains.
With warm regards and best wishes,
**Disclaimer: This post is for patient enlightenment only and should not be taken as a replacement for the advice of your physician.