Excessive use of Painkillers and Infertility:Felvin, Ibuprofen,etc side effects

Excessive Use of Painkillers and Infertility

I was thirteen when I started having my periods, and boy! they were painful! Until I finished secondary school, I relied on hot water bottles and my mom’s abdominal massages for relief from the PMS. However, by the time I got into the University and was left on my own, I couldn’t massage myself properly and had lost the patience for hot water bottles. My roommate saw me writhing in pain one morning, and applying an hot water bottle on my lower tummy; it was obvious that I was going to stab all lectures that day. She asked if I had taken painkillers and I replied that paracetamol takes so long to relieve me, and I had long given up on it. She then introduced me to stronger painkillers, Felvin and Ibuprofen. She gave me one tablet of each and I swallowed. About ninety minutes later, I was totally relieved and I was able to attend my afternoon lectures. That was how my love affair with painkillers started.

I graduated from taking painkillers on the onset on my period, to taking pills just before my period was about to start. The minute I started having the signs, I was popping my pills. I never had any pains that way, because my body was already filled with painkillers before all the contractions start. During the first semester break, my mother noticed that I wasn’t having cramps anymore and she asked me what I did. I told her about the painkillers I was taking and she was a bit alarmed “you better not get addicted to pain relief oh, it would not be funny! It can prevent you from having a baby” she echoed. She asked how many pills I took during each period and I said four, when it was actually six (two pills, three times) and she admonished me to take only two, when the pain kicked in. The next time my period came, I tried to be faithful to my mom’s words, but because it took a little bit for the drugs to kick in, I soon went back to my old ways. Until I got married, I was taking pain killers to relieve PMS. I tried to control it though, by not taking the drugs for anything else. I could be having severe headache, but I would rather drink a hot cup of milk and take a nap, than take even paracetamol. Even when I had malaria, I took the smallest dose of painkillers possible. In my mind, I was making up for the excess dose I took when my period came.

Fast forward to when I got married and happily ready to have a baby, my mother was on hand to remind me that I would probably have gotten pregnant on first touch if I had not ‘messed up’ my system with painkillers. By that time, darling Michael Jackson had died of painkillers overdose and my mom never failed to refer to him whenever she was complaining about how much I had abused the pills. “It’s not food, I kept on telling you, but you wouldn’t listen. You think you can cheat nature. You were trying to prevent having cramps at all; now, you are looking for a baby” my mother said to me one evening. Guilt washed over me as I thought I had indeed ruined my conception chances by overindulging in painkillers. So, I called my roomy who was also addicted to using painkillers for everything, and got married around the same time I did. I asked if she was trying to conceive yet, and she said no oh. She and hubby had agreed to wait for two years before having kids. If she wasn’t trying yet for a baby, there was no way I could find out if her own fertility was also affected by the painkillers.

But then Chisom asked what the matter was, and I told her everything. She then said screamed and said “Yes oh! I am so sorry I forgot to tell you! Did you know that I stopped ovulating a long time ago? I didn’t even know until we went for tests before marriage. That was when we discovered that I had absence of ovulation. The doctor made inquiries upon inquiries, even as I went in for further tests, and he finally made an association between the Ibuprofen I was taken in excess and my missing ovulation” Chisom informed me. She said the excessive Ibuprofen in her system had led to the production of excess prolactin which made her stop ovulating. Prolactin is that hormone secreted when a woman is breastfeeding that makes it difficult for her to get pregnant while breastfeeding. When secreted in excess at other times, it leads to an absence of ovulation.

I did further research based on what Chisom told me and discovered that Ibuprofen is from a family of drugs called non steroidal anti inflammatories (NSAIDS). This group includes mefanamic acid (ponstan) often given for period/endometriosis pain, and diclofenac(voltarol) which is often used for muscle and joint pain. There are some small scale research studies that show that taking NSAIDS around the time you would normally ovulate can delay or even prevent ovulation. I also found studies that showed that excessive use of ibuprofen could lead to miscarriages. I found it really hard breaking away from painkillers, but I dropped the pills like bad habits! Many of us women have period cramps; some are easy to deal with, while others require relief. You might have tried all the usual methods; hot water bottle inclusive but it helps to note that the pain is at its most severe when you are actually moving blood clots down the cervix. Once you feel the clot having been passed, often the pain eases rapidly. Gentle downward massage near the base of your abdomen can sometimes ease clots down faster and get them out of the way. I have also found that exercises help to relieve the pain, as it aids the clots to move down faster. Relaxation techniques and  reflexology are also great for relieving period tension and pain. It’s okay to take painkillers once in a while, but if you are trying to conceive or currently pregnant, it is a good idea to stay away from strong painkillers like Ibuprofen, and only take paracetamol in moderation.

Ask Dr. Craig!: Will Felvin Affect My Fertility?

***

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,

Miss Painful-Periods,

Yaba, Lagos
***

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 diarrheahematemesis (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,

Dr. Craig

**Disclaimer: This post is for patient enlightenment only and should not be taken as a replacement for the advice of your physician. 

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5 thoughts on “Excessive use of Painkillers and Infertility:Felvin, Ibuprofen,etc side effects

  1. Did you know that ms contin is safer for your internal organs than anything mixed with Tylenol or advil? ms contin extended release also does not get you ‘high’ or ‘euphoric’ so it’s less habit forming, as well, if you can handle the nausea.

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