Some of the more common NSAIDs include ibuprofen, naproxen, and ketoprofen. These drugs can be effective in alleviating pain and inflammation, but to do so, they must be used correctly. Too often, women are prescribed NSAIDs without clear instructions about their use, so they use them the same way they use analgesic drugs. However, when used incorrectly, NSAIDs don’t work!
Much of the pain of endometriosis, especially menstrual pain, is due to inflammation that may be caused in part by high levels of “bad prostaglandins.” Prostaglandins are hormone-like chemicals that can be found in every cell of the body. Prostaglandins have beneficial effects (enhance immune function, block inflammation, relax muscles, maintain the integrity of the stomach lining, dilate blood vessels, etc.), as well as detrimental effects (produce inflammation, decrease oxygen flow, contract muscles, induce pain, etc.). The bad news is that women with endometriosis have been shown to produce an excess of a prostaglandin called PGE2, which causes inflammation, pain, and uterine contractions.
Since NSAIDs work by stopping the production of the pain-causing prostaglandins, they must be taken before any of these chemicals are produced. In other words, you must start taking NSAIDs at least 24 hours before you expect to experience pain. If you delay taking them until after you feel pain, the medication cannot block the pain-producing chemicals that have already been released, so they will not alleviate pain.
To be effective, it is important to take NSAIDs regularly every six hours so that no pain-producing chemicals are produced during ovulation or menstruation. Another advantage of taking certain NSAIDs is that they decrease the amount of menstrual bleeding.
The most important thing to remember is that unlike analgesics, NSAIDs do not block existing pain. Instead, they block the production of prostaglandins that produce the pain. Therefore, they must be taken before you feel any pain.
Like many drugs, NSAIDs can have side effects – some quite serious. Because NSAIDs block all prostaglandin production, they also block the good prostaglandins responsible for maintaining the integrity of the stomach lining. That’s why the most common side effects of NSAIDs include nausea, vomiting, diarrhea, irritation of the stomach, and stomach ulcers. To help reduce stomach irritation, NSAIDs should be taken with food.
Finally, it’s important for you to know that the effects of “bad prostaglandins” can also be moderated in part by diet and supplements. Reducing animal fats, caffeine, and alcohol, and adding flax oil, fish oil, and olive oil to your diet can increase the production of “good prostaglandins” and decrease the production of “bad prostaglandins.”