Post the Meftal warning, South First spoke to doctors to gather information on safer alternatives for effective menstrual pain relief.
Published Dec 14, 2023 | 3:00 PM ⚊ Updated Dec 18, 2023 | 10:48 PM
Representational use. (Creative Commons)
The recent safety warning issued by the Indian Pharmacopoeia Commission against mefenamic acid, a chemical used in pain relief medication, most commonly for menstrual cramps, has led to a significant dilemma regarding alternative options.
Meftal Spas, a combination of dicyclomine and mefenamic acid, is known for its effectiveness in alleviating menstrual and stomach cramps. However, concerns over allergic reactions such as DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome and adverse effects on kidney function related to mefenamic acid have raised serious questions about its safety, especially with prolonged use.
This development has left many users, particularly women who have depended on this medication for menstrual cramp relief, in a state of uncertainty. South First speaks to doctors on a few safe alternative medications.
The advisory issued on mefenamic acid stems from concerns about potential severe allergic reactions. Safety alert was issued specifically concerning the risks associated with its active ingredient, mefenamic acid.
The alert warns that mefenamic acid could trigger allergic reactions like the DRESS syndrome. DRESS is a severe adverse drug reaction characterised by an extensive skin rash, visceral organ involvement, lymphadenopathy, eosinophilia, and atypical lymphocytosis.
There are also concerns about the drug’s potential impact on kidney function with prolonged use.
The drug, a combination of dicyclomine (anti-spasmodic) and mefenamic acid (a non-steroidal anti-inflammatory drug), has been a common choice for relief from symptoms caused by menstrual pain and cramps, as well as treating soft tissue swellings, fever, and injuries related to fractures, tooth decay, and minor surgeries.
Healthcare professionals have emphasised the need for caution and restraint in the use of medicines containing mefenamic acid following this alert, advising against its regular use, especially in patients with kidney function impairment or kidney failure.
Doctors South First spoke to said that occasional intake may still be considered safe under medical supervision, but the emerging concerns necessitate further research and careful monitoring of any adverse effects.
Individuals like Megha Rajesh, Disha Gowda, and Ruthika Naidu, spoke to South First and said that they are highly reliant on medicines like Meftal Spas, which contains mefenamic acid, to deal with their period pain.
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Ruthika Naidu said, “I am already dreading my period this month. I have checked with my gynaecologist regarding the reason for my pain and all my scans are normal. However, I function only after taking medicines for the first two days. Now, I am confused and don’t know what to do.”
South First spoke to few a gynaecologists to get an idea of alternative medicines. Speaking to South First, Dr Sowmya Sangamesh, Consultant Gynaecologist and Laparoscopic Surgeon from Bengaluru, said, “Ibuprofen, aspirin, paracetamol, naproxen, ketoprofen (which are chemical names) could be used as alternatives.”
However, she warned that it is absolutely important to consult one’s gynaecologist before taking these medications and know the exact cause of the pain. Period pain, especially excrutiating pain, is not normal and requires medical intervention.
She stressed, “They need to consult their doctor. They need to know the exact cause of their pain. They can take any of these medications only after consulting their doctor and rule out all causes of pain. Otherwise, taking over-the-counter medicines might not help, in fact they can cause harm.”
Citing similar medications, Dr Devika Gunasheela, Chairman, Gunasheela Maternity Home in Bengaluru, said, “For period pain, one can take diclofenac, paracetamol, or ibuprofen.”
Doctors inform that period pain, medically known as dysmenorrhea, is a common occurrence in many women during their menstrual cycle. It’s primarily caused by contractions of the uterus as it sheds its lining, which is a normal part of the menstrual cycle.
Endometriosis. (Wikimedia Commons)
During menstruation, the body releases hormone-like substances called prostaglandins. These prostaglandins trigger the uterine muscles to contract. Higher levels of prostaglandins are associated with more-severe menstrual cramps.
These contractions can cause pain and inflammation. They also help the uterus to expel the tissue and blood during menstrual bleeding. For some women, these contractions can be quite painful.
“There might be various reasons for menstrual pain. In some cases, the cause of severe menstrual pain can be a condition known as endometriosis, where the tissue that normally lines the uterus grows outside it. Other conditions that can cause or exacerbate period pain include fibroids (noncancerous growths in the uterus), adenomyosis (where endometrial tissue grows into the muscular wall of the uterus), pelvic inflammatory disease (a bacterial infection of the female reproductive organs), and cervical stenosis (a condition where the cervix is smaller than normal),” said Dr Jyoti, a gynaecologist at NRR Hospitals in Bengaluru.
Fibroids. (Wikimedia Commons)
The severity and experience of period pain can vary significantly among women. Some may experience mild discomfort, while others may have severe pain that interferes with daily activities.
Other than pain relief medication, lifestyle changes such as exercise and diet modifications can help in managing period pain. In cases of conditions like endometriosis or fibroids, specific treatments may be required, she added.
For women experiencing significant period pain, especially if it’s impacting their daily life, it’s important to consult a healthcare provider to rule out underlying conditions and discuss effective management strategies.
