Does tylenol or ibuprofen work better for period cramps

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When the pain of menstrual cramps are at their worst, more often than not you'll reach for whatever painkillers are at the front of your medicine cabinet. If there's none on hand, taking a trip to your local pharmacy can be even more of a pain as there are so many brand names to choose from.

Essentially, whatever you decide to go with (whether that's Tylenol or Advil), you'll be choosing between two types of over-the-counter painkillers –- acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (via Cosmopolitan). On the surface level, both painkillers essentially do the same job –- they kill pain. But there are some major differences between the two, as they work in vastly different ways in the body depending on the type of pain you are experiencing.

For menstrual cramps, the pain comes as a result of the muscular wall of the womb contracting to shed its lining as part of the menstrual cycle. This can often radiate to other muscles in the body, amounting in even more pain. So which painkiller is better for this specific type of pain?

Ibuprofen inhibits a specific chemical related to painful period cramps

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The main difference between acetaminophen and ibuprofen is the parts of the body it targets. Acetaminophen is usually prescribed to relieve "mild to moderate" pain from headaches, muscle aches, menstrual cramps, and other painful aches in the body (via Medline Plus). Acetaminophen is an analgesic (pain reliever) and antipyretic (fever reducer) and works by cooling down the body and changing how it perceives pain.

Unlike ibuprofen, acetaminophen isn't broken down in the stomach so it's a good option to take if you tend to have an upset tummy with your period. But as this drug is broken down by the liver, Cosmopolitan notes that it should never be taken with alcohol as it can cause irreversible damage.

Ibuprofen, on the other hand, is a non-steroidal anti-inflammatory drug (NSAID). This specifically targets inflammation by blocking chemicals that cause this body response (via Cleveland Clinic). They also inhibit the production of a chemical messenger called prostaglandin. According to Informed Health, too much of this chemical in the womb can cause painful periods, and as NSAIDs specifically target it they can relieve pain more efficiently than acetaminophen.

However, this suppression of prostaglandin can also be bad for your stomach. This is because one of its functions is protecting the stomach by reducing stomach acid and increasing mucus (via Healthline). This doesn't happen to everyone, but it can lead to severe gastrointestinal (GI) side effects if used regularly over a long period of time.

NEW YORK (Reuters Health) - Although both ibuprofen and acetaminophen reduce menstrual pain, ibuprofen appears to have more potent effects, according to investigators from the West Virginia University School of Medicine, Morgantown.

Although ibuprofen is accepted as an effective treatment for painful periods, or dysmenorrhea, Drs. M. Yusoff Dawood and Firyal S. Khan-Dawood note in the American Journal of Obstetrics and Gynecology, there is still controversy about the usefulness of acetaminophen. Acetaminophen, the active ingredient in Tylenol, is known as paracetamol in several countries.

To investigate further, the duo conducted a small trial involving 12 women with dysmenorrhea who were given three different treatments in random order for three different periods: 1000 milligrams of acetaminophen, 400 milligrams of ibuprofen, or an inactive placebo, four times daily for three days.

The women rated the active medications as being more effective than placebo. “However,” Dr. Dawood told Reuters Health, “it appears that ibuprofen has a greater effect and patients also preferred it.”

SOURCE: American Journal of Obstetrics and Gynecology, January 2007.