Advising patients with dysmenorrhoea

Pharmacy teams can play a key role in identifying and helping patients with dysmenorrhoea.

There are two key priorities when it comes to managing dysmenorrhoea in the pharmacy:

The first is that the patient feels their condition is recognised as being a legitimate health concern and is not dismissed as being ‘normal’
The second reason is that, as dysmenorrhoea has been associated with an increased future risk of developing chronic pain conditions^1,12,18 early and effective pain management is important¹⁸.

Due to the stigma and embarrassment that some patients can feel about their dysmenorrhoea² it may be useful to explore what type of pain the patient is experiencing and be alert to visual cues:

Requesting strong analgesics – if these are paracetamol-opioid combinations as paracetamol is a second-line NICE analgesic recommendation and opioids are not recommended. Switching a patient to an NSAID as a NICE first-line analgesic, such as Ultravana® where appropriate, could make a significant difference to a patient’s dysmenorrhoea management¹
Buying sanitary products, particularly if they are buying large quantities or doubling up on both tampons and towels, as this could indicate they have heavy periods (menorrhagia). If they experience heavy periods, it is important to make them aware that NICE-recommended tranexamic acid is also available OTC for the management of menorrhagia ²⁶. Tranexamic acid products such as Evana Heavy Period Relief 500 mg tablets can be used in the treatment of menorrhagia in combination with Ultravana for any associated period pain.

woman sat at the computer looking at the camera

Advising patients on Ultravana^®

Once you have established, using the Pharmacy Supply Model, that Ultravana is an appropriate treatment for your dysmenorrhoea patient there are several key points to advise the patient on.

Dose

On the first day of dysmenorrhoea: take 2 x 250 mg tablets initially and then 1 x 250mg tablet after 6–8 hours, if required
On days 2 and 3: take 1 x 250 mg tablet every 6–8 hours, if required

Diet

Take whole with water, with or after food. Ultravana is not to be broken or crushed.

Duration

Maximum continuous use of 3 days per menstrual cycle

Additional self-care advice

In addition to recommending a suitable dysmenorrhoea treatment, such as Ultravana you can also offer advice on self-care measures that can also help ease their pain.

Self-care for dysmenorrhoea

	Heat, such as a hot water bottle or heat patch, can also help to reduce pain¹
	TENS machines can also help to reduce pain¹
	Increase physical activity – there is some evidence that exercising for 45–60 minutes at a time at least three times a week can reduce period pain by around a quarter¹³
	Relaxation exercises can help with the cramping pains of dysmenorrhoea²⁷

Some patients may ask about dietary interventions and supplements that can help with dysmenorrhoea. In a Cochrane review there was some evidence that vitamin B1, fish oil, zinc sulphate, ginger, valerian, fenugreek and zataria may have potential benefit²⁷.