Ibuprofen reduces menstrual pain more effectively than paracetamol by targeting prostaglandins at source

The mismatch arises because ibuprofen and other NSAIDs inhibit cyclooxygenase enzymes to cut prostaglandin production that drives uterine contractions and inflammation. Paracetamol acts centrally with minimal peripheral anti-inflammatory action, limiting its utility for dysmenorrhoea. Transaction data reveal consumers default to familiar options even when clinical evidence favors the swap.

Timing amplifies the difference. Starting ibuprofen one to two days before menses blocks the prostaglandin surge more completely than reactive dosing. Real-world adherence data indicate most users begin after pain onset, reducing efficacy. No head-to-head NSAID superiority exists, though mefenamic acid additionally lowers bleeding volume in some observational cohorts.

Gastrointestinal and renal risks remain low for short monthly courses in healthy users yet warrant caution in asthma or ulcer history. Regulatory labels already reflect this profile. Next steps include targeted public messaging on preemptive NSAID use and trials measuring adherence when transaction-linked reminders are deployed.