How much ibuprofen can i take for menstrual cramps

• A tweet talking about using ibuprofen to lessen menstrual flow went viral. 
• Gynecologist Dr. Lauren Streicher said taking ibuprofen to lessen menstrual flow is a valid and recommended method. She said it is fine for healthy women to do without medical supervision. 
• Dr. Jen Gunter, author of The Vagina Bible, told Insider there is a severe lack of information about periods.
• Visit Insider's homepage for more stories.

For anyone dealing with bloating, discomfort, and pain during their periods, the prescription is: find your own solution, be it electric blankets, painkillers, or dark chocolate.

But on Sunday, a viral tweet resurfaced a rarely-discussed method for lessening menstrual flow – and gynecologists told Insider it is valid, safe, and should be common knowledge. 

"I learned that ibuprofen reduces menstrual flow BY 50%. We're such a misogynist culture, we can't talk about something that women have to deal with every four weeks for 30 years," Twitter user Holly Wood wrote in a post that had garnered almost 20,000 retweets by Wednesday, including from Neil Gaiman and Mara Wilson.

It's not a new finding – celebrity gynecologist Dr. Jen Gunter spoke about it in her TED Talk, it's listed on the UK's National Health Service website, and rapper Cardi B told an interviewer last year that she took two ibuprofen (washed down with a drink of gelatin) to delay her period for a date. 

However, many women responded to the tweet saying they had no idea. 

Ibuprofen can delay periods for up to 2 days by disrupting a chemical in the uterus 

"I've been advising this for years as a gynecologist," Dr. Lauren Streicher told Insider. "We know that ibuprofen can reduce menstrual cramps as well as menstrual flow."

Ibuprofen and naproxen are both nonsteroidal anti-inflammatory drugs, known as NSAIDs, that reduce the production of something called prostaglandins – the chemicals that cause the uterus to contract and shed its uterine lining monthly.

In 2013, a study found that taking NSAIDs can reduce menstrual flow by 28% to 49%. In 2019, the Cochrane Database of Systematic Reviews found that NSAIDs were "modestly effective" at controlling heavy menstrual flows.

According to Streicher, the delay can stretch for a day or two, but you'd have to take more than the recommended dose. She tells her clients to take 600 milligrams of ibuprofen at the onset of their periods because that's when the level of prostaglandins are at their highest. 

If your period is like clockwork every month, Streicher recommends taking one 600 mg dose on the morning you expect your period. If your period isn't as regular, Streicher recommends you taking a dose as soon as you see blood.

If you want to continue lessening your flow, you need to continue taking ibuprofen – 600 mg daily.

Though this method can be a book for people with heavy flows, Streicher says ibuprofen should not be used to mask or ignore a serious problem. Extremely heavy periods can cause anemia, and may be symptoms of endomedtriosis and PCOS.

Quantifying a 'heavy flow' is tricky ("0ne person's hemorrhage is another person's spotting," as Streicher puts it) but anyone who finds their period is getting in the way of their everyday life should consult their doctor.

Pain pills are linked to ulcers, kidney damage, and heart issues, but gynecologists say the risk is very low for healthy young women

Side effects of taking so much ibuprofen could be kidney damage or stomach ulcers, although Streicher considers it perfectly reasonable for healthy women to take this dose by themselves, without consulting a doctor.

She says 600 mg, while more than what the bottle recommends, is not an unreasonable high dose in medicine. "The chronic damage you hear about it is from people taking ibuprofen every single day," she said. 

There is a knowledge gap when it comes to information on periods 

Wood, who was stunned to see her tweet go viral, told Insider she was inundated with responses – from men trolling her ("what's the big deal?"), women saying they feel ashamed to discuss their periods, and doctor friends admitting they didn't know that NSAIDs could reduce menstrual flow.

"Periods are treated like it's an illness we all have, and we're all ashamed to talk about it — even though it's something everyone with a uterus goes through," Wood said. 

Dr. Jennifer Gunter, author of The Vagina Bible and a lecture called Why can't we talk about periods, told Insider she's not surprised. 

Gunter learned about this method decades ago when, as a medical resident, she saw it listed in guidelines for heavy periods, which, research recently found, can cause cramps as painful as having a heart attack. 

"I know there is a knowledge gap getting this information to patients," Gunter told Insider. Periods are still one of the world's biggest taboos, and many women suffer because of it. "Some providers as well as patients don't believe an over the counter medication could help for such a serious issue," she added.

"The lack of women in medicine meant the medical canon about menstruation was first created by literally the least informed people: those who had never had a period," Gunter wrote in a column for The New York Times.

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