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[ucprof]

I tolerate codeine pretty well, generally.  It's definitely the Naproxen that gives me stomach issues.
You're right, of course, about needing to take it in advance.  I always tell myself that I shouldn't be reliant on drugs and so don't take anything, and it becomes unbearable.  You'd think I'd have learned by now though.

If Nap wrecks your stomach then (a) take with food or more food than you have been taking with (take with
a meal for example) and (b) by all means start it earlier than you have been.  Assume you will be in intense
pain every month and head it off "at the pass".

You should definitely try ibuprofen if you have not had it.  it's the gold standard OTC cramp drug in the US.  It's what we recommend all the women who come from Europe to study here.  The locals are already "in the know".
Given that you say "paracetamol" I assume you are not in the US because here we call it tylenol (or the generic acetaminophen).  It does not work for cramps (very well) because it does not address prostaglandins.  Again, if you take ibupro. it must be with food, and again earlier rather than later.

Finally I really really recommend (based on personal experience) celebrex if you have GI issues with OTC NSAIDS.  It does the same thing as ibu and naprox as far as pain/prostaglandins is concerned but the cox2
versions of the NSAIDS remove the main contributor to GI problems.  Go ahead and read about it on the internet.
You have to ask the drs for a script, they will not offer it to you, but they also will likely not argue about it either.
I've had no problems getting scripts filled for it.  Generally they don't consider cramps a "long term" issue.
For me the cox2's have really been miracle drugs as I age.  Whether someone from pfizer did something with data or not, I will continue to take celebrex for the simple reason that it works for me and it really cuts down on the GI trouble that one gets from the older NSAIDS. 

Celebrex is marketed to people who have to take it long term (and thus need something gentler on the GI) - like those with arthritis, etc. 
But for cramps, you may need a high dose for a few days and this will also cause GI issues, as it did in me when I was taking IBU like M&Ms (our common brand advil looks like M&Ms which is why I use that analogy).
IN the US Cele. is not cheap (I pay $40 for a month supply and that is the insurance rate) but I do find it
far superior to the older NSAIDS.  I also hope someday someone brings back vioxx - I will be first in line to buy it.  It was, hands down, the best drug I've ever taken for cramps.   Most importantly I did not have to overdose on that in order to get relief, unlike all the other products.

Also, for what it' worth, it appears that all NSAIDS have some cardiovascular issues regarding long term use.
My best guess with the cox2s is that people tolerate them at a higher dose so they are more likely to overuse them because of the lack of side effects, and this alone could contribute to unseen effects like the cardio stuff, at a higher rate than the older NSAIDS simply because people are dosing higher on the cox2s.  Personally I find it very easy to go over the recommended dose on the cox2s, due to lack of side effects, and find I often have to with acute pain so I could see others doing it as well.

Of course you can also have radical surgery to deal with this once and for all....I do not think that is so crazy if the pain is interfering with your life.  My biggest regret is that I did not have radical surgery years ago.

[wet_blanket]

You should definitely try ibuprofen if you have not had it.  it's the gold standard OTC cramp drug in the US.  It's what we recommend all the women who come from Europe to study here.  The locals are already "in the know".
Given that you say "paracetamol" I assume you are not in the US because here we call it tylenol (or the generic acetaminophen).  It does not work for cramps (very well) because it does not address prostaglandins.  Again, if you take ibupro. it must be with food, and again earlier rather than later.

Not from Europe, but not entirely American either. Funny, in the country I last lived in, ibuprofen was not thoguht of as particularly useful.  I have tried it before though, didn't do much good.  I mainly use paracetamol because that's what the codeine comes with.  I figure it can't hurt to use something working on three separate pathways. 

Maybe I'll give the ibuporfen another chance next time.

[keineidee]

unoriginal: So sorry to hear about your experience! That is really awful. I hope you find relief soon. My sister (who did not have medical insurance so was relying on free clinics for her “care”) also had an experience where she went in to get some OCPs and ended up in the hospital being transfused.  She’d been given a Depo shot, which I don’t think had helped anything. I had an embolization in 2002 – it really helped for a while and wasn’t that big a deal as hospital procedures go.  Feel free to PM me if you have questions.

ucprof: I second you on considering the hysterectomy when other options fail. I had one in April once my endo and adeno got out of control, and it has been truly life changing (and not in the menopause sense – I still have an ovary that seems to be doing its job). It was indeed one of the less invasive varieties you mentioned. I did get some flak from some well-intentioned people who thought I was buying into patriarchal-hegemonic structures of domination by having my uterus removed. As a feminist I appreciated their concern, but was also annoyed that they didn't honor my careful choice.

wet_blanket: I know exactly what you mean about not wanting to rely on drugs, but consider that everything we take into our bodies has an impact in some way, and your body is out of whack already. (I always found this particular rationalization useful when popping pills.) I also found naproxen at higher doses worksed(!) best for me. Ibuprofen did very little. I hope you find a good new mix that your gut can take.

Best wishes to you all! The continuing existence of this thread reminds me again that there's much work to be done in basic women's health research.

[wegie]

You should definitely try ibuprofen if you have not had it.  it's the gold standard OTC cramp drug in the US.  It's what we recommend all the women who come from Europe to study here.  The locals are already "in the know".
Given that you say "paracetamol" I assume you are not in the US because here we call it tylenol (or the generic acetaminophen).  It does not work for cramps (very well) because it does not address prostaglandins.  Again, if you take ibupro. it must be with food, and again earlier rather than later.

Not from Europe, but not entirely American either. Funny, in the country I last lived in, ibuprofen was not thoguht of as particularly useful.  I have tried it before though, didn't do much good.  I mainly use paracetamol because that's what the codeine comes with.  I figure it can't hurt to use something working on three separate pathways. 

Maybe I'll give the ibuporfen another chance next time.

If you can get somebody to prescribe it for you, I heartily recommend ibuprofen and codeine. I tried one of the NSAIDs specifically for cramps (ponstan) a decade or so ago, and happily chucked it away as soon as ibuprofen (200mg) and codeine (12.8mg) became over the counter over here. Cheaper than a prescription, works just as well, and can cope with hangovers or broken extremities to boot.

After a while, it even persuades right hand cyst (just bugger off, ok?) to stop acheing. Grrrrrrrrrr.

[llanfair]

My God, Unoriginal! What a nightmare.  I opted for the hysterectomy as soon as I found out about the fibroids (I didn't need the uterus for anything) and like you and Keineidee, I found it freeing and life-changing.  I know there are people who are uncomfortable with the idea, but if anyone needs info, feel free to PM me.  Best decision I ever made.

[ucprof]

I second you on considering the hysterectomy when other options fail. I did get some flak from some well-intentioned people who thought I was buying into patriarchal-hegemonic structures of domination by having my uterus removed. As a feminist I appreciated their concern, but was also annoyed that they didn't honor my careful choice.

I had to laugh at this one.  I'm on the "other side of campus" so to speak (sciences/engineering) and I can not imagine anyone talking to me about `patriarchal-hegemonic structures of domination' with regard to getting a hysterectomy.  And frankly, after having it done i have no idea what all the fuss is about.  It can be a really annoying organ if you do not plan to use it to have children.   I think the medical profession has gone too far the other way now by trying to discourage women from taking it all out - you can go crazy with conservative surgeries and end up giving yourself a lot of trouble trying to preserve parts that are no good anyway, compared to just yanking stuff that's otherwise not needed.  On top of that you set yourself up
for complications from surgery.  Two years ago I was freaked at the idea of H but after having it done I wish I had it done when I was ... I dunno, maybe 11?  Seriously....I mean if
you used your tonsils to have children in some bizarre way would you still not take them out if they were constantly swollen and causing you pain?  Same things for gall-bladder, appendix, etc.  So I don't see what the fuss is about.  At some level women are lucky - the uterus is easily modified and removed without disturbing function of much else in the pelvis.  Not the same for men and their prostate gland. 

[biomancer]

I second you on considering the hysterectomy when other options fail. I did get some flak from some well-intentioned people who thought I was buying into patriarchal-hegemonic structures of domination by having my uterus removed. As a feminist I appreciated their concern, but was also annoyed that they didn't honor my careful choice.

I had to laugh at this one.  I'm on the "other side of campus" so to speak (sciences/engineering) and I can not imagine anyone talking to me about `patriarchal-hegemonic structures of domination' with regard to getting a hysterectomy.  And frankly, after having it done i have no idea what all the fuss is about.  It can be a really annoying organ if you do not plan to use it to have children.   I think the medical profession has gone too far the other way now by trying to discourage women from taking it all out - you can go crazy with conservative surgeries and end up giving yourself a lot of trouble trying to preserve parts that are no good anyway, compared to just yanking stuff that's otherwise not needed.  On top of that you set yourself up
for complications from surgery.  Two years ago I was freaked at the idea of H but after having it done I wish I had it done when I was ... I dunno, maybe 11?  Seriously....I mean if
you used your tonsils to have children in some bizarre way would you still not take them out if they were constantly swollen and causing you pain?  Same things for gall-bladder, appendix, etc.  So I don't see what the fuss is about.  At some level women are lucky - the uterus is easily modified and removed without disturbing function of much else in the pelvis.  Not the same for men and their prostate gland. 

If only all doctors and insurance companies saw it that way...

[zoelouise]

Also, for what it' worth, it appears that all NSAIDS have some cardiovascular issues regarding long term use.

False. Low-dose chronic aspirin administration is recommended to prevent myocardial infraction and stroke.
 
Also had hysterectomy (cervical cancer), also do NOT miss uterus.

[biomancer]

Also, for what it' worth, it appears that all NSAIDS have some cardiovascular issues regarding long term use.

False. Low-dose chronic aspirin administration is recommended to prevent myocardial infraction and stroke.
 
Also had hysterectomy (cervical cancer), also do NOT miss uterus.

The NSAIDs to which UCProf is referring are the newer drugs created for arthritis and other chronic inflammatory pain, such as Celebrex and Vioxx (both COX-2 inhibitors if I recall correctly, and Vioxx is off the market in the US), that some women also find relieves uterine cramping.  Ibuprofen does not have these cardiovascular side effects, but, like aspirin, it can irritate the stomach.  Plus, it doesn't work for all women (I find ibuprofen to be useless).  Acetaminophen/paracetamol is toxic to the liver in large doses and over time, and also doesn't work for all women.

[zoelouise]

The NSAIDs to which UCProf is referring are the newer drugs created for arthritis and other chronic inflammatory pain, such as Celebrex and Vioxx (both COX-2 inhibitors if I recall correctly, and Vioxx is off the market in the US), that some women also find relieves uterine cramping. 

Also, for what it' worth, it appears that all NSAIDS have some cardiovascular issues regarding long term use.

The term "all NSAIDs" doesn't really suggest reference to COX-2 inhibitors exclusively.

That may have been her meaning; if so it was not clear.

[wegie]

Oh joy! Whatever type the painkillers are I'll have some!

Not content with the events of the past two months, it looks as if she may just have decided that now would be a good time to start shoving out the perimenopausal symptoms :-(

<wanders off in search of large glass of wine and packet of ibuprofen and codeine>

[ucprof]

The term "all NSAIDs" doesn't really suggest reference to COX-2 inhibitors exclusively.

That may have been her meaning; if so it was not clear.

Sorry to clarify - I have read that both older and cox2 NSAIDS can have cardio issues.  I
personally find that both classes of NSAIDS, e.g. ibupro, celebrex, vioxx, naproxen (to some degree) are all pretty good for cramps which
is consistent with how they are all designed to suppress prostaglandins.  I have also found that the older ones, e.g. ibupro. etc are much harder on my stomach than celebrex and vioxx.  There is a significant different in GI symptoms.  This is also consistent with what I have read about them.  Hence, when I have a choice, I take celebrex. I don't take it regularly, just for the occasional pain.  I used to take it every month for cramps, until
I had the uterus removed.  I still get it filled because at my age I have other occasional inflammation issues
that benefit greatly by a bit of celebrex now and then.  Still miss the vioxx.  Would get a script filled instantly if they brought it back, throwing caution to the wind as far as cardio problems.  That said, I do not take it
every day like the folks who had the heart attacks.  During brief periods when I was taking it every day
for a short term chronic pain, my Dr was more concerned with GI bleed than with cardio, even on the cox2s.
I'm in my 40s and premenopausal.

[wet_blanket]

Regressing to my undergrad physiology major:

All cox-2 inihibitors have cardio issues?  I thought it was fairly well established that daily low dose aspirin is protective against heart attack (and stroke)?  Because it thins the blood?

Hmmm.  Returning to the topic of the thread... NSAIDS also reduce flow (presumably though vasoconstriction?)  Does that mean the period lasts longer?  Or that the uterine lining is incompletely shed?

[ucprof]

All cox-2 inihibitors have cardio issues?  I thought it was fairly well established that daily low dose aspirin is protective against heart attack (and stroke)?  Because it thins the blood?

Hmmm.  Returning to the topic of the thread... NSAIDS also reduce flow (presumably though vasoconstriction?)  Does that mean the period lasts longer?  Or that the uterine lining is incompletely shed?

Aspirin is a very different drug from these others.  Yes it does thin the blood.  Last time I had major surgery I was allowed celebrex before the surgery but not aspirin.  Aspirin is not a cox2 drug and it does a number on the GI tract.  I never noticed the period lasting any longer or shorter when I tood these meds.

[frogfactory]

On a different topic, I have my fingers crossed.  Visiting the nurse today to see if I can get back on Depo Provera, because with just Implanon (I assume after the ~1 year it took the Depo to wear off) I've been bleeding constantly for weeks.  Not cool.

Wish I could justify having the whole damn organ whipped out, but I don't think my insurance would think 'I don't like it and I don't want it' was a particularly convincing reason.  Plus the idea of risking vaginal prolapse is scary.  (Is that a significant problem with recent surgical methods?)