Finally, medical science has learned what women have known all along: Heat is one of the best treatments for menstrual cramps.
Be it hot water bottle, heating pad or curling up next to your cat, women knew putting something warm on their aching tummy would ease the cramping pain that can last up to three days each month.
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Now, a new study has proven not only that women are right; it's also shown heat may ease cramp pain longer than ibuprofen.
"We always knew, anecdotally, that heat helped, but now we have evidence that it may actually have some advantages over and above medication, in terms of extended pain relief," says study author Dr Roger Smith, vice-chairman of obstetrics and gynaecology at the University of Missouri-Kansas City.
Indeed, while the new research revealed that, statistically, both heat and ibuprofen yielded similar results in terms of pain relief, heat alone reduced cramping up to 12 hours after the treatment was stopped.
This, says Smith, was not the case with ibuprofen: "If you stopped using the drug overnight, the next day, the pain was back."
The research, published in the current issue of Obstetrics and Gynaecology, involved 81 women, all diagnosed with a history of menstrual pain and all experiencing cramps at the time of study. Each woman was given a treatment kit consisting of one of the following: a self-generating heat patch and placebo tablets; a placebo patch and 200-milligram tablets of ibuprofen; or a heat patch and the ibuprofen tablets.
The double blind study took place over two days. Women were told to place the heat patch in their panties, next to the lower part of their abdomen, and leave it there for 12 consecutive hours. The patch, a continuous source of heat at a regulated temperature, was removed before bedtime. At the same time, the women were also told to take two tablets three times daily, approximately six hours apart. After two days, the treatments were measured by levels of both pain relief and extended pain relief.
"Statistically, pain relief was about the same for those using the heat patch or the ibuprofen," says Smith.
If you're thinking the combination of heat and drugs will pack the most powerful pain punch, guess again. Surprisingly, the study also found that combining drugs and heat didn't yield any greater benefits.
Even more interesting, however, was that when heat and ibuprofen were combined, the long-lasting effects of the heat disappeared.
"If you used ibuprofen alone, the pain came back; if you used ibuprofen and heat together, the pain came back; it was only when heat was used on its own that we saw the extended pain relief," says Smith.
The findings indicate that more than one mechanism may be at work with pain relief, says Dr Reginald Puckett, a gynaecologist at New York Hospital-Cornell Medical Centre.
"It's pretty surprising that using both the heat and the medication together did not yield a greater result than either one separately - which tells me there almost has to be more than one pain relief mechanism going on at the same time," says Puckett.
Smith agrees and pegs the difference to a rebound effect commonly seen in drugs, but not observed with heat.
The medication, he says, works by inhibiting the production of prostaglandin, a biochemical linked to pain response. But in doing so, it appears to cause the build-up of a second chemical known as arachadonic acid.
"Once the medication wears off, the arachadonic acid is released into the body, which in turn ignites the production of more prostaglandin, thus causing the pain to return," says Smith.
Heat has a muscle-relaxing effect that works directly on the uterus, Puckett says. "This calms the contractions and relieves the pain naturally," and that means no rebound action.
"This appears to be one of the reasons why women who used the heat alone experienced pain relief even after the heat source was gone. They avoided the rebound action," says Smith.
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