Ref (type) | Population | Outcome, Interventions | Results and statistical analysis | Effect size | Favours |
Pain relief | |||||
Systematic review |
599 women with moderate to severe pain 14 RCTs in this analysis |
Proportion of women with pain relief
192/288 (67%) with NSAIDs (naproxen [7 RCTs], diclofenac [2 RCTs], indometacin, mefenamic acid, niflumic acid, nimesulide, and piroxicam [1 RCT each]) 61/311 (20%) with placebo |
RR 3.43 95% CI 2.70 to 4.35 |
Moderate effect size | NSAIDs |
RCT Crossover design 5-armed trial |
104 women with primary dysmenorrhoea |
Pain outcomes (TOTPAR scores at 8 and 12 hours, time to pain relief, and time to remedication)
with ibuprofen arginate 200 mg with ibuprofen arginate 400 mg with ibuprofen 200 mg with ibuprofen 400 mg with placebo Absolute results not reported |
The RCT reported significantly improved pain outcomes with ibuprofen arginate 200 mg or 400 mg and ibuprofen 400 mg compared with placebo, further details not reported P values not reported |
Effect size not calculated | ibuprofen arginate 200 mg or 400 mg and ibuprofen 400 mg |
RCT Crossover design 3-armed trial |
73 women with moderate to severe primary dysmenorrhoea |
Pain, assessed by TOPAR-8 score
over 8 hours
20.0 with etoricoxib (120 mg, taken at the onset of painful menses) 12.6 with placebo (taken at the onset of painful menses) |
P <0.001 |
Effect size not calculated | etoricoxib |
RCT Crossover design 3-armed trial |
73 women with moderate to severe primary dysmenorrhoea |
Pain, assessed by TOPAR-8 score
over 8 hours
21.5 with naproxen sodium (550 mg, taken at the onset of painful menses) 12.6 with placebo (taken at the onset of painful menses) |
P <0.001 |
Effect size not calculated | naproxen sodium |
RCT Crossover design 4-armed trial |
144 women with moderate to severe primary dysmenorrhoea |
Pain intensity, assessed by SPID-8 score
over the first 8 hours
12.11 with naproxen (500 mg twice daily) 8.22 with placebo |
P <0.001 |
Effect size not calculated | naproxen |
RCT Crossover design 3-armed trial |
149 women aged between 18 and 44 years, with primary dysmenorrhoea |
Pain intensity, assessed by mean TOTPAR-8 scores
over the first 8 hours
18.28 with celecoxib (400 mg, followed by 200 mg on day 1, then 200 mg twice daily as necessary on days 2 and 3) 12.82 with placebo |
P <0.001 |
Effect size not calculated | celecoxib |
RCT Crossover design 3-armed trial |
149 women aged between 18 and 44 years, with primary dysmenorrhoea |
Pain intensity, assessed by mean TOTPAR-8 scores
over the first 8 hours
20.59 with naproxen sodium (550 mg twice daily on day 1, then 550 mg twice daily as necessary on days 2 and 3) 12.82 with placebo |
P <0.001 |
Effect size not calculated | naproxen sodium |
RCT Crossover design 3-armed trial |
149 women aged between 18 and 44 years, with primary dysmenorrhoea |
Pain intensity, assessed by mean SPID-8 values
over the first 8 hours
10.06 with celecoxib (400 mg, followed by 200 mg on day 1, then 200 mg twice daily as necessary on days 2 and 3) 5.96 with placebo |
P <0.001 |
Effect size not calculated | celecoxib |
RCT Crossover design 3-armed trial |
149 women aged between 18 and 44 years, with primary dysmenorrhoea |
Pain intensity, assessed by mean SPID-8 values
over the first 8 hours
11.48 with naproxen sodium (550 mg twice daily on day 1, then 550 mg twice daily as necessary on days 2 and 3) 5.96 with placebo |
P <0.001 |
Effect size not calculated | naproxen sodium |
RCT 3-armed trial |
180 women with primary dysmenorrhoea |
Pain scores, assessed by visual analogue scale [scale 0–10, higher scores indicating more severe pain]
2 months
3.6 with mefenamic acid 5 with placebo |
P <0.01 |
Effect size not calculated | mefenamic acid |
RCT 3-armed trial |
180 women with primary dysmenorrhoea |
Pain scores, assessed by visual analogue scale [scale 0–10, higher scores indicating more severe pain]
3 months
2.4 with mefenamic acid 6 with placebo |
P <0.01 |
Effect size not calculated | mefenamic acid |
RCT 3-armed trial |
180 women with primary dysmenorrhoea |
Pain duration
2 months
3 hours with mefenamic acid 16.2 hours with placebo |
P <0.01 |
Effect size not calculated | mefenamic acid |
RCT 3-armed trial |
180 women with primary dysmenorrhoea |
Pain duration
3 months
3 hours with mefenamic acid 15.4 hours with placebo |
P <0.001 |
Effect size not calculated | mefenamic acid |
Need for additional medication | |||||
Systematic review |
667 women 10 RCTs in this analysis |
Need for additional analgesia
104/390 (27%) with NSAIDs 150/277 (54%) with placebo |
RR 0.57 95% CI 0.47 to 0.69 Analysis included data from 1 arm of an RCT (85 women; 4 treatment arms), which compared aspirin versus placebo |
Small effect size | NSAIDs |