Receipt data suggests many choose paracetamol when ibuprofen may better target cramps

A vast analysis of shopping receipts suggests many people may be choosing a less targeted form of pain relief when period cramps strike.

Researchers examined 211,332,752 loyalty card transactions made by more than 3.4 million shoppers at a major health and beauty retailer in England between April 2006 and April 2015. They tracked purchases of tampons, sanitary pads and over-the-counter pain products to explore how people manage menstrual discomfort.

Paracetamol emerged as the most frequently purchased painkiller alongside menstrual products. Around two-thirds of the pain tablets bought in those baskets were paracetamol-based, while roughly one-third contained ibuprofen.

Both medicines can relieve pain, but experts say ibuprofen may work better for many people experiencing menstrual cramps because it tackles one of the biological processes behind them.

During a period, the womb contracts to shed its lining. The body produces hormone-like substances called prostaglandins, which help trigger those contractions. Higher prostaglandin levels have been associated with more severe cramping.

Ibuprofen belongs to a group of medicines known as non-steroidal anti-inflammatory drugs, or NSAIDs. It reduces inflammation and blocks the production of prostaglandins. Paracetamol works differently, acting mainly within the brain to reduce pain signals. It can still ease period pain, but it does not have the same anti-inflammatory effect.

The study, published in PLOS Digital Health, found that 26.7 per cent of customers who bought menstrual products also purchased pain relief in the same transaction. Among that group, half of their menstrual-product transactions included a pain item. Those shoppers were almost four times more likely to buy pain relief when purchasing menstrual products than during other shopping trips.

The findings offer an unusual glimpse into the scale of period pain and the way people respond to it. Researchers said shopping records could reveal patterns that traditional surveys may miss, although they warned against treating the data as a complete picture of England.

The information came from one retailer and only covered customers using loyalty cards. A purchase of pain relief alongside menstrual products also does not prove that the medicine was intended for period cramps. Some shoppers may have bought it for another person or for an unrelated condition.

Dr Anya Skatova of the University of Bristol described the results as a snapshot rather than a nationally representative account. Familiarity may help explain why shoppers selected paracetamol more often, even when ibuprofen might provide more targeted relief for cramps.

Professor James Goulding of the University of Nottingham said the results highlighted an opportunity for better public health education and exposed how little research has focused on menstrual pain management.

Timing may also affect how well anti-inflammatory medicines work. Endometriosis UK advises that NSAIDs such as ibuprofen can be more effective when taken before the body produces prostaglandins, often from the day before an expected period or pain begins.

However, ibuprofen is not suitable for everyone. People should read the information supplied with the medicine and speak to a pharmacist or doctor when unsure. It may be unsuitable for some people with asthma or stomach, heart, kidney or liver conditions.

Most period cramping forms part of the normal menstrual cycle. Severe pain that disrupts everyday life, becomes worse or causes concern should not simply be endured. NHS guidance advises seeking medical help because intense period pain can sometimes signal an underlying condition, including endometriosis or fibroids.

The research does not suggest that paracetamol is useless. Instead, it raises a more practical concern: many shoppers may be reaching automatically for the medicine they know best, rather than the one that may more directly address the contractions causing their cramps.