Codeine is not usually appropriate for the treatment of dysmenorrhea, or pain associated with menstrual cramps. Dysmenorrhea can be severe and sometimes debilitating, but its negative impacts generally do not justify prescribing an opioid-like codeine.

Since menstrual cramps are a cyclical and long-term condition, medications with an addictive potential should be a last resort for physicians and other prescribers. Codeine, even used in short bursts, can become addictive with long-term use.

What is Codeine Prescribed For?

Codeine is typically used to treat pain and sometimes a severe cough. Since it has the potential for addiction, most physicians would prescribe other, less-addictive medications before resorting to codeine.

Codeine is classified as a Schedule II medication by the Food and Drug Administration, meaning it has a high potential for abuse and addiction, but with recognized medical uses. Most codeine comes mixed in with other medications, like acetaminophen, to make cough syrups and other liquid mixtures. Liquid mixtures of codeine have a different schedule, usually Schedule V, because they have a lower potential for abuse than pure codeine.

Dangers of Taking Codeine for Menstrual Cramps

The primary issue with using codeine for menstrual cramps is that opioids are very addictive. When a person has an opioid addiction, they can develop dependence, which means if they stop taking the drug, they develop uncomfortable withdrawal symptoms.

Withdrawal symptoms, however, are not the most concerning side effects of opioids. Opioids have a high potential for causing a fatal overdose.

  • Some symptoms of overdose include:

    • Blue or purple lips
    • Confusion
    • Fatigue or sleepiness
    • Nausea and vomiting
    • Small pupils
    • Trouble breathing
    • Trouble walking
    • Unconsciousness
    • Unresponsiveness

An opioid overdose is a medical emergency. If you suspect one is happening, call 911 immediately. Someone experiencing an overdose will need immediate medical attention.

Alternatives to Codeine for Period Pain

Anyone experiencing dysmenorrhea should speak with their physician about alternate treatment options other than codeine.

Some people might already be taking codeine for dysmenorrhea, with or without a prescription. These people should also talk to their doctor about the following alternative menstrual cramps treatment options:

  • Lifestyle changes: Lifestyle changes may include exercise, getting enough sleep and relaxation techniques like meditation or massages. Lifestyle changes are usually recommended before medications because they are usually not invasive and not harmful in the long term.
  • OTC medications: Some common over-the-counter (OTC) pain medications include NSAIDs like ibuprofen, naproxen, and acetaminophen. Other OTC drugs marketed for menstrual cramps treatment are not effective.
  • Prescribed medications: Oral contraceptive pills (OCPs) are commonly prescribed to relieve dysmenorrhea. Other hormonal options exist but have many side effects, so they are less common. These are usually reserved as severe period pain treatment.

The dangers of codeine and opioid addiction may not always appear right away. Addictions can develop slowly but are much more likely with repeated exposure to drugs with abuse potential.