Period pains, can you use medication?

[pilotpilot]

Help! Are mild pain killers (like panadol) allowed to be used?

[Notso Fantastic]

Let me say, on my second wife- I am an expert on period pains. I have suffered from them for 33 years. Yes, take whatever you have got in the house, full dose. Whatever rocks you. Just don't overdose on the paracetamol/acetaminophen ones- it tends to kill you. Why you ask Squaw Eviltemper?

[flapsforty]

pilotpilot, am leaving it to wiser heads than my own to answer your question.
However, for period pains, Ibuprofen (Unfortunately 12000 pounds a year does not buy much in the way of EQ, empathy and psychology.) in most of it's guises is often more effective than medicines from the paracetamol family like Panadol.
This info both from own experience and medical literature. :)
Good luck.

[Ryanairpilot]

pilotpilot

my life took a dramatic turn for the better when the missus found this:

she swears by it.

best of luck.

No direct links to foundation site .
H

[Gerund]

pilotpilot

Basically no! If the Maltese regulations are based on the SA regulations which are based on the JAR ones etc etc

The South African CATS state that:

Aspirin is allowed as a prophylactic/anticoagulant in low doses, ie 75mg/day that is a quarter of a standard tablet!!!

Paracetamol can be used (short term) - not during flying

And that's your lot!! No other painkillers appear on the list and it is stated that anything not on the list is basically unacceptable.

Oh, yes, and oral contraceptives are only acceptable after a three month stabilisation period.

So you can smoke and drink, but make sure you break that aspirin in four, and tell your employer you can't fly for three months because you and hubby have just decided to do a bit of family planning.

Shouldn't say this, but suggest you employ a bit of the Nelson's blind eye to the regulations. What is worse? Period pains on final approach, or the dire effects of half an aspirin, or worse!!?

PS Panadol is paracetamol by a trade name and so is unacceptable! Um, yes.

A CAA medical examiner care to comment?

[Intruder]

I suppose where pilotpilot has her license...

In the US the FAA is a bit more liberal concerning the use of common over-the-counter medications. Aspirin, Aceteminophen (Tylenol), and Ibuprofin (Motrin) are all acceptable for occasional self-medication, as far as I know.

There is even a list of prescription medications that can be taken with minimal observation periods (72 hours). As long as you have no adverse reactions, many medications are MUCH safer than flying with the symptoms they cure!

I don't know if non-members can view it, but AOPA (Aircraft Owners & Pilots Association has a list of FAA approved drugs at http://www.aopa.org/members/databases/medical/druglist.cfm. If needed, I might be able to produce a PDF copy...

[gingernut]

There's a lot of crap written about period pain treatment, (because there is probably a lot of money involved in its treatment.)

Basically, the evidence suggests;

1st line : Paracetamol - very effective and safe drug in its correct dosage. (Remember to take 4gms a day, once you wait for the pain, it will be harder to treat.)

2nd Line : Ibuprofen (Remember this can be taken with paracetamol)

3rd Line : Mefanamic acid (Available in UK only on prescription)

I'm not sure how these drugs fit in with the regulatory frameworks for aviation.

Beware the snake oil salesmen ! Good luck.

[pilotpilot]

I meant to say, ?are mild over-the-counter pain killers allowed to be used whilst flying to overcome period pains?

Thanks everyone for your feedback.
PS.Ryanairpilot, does "ladycarehealth" contain some kind of magnet which might interfere with the plane's instrumentation

[pinni]

dear gingernut, obviously a man. As you would know if you were a women that paracetamol does nothing for period pains!!!!!!!!!!

Dear pilotpilot. i have tried most things (over the counter of course) find ibruprofen the most effective. Dont know about flying regulations though.:rolleyes: Dont really care so long as they enable me to get out of bed and get into work:ok:

[Flyin'Dutch']

Gerund,

Can you elaborate a bit and explain where you found that you can not take Ibuprofen or Paracetamol when flying and have to be laid off for 3 months when starting on the contraceptive pill?

FD

[Gerund]

Flyin'Dutch'

Sure thing, here: http://www.caa.co.za/resource%20center/acts%20&%20regs/cats/pdf/sa-cats-mr.pdf

SA-CATS-MR 67.00.9 'Duties of Holder of Medical Certificate' (pages 30 and 31 as printed).

The SA CARS and CATS are modelled on the JAR ones. I assume the JAR medical technical standards have something similar but I believe they are not on-line, ie you have to pay to find out what your duties are!!

[Flyin'Dutch']

Hi Gerund,

Thanks for the link.

However it states:

(25) Non steroidal antiinflammatories: etc

Of which Ibuprofen is one of course.

Think it would be prudent for 'pilotpilot' to consult her AME and discuss this.

Have to say that this list is pretty restrictive and wonder how they defend some of the things on there.

Seems a pretty straightforward copy of the FAA rules.

FD

[Gerund]

Flyin'Dutch'

I think the interpretation of (25) is: Of the Non Steroid Anti Inflammatories, some of the newer drugs such as Mobic can be acceptable in certain conditions. ie the older ones are not acceptable.

Part of my murky past dealt with legal interpretation.

This would fit in with aspirin being specifically mentioned as allowable at 75mg/day under certain conditions, aspirin also being an anti inflammatory. I think you will find this leaves ibuprofen out in the cold.

Lot of old nonsense if you ask me. Coffee and tea both have significant pharmacological actions, and nicotine? But it is one of those lovely cases of it being almost impossible to legislate against recreational drugs that have been socially acceptable for years. Alcohol is a notable exception probably due to the major and very noticeable effects.

As it seems one has to pay to get the JAR medical CATS, I reckon it is reasonable to keep taking aspirin for a headache until they distribute the relevant bits for free, and explain why an aspirin is worse than twenty cups of coffee, and a quick fag.

[Flyin'Dutch']

Gerund,

That was a bit tongue in cheek.

I think the main thing is for people to be fit to fly.

Therefore I would think it better for people with period pains to sort them out 'properly' so that they become a non issue rather than have to rely on NSAIDS which can be a bit hit and miss and have only a limited time span in which they work (as in their effect reduces some hours after taking the medication)

Agree that it is all a bit legal speak and mumbojumbo, and certainly pretty defensive, rather than proactive. But they have to be seen to offer a watertight system.

FD

[STS]

Half the medicines mentioned here (as someone pointed out) do naff all to help. Naproxen sodium and mefenamic acid are the common ones. The amount of them I used to have to take zombified me so it wasn't really safe for me to do anything.

Genuinly don't know about the regs for this, but as a general comment, depo provera is a marvellous contraceptive- can stop periods altogether with one injection every 3 months. So if you're comfortable with this, I'd go this way. Bleedin' marvellous it is.

[Ryanairpilot]

pilotpilot

i wouldn't worry about a small magnet affecting aircraft systems.

[QDMQDMQDM]

Half the medicines mentioned here (as someone pointed out) do naff all to help. Naproxen sodium and mefenamic acid are the common ones. The amount of them I used to have to take zombified me so it wasn't really safe for me to do anything.

We have to be really careful here about over-generalising, like the other poster who said paracetamol doesn't help for period pains (and that therefore it was clear that gingernut who suggested it was a man!). Well, it does work, as does narpoxen and mefenamic acid. It's just that not every medication works for every person. To imply that 'it doesn't work for me, therefore it doesn't work' is highly misleading and very lax. It is not helpful for other people seeking information about the condition.

Genuinly don't know about the regs for this, but as a general comment, depo provera is a marvellous contraceptive- can stop periods altogether with one injection every 3 months. So if you're comfortable with this, I'd go this way. Bleedin' marvellous it is.

Ditto. It's marvellous for you, but many women find it bloody awful. Finding suitable medication is a matter of tailoring to the individual and trial and error.

Also, and on a general point, it is sexist and incorrect to imply that, by virtue of their gender, male doctors / nurses can make no worthy comment on the management of conditions affecting women exclusively. I have never suffered from cancer pain, yet have helped a lot of people with cancer pain manage their condition. I have never had a period, but have helped a lot of women manage their periods.

QDM

[STS]

Well, that's decided it for me. I don't want anyone to share their experiences with me. Never know - if I research more about the options they're giving me, heaven forbid I might actually find something that works.

I'm not a doctor, but I do know something about the options available on this one and am entitled to say what has worked for me and plenty of others I know. With the medicines mentioned here (apart from iboprofen), in the UK they are presciption only unless something has changed recently, correct me if I'm wrong on that. Therefore, a chat with the doctor before making an informed decision is the path that would be taken.

I see nothing lax with saying "yes, I used this, it was crap, have you heard of this? works for me, might for you".

[QDMQDMQDM]

STS,

Re-reading my post, apologies for coming over rather harsh. Of course, you're entitled to say what works for you. It's just that I don't think sweeping, categorical statements of what doesn't work ("Half the medicines mentioned here (as someone pointed out) do naff all to help") or what does ("as a general comment, depo provera is a marvellous contraceptive- can stop periods altogether with one injection every 3 months") are terribly helpful.

Your first statement is wrong: many of the medicines listed here do help period pains. They just don't help your period pains. Your second statement is over-ambitious: depo-provera is excellent for some women, but not as many as your statement would imply. Many women don't get on with it because they have very irregular, often heavy bleeding, sometimes continuous bleeding, develop spots, put on weight, become irritable and / or depressed and it can take some considerable time to re-establish a normal menstrual cycle after stopping.

Why is the semantics of this stuff so important? Because opinions are very easy to form (frighteningly easy, especially using suggestion techniques -- just ask the drug companies selling drugs to GPs, who fall for every trick in the book) and very difficult to change. A woman reading this thread could go along to her GP with period pains, get prescribed some of the drugs here and start off by thinking 'Well these are a load of old rubbish and won't work. What an idiot to prescribe them -- typical [male] GP!'. That will put her at an immediate disadvantage because, if you don't believe something might work, especially a painkiller, it is less likely to be effective.

I'm not against accounts of personal experience, just against wrong information. If this board was just about chat, I wouldn't be so up on my high horse, but it is a useful resource to which people turn for guidance. For it to remain a useful resource, it is important that we are careful about how we frame things and that people stand up and say when they see something they do not think is correct and which could be misleading.

QDM

[Gerund]

Hang on a minute! Wasn't this post about whether it was ok to take mild painkillers for period pains, presumably as a member of aircrew? It seems to have degenerated into what works for someone or other! Returning to the original question: I am sorry but if you want to remain within the medical boundaries, forget taking anything. However, I suggest a blind eye, and swallowing the pills that work for you, may be the answer.

For heavens sake! Depo Provera?!!!! Yes, wonderful, but if you are aircrew, take a long break before you fly again. Or don't tell anyone! But why should you know it 's a problem?

A bit like not not knowing that you should stop driving if your eyesight gets a bit dodgy and you haven't updated your lense prescription. Can you still read the number plate at 50yds or whatever? And if you can't, even though you haven't tried recently, you are breaking the law.

But, in aviation, for some perverse reason,what you can, and can't, take seems to be buried in the small print. Anyone out there with access to the JAR CATS-MR able to tell us what we can and can't take (and thank you, in advance, for having paid for the information)?

[redsnail]

I scoff a panadol if the pain is getting a tad annoying. Usually required for one day only. As far as I know, the CAA don't worry about that sort of medication.
(Nope, not on the pill either).

[DX Wombat]

A couple of other, drug-free hints which may help avoid having to take medication.
Avoid constipation.
Avoid having a very full bladder.
Buy one of those gel packs which you can heat up in a micowave or hot water and slip it between your back and the seat.
Hope this helps.

[Whirlybird]

Find out if any of those mentioned affect YOUR flying (not anyone else's). I can't take Ibuprofen and fly...or rather, I can't take it and successfully do something requiring good coordination like R22 auto-rotations. I'm fine for driving or cross country flying (though I'm wary of it now), but it seems to make me ever so slightly disorientated. Paracetamol, on the other hand, seems to be just fine and have no unwanted side effects whatsoever...and a test pilot friend said that was a common finding. However, since finding out what I did about Iboprofen, I'm a little wary of taking anything. But that's me; I'm not saying what anyone else should do...but just find out how it is for you, that;'s all.

[gingernut]

For the record, yes I am a man !

I can still give my opinion on managing period pains.

(I probably do this on a weekly basis for my own patients.)

I can base my opinion on one of three things:

(a) I can ask the manufacturers of treatments their opinion.
(Sometimes works well, but subject to obvious bias!)

(b) I can use my experiences as a patient (not in this case!), or I can use the experience of my patients. (Tends not to work well because of internal and external bias - patients sometimes tend to tell you what you want to hear, and I sometimes only listen to the bits I want to hear.)

(c) I can look at the results of clinical trials. Decent trials tend to collect the evidence from many women who suffer from period pains etc, and "subject" them to various interventions, eg paracetamol, ibuprofen, mefanamic acid, oral contraceptives, surgery (D+C's were commonplace at one time). - this is the most reliable method of forming a medical / nursing opinion and is the basis on which I formed my answer to the question.

I hope this resolves some of your bigotry pinni.

[pinni]

Dear Gingernut, I am no bigot!

Just giving my informed opinion of which I am entitled, As a woman who suffers period pain, as an ex nurse.

I think you would find if you researched it that paracetamol does help some but most definately not the majority of period pain.

I have spoke to many women about the said subject and found hardly anyone who found paracetamol satisfactory for this condition. Of course very useful for headaches and colds etc.

I do not wish to offend anybody on here. Just a bit of friendly banter as far as im concerned. In fact I think anyone who takes it too seriously needs to get a life and grow up.;) Pinni

[min]

Topic, not person please guys/girls :)

M.

[Crótalo]

Gerund brings up a good point with the comment: “But, in aviation, for some perverse reason, what you can, and can't, take seems to be buried in the small print.”

Here’s one idea. Every medical reference I’ve found (whether FAA, CAA, JAR, etc.) makes a statement questioning the underlying condition which is causing the need for medication. For instance, there’s a big difference between someone taking aspirin for temporary pain caused by a period, and someone taking aspirin to combat a headache caused by sinus blockage. Both people could “legally” take a small dose of aspirin, but common sense says that the person with the sinus-blockage-headache should refrain from flying until the sinus blockage is cured.

That’s why, IMHO, the professional aviation medical folks are hesitant to give pilots “carte blanche” by making a list of allowable/unallowable medications. They are concerned that some pilots will self-medicate when, instead, given their particular condition, they should let themselves get well.

Here’s some guidance about self-medication, from the JAA website. It’s an excerpt from JAR-FCL 3 (don't know if it's the latest version), which can be found here:
http://www.jaa.nl/section1/jars/43/52/435247/435247.pdf
JAR-FCL 3.040 Decrease in Medical Fitness
(b) Holders of medical certificates shall not take any prescription
or non-prescription medication or drug, or undergo any other
treatment, unless they are completely sure that the medication,
drug or treatment will not have any adverse effect on their ability
to perform safely their duties. If there is any doubt, advice shall
be sought from the AMS, an AMC, or an AME. Further advice is
given in IEM FCL 3.040.It would be interesting to know what IEM FCL 3.040 says, but I can’t find that anywhere.

This paragraph shows that there is some room for self-assessment. If a person is completely sure that short-term doses of panadol (or whatever) won’t adversely affect them personally, then it sounds like they would be okay. Keep in mind, though, there’s also a statement in a paragraph further down which says this:(c) Holders of medical certificates shall, without undue delay, seek the advice of the AMS, an AMC, or an AME when becoming aware of:
.
.
(3) The regular use of medication;
.How do you define “regular”? I think you have to go back to the previous paragraph and read the penultimate sentence. Again, it's probably to ensure that you’re not incorrectly treating the symptoms of an underlying condition.

Pilotpilot, even though your occasional need for pain relief is due to a normal physical condition (i.e. not because of any problematic underlying conditions), the only 100% correct answer is for you to discuss this with your AME. Many AME offices will answer these questions over the phone or via e-mail. Try that first with your local doctor, or one on the internet, and see if you can save yourself an office visit. Be sure to tell them if you’ve taken panadol (or other pain reliever) on the ground without any adverse reactions. That will help them assess you, and they will probably agree that you can take it in conjunction with flying duties.

The nice thing is that you’ll have official approval. No matter how well-intentioned we PPRuNers may be with our advice, it doesn’t substitute for the official word.