I know what it feels like to have pain. I have experienced the 10th degree of pain when I was first diagnosed with Stage 4 Endometriosis. Those nights of lying on the bathroom floor, rocking my body for some kind of weird maternal comfort, just waiting those 15 minutes for the pain relief to kick in, are still memories that drive me to share what I do. They were horrible, torturous nights that felt like far too many for someone in their early 20s, supposedly in the prime of her life. The world was supposed to be my oyster and yet, all I could focus on was Endometriosis and trying to work out how to get through another day, with varying levels of pain.
So, I get the desire for painkillers. I get that they alleviate the pain, even if it is just for a few degrees or for a few hours. I get that they offer comfort on a weird kind of psychological level because they are always available and can somehow make life more bearable. What I don’t get is that no one ever told me about the dangers and long-term side effects of taking them, including my doctor.
I want to share these long-term side effects with you today, so at least you are aware of the dangers for yourself. I am also going to share some insights on how to truly manage pain with your Endometriosis.
The real dangers of Tylenol/Paracetamol
Tylenol/Paracetamol is advertised as a non-habit forming painkiller. Their website indicates it is a great pain reliever and will help you sleep better. What’s scary is that there is even a dosing option to give to children.
Here’s what they don’t tell you:
- A number of studies have indicated acetaminophen (the generic name for Tylenol/Paracetamol) as a toxin. (Moore, 1985) It is included in a “toxicology panel” to detect poisons.
- In studies that examined mortality risk, the death rate for men and women who used acetaminophen was 90% higher than those who didn’t use the drug. (Roberts, 2015)
- In a systematic review of 1,888 studies in the U.K., adverse events reported included deaths, as well as toxicity to the heart, GI tract and kidneys. (Roberts, 2015)
- It has been proven to affect liver health in rats. (Moore, 1985)
Why does this matter?
Endometriosis and our liver health are closely related. The more stagnant our liver becomes, the more our hormones are thrown out and the more our bodies will struggle with Endometriosis. Anything that is a toxin will affect this liver health, including taking acetaminophen. Poor liver health will contribute to more hormone disruptions, more skin break-outs, thyroid issues, inflammatory responses etc. (Cabot, 2008)
What about NSAIDs?
This umbrella of drugs includes ibuprofen (ACT-3, Advil, Brufen, Motrin, Nurofen), naproxen sodium (Aleve, Naprogesic, Naprosyn, Naproxen), ketoprofen (Orudis KT), Mefenamic acid (Ponstan).
The way that these drugs work is by inhibiting the prostaglandins which trigger pain and inflammation we experience with Endometriosis. There are essentially two prostaglandins we want to concern ourselves with, the ones which trigger inflammation and pain and the ones which reduce it. The “good” ones enhance immune function, block inflammation, relax muscles, maintain the integrity of our stomach lining and dilate blood vessels. The “bad” ones pretty much do the opposite. With Endometriosis, we tend to produce more of the “bad” prostaglandins, also called PGE2, which results in an increase in inflammation, pain and uterine contractions.
NSAIDs block the production of ALL prostaglandins. This means, they block the “good” and the “bad”. The trick, however, for them to be truly effective is to take them before that response even starts. This means, taking them before we experience ovulation pain or period pain and try to predict when we might experience pain.
The trouble with taking a drug which inhibits ALL prostaglandins is that it causes the “good” prostaglandins to stop their important work too. This includes:
- Making sure our stomach lining is protected. (when experiencing nausea, vomiting, diarrhoea, irritation in the stomach and stomach ulcers.)
- Reducing our immune function. I have personally made a connection with Endometriosis and our immune function over the years and know that this is counter-intuitive to truly heal Endometriosis. (Kyama, 2003)
- Obviously, the reduction of pain and inflammatory responses within the body.
Prostaglandins are hormone type responders in the body. We can certainly turn off the “messenger” but ultimately we are not working on why that “messenger” is informing us of pain. Pain is a message from our bodies, sent to tell us to listen. Dulling it with drugs is not a treatment, it is merely stopping the “messenger” from working.
Are you inhibiting ovulation with NSAIDs?
What’s interesting is that I recently found a study that indicated that taking NSAIDs can affect our ability to ovulate. This is really interesting! The figures were quite alarming! Women on NSAIDs for only 10 days experienced dramatically low figures for ovulating! Only 6-27% of women ovulated! (Science Daily, 2015) For some of us, we may think that ovulating is not that important if we are not trying to get pregnant, but when we don’t ovulate, we are throwing out a range of other hormones in the process.
What is the solution to alleviate the pain?
Okay, so we don’t want to take painkillers if we can help it because ultimately we are affecting our liver health and not really aiding our body by simply blocking the “messenger” of pain. So, how do we reduce pain and inflammation with Endometriosis without them? The key thing to know is that we also have “good prostaglandins” which will help reduce pain and inflammation. What we want to do is encourage these guys!
Take in more of these:
- Healthy fats like Krill Oil, Chia Seeds and avocados
- Eat plenty of wild fish
- Coconut oil and Olive Oil
Have less of these:
- Bad fats like Canola Oil and deep fried foods
Pain is not the enemy. We need to know that it is just a signal, a message from our bodies that is crying out for help! So tell me your story… what level of pain do you currently experience on a scale of 1-10? How many painkillers do you currently take? You can find a copy of my Pain Relief Strategies guide to get some more natural options to reduce pain.
[otw_shortcode_content_toggle title=”References” opened=”closed” icon_type=”general foundicon-checkmark”]Cabot, S. (1999). The Healthy Liver & Bowel Book. Scb International. Science Daily. (n.d.). Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days. Kyama, C. M., Debrock, S., Mwedna, J. M., & D’Hooghe, T. M. (2003). Potential involement of the immune system in teh development of endometriosis. BioMed Central, www.ncbi.nlm.nih.gov–pmc–articles–PMC305339–pdf–1477–7827–1–123.pdf. Moore, M., Thor, H., Moore, G., Nelson, S., Moldéus, P., & Orrenius, S. (1985). The toxicity of acetaminophen and N-acetyl-p-benzoquinone imine in isolated hepatocytes is associated with thiol depletion and increased cytosolic Ca2+. Journal of Biological Chemistry, 260(24), 13035–13040. Roberts, E., Delgado Nunes, V., Buckner, S., Latchem, S., Constanti, M., Miller, P., et al. (2015). Paracetamol: not as safe as we thought? A systematic literature review of observational studies. – PubMed – NCBI. Annals of the Rheumatic Diseases. http://doi.org/10.1136/annrheumdis-2014-206914[/otw_shortcode_content_toggle]
This Post Has 50 Comments
Stage 4 endo on bowel. I think it’s slightly difficult to be told that painkillers are not helping me when morphine sometimes is the only thing that works. We all need to do what we need to do to live with this condition and if that involves painkillers then so be it.
That is terrible Lili and I hate to hear how terrible you’ve been treated. I would certainly go for a third opinion. I would embrace what you can do naturally and really implement every aspect of the REACH Technique. First maybe check to see there isn’t something else going on though…
I went for a scan last 2 weeks and doctor diagnosed me of having 2 chocolate cyst at the right and left ovaries. She prescribed me with a painkiller called and soon after I began to have bleeding and it prolong until more than 8 days.
So I went for a second opinion but the doctor gave me an appointment in 2 months’ time and some medication to stop my bleeding.
Problem is that I am having cramps almost everyday. Now that my bleeding has stopped, there are still cramps and some vaginal discharge or clear white no odour colour.
I began to think the doctors are not taking this seriously. Most of them asked if I am married or planning soon and asked me to get marry and quickly conceive.
So… if I plan to delay marriage or God knows what, how should I endure the pain every day? I can’t be taking painkillers all the time. Should I go for a third opinion or for a surgery? I just need to feel okay again without the cramps anymore… I am so sad to not knowing the solution to it.
I have a large ovarian cyst that is suspected to be endometriosis. I am 33 now and I can remember moments of horror when I was 16, when I would faint from the pain that I thought, and was told, was “normal”. I would take massive amounts of acetaminophen to relieve the pain… Later, in my late twenties, I started eating organic, not using any artificial products, and I decided to stop using painkillers, knowing they had side effects. I tried plant tinctures, which didn’t help much, and thought I would just live with the pain; in the last years I had episodes when I thought something was exploding inside of me, and made me lie on the floor incapable of staying still and crying in agony. Last September I thought I had had enough of this, that I just wouldn’t take it anymore; I started taking ibuprofen. I did not like the thought of it, but my period started on the morning of my first day of school (I am a teacher) and I could not just stay home. Ibuprofen worked and I barely felt anything and I thought I should never have let myself suffer the way I had in the past years… But now reading your article makes me wonder, as I have been sick from September 15 to December 25: a series of laryngitis, bronchitis, colds… That had never happened to me before.
I wonder whether taking ibuprofen could have had a negative impact on my immune system. I took only 2, 3 or 4 regular tablets per month, which is not much, but whenever I did not take food at the same time, I would have heartburn that would last for a while, so obviously it has an effect on the gut.
(I am in kindergarten for the first time though, so this could also be the reason I have been so sick).
This month I am lucky and my period started (well, considering I am TTC, it does not feel that lucky…) on Friday afternoon, so I could take care of myself and it seems to be one of those rare months where pain is mild and manageable… I have yet not taken ibuprofen, and am hoping pain won’t come now…
Thank you for reminding me the reason I stopped painkillers so many years ago.
Oh sweetheart.. that sounds horrid and my heart goes out to you. Did you have surgery 4 months ago?
I would highly recommend you start by simply eliminating gluten from your diet and sugar. Go as 100% on those as you can. Sometimes the pain overlaps with digestive issues and it is hard to tell the difference but endo and gluten intolerance are very common too.
The painkillers unfortunately mess up the digestive lining which will just aggravate any inflammation you may be experiencing there too.
Try drinking Camomile tea and making castor oils packs: http://endoempowered.com/castor-oil-pack-providing-instantly-relief-pain-endometriosis-inflammation/
Hey, I have endometriosis for 4 months now if not even longer. I was in so much pain first 2months that I had to quit my job and spend hrs I’m hospital then get sent back home with nothing, and spending most of my time laying in bed trying to find comfortable position to sleep, none of the painkillers helped me which was given by doctors, now they have put me on contraception for 3months to see if they help, but my pain is just there all the time and sometimes I barely can cope with it, I use at least 2/3 pack of painkillers a day, funny part is they don’t even help. Work is becoming harder now with the pains and I’m waiting for 19th of January as they have given me appointment to gynaecologist. Till then I just have to bare with pain I just don’t know how, every time I go A&E because of the pain I get sent home.
Thanks for you time Malvine xx
I’m in the throes of incredible Endo pain right now, everything hurts, I’m just lying here crying cos I don’t want to move, I can’t sleep Ive already taken 6 ponstan today and I need to take some paracetamol or I will lose my mind. Eating fish isn’t going to help me to get through the night right now ?
I have stage 4 endo with pain only during my period. I used be screaming curled up and my whole body going stiff from the hyperventilation despite trying to breath calmly. My sister once said she doesn’t remember having been in that much pain during labour! I had cysts (one chocolate one) removed as well as the endo tissue which was suppose ito increase my chance if conception by 89%! But it in didn’t. More MC’s. The pain has lessened but I had a few bad ones again. Scans came back fine with ovaries beeing clear and the womb looking fine. I take ibuprofen which I hate as I am aware if the side effects and don’t like taken anything as it is. But I also suffer from anxieties! So the min I can feel it coming on I get anxious. I have tried to do without it but that very often backfired. The pain causes me nausea and comfortable bowel movement. I had acupuncture done taken herbs changed my diet and continue to do so. But there is still pain. There is no healthy full term pregnancies. I was diagnosed 10 years ago. I am now 38. And at the end of.my tethers with all this physical and emotional stress regarding not.only my “infertility” but also the painkillers.
Warm wishes to all!
Lovely to “meet” you Gracie and thank you for your lovely comment. Hugs,
I’ve recently been diagnosed with Endo. But I’ve been carrying it for the past 5 years without knowing it was that. For the past 5 years I’ve been going through hell every time I have my period and even not having them I did experience level 10 pain. But pain killers could never help so I’ve stop taking them. I could do once in a while but what help me with pain is hot water and it still helps me. Now knowing all the dangers of taking pain killers I’m glad I’ve away from it ever since I noticed their ineffectiveness.
Thank you Melissa for this article. It is so good to know, it helps a lot going through your website. I’m 27 and God knows how much I dream to bear my first child. And can’t wait to be endo free. Also, I’ve chosen to treat it using the natural and holistic ways. I’m on my 5th month Naturone Therapy and my pain level has reduced for the first time from 10 to 5. I know it will take time for me to be Endo free but it will surely come.
I’ve recently been diagnosed with Endo. But I’ve carrying it for the past 5 years without knowing it was that. For the past 5 years I’ve going through hell every time I have my period and even not having them I did experience level 10 pain. But pain killers could never help so I’ve stop taking them. I could do once in a while but what help me with pain is hot water and it still helps me. Now knowing all the dangers of taking pain killers I’m glad I’ve away from it ever since I noticed their ineffectiveness.
Thank you Melissa for this article. It is so good to know, it helps a lot going through your website. I’m 27 and God knows how much I dream to bear my first child. And can’t wait to be endo free.
I have endo honestly can’t afford operation coz I’m jobless all I do is read all post and thanks for all.. I take yaz now for seven days hoping to be ok and I take ibuprofen once a day for almost two months now… Please help :'(
I am taking far too many painkillers for suspected endo. Awaiting tests and have tried taking less painkillers but the pain is unbearable. I’m off work with it and can barely sleep. I don’t think doctors warn u enough of the damage of too many pills nd the chances of getting addicted to them.
I was diagnosed with stage four endo. I had the worst pains before my lap i have them now just not as bad. What should i do for my pain besides tylenol or alleve
It is a tough one to get through and well done for all the changes you have already made. Have you signed up to my REACH Technique mini course yet?
I am also launching a 21 day endo challenge soon, so will keep you posted on that one 🙂
Thank you so much for this post! This is something that has been on my mind a lot lately as I’ve been in a lot of pain and as my husband and I are ttc. Im 25 and have had endo problems since about age 14 (finally diagnosed at 19) I have taken Advil and Tylenol in large doses for all of these years and even throw in hydro codine or other perscription pain killers when Ive had surgery or a cyst. I know the damage it is doing. The problem is that even after changing over my diet to mostly gluten and sugar free, low dairy, lots of fresh juice and daily multi vitamins, b complex and omega fatty acids, my pain is still terrible. (Mostly for the 2 weeks around my period.) This last month I had period pain the worst I have in a while. It was so bad I had a panic attack and actually got sick. So I caved and took Advil and a hydro codine. Now I’m concerned I won’t ovulate. Is there a way (besides what I’m already doing) to cleanSe from these meds and anything else I can try to make the pain lessen? I have tried other natural alternatives like cramp bark. I live on my heating pad. I get accupuncture (which only helps my pain for a few hours)
Thankyou so much for your page to support all of us who are suffering. It’s so nice to have a support group of girls who are going through the same thing. I am bound and determined to not let it control my life. I will learn how to control my endo instead. Thankyou for being a tool to get me there!
Thank you so much, i love your work!
Pleasure Lisa. Here is the free guide. Feel free to pass it around your circles too :)http://endoempowered.com/wp-content/uploads/2014/12/PainReliefStrategies.pdf
Thank you for sharing Andrea! Such good advice 🙂
Wow! That is heaps! Definitely not great for the liver.
Thank you for sharing 🙂
Pain relief is such a big topic and the guide I share are suggestions which can help but ultimately we need to work on the root cause of your pain.
For many of us it is a deficiency within our diet. The easiest way to remedy this is to eat a diet rich in loads of nutrients.
I also found that moving my body with Yoga made a huge differences. I will be sharing more over the next few weeks. Will keep you posted.
One of the key things to notice is if certain foods alter your pain levels Barbara. The key thing with abdominal pain is that it can come from different sources and isn’t always endo specific. I noticed a dramatic improvement when I cut out gluten from my diet.
Super proud of the changes you have made! Biggest hugs!
Thank you so much Rachael and lovely to hear from you! You have done incredible work and it is amazing to hear of your transformation! I hope you will share your story on my blog for us 🙂
Big hugs Sommer. That is one way to stay motivated to eat a good diet but I am sure it is not a positive feeling. Perhaps look at Yoga? It can alleviate so much pain too.
Sorry to hear of your struggles Jessica. I am sure things will improve for you soon.
Here is a copy of the Pain Guide for you. Glad to hear you are steering away from the pills etc. Big hugs.
Glad to hear things are better since the surgery. I wouldn’t recommend taking flaxseeds long term. I have found them quite oestrogenic and could aggravate hormone imbalances we experience with Endometriosis. Great work on the probiotics and the liptropic factors.
You are doing incredibly well Fiona! This natural option is a longer journey but the fact that you have reduced your pain to only one day in a month is fabulous! Those recommendations are fantastic too.
Big hugs Mehraj and wishing you all the best for the future.
That certainly does look interesting Petra 🙂
Thank you for sharing your experience, which I am sure took some courage to post on the internet. You are a brave women and you have been through so much.
Stay tuned to my website, as I will be sharing a free mini course very soon.
Thank you for your help, advice & for giving us somewhere to turn to.
I’ve only been diagnosed last August but suspect I’ve had this for quite a while (together with PCOS). My periods have always been excruciating (lv10 first few days) and I have been taking painkillers since I was in early teens. It would get so bad I couldn’t get up and go about my life for first 3 sometimes 4 days of my period. Aspirin doesn’t work for my pain, I take 400mg ibuprofen every 4 hrs and if it’s really bad, paracetamol in between. This is just so I can go to work & be at least semi funcional. I am constantly in pain, but can live with it most of the month (between lv4 &lv6 for usual pain) and only try to take pain killers when I absolutely must. There are many things I should be doing differently .. it’s all so overwhelming I just want to hide under my duvet. I know that won’t get me anywhere, so I’m trying to help myself. Having the opportunity and privilege to learning from your experience & eperiences of all the ladies who are kind enough (and brave enough ) to share is what’s keeping me from just crumbling, so thank you all.
I haven’t yet tried it myself, but maybe it works…:
Hi Melissa, I take about 3 ibprophens the first day of my cycle and continue taking it the next day to get just a little relief from my burning pain. I use castor oil with a heating pad over it , that helps. But it’s hard laying there when u have three young children. Sometimes I want to give up on everything because the pain is always there it flares up out of no where and gets me really down, I’m in bed a lot. I take ibprophen even when I’m not on my period, because the pain is so intense. Doctors don’t take it serious. They don’t understand the cutting pain, it’s unexplainable how bad it hurts at times. I’ve had this for 7 years now. Can you please send me the e book I would really appreciate it.
i take 4 to 6 nurofen tablets on the first day of my period but try really hard not to have it any other days. I’m always wondering whether taking this amount just one day a month will end up damaging my liver more, i’d really like to know the amount you can safely taking without repercussions. for pain throughout the month i take a herbal mixture, fish oils, and tea with calendula, nettle, dandelion, raspberry leaf and ginger. i try hard to avoid gluten, sugar and processed foods but still i cant cope without painkillers on the first day…i just hope im doing enough and not making things worse..
Thanks so much for writing this article, its been on my mind for ages!
before my surgery in 2013 to remove my left ovary, I took 4 tylenol at once when the pain would come. All I could do was lay down until the pain let up (pain level 10), and after I would take a warm bath. The the pain usually started in the morning, and by night I would still hurt, though, it would feel more sore. For about the rest of my cycle I would take about 2 tylenol each day. Since my surgery my pain has been around the colon. None around the ovary . So far so good for that. I take a teaspoon of coconut oil each day. I also sprinkle grounded flaxseeds over things like oatmeal, vegetables, over salmon, etc. just over anything really. flaxseeds are good with omeges 3’s. I have been taking probotics and lipotropic factors (they help the liver).
I love your blog! It is so kind to us, endo suffers, I just wanna hug you and say thank you! I am 21 years old, and now I am finishing my college, starting my work and helping my aunt, she is very, very ill…so many cigars and she just wont stop, its been difficult, I find some relieve in one stray dog I rescue from the streets, but my mother dont want her, she will leave us soon :/ Stress and more stress, I always have pain, moderate pain (pain 7), , except in crisis (pain 10), but it used end in two weeks, now I am crisis for a month, so hard… I just wanna lay in bed all day, but have much responsabilities. I dont use pain killers, because they simply doesnt work with me, I tried them all, many combinations too, tramadol in vein is the only one which work, it was exausting… Can you help me, please? I am so afraid for the pain, this is the worst. I want to know how can I start? which steps I need take? I dont want another video, or more Allurene/Visanne or Mirena DIU, I tried them all, they helped me, but never ended the pain. Sorry for bad english, I am brazillian and never finish the english course… you need pay for every fault, it was so expensive because the endo, so many fault, then I need stop. I hope you can read this anyway. Thanks!!
I take on average 20 advil per cycle ir ibuorofen. My body has gotten weaker ovrr the years, can hardly bear the pain. Also have scaitica pain in right buttocks, leg
Melissa, I am so encouraged by your site! Interesting enough I am reading this article, flat on my stomach due to severe pain in my bottom. Yes ladies, I said bottom. I have the privilege of having endometriosis adhering my uterus, bladder, and colon together. During one of my surgeries, my OB/GYN had a deep tissue cancer surgeon come in and he said he wouldn’t remove unless I was in extreme amount of pain, scared he would slice my colon trying to remove it. So I have been enduring this horrible pain in my colon. Interesting enough I have found when I am very disciplined about not eating dairy and sugar, the pain is minimal. So it is a matter of staying disciplined and maybe making a video of me in my misery so when I go to reach for that slice of pizza or scoop of ice cream, I won’t :). Press on Endo ladies, press on.
When I first learnt I had severe endometriosis many years ago and was put on heavy duty painkillers (with horrendous side effects) I knew there must be much I could do holistically to manage the pain. I changed my diet to gluten/dairy free, yoga, mediation, and use natural pain relief like omega-3, white willow bark (contains salicin, a chemical similar to aspirin but is a natural herb with powerful pain-relieving and anti-inflammatory benefits), plus I have tons of coconut oil! Yum! Was told I would never be able to have kids, I have 3 🙂 Would love your e-book Melissa, love the work you do!
I totally agree that these pain meds are completely toxic! I spent 22 years taking so many nsaids that it completely ruined my gut. I’ve been on a 3 year healing ride that i’m still dealing with (for my gut). I’ve had to endure a lot just to try and fix the damage that nsaids has done to me, including 7 months on the GAPS intro diet, which did help but then messed up my thyroid and metabolism in the process due to no carb intake, so now I’m having to heal that! Ug! I do have to take percocet but I’m down to only taking 1 per period now, which is great for me…the rest of the time I just suffer with the pain since I don’t want more liver problems. So far the only thing that’s helped is taking red raspberry pills (have to take for at least 4 months to see a difference), eating correctly, and the geranium oil rubbed onto the abdomen with a heating pad that Mel suggested…next i’m going to try fennel as I’ve heard it can help cramps.
thanks for sharing! on day 1 and 2 of the monthly I do not function or sleep if I don’t take anything… I try to postphone taking it, but it only seems to extend the time of pain… level of pain is hard to say… I could say 7 for the monthly but then when endo pain kicks in randomly during the month it is like nothing I ever felt was like anywhere near that level… so it seems all relative… as for alternatives I try teas, herbal supplements (cramp bark, omega’s, frauenmantel, …) and hot water bottles but it only relieves me for maybe one level while the painkillers really do the trick… wish i could say different….
Thank you for this invaluable info Melissa. Having been diagnosed with adenomyosis a year ago I have suffered through indescribable pain & it was only when I literally couldn’t bear it any longer that I would reach for the panadol. Having not taken any pain killers for the last 10 years it would have to be a desperate situation & the amount of guilt that I suffer after taking 1 almost makes it not worth the mild relief so I have recently decided to get rid of the remaining packet. I would love to know more about your experience with natural pain relief as my period is about to start & I’d love to avoid the agonising pain that comes with it!
This is good to know! My doctor told me to alternate Tylenol and Motrin, that has been working ok for me lately, but I dont expect it to continue to!
Can u plz share ebook I have pain n I take pain killers 🙁
Hello I was told by doc ok t o take up to 2400 mg of ibuprofen a day and take Tylenol in between if need bUT prob not good for liver. I use my warm compress also even at work sometimes.
When I learned I had Endo, I started going natural all the way. Previously I had taken pain killers to the max for my periods. It takes a while, but detoxing and cleaning all your organs is the best thing you can do for pain. Short term if it ever gets too unbearable and my hot water bottle doesn’t help (my best friend), a hot bath is amazing!
I had always had fears of NSAIDs and liver damage. Thank you for your thoughts today!