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mrsjasper

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Thursday, March 29th 2007, 8:45pm

Fertility and painkillers

I've been having a quick browse around some of the fertility threads and there is something I wanted to bring to everyones attention.

Painkillers like ibuprofen can affect ovulation. Ibuprofen is from a family of drugs called non steroidal anti inflammatories (NSAIDS). This group includes mefanamic acid (ponstan) often given for period/endometriosis pain, and diclofenac(voltarol) which is often used for joint pain. There are some small scale research studies that show that taking NSAIDS around the time you would normally ovulate can delay or even prevent ovulation. The studies are not all conclusive and when I say small scale, some have only been done on a handful of women but when you are TTC you don't want to take any chances.

A google search on 'NSAIDS and fertility' will bring up the studies if anyone wants to read them.

This post has been edited 1 times, last edit by "mrsjasper" (Mar 29th 2007, 8:45pm)


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Thursday, March 29th 2007, 9:01pm

thanks mrs j.
i'm also aware that taking ibuprofen just before/ after conception increases the chance of early m/c? was told ONLY to take paracetamol, or codiene with paracetamol if recommended by a gp and very necessary, when ttc

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Thursday, March 29th 2007, 10:13pm

http://www.google.co.uk/search?hl=en&q=n…yUK%7CcountryGB

Here's a link to the Google search that Mrs Jasper has recommended.

I would like to make this sticky but am aware than stickies are often missed so can we bump this over the next few days and then stick it?

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Wednesday, June 13th 2007, 10:57pm

I'd always stick to just paracetamol to be safe personally

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Thursday, June 14th 2007, 8:21am

me too - you know you can also inadvertently become addicted to neurofen/ibuprofen?

if you get regular daily headaches and regularly take at least 2 painkillers a day for it, then chances are you are addicted! 8o

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Thursday, June 14th 2007, 8:50am

Neuro and Ibuprofen affect my stomach - and make me rather quesy - whether I am pregnant of not ! 8o

I stick to aspirin

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Thursday, June 14th 2007, 9:29am

aspirin, bad for tumtums as well

can cause stomach ulcers and thins blood sometimes too much

best bet is paracetamol for pains & fevers, and ibuprofen for muscle ache IF you are not pregnant.
and aspirin for kids is now a no-no as a general rule.

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Thursday, June 14th 2007, 4:45pm

Funny you should mention the effect of Mefanamic Acid. I was prescribed this in 2003 while I was in the Gulf to STOP MY CYCLE to PREVENT PERIODS!!! It certainly does have an adverse effect of ovulation cos it took me ages to get back to being regular again. It was probably nearly a year after I stopped taking it that I got back to normal.

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Thursday, June 14th 2007, 4:53pm

I agree to stick with paracetamol and I checked this out and its safe to use, anything that says that you cant take while pregnant you not allowed to use through out the ivf/icsi, or while trying for a baby period.

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Friday, June 15th 2007, 8:35am

oh, and mrK? ibuprofen bad for wrigglies as well.... not that you are going to be getting any for the next year or so anyway ;)

:P

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Tuesday, July 17th 2007, 10:24pm

I asked a few different pharmacies about ibuprofen about none of them heard it affects ovulation or early miscarriages, ibuprofen is the only thing I take because its the only thing that works :headache however I have had three early miscarriages ?( I do have low progesterone too though which was only detected last month

Im going to ask my RE about this at the end of the month because as I said its the only thing that works for me

This post has been edited 1 times, last edit by "Lorna" (Jul 17th 2007, 10:25pm)


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Tuesday, July 17th 2007, 10:41pm

Sorry Lorna but I have to disagree with you.

My consultant, and many other girls consultants on here, are very much against the use of NSAID's when TTC, not only because of the effects on ovulation but also because of the increase of the chances of miscarriage.

St George's clinic quote the British Medical Journal: reports that in a study involving 1,055 pregnant women it was found that the use of NSAIDs during pregnancy increased the risk of miscarriage by 80 percent. The association was stronger if the initial NSAID (nonsteroidal anti-inflammatory drug) use was around the time of conception or if NSAID use lasted more than a week.


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Tuesday, July 17th 2007, 10:44pm

I didnt say it wasn't true was just saying what chemists had told me :D

Oh buggar its the only thing that works for me ?( ... maybe my RE can help me there? or normal doctor?

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Tuesday, July 17th 2007, 10:46pm

What are you taking it for and over what period?

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Tuesday, July 17th 2007, 10:50pm

I take it for af cramps (but I dont always get them) and I use it for headaches because paracetamol doesnt work for either

mrsjasper

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Wednesday, July 18th 2007, 7:37am

Lorna, if you're getitng frequent headaches get your eyes tested and make sure you are drinking enough fluids. I've found those Fore head sticks that you rub on quite useful in the past, they don't get rid of a headache but they can take the edge off it.
If you take ibuprofen for af pains then in theory you are taking it at the opposite end of your cyclt to when you ovulate so it shouldn't affect it.

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Friday, July 20th 2007, 9:11pm

Hi Lorna,

I would agree with Eeyore's comments that ibuprofen will not help you if you are trying to conceive and also have an obvious miscarrying problem. You need to look for another option, and certainly avoid using it after ovulation.

I note also that you say they have just discovered that you have a low serum progesterone. This is probably the most common reason for failure to conceive and for early miscarriages. I am amazed (although perhaps I shouldn't be by now) that this was not tested as soon as you first started having problems and sought advice and help. It is such an easy test to do especially if you have a fairly regular cycle, inexpensive to do, so common a finding, and so easy to put right.

Progesterone is the hormone that causes the uterine lining (endometrium) to ripen and mature for embryo implantation. You may hear this referred to as a poor luteal phase. A very low progesterone, say less than 10 indicates that you probably did not ovulate in that cycle; between 10 and 17 you ovulated but would not implant and therefore not get a pregnancy, even if you produce an embryo; 17 - 23 you will implant if it is a good embryo, but the lining will probably be too immature to provide the right environment to sustain implantation and embryo/foetal growth such that you may miscarriage either very early on, or have a difficult and unstable early pregnancy with perhaps bleeding then go on to have a miscarriage.

If the level is over 25 you are out of the danger range in that particular cycle, but values can vary from month to month so you are safer to be over 30, with values over 40 being common. So get yourself on to treatment and insist that they recheck your progesterone in the first or second cycle on treatment to check for an adequate response. Don't let them just assume that this has worked (although it usually does), and certainly don't let these low values continue as the miscarriages are causing so much heartache. And stay of the ibuprofen!

Kind regards,


Paul

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Saturday, July 21st 2007, 12:45am

Hi thanks :D

Im on cyclogest progesterone from ovulation now (I start this month)

I asked a numberous times for this to be tested and it was only when I started seeing the RE she agreed it needed doing, they didnt even check it in my recurrent miscarriage testing :rolleyes: but than this is the nhs were talking about

good thing is its the only thing they picked up and I hope it works :))

I will be trying another painkiller, see how I get along

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Sunday, July 22nd 2007, 11:41am

Wow, this is info I havent heard of before

I usualy take Ibrupen when I get muscle aches from the gym etc

and asprin for headaches etc

From now on I guess I'll stick to herbal teas or parecetomol

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Monday, August 6th 2007, 7:19pm

This is really interesting - I am another one who usually takes ibuprofen for any headaches or period pains. I guess I'll be trying something different now. As someone else mentioned, that 4head stuff does seem to dull the headache pain, and I have recently found that drinking lots of water has got rid of headaches, so I must not be drinking enough.

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Sunday, August 26th 2007, 9:16am

A quick question if anyone is still reading this thread.....

I use ibuprofen every month for period pain and use it for about 2 days. I make sure I don't take it at any other time and really try to leave it until the last minute to take it. If I don't take it, I would be incapacitated by the pain. It's the only thing that makes me able to function during the first day or two of my af. My dh SA isn't great and so far this is the only reason why we aren't conceiving (although I haven't had a lap and dye). My other tests came back fine (doc said I had a 'cracking' progestrone level!).

Could this still be affecting me do you think?

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Saturday, September 1st 2007, 9:59pm

Hi Katy,

Regarding ibuprofen - As you will have read from the earlier postings there can be problems in using this regularly when TTc or when pregnant. The way you are using it is probably relatively safe but the mechanisms whereby it acts to impede ovulation and to increase the chances of miscarriage are still unclear. It is better therefore that you try to find another way of reducing your period pain. The risks may be slight but you need to protect yourself from problems, and to be able to maximise your chances.

You will have tried all the usual methods including a hot water bottle I'm sure. Often the pain is at its most severe when you are actually moving blood clots down the cervix. Once you feel the clot having been passed, often the pain eases rapidly. Gentle downward massage near the base of your abdomen can sometimes ease clots down faster and get them out of the way. Relaxation techniques and hypnotherapy can help in releasing tension which will minimise the impact of your period pain.

Many women have very little pain with their period, but sadly some women have very severe pain. It has little bearing on their fertility. Only if your pain has been getting steadily worse over say the last 12-18 months is it worth while getting some further advice about this as this is suggestive of endometriosis, and needs treating before it gets worse. Mild endometriosis is very common and not too significant, but mild will become moderate and moderate will become severe - so don't let them ignore this for much longer.

Low sperm counts do get pregnancies as you will have heard, providing the sperm quality is good - AND - you do not have problems of your own that are adding in to the situation. It is too easy to fob couples off with "its a sperm problem" and not look at the women thoroughly. It is especially important that you are fully investigated when there is already a male factor present, as it is your fertility as a couple that is important, and poor hormones can let you down. Get your serum progesterone checked regularly as this is a common reason for reduced female fertility.

Good luck,


Paul
x

This post has been edited 2 times, last edit by "Paul Entwistle" (Sep 1st 2007, 10:06pm)


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Tuesday, September 25th 2007, 4:40pm

Hello Paul. I am meant to start my second icsi cycle in two weeks but have what I think is a breast abscess. I have been prescribed Erythromycin 250mg four times a day for the infection and Dihydrocodeine 30mg two four times a day for the pain. It started off Sat evening as an inflammation of a pea sized lump I already had. The antibiotics have not cleared up the infection and the lump is now bigger than a 50p piece. I have to see my GP again tomorrow but I think it would be best to put the icsi off for another month. I do not know if the drugs I am on would effect the outcome, but if they have to cut the infection out it will not be healed properly before I start treatment. Your expertise would be greatly appreciated.

This post has been edited 1 times, last edit by "melusine" (Sep 25th 2007, 4:41pm)


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Wednesday, September 26th 2007, 8:20pm

Hi Melusine,

My thoughts are that you should defer your ICSI /IVF cycle. I know that this will be a blow as you will have been working towards it for a while and will have made various arrangements which you will have to cancel.

My reasons for say this are:

The success rates for ICSI are not that high as you will know, even when things go smoothly and you are feeling positive and well. It may take some time for your breast abcess to be sorted and you will be worrying about this as you go into your cycle. If you go ahead with your treatment feeling doubtful about your decision to do so, and you have a poor response, you are liable to blame yourselves for not waiting until things were better and sorted out. And stress can certainly impede the response to ovulation induction drugs.

If you have to have some physical intervention then you are likely to be put on further antibiotics following this. Erythromycin is generally considered safe even in early pregnancy , but post surgery they may want/need to use a different antibiotic which may not be safe to use if you could be newly pregnant

If you are carrying an active infection the unit may be unhappy about seeing you and may decide at the last minute not to see you - which will be a great disappointment.

In general I can't think of any scientific or medical reason why your breast problem or your erythromycin should stop you having you treatment or responding to it. But my three points outlined above make me counsel you to defer your ICSI to a time when you feel better, happier, not in pain and ready to give this your best shot.

Either way, good luck, and let me know how you get on.


Kind regards to both,



Paul
XX

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Wednesday, September 26th 2007, 8:37pm

Thanks for the advice. We have decided to put it off for a month now anyway, it made sense really. Am off the Erythromycin now and on Flucloxacillin four times a day for a week. Going to have the abscess drained on Fri and a thorough check of my breasts while I am there. Is a month enough for my body to recover?

This post has been edited 1 times, last edit by "melusine" (Sep 26th 2007, 8:45pm)


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Wednesday, September 26th 2007, 10:52pm

Hi Melusine,

You need to see how it settles down after it has been drained. A month after all symptoms have settled will probably be fine - but you don't know yet how long that process will take. Abcesses like cysts can sometimes refill.

If possible don't rebook your ICSI until you know you are over this. And don't let others including your treatment unit try persuade you to book in yet. Unless you have other plans dependent upon this, or there is some particular reason, it is better not to put yourselves under this pressure. It makes more sense I feel to wait until you are sure that things are sorted and you are well again. Better this than to rebook and then have to cancel again.

Good luck,

Paul

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Thursday, September 27th 2007, 11:58am

Thanks for the advice paul. Not happy to hear that I may fill up with pus again :thumbdown:

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Thursday, October 9th 2008, 11:27am

bump

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Monday, October 13th 2008, 5:06pm

Does anyone know what tablets i can take that are stronger than paracetemol which won't effect fertility?

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Monday, October 13th 2008, 5:34pm

Co-codamol should be fine hun (contains codeine & paracetamol).
Is this for AF type pains?

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Monday, October 13th 2008, 5:46pm

Yeah and headaches or anything like that.

I don't want to use ibuprofen anymore so i will use co-codomol instead.

Thanks hun x

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Monday, October 13th 2008, 5:48pm

well it's pretty strong and does contain codeine so don't get yourself addicted to it now! If you're having regular headaches that paracetamol can't deaden I would consider asking your GP about them - when you finally get to see your doc you can have a whole list of stuff to discuss :D

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Monday, October 13th 2008, 7:36pm

i know! I have an appointment for 5:50pm tomorrow so i shall see what he says x

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Tuesday, October 14th 2008, 10:07am

Lorna, the chemists you asked were probably protecting their profit margins!
It's actually written on 'nurofen plus' packs that the drug can affect fertility so they should've known.
I don't take Ibuprofen anyway cos it upsets my guts. Co-codamol is good if the pain's really bad.
If you take painkillers too regularly it can end up causing headaches so sometimes having a day or 2 break (and putting up with the pain) might break the cycle.

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Thursday, October 16th 2008, 6:49pm

Do painkillers like ipobrusfe/aspirin/paracetamol also alter your natural cycle?

I'm wondering...

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Thursday, October 16th 2008, 10:32pm

Hi Maria,

I'm not aware of any major alteration to the cycle from taking pain relief tablets, but the cycle may be influenced by whatever the reason for your taking the tablets, ie viral infection, abdominal/bowel pain etc.

Paul

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Saturday, October 18th 2008, 9:48am

Thanks Paul,

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Tuesday, October 21st 2008, 1:55pm

Wow I am so glad I read this thread! I had no idea that something simple like ibuprofen could affect your fertility like this.

As a headache sufferer I have taken all kinds of pain relief for many, many years now, although over the past year I have tried to persevere with the pain and not take anything for days on end.

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Thursday, November 6th 2008, 10:43pm

I have a question about this, it's something that's been niggling me for a while ...

I get terrible pains for the first 2 days of my period. Not just cramps, but sharp pains that cripple me. It's all been investigated - 2 ultrasounds (well 3, 2 external, 1 internal), blood tests, gyne exam ... nothing amiss they tell me ?(

The only painkiller that seems to help is Dicolflex. Trouble is, I need to take it for several days before my period to make sure that there's enough in my body to dull the pain (that was doctor's advice). I then take them for the two days, and not again until my next period.

What should I do? We're not TTC yet - that starts in January - and I was thinking that maybe I should start charting so that if I fall pregnant, I notice a BBT change before I need to start taking the painkillers.

Any thoughts? I'll have pre-pregnancy appointment with the doctor soon (I just need to get round to making it!) so I'll ask their advice, but I wondered what folks thought here?

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Friday, November 7th 2008, 11:02am

Hi Ava

I think the best plan is to talk it over with your doctor at your pre-pregnancy appointment and make sure you ask directly about any possible link between these painkillers and your fertility. Charting can be a great way to know what your body is up to but you can't rely on it to tell you whether or not you're pg.

x

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Saturday, November 8th 2008, 2:25pm

Thanks Bubble - I'll post what he/she says once I've been :D

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Saturday, November 8th 2008, 11:05pm

Hi from me also, Ava

Women very greatly as to how much pain they get with their period, how long this lasts; how much they bleed and how long for; and whether their period starts immediately with fresh, heavy bleeding or whether they have a couple of preliminary days of spotting or dark blood. All of these variations are basically normal. None of these things seem to corellate with fertility and how easily women get pregnant. What can be more significant though is when any of these symptoms appear to be changing over a period of time.

For instance if ovulation has not been happening well and the woman goes on to Clomid - often this causes more painful periods and this is a good sign even though it is not pleasant. Extra pain can be the result of going into better ovulatory cycles. Painful, but normal cramps are usually due to the passage of larger clots down the cervix, which can happen whether or not there has been ovulation in that cycle. Warmth and massaging the pelvic area can sometimes help in getting them to pass through the cervix faster and out of the system.

The more sharp pains that you describe are not uncommon and it may just be that you are unlucky in having this sort of period pains. And the clear scans are reassuring in this respect. But if they have been increasing steadily over the past 12-14 months or so, they may be a hint of a degree of endometriosis. Endometrial cysts around the cervix are often being pulled on when you are passing clots. Such cysts can also give the same sort of sharp pain during intercourse, when again the cervix is being pressed on. So if they are increasing this is worth stressing to your GP, as it is often around the cervix that such cysts are first detected.

Finally as Bubble says you can use sympto-thermal charting (temperature combined with observations about the cervical position and cervical mucus examination) to monitor how your cycle is progressing, but it cannot tell you soon enough whether or not you are pregnant. The temperature will stay high if you are pregnant, but this is only a reliable guide if it stays high past the point of your period being due, by which time you will have already started your tablets. What you are taking sounds like a diclofenac preparation, which should be avoided during the first trimester or your pregnancy. So as Bubble says talk to your GP about this before you are actively trying for your baby.

Lots of luck,

Paul

This post has been edited 1 times, last edit by "Paul Entwistle" (Nov 8th 2008, 11:08pm)


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Friday, August 28th 2009, 8:42pm

Pain killers and ttc

Hi there

I know this is a year old topic now but hopefully someone will see my message and be able to offer me some advice.

I have PCOS and am about to start my second cycle of clomid (the first didn't work, so this time i've been told to double the dose). This discussion on pain killers has worried me because I also suffer from severe Fibromyalgia. I know I will have to stop all meds when (if) I get pregnant and this will be very hard but I'm desperate to have a child of our own so I will have to manage and I would not want to do anything to harm my baby. The advice I've been given is to change from my normal painkiller - Tramadol- to an older type of pain relief - dihydrocodeine whilst trying to conceive, and then to stop as soon as I get a postive pregnancy test. I've also stopped a sleeping pill called Zimovane, and now take an old fashioned anti-histamine for sleep - Phenergan. I take around 6 30mg of dihydrocdeine tablets a day, and am now worried after searching online that they may be affecting ouvlation or fertility. I cannot function at all without pain relief so am wondering if the increased pain and stress if I was without medication would be just as bad for my ovulation as the medication itself.

I'm feeling a bit hopeless about everything at the moment, as it seems I have so much stacked against me. Does anyone have any advice or are in a similar situation? I'd be really grateful, as I don't get much sense from my doctor about this (in an ideal world you obviously stop all meds when ttc, but when it is taking a long time to conceive and the meds help you function and sleep, it is a very grey area)

Thank you, and I'm really pleased I've found this forum. My clinic is the Liverpool Women's although we live on Anglesey in Wales,

All the best to everyone out there,
Gwenan xxxx

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Saturday, August 29th 2009, 5:21pm

Hi and welcome!

Have you spoken to your fertility consultant about your fears and the medication you are taking?

I have endometriosis and had to take painkillers, I was prescribed voltarol and dihydrocodeine for my pain relief by my fertility consultant. I did manage to cut down the amount of days I took painkillers to 3 days per cycle during af only, it is hard putting up with the pain but I kind of got used to it. Even so when I got pregnant with my daughter I had very bad pains early on in my pregnancy and was told by my GP that I could take a low dose of dihydrocodeine if need be in the first and second trimester. I didn't take anything but the option was there if it got too bad.

Hey, why not pop over to the NEWBIES section HERE and start a new thread to say hello as you may get a bit overlooked in this section and we wouldn't want that!

Good luck hun and I really hope you soon get your BFP

xxx

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Thursday, February 11th 2010, 9:09am

interesting thread mmmmmm will stick to just paracetamol XX

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46

Thursday, February 18th 2010, 10:10am

Ditto. I only take ibuprofen for a couple of days when AF comes. I get bad cramps, back ache and feel quite bloated. Think I'll stop now after reading this. Will stick to paracetamol (doesn't work as well though). I have been taking EPO from day 1 of AF until OV. I do find that it has helped a little with pmt. I'm not sure if it's the EPO, but about 1 week before AF was due I used to get quite sore boobs (sorry tmi) when I was first ttc I thought that this was my body telling me I could be pregnant and I got quite excited. After a few more cycles I just put it down to another symptom that AF was on her way. But the last few months I haven't got this symptom anymore and the bloating isn't as bad. These symptoms seemed to have stopped since I've been taking EPO, or maybe it's just a coincidence I don't know?

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Reg: Oct 8th 2015

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47

Friday, October 9th 2015, 12:37pm

Thanks for the information

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