Health Matters: Period Pain and Meftal – A Secret Love Affair Every Girl Wants to Ditch

Meet this tiny friend of mine. She looks slightly pale and has been my companion since school and college days.

I am sure you all girls know her well, too.

Hiding in tiny pockets of my handbags, she is a circular and flat pill that you may know as “Meftal Spas”.

Popular among ‘we’ girls and ladies for the past several decades, Meftal is used to relieve pain of menstrual cramps apart from comforting the pain caused during the ovulation phase. A random keyword search for “Meftal Spas” on Twitter shows a teaser of the fully bloomed love story between us.

Data never lies. Sample this: Meftal Spas is a combination of two salts – mefenamic acid and dicyclomine.

While the entire market of such products which has more than 70 brands made using these two salts registered sales of around Rs 176 crore from January 2021 to January 2022, brand Meftal Spas alone captured Rs 153 crore market turnover, data by market research firm IQVIA shows.

In fact, in the past one year ending January 2022, women have purchased approximately 470 crore tablets (47 crore strips of 10 tablets each) of Meftal Spas out of total category sales of 570 crore tablets.

The sale of Meftal Spas is more than double the sale of popular anti-pyretic pill ?Dolo?, despite the former being prescribed mostly to women aged between 12 and 55 years unlike the latter which is consumed by everyone across age groups.

In the last one year, 217 crore Dolo tablets have been sold and since last two years, its sales spiked to 350 crore pills.

However, the sales of Meftal have remained largely unaffected due to spikes led by Covid-19. For instance: even in January 2017-18, 426 crore pills (42.6 crore strips) were sold.

Meftal is not just an old companion, but it has a deep connection with our social relationship with glorification of menstrual pain.

The misplaced admiration of the period’s pain gives us nothing but a plethora of undiagnosed health issues in the later stages of our life.

We are thankful to the tablet that it was one of those very few people/things who comforted us in extreme menstrual pain, unlike the Indian society.

While there is a dearth of research papers in the Indian context on menstruation, a paper published in 2015 in International Journal of Medical Science and Public Health found the prevalence of painful periods among 75 girls out of 100. It said that its prevalence is even more among girls with a family history of painful periods.

Still, for relief, only 5% girls consulted the doctor, 28% girls resorted to self-medications, whereas almost 65% girls resorted to self-help techniques such as rest and home remedies.

The three gynaecologists I spoke to — one with an IVF chain in New Delhi, one at a top private hospital in Mumbai and another one at AIIMS, New Delhi — told me that the prevalence is more than 85% and a majority of girls self-prescribe Meftal Spas on the advice of friends and relatives.

From an early age, girls are conditioned to live with this pain and rarely do we see them seeking medical help when in discomfort due to periods.

The myths force us to accept conservative narratives on menstruation, without giving us the margin to ask questions or take our pain seriously.

Ironically, it is the women who dismiss the seriousness of women’s problems.

When her daughter struggles with a minor backache or a headache, this woman will take her from one doctor to another, but, surprisingly, she would leave her to destiny (to be born as a girl) when she suffers from period cramps.

As soon as we label these symptoms as obvious, we eliminate the options for girls to seek medical treatment. As a result, dysmenorrhea (painful periods) is the most common, yet the most under-reported gynaecological problem in India.

Now, you know who to blame when in later years you are diagnosed with polycystic ovarian syndrome (PCOS) or endometriosis, uterine fibroids or any other reproductive health issues. They always told you pain is normal, when it was not.

A gynaecologist, working in a popular IVF clinic chain in New Delhi, told me that a majority of women find out the reasons behind painful periods only when they fail to conceive or reach out to doctors after some mishap.

Let’s stop glorifying the idea of bearing menstrual pain because it shows that “this woman who is in pain is fertile and hence, she is complete”.

There is a science behind painful periods. Dysmenorrhea — a medical term for the painful cramps that may occur immediately before or during the menstrual period — is caused by the production of biochemicals called prostaglandins. Body releases prostaglandins as menstruation begins which stimulates contraction of uterine muscles and squeezes nearby blood vessels which causes pain.

Now, carefully reread the above paragraph. I did it at least 10 times, but failed to find a single word that can be labeled as taboo or illogical or shameful. It’s a natural phenomenon, something as normal as digestion of food.

In fact, this pain makes a majority of girls miss school and workplaces apart from isolating them from participating in sports and halting their household chores.

Unfortunately, the real impact of the National Menstrual Hygiene Scheme under the ‘Rashtriya Kishor Swasthya Karyakram’ programme in 2014 is yet to be seen. The central and state governments need to realise that free distribution of sanitary napkins has no role in ensuring its usage or driving awareness around menstruation.

Meanwhile, here is the story behind the birth of Meftal.

The drug was launched by Mumbai-based Blue Cross Laboratories in 1981 as their first product, thanks to the founder of the company, NH Israni.

Israni was the former managing director at pharma firm Parke Davis, which was later merged with American pharma giant, Pfizer. Israni served Pfizer at the company?s top positions across the globe and eventually, he left his job to return to India and boost India?s pharmaceutical industry.

“One product which he thought could help Indian women, but has been under-promoted by Parke Davis was the Pfizer’s brand Ponstan,” an industry veteran told me.

“The typical interest of multinational companies is to sell expensive patented products, but Israni ji chose Ponstan as their first product to be launched by Blue Cross in 1981.”

While Ponstan was just mefenamic acid, a painkiller for menstrual cramps, the company went on to add dicyclomine to comfort and cure spasms.

While mefenamic acid is a nonsteroidal anti-inflammatory painkiller, dicyclomine relieves muscle spasms by blocking the activity of a certain natural substance in the body.

It’s time to clean the painful mess and bring a change. We must tell our daughters, periods are normal. Period pain is not.

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