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If you were getting body aches and pains on the regular before your pregnancy, you’re probably familiar with using Biofreeze for pain relief.

And if you weren’t already familiar with it, you may have discovered it now that you’re pregnant and googling things like “pain relief for muscles and joints.”

But like many over-the-counter (OTC) products, Biofreeze’s effects on pregnancy aren’t entirely known. Here’s what you may want to consider before using it.

Biofreeze is a pain relief product that markets itself as a solution for athletes (and us regular folks taking on more humble athletic pursuits, too) experiencing localized muscle and joint pain or soreness.

Anywhere you might use hot and cold therapy — arthritic joints, the lower back, a sprained ankle — Biofreeze claims to bring fast, effective relief.

It’s a topical menthol treatment that feels cool on contact and comes in a variety of forms, including a:

  • patch
  • cream
  • gel
  • spray
  • roll-on

Menthol creates the cooling sensation on your skin. Your brain essentially gives the cold sensation priority over the pain sensation, which is also why an ice pack is effective for pain.

But you might prefer a product like menthol over good old-fashioned ice because you can put in on your skin and forget it, going about your routine as usual.

In pregnancy

Pregnancy can put extra strain on your joints, especially in the second and third trimesters. Your leg muscles, in particular, may feel sore from the extra weight you’re carrying.

And the hormone progesterone loosens up your muscles, which can lead to body aches during any trimester. Your changing center of gravity, along with more of the hormone relaxin (which loosens your joints) circulating in your body, can also cause more frequent backaches.

All this may have you looking toward menthol-based topicals like Biofreeze during pregnancy.

The short answer to this question is that we just don’t know. There isn’t any research specific to topical menthol use during pregnancy.

That being said, there is one very old study from 1996 that looked at the efficacy of massage with two different stretch mark creams during pregnancy. One of the creams contained menthol, among other ingredients.

No adverse outcomes were reported from using menthol topically in this instance — though there wasn’t a reduction in stretch marks necessarily associated with menthol, either. Researchers felt the massage itself may have explained fewer stretch mark cases among the groups that used the lotions.

Another, more recent 2016 study looked at the impact of throat lozenges containing Lactobacillus reuteri on pregnancy gingivitis. These throat lozenges also contained menthol.

Again, no adverse effects associated with the menthol (or the lozenge itself) were reported. But, of course, this study wasn’t specifically looking at menthol at all — and the menthol was consumed orally, not used topically.

More research is needed before any definitive statements can be made about the use of Biofreeze in pregnancy.

The company’s statement, given on its U.K. product page, is that Biofreeze hasn’t been tested on people who are pregnant or breastfeeding and that you should check with your healthcare provider.

The Food and Drug Administration (FDA) used to give medications pregnancy safety ratings according to a categorization system. Although the FDA has dropped this system, it’s still helpful to a lot of people.

However, this lettered system (A through D and X) never covered all drugs — in particular, OTC medications.

In addition to finding menthol in topical lotions and gels, you’ll see it on the ingredient list of many cough drops, throat lozenges, and sprays. But these products, along with menthol itself, have never received pregnancy category ratings.

Without human studies, there’s just not enough data to determine level of safety for menthol in pregnancy.

Note that Biofreeze doesn’t test its product on animals, so there are no animal reproduction studies, either. There’s no pregnancy category that adequately describes a drug with no available data.

Remember that even topical creams and lotions are absorbed by your body. While Biofreeze may be safe, other products aren’t.

Many muscle creams and patches contain methyl salicylate, an NSAID related to Aspirin that should be avoided during pregnancy unless your OB explicitly says you should take it.

Tylenol is often recommended by doctors for pregnancy-related aches and pains, though it’s not without risk.

You may opt for less medicated options, like heat and cold therapy or massage.

Just avoid placing high heat, like you would get with a heating pad, directly over your uterus area. Also choose massage therapists who are knowledgeable about pregnancy.

Light exercise, stretches, and side sleeping positions can also provide relief.

There’s not enough known about Biofreeze during pregnancy to determine whether it’s safe. The product hasn’t been tested on people who are pregnant.

Check with your doctor about using Biofreeze or other pain relief treatments. They may give you the go-ahead to use topical menthol products or may suggest alternatives.

Either way, stay in communication with your provider.

Aches and pains aren’t just normal during pregnancy, they’re common. Even so, it’s important that your doctor knows what’s going on during these 9 months so they can help you have as smooth a pregnancy as possible.