Advil is America's No.1 selling over-the-counter pain reliever. Millions of us reach for a bottle to ease life's common aches and pains, such as headaches and overworked muscles, but should we?

Ibuprofen — the generic name for Advil and Motrin — is a popular over-the-counter painkiller (OTC) that belongs to a class of drugs known as NSAIDs (nonsteroidal anti-inflammatory drugs). It relieves pain, lowers fever, and reduces inflammation.

Ibuprofen has been used for more than 30 years, and until recently, it was considered safe.  However, several studies have questioned that belief. The most recent findings, which were published in the journal Proceedings of the National Academy of Science, discovered that ibuprofen can reduce fertility in men.

Male volunteers aged 18 to 35 took a daily dosage of 600 milligrams of ibuprofen twice a day — the maximum dosage listed on the label — or a placebo. Within fourteen days, the levels of testosterone in those taking ibuprofen dropped enough to cause a condition called "compensated hypogonadism," a disorder common in elderly men which is associated with reproductive disorders, as well as cardiovascular problems.

Although the researchers believe that the negative effects of ibuprofen on male fertility can be reversed in those who use it for only a short time, they are unsure if they are reversible in long-term users.

Other troubling research has recently emerged. Several studies have linked OTC painkillers with an increased risk of heart attack. While most studies peg the increased risk at about a third, one study found that ibuprofen more than doubled the risk. A study published in the British Medical Journal found that the risk can begin as soon as a week after beginning to take painkillers.

The medications, which are all non-steroidal anti-inflammatory drugs (NSAIDs), include ibuprofen (Advil, Motrin), diclofenac (Voltaren, Cambia), celecoxib (Celebrex), and naproxen (Midol, Aleve). The study also found that the higher the dose, the greater the risk.

Ibuprofen, as well as acetaminophen (Tylenol), increases the risk of hearing loss in women. A study published in the American Journal of Epidemiology found that the risk was present even if a woman took as few as two doses a week. 

The risk increased with the amounts of painkillers taken, and the danger was greater for women under the age of 50. Women who used ibuprofen or acetaminophen four to five days a week had a 21 percent increase in risk which rose to 24 percent for those who took ibuprofen daily.

Ibuprofen has also been found to raise the odds of dying prematurely, and studies found it was as dangerous to the heart as the painkiller Vioxx, which was withdrawn from the marker because of its cardiovascular risks.

A study of 639 randomized trials published in The Lancet medical journal found that taking high doses (2,400 milligrams a day) of NSAIDs (non-steroidal anti-inflammatory drugs), such as Advil for a year increased the odds of suffering a heart attack, stroke, or dying from cardiovascular disease by about a third.

Ibuprofen can also contribute to bone loss. A study of senior citizens from Canada's University of Saskatchewan found that scans of volunteers who took ibuprofen immediately after they exercised showed more bone loss than those given a placebo. Researchers recommended that people who take ibuprofen take it at least two hours before or after exercising.

Your kidneys can also be at risk. Research published in the Journal of Clinical Pharmacology found that ibuprofen could affect kidneys in healthy people. High doses or long-term doses can cause chronic kidney disease and even kidney failure.

Should you ditch ibuprofen? It depends. Other studies show ibuprofen to be helpful, especially in lowering the risk of several types of cancer, probably because of its inflammation-lowering properties.

According to the National Institutes of Health, aspirin, ibuprofen and other anti-inflammatory drugs lower the risk of four major types of cancer—colon (63 percent), breast (39 percent), lung (36 percent), and prostate (39 percent). Risks were also lowered for esophageal (73 percent), stomach (62 percent) and ovarian (47 percent) cancers.

If you'd like to avoid ibuprofen but still need an effective remedy for pain, there are many natural options you could try. They include:

Comfrey. Comfrey is an herb that's been used for thousands of years in topical ointments to ease muscle pain and reduce inflammation. A double-blind, placebo-controlled study published in the British Journal of Sports Medicine found that volunteers with acute back pain who used an ointment containing comfrey root extract three times daily for five days, reported a 95 percent reduction in pain compared to only 38 percent in those who used a placebo ointment.

Other studies have found that comfrey relieves the pain of sprains better than a prescription medication, and also reduces arthritis pain.

Arnica. Sometimes called the "mountain daisy," arnica gels and creams have been used since the 12th century to ease the pain of strains and arthritis. A randomized, double-blind 2007 study found that arnica gel alleviated the pain of osteoarthritis of the hand as effectively as ibuprofen. A 2008 study published in Complementary Medicine found that arnica relieved signs of inflammation as well as the painkiller diclofenac.

Turmeric. An Italian study found that patients with osteoarthritis who took a special formulation of turmeric for 90 days experienced a 58 percent decrease in pain. Blood tests showed a 16-fold decrease in the amount of C-reactive protein, a marker for inflammation and also a risk factor for heart disease. Patients taking the turmeric formulation were able to reduce their pain medication by 63 percent compared to the control group.

Capsaicin. Capsaicin is the component which gives hot peppers their heat. Applied to the skin, it soothes pain by desensitizing pain-causing nerve receptors. Studies have shown it to be helpful in relieving back pain as well as pain caused by arthritis, shingles, headaches, fibromyalgia, psoriasis, and diabetic neuropathy. In a study at Case Western Reserve University of Ohio, 80 percent of patients with arthritis reported a decrease in pain after using topical capsaicin for two weeks.

Astaxanthin. This herb even fights the pain of rheumatoid arthritis. In a double-blind, randomized study, patients given 4 milligrams of astaxanthin reported an 85 percent improvement in their pain and a 60 percent improvement in mobility. Most of the volunteers said the supplement was just as effective as their prescription drugs. Numerous studies show it is effective for all types of joint pain, including carpal tunnel syndrome.