Acupuncture for Primary Dysmenorrhea: A Potential Mechanism from an Anti-Inflammatory Perspective.

Wen-Yan Yu,Jie-Dan Mu,Tian-Yi Sun,Yi-Dan Zhang,Liang-Xiao Ma,Yuan Tian,Xu Qian,Zhou Zhang,Liming Lu

doi:10.1155/2021/1907009

Abstract

The low adverse effects of acupuncture for primary dysmenorrhea (PD), known as one of the most commonly reported gynecological debilitating conditions affecting women's overall health, have been thus far confirmed. Moreover, it has been increasingly recognized that inflammation is involved in such menstrual cramps, and recent studies have further shown that the anti-inflammatory effects of acupuncture are helpful in its control. This review portrays the role of inflammation in PD pathophysiology, provides evidence from clinical and animal studies on acupuncture for inflammation-induced visceral pain, and reflects on acupuncture-related therapies for dysmenorrhea with regard to their anti-inflammatory characteristics. Further research accordingly needs to be carried out to clarify the effects of acupuncture on proinflammatory factors in PD, particularly chemokines and leukocytes. Future studies on this condition from an anti-inflammatory perspective should be also performed in line with the notion of emphasizing stimulation modes to optimize the clinical modalities of acupuncture. Additionally, the effects and mechanism of more convenient self-healing approaches such as TENS/TEAS for PD should be investigated.

Highlights

Primary dysmenorrhea (PD), called functional painful periods or menstrual cramps, is manifested as lower abdominal pains during menstruation without pelvic pathologies, accompanied by symptoms such as lumbago and leg pain, diarrhea, nervousness, fatigue, loss of appetite, and nausea and vomiting
Nonsteroidal anti-inflammatory drugs (NSAIDs) are currently the first-line medication for PD with well-grounded efficacy, the ineffective rate can reach about 20–30% [7]. erefore, there is an urgent clinical demand to find a low-risk and effective nonpharmacological treatment option to relieve menstrual cramps
Menstruation represents a highly regulated inflammatory process, manifested as substantial leukocytes before the occurrence of menstruation [44]. e major leukocyte subsets, like uterine NEUT, natural killer (NK) cells, mast cells (MCs), EOS, and macrophages, constitute up to 40% of the total cells in the premenstrual endometrium [69]. ere is growing evidence that leukocytes are closely associated with PD

Summary

Introduction

Primary dysmenorrhea (PD), called functional painful periods or menstrual cramps, is manifested as lower abdominal pains during menstruation without pelvic pathologies, accompanied by symptoms such as lumbago and leg pain, diarrhea, nervousness, fatigue, loss of appetite, and nausea and vomiting. PGE2 mediated by the PGE2 receptor 2 plays the role of relaxing vessels and inhibiting the contraction of uterine smooth muscles and may even work to increase edema and recruit leukocytes [44] Studies in this line have reported that patients with PD experience significantly higher levels of PGF2α and PGE2 in the endometrial and menstrual blood than those without this condition [30]. In addition to classic paincausing substances (such as PGs and LTs), the inflammatory response contributes to PD, mainly caused by cytokines (i.e., IL-6 and TNFα), chemokines (viz. Monocyte chemoattractant protein-1 [MCP-1] and eotaxin), and leukocytes (including, NEUT, EOS, and MC), which need further examinations

Acupuncture for Inflammatory Visceral Pain

Anti-Inflammatory Mechanisms of Acupuncture-Related Therapies for PD

Recommendations for Future Researches

Findings

Conclusion