Acupuncture to Treat Primary Dysmenorrhea in Women: A Randomized Controlled Trial

Caroline A Smith,Oswald Petrucco,Justin Beilby,Hannah Dent,Caroline A Crowther

doi:10.1093/ecam/nep239

Abstract

We examined the effectiveness of acupuncture to reduce the severity and intensity of primary dysmenorrhea. A randomized controlled trial compared acupuncture with control acupuncture using a placebo needle. Eligible women were aged 14–25 years with a diagnosis of primary dysmenorrhea. Women received nine sessions of the study treatment over 3 months. The primary outcomes were menstrual pain intensity and duration, overall improvement in dysmenorrhea symptoms and reduced need for additional analgesia, measured at 3, 6 and 12 months from trial entry. A total of 92 women were randomly assigned to the intervention (acupuncture n = 46 and control n = 46). At 3 months although pain outcomes were lower for women in the acupuncture group compared with the control group, there was no significant difference between groups. Women receiving acupuncture reported a small reduction in mood changes compared with the control group, relative risk (RR) 0.72, 95% confidence interval (CI) 0.53–1.00, P = .05. Follow-up at 6 months found a significant reduction in the duration of menstrual pain in the acupuncture group compared with the control group, mean difference –9.6, 95% CI –18.9 to –0.3, P = .04, and the need for additional analgesia was significantly lower in the acupuncture group compared with the control group, RR 0.69, 95% CI 0.49–0.96, P = .03, but the follow-up at 12 months found lack of treatment effect. To conclude, although acupuncture improved menstrual mood symptoms in women with primary dysmenorrhea during the treatment phase, the trend in the improvement of symptoms during the active phase of treatment, and at 6 and 12 months was non-significant, indicating that a small treatment effect from acupuncture on dysmenorrhea may exist. In the study, acupuncture was acceptable and safe, but further appropriately powered trials are needed before recommendations for clinical practice can be made.

Highlights

Primary dysmenorrhea refers to painful menstrual periods in the absence of any underlying pathology
Studies report simple analgesics are commonly used by young women, with use of analgesics reported by 52% of adolescents, and use of non-steroidal anti-inflammatory drugs (NSAIDs) reported by 42% of adolescents to alleviate their dysmenorrhea [4]
Evidence of efficacy supports use of pharmacological agents such as NSAIDs [6], or the use of oral contraceptives [7] to alleviate menstrual pain, pain relief may be inadequate for some women, or side effects may not be well tolerated

Summary

Introduction

Primary dysmenorrhea refers to painful menstrual periods in the absence of any underlying pathology. Studies report simple analgesics are commonly used by young women, with use of analgesics reported by 52% of adolescents, and use of non-steroidal anti-inflammatory drugs (NSAIDs) reported by 42% of adolescents to alleviate their dysmenorrhea [4]. In a Swedish study, 38% of women used analgesics and 22% used oral contraceptives to alleviate their dysmenorrhea [5]. Evidence of efficacy supports use of pharmacological agents such as NSAIDs [6], or the use of oral contraceptives [7] to alleviate menstrual pain, pain relief may be inadequate for some women, or side effects may not be well tolerated. The randomized groups were comparable for most baseline characteristics at trial entry (Table 1).

Objectives

Methods

Results