Dysmenorrhea refers to the occurrence of painful menstrual cramps of uterine origin and is a common gynecological complaint. Based on epidemiologic studies, at least 72.7% of female adolescents reported "pain or discomfort" during their period and almost 58.9% of them reported decreased activity and 45.6% reported school or work absenteeism (Taylor et al. 2002). A survey conducted on a group of female adolescents indicated that the majority of the respondents identified dysmenorrhea as one of the problems interfering with their academic performance and school absenteeism. Thus dysmenorrhea and premenstrual symptoms are common pediatric pain problems (Helms 1987). Common treatment for dysmenorrhea includes medical therapy such as NSAIDs or oral contraceptive pills (OCPs). Both modalities work by reducing myometrial activity (contractions of the uterus). The efficacy of conventional treatments such as NSAIDs is considerable. However, the failure rate can be as high as 20-25%. It is not surprising, therefore, that acupuncture and related interventions have been considered as treatments or adjunct treatments for dysmenorrhea. A RCT indicates that an acupressure garment (the Relief Brief®®; Underworks, Miami, FL) decreases pain and symptoms associated with dysmenorrhea (Taylor et al. 2002). Sixty-one young women with moderately severe primary dysmenorrhea were randomized and assigned to the standard treatment control group or the Relief Brief®® acupressure device group. The researchers found that patients who received Relief Brief®® had less pain and used less pain medication (P < 0.05). The use of Relief Brief®® was associated with at least a 50% decline in menstrual pain intensity in more than two-thirds of the women (Taylor et al. 2002). The researchers recommended that this acupressure device might serve as an adjuvant therapy to medication in more severe cases of dysmenorrhea.
Helm (1987) conducted a RCT to study the effectiveness of acupuncture in managing the pain of primary dysmenorrhea. Forty participants were randomized into one of the four groups: the real acupuncture group was given appropriate acupuncture and the placebo acupuncture group was given random point acupuncture on a weekly basis for three menstrual cycles; the standard control group was followed without medical or acupuncture intervention; the visitation control group had monthly non-acupuncture visits with the project physician for three cycles (Helm 1987). The investigator found that 10 of 11 (90.9%) participants in real acupuncture group, 4 of 11 (36.4%) in the placebo acupuncture group, 2 of 11 in the standard control group, and 1 of 11 in the visitation control group showed improvement. There was a 41% reduction in analgesic medication usage by the women in the real acupuncture group after their treatment series than those of other intervention groups (Helm 1987). Similarly, transcutaneous electrical nerve stimulation (TENS) and acupuncture have been used as adjunctive treatment for primary dysmenorrhea. Lastly, intramuscular injection of vitamin K3 into the acupuncture point was evaluated as a treatment for primary dysmenorrhea (Wang et al. 2004). One hundred and eighty patients with history of dysmenorrhea or pelvic inflammatory diseases were enrolled in the study. All these patients had been previously treated without relief using Chinese herbal or Western medicine. They were divided into three groups according to the history of their illness, pelvic examination, and ultrasonography: group A consisted of 60 patients with primary dysmenorrhea, group B of60 patients with chronic pelvic inflammation, and group C of60 patients with endometrio-sis. Patients with primary dysmenorrhea were subdivided into three subgroups according to the pain-relieving efficacy of analgesics and the influence of the illness on the patients' daily life. Pain that was relieved by the analgesics and where daily life was not impacted was considered as mild symptoms; pain which was partly relieved by analgesic and constrained daily activity was considered moderate symptoms, and when the pain could not be relieved by analgesic at all and daily life was arrested, it was considered as severe. Patients in this study received intramuscular injection of a total 8 mg of vitamin K3 (4 mg in each acupoint) into the spleen 6 acupuncture points. These patients were followed for three menstrual cycles. The researchers found that 95% of patients in the mild dysmenorrhea group had significant improvement in their pain and daily activities (P < 0.05). Sixty-three and 65% of patients in moderate and severe groups, respectively, also had reduction in their pelvic pain. The researchers concluded that bilateral intramuscular injection of vitamin K3 into spleen 6 is effective in decreasing the pain and dysfunction associated with primary dysmenorrhea. Thus at present, acupuncture and related intervention may be considered as an effective adjunctive treatment for primary dysmenorrhea (Wang et al. 1997). However, there is a lack of clinical data supporting the long-term benefit of acupuncture and related treatments in patients with primary dysmenorrhea owing to the study design and follow-up.
Was this article helpful?
Have You Always Been Curious About Acupuncture, But Were Never Quite Sure Where To Stick The Needles? If you associate acupuncture with needles, pain and weird alternative medicine then you are horribly misinformed about the benefits of the world's oldest form of medicinal treatment.