Acupuncture Treatment of Dysmenorrhea Resistant to Conventional Medical Treatment

V. Iorno; R. Burani; B. Bianchini; E. Minelli; F. Martinelli; S. Ciatto

Disclosures

Evid Based Complement Alternat Med. 2008;5(2):227-230. 

In This Article

Methods

Between December 2004 and March 2005, a consecutive series of 15 nulliparous patients (age range 13–35, average 27) was enrolled at the 'Mario Tiengo´ Pain Control Clinic of the Mangiagalli-Regina Elena Hospital of Milan, Italy. Patients were suffering from moderate to severe dysmenorrhea since at least 1 year, had a poor response to NSAID and refused oral contraceptive therapy, which is currently employed as a first line treatment of dysmenorrhea.[4,18,19] All patients underwent careful anamnesis, pain evaluation, transvaginal ultrasound (transabdominal if virgo), and CA125 dosage in the second part of menstrual cycle. Patients features at presentation are summarized in Table 1 .

All patients were given 8 weekly acupuncture sessions, for a total duration of 2 months. Needle positioning was based on conventional diagnostic criteria of traditional Chinese medicine. Sterile needles were positioned for 30 min at a variety of acupoints, namely KI-3, LV-3, SP-4, ST-36, ST-25, ST-29, ST-30, REN-4, REN-6, BL-62, HT-7, LI-4, PC-6 and ZI GONG extra point.[20] No limitation to additional NSAID use was required, if necessary.

The efficacy of acupuncture was assessed through Visual Analogue Scales (VAS), a self assessment scale ranging from 0 to 10, where the patient was requested to indicate the point most representative of pain intensity, from score 0 (no pain) to score 10 (pain as bad as it could be), chosen for its simplicity.[21] VAS was determined at five different points in time, namely baseline (T1), mid treatment (T2), end of treatment (T3), and 3 (T4) and 6 months (T5) after the end of treatment. Overall NSAID use (number of assumed doses), and duration of pain (days), were determined at the same points in time. Cost analysis was attempted, based on average cost of baseline NSAID (Nimesulide®) use (€0.1563/single dose), assumed to be stable in absence of acupuncture, for a period of 8 months (equivalent to 2 months of acupuncture treatment + 6 months of follow-up), compared with (i) the cost of NSAID documented use since treatment started, plus (ii) the cost of the acupuncture procedure (€17.50 per session, according to Regional Health Service tariff).

Statistical significance (P < 0.05) of observed results was determined by analyzing the distribution of pain intensity (VAS), pain duration and NSAID consumption at T1 (prior to treatment) as compared with T3 (end of treatment) or T5 (6 months after end of treatment) with Wilcoxon's signed rank test, using STATA 8.0 (www.stata.com) software.

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