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

Discussion

The present study, though limited to a single treatment arm, shows a favorable effect of acupuncture in controlling the duration and intensity of moderate/severe dysmenorrhea related pain (VAS ≥ 6) over time, thus confirming previous reports of non-controlled studies[22] and of two controlled trials of acupuncture reported thus far.[23,24]

Pain control (minor or absent, VAS ≤ 2) obtained at the end of treatment is maintained up to 6 months in approximately 50% of cases, which confirms that acupuncture obtains more than just a temporary symptomatic effect. As a placebo effect cannot be excluded, the observed effects might be at least partially attributed to patient's expectation. Nevertheless, the observed large, statistically significant, reduction of pain suggests a true therapeutic effect of acupuncture, as the placebo effect of any treatment is not likely to occur in more than 50% of cases.

Substantial reduction of NSAID use was also evidenced as a consequence of pain control by acupuncture: this may be a further benefit, as NSAID side effects[25] may be reduced. Overall costs, however, were not reduced, due to the higher cost of acupuncture as compared with NSAID. This confirms recent reports of a higher cost of acupuncture as compared with conventional treatments.[26]

Our findings suggest that acupuncture may be indicated to treat dysmenorrhea related pain, in particular in those subjects in whom NSAID or oral contraceptives are contraindicated or refused, pain control being substantially higher than what might be expected only with a placebo effect. The definition of more precise criteria for treatment and its modalities (e.g. duration and intensity) should be the object of further studies allowing for a longer follow-up.

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