Acupuncture for Painful Periods

Dysmenorrhoea is painful cramps originating in the uterus just prior to or during menstruation. It can be primary (i.e. without any organic pathology) or secondary (i.e. associated with a pathological condition, such as endometriosis or ovarian cysts). The pain usually lasts between 8 and 72 hours.

Recent systematic reviews of randomised controlled trials found that both acupuncture and acupressure are effective for primary dysmenorrhoea, providing significantly more pain relief than pharmacological treatments. The most compelling evidence comes from a large, high-quality German trial that also found acupuncture to be cost-effective (1).

Acupuncture may help reduce symptoms of dysmenorrhoea by:

• regulating neuroendocrine activities and the related receptor expression of the hypothalamus-pituitary-ovary axis (2)

• increasing nitric oxide levels, which relaxes smooth muscle and hence may inhibit uterine contractions (3)

• increasing relaxation and reducing tension (4). Acupuncture can alter the brain’s mood chemistry, reducing serotonin levels (5) and increasing endorphins (6) and neuropeptide Y levels (7), which can help to combat negative affective states

• stimulating nerves located in muscles and other tissues, which leads to the release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (8)

• reducing inflammation, by promoting the release of vascular and immunomodulatory factors (9)

Reference:

1. Witt CM et al. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol 2008;198:166.e1-8.

2. Liu F et al. Study on the underlying mechanism of acupuncture in regulating neuroendocrine activity in dysmenorrhea rats. Zhen ci yan jiu = Acupuncture research 2009; 34: 3-8.

3. Wang MC et al. Effects of auricular acupressure on menstrual symptoms and nitric oxide for women with primary dysmenorrhoea. Journal of Alternative and Complementary Medicine 2009; 15: 235-42.

4. Samuels N et al. Acupuncture for psychiatric illness: a literature review. Behav Med 2008; 34: 55-64

5. Zhou Q et al. The effect of electro-acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. Int J Clin Acupunct 2008;17: 79-84.