Acupuncture has been found to be very effective for primary dysmenorrhea (Helms 1987; Thomas 1995; Neighbors 1987; Lu 1991; Steinberger 1981; Zhan 1990; Zhang 1984). Its effectiveness is similar to that of Ibuprofen and better than placebo (Pouresmail et al 2002). Often pre-emptive treatment is begun 3-7 days before the expected periods.

Acupuncture is commonly used for premenstrual syndrome. In one study (Habek et al 2002) the success rate of acupuncture in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. Symptoms included anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, with a smaller number of women suffering from phobic disorders, premenstrual headaches and migraines. The authors suggest that “the positive influence of acupuncture in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions.”

Amenorrhea is either primary or secondary. Primary amenorrhea is most commonly due to reproductive failure or an anomaly of the reproductive tract and would not be helped by acupuncture. Secondary amenorrhea is most commonly due to anovulation and could be helped by acupuncture. One descriptive series of 225 cases showed a high rate of success, with greater success reported in patients with a shorter history of amenorrhea (Liu, Liu & Liu 1992). A further descriptive series of 20 cases showed a 70% success rate (Yu 1990).

Traditionally, acupuncture has been used for dysfunctional uterine bleeding. A definite decrease in hemoglobin concentration and plasma iron concentrations follows when the menstrual loss exceeded 80 ml and this value is now taken as the upper limit of normal. The bulk of the literature on acupuncture treatment of this condition is traditional and descriptive (Liu et al 1988; Sternfeld et al 1993; Lyttleton 1988; Wu et al 1987)

For the use of acupuncture in the management of pelvic pain, see the section on PREGNANCY above for details and results of controlled clinical trials.

Helms JM. Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol 1987 Jan;69(1):51-6. The effectiveness of acupuncture in managing the pain of primary dysmenorrhea was investigated in a randomized and controlled prospective clinical study. Forty-three women were followed for one year in one of four groups. There was a 41% reduction of analgesic medication used by the women in the acupuncture group after their treatment series, and no change or increased use of medication seen in the other groups.

Thomas et al, 1995 Pain and discomfort in primary dysmenorrhea is reduced by preemptive acupuncture or low frequency TENS. European Journal of Physical Medicine and Rehabilitation 5:71-76 RESULTS: “All modes of acupuncture gave improvement in outcome measures and were significant for pain, analgesic intake and subjective assessment. At 3 months’ follow-up, significant improvement continued with pain and subjective assessment”

Pouresmail Z, Ibrahimzadeh R. Effects of acupressure and ibuprofen on the severity of primary dysmenorrhea. J Tradit Chin Med. 2002 Sep;22(3):205-10. “the therapeutic efficacies of acupressure and Ibuprofen were similar with no significant difference, and were significantly better than the placebo. Thus acupressure, with no complications, is recommended as an alternative and also a better choice in the decrease of the severity of PD.” 216 subjects.

Neighbors L E, Clelland J, Jackson J R, Bergman J, Orr J 1987 Transcutaneous electrical nerve stimulation for pain relief in primary dysmenorrhea. Clinical Journal of Pain 3:17-22. “Seven out of 10 patients had a statistically significant drop in pain. Only one out of 10 in the placebo group had a similar drop in pain.”

Lu S 1991b Acupuncture therapy in the treatment of dysmenorrhea. International Journal of Clinical Acupuncture 2:283-291

Steinberger A 1981 The treatment of dysmenorrhea by acupuncture. American Journal of Chinese Medicine IX: 57-60

Zhan C 1990 Treatment of 32 cases of dysmenorrhea by puncturing hegu and sanyinjiao acupoints. Journal of Traditional Chinese Medicine 10:33-35

Zhang Y 1984 A report of 49 cases of dysmenorrhea treated by acupuncture. Journal of Traditional Chinese Medicine 4:101-102.

Habek D, Habek JC, Barbir A. Using acupuncture to treat premenstrual syndrome. Arch Gynecol Obstet 2002 Nov;267(1):23-6. RESULTS: “The success rate of AP in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions.”

Liu G, Liu J, Liu S 1992 A clinical report of 255 cases of amenorrhea treated by acupuncture and moxibustion. International Journal of Clinical Acupuncture 3:419-421.

Yu X 1990 Experiences in the treatment of amenorrhoea with acupuncture together with syndrome differentiation. International Journal of Clinical Acupuncture 1:15_5-158

Liu W, Zhang J, Zhang Y, Pci T 1988 Acupuncture treatment of functional uterine bleeding -a clinical observation of 30 cases. Journal of Traditional Chinese Medicine 8:31-33

Sternfeld M, Finkelstein Y, Segal Y, Katz 7, Fliraz A, Hod I 1993 The effect of acupuncture on functional and anatomic uterine disturbances: case report-secondary infertility and myomas. American Journal of Acupuncture 21:5-7.

Lyttleton J 1988 The treatment of endometriosis. Journal of Chinese Medicine 26:3-7

Wu, X, Cui Y, Yang B, Zhou Q 1987 Observations on the effect of He-Ne laser acupoint radiation in chronic pelvic inflammation. Journal of Traditional Chinese Medicine 7: 263-265