A Cochrane database systematic review by Australian authors has concluded that current evidence supports the use of acupuncture to reduce menstrual pain. Ten trials with data reporting on 944 participants were included in the review. The results showed that there was an improvement in pain relief from acupuncture compared with a placebo control or with Chinese herbs. In two trials acupuncture reduced menstrual symptoms (for example nausea and back pain) compared with medication; in one trial acupuncture reduced menstrual symptoms compared with Chinese herbs; and in one trial acupuncture improved quality of life compared with usual care. There was an improvement in pain relief from acupressure compared with a placebo control, and in one trial acupressure reduced menstrual symptoms compared with a placebo control. The risk of bias was judged to be low in 50% of trials and the authors called for further well-designed trials. (Acupuncture for primary dysmenorrhoea. Cochrane Database Syst Rev. 2011 Jan 19;1:CD007854).

In another German study, the clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhoea was studied. In a randomised controlled trial plus non-randomised cohort, patients with dysmenorrhoea were randomised to 15 sessions of acupuncture over three months or to a control group (no acupuncture). All subjects were allowed to receive usual medical care. Of 649 women, 201 were randomised. Those who declined randomisation received acupuncture treatment. After three months, the average pain intensity was lower with acupuncture than without (3.1 vs. 5.4). The authors concluded that additional acupuncture in patients with dysmenorrhoea was associated with improvements in pain and quality of life as compared to usual care alone and was cost-effective within usual thresholds (overall ICER 3,011 euros per QALY). (Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. 2008 Feb;198(2):166.e1-8).

 The evidence supporting the use of Chinese herbal medicine (CHM) for primary dysmenorrhoea is promising, but better quality research on the subject is still required. These are the conclusions of a systematic review by Australian researchers, which included 39 RCTs involving a total of 3475 women. CHM was found to result in significant improvements in pain relief, overall symptoms and use of additional medication when compared with use of pharmaceutical drugs. CHM also resulted in better pain relief than either acupuncture or heat compression in the studies analysed. There were no indications that CHM caused any adverse events. (Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2007 Oct 17;(4): CD005288).

A pragmatic randomised study has evaluated the clinical and economic effectiveness of acupuncture in the treatment of women with dysmenorrhoea. 201 patients were allocated to receive either up to 15 acupuncture sessions over three months or no acupuncture. Both groups additionally received usual medical care. Outcome measures of pain intensity and quality of life were recorded at baseline and after three months. After three months, patients in the acupuncture group were found to have less pain than controls. A cost-effectiveness calculation was performed, based on calculating quality-adjusted life years (QALYs). This analysis showed that although acupuncture treatment incurred additional costs when compared with usual care, the improvement to patient’s quality of life means it can be regarded as cost-effective when compared with international benchmarks.

(Pragmatic randomised study evaluating clinical and economic effectiveness of acupuncture treatment in patients with dysmenorrhoea. Focus Altern Complement Ther. 2006;11(5):53)