Investigatingthe Effect of Pressure on Third Liver Point on Primary Dysmenorrhea: a Randomized Controlled Clinical Trial

Abstract

Background: Primary dysmenorrhea (PD) is a term used to describe uterine muscle spasms which occurs during the days of menstruation. Objectives: To determine the effect of acupressure on third liver point on primary dysmenorrhea. Patients and Methods: Female students living in dormitories of Kashan University of Medical Sciences in Iran who had PD were studied for three menstrual cycles between March till June 2012. Individuals with depression score higher than 19 according to the Beck-21 Depression scale were excluded. In the first cycle, pain intensity was assessed without intervention, and 67 samples with a pain score greater than 4 according to the visual analogue scale (VAS) were selected. Then they were randomized into third liver point (liv3) and control (placebo) groups using randomized block design with 1:1 allocation ratio based on pain intensity. In the second and third cycles, pressure was applied by the research unit intermittently for 16 minutes (2 minutes pressure, 2 minutes resting) with the starting of blood flow. Primary outcome of this study was the pain intensity which was compared between first and third cycles. Someone who divided groups, samples and data analyzer was blinded. Results: In the treatment group 27 samples and in the control group 32 samples were analyzed. Friedman test showed significant differences in pain intensity before and after the intervention within both groups (P < 0.05). There were no significant differences between the groups according to the ordinal regression test in 3 cycles (P > 0.05). Conclusions:The pressure on the LIV3 applied in this investigation was effective in reducing primary dysmenorrheal pain. So using this method is recommended to reduce PD.

Sham Acupressure Controls Used in Randomized Controlled Trials: A Systematic Review and Critique

“…Descriptive analysis showed that true acupressure can be an effective approach in managing postoperative and pregnancy-related nausea and/or vomiting, perioperative/prehospital pain, labor pain, sleep disturbances, respiratory disorders, anxiety, postoperative gastrointestinal dysfunctions and motion sickness. Studies on primary dysmenorrhea and chemotherapy-induced nausea and vomiting reported contradictory findings, where two studies [ 57 , 77 ] supported the superiority of true acupressure, while another two [ 17 , 64 ] stated no difference between groups. Results from a single study indicated that the true intervention was better than sham control in treating urodynamic stress incontinence [ 23 ], traumatic brain injury [ 24 ], cancer-related fatigue [ 16 ] and myocardial infarction-related nausea and vomiting [ 71 ], and in maintaining women’s general health [ 25 ] and stroke survivors’ cardiovascular functions [ 27 ].…”

The effect of acupressure at third liver point on the anxiety level in patients with primary dysmenorrhea

“…We did not find any study that evaluated the effect of acupressure at liv3 on anxiety. But our previous report[ 13 ] and Bazarganipour et al . 's study[ 12 ] showed decrease in dysmenorrhea after acupressure was performed on this point.…”

“…One of the energy-consuming organs of the liver meridian is genitalia,[ 11 ] and acupressure on the LIV3 can treat dysmenorrhea. [ 12 13 ] Although no study has been conducted about any change in anxiety occurring after acupressure on liv3 point, anxiety is associated with pain and pain relief may lead to an anxiety reduction. [ 14 ] Some studies have reported that acupressure can reduce dysmenorrhea[ 5 12 ] and the anxiety caused by dysmenorrhea.…”

A randomized controlled clinical trial evaluating quality of life when using a simple acupressure protocol in women with primary dysmenorrhea

“…While, Kafaei-Atrian et al (2013) found that there is no significant difference between LIV3 and the placebo group in term of pain intensity in the third cycle. To address these issues, in our study, the acupressure protocol was started 3-7 days before menstruation (20 minutes per day) (26). In Kafaei-Atrian et al's study, acupressure was started by the onset of menstruation (less than 16 minutes per day) when pain had commenced.…”