The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial

Abstract

ObjectivesWe examined the effect of changing treatment timing and the use of manual, electro acupuncture on the symptoms of primary dysmenorrhea.MethodsA randomised controlled trial was performed with four arms, low frequency manual acupuncture (LF-MA), high frequency manual acupuncture (HF-MA), low frequency electro acupuncture (LF-EA) and high frequency electro acupuncture (HF-EA). A manualised trial protocol was used to allow differentiation and individualized treatment over three months. A total of 74 women were randomly assigned to one of the four groups (LF-MA n = 19, HF-MA n = 18, LF-EA n = 18, HF-EA n = 19). Twelve treatments were performed over three menstrual cycles, either once per week (LF groups) or three times in the week prior to menses (HF groups). All groups received a treatment in the first 48 hours of menses. The primary outcome was the reduction in peak menstrual pain at 12 months from trial entry.ResultsDuring the treatment period and nine month follow-up all groups showed statistically significant (p < .001) reductions in peak and average menstrual pain compared to baseline but there were no differences between groups (p > 0.05). Health related quality of life increased significantly in six domains in groups having high frequency of treatment compared to two domains in low frequency groups. Manual acupuncture groups required less analgesic medication than electro-acupuncture groups (p = 0.02). HF-MA was most effective in reducing secondary menstrual symptoms compared to both–EA groups (p<0.05).ConclusionAcupuncture treatment reduced menstrual pain intensity and duration after three months of treatment and this was sustained for up to one year after trial entry. The effect of changing mode of stimulation or frequency of treatment on menstrual pain was not significant. This may be due to a lack of power. The role of acupuncture stimulation on menstrual pain needs to be investigated in appropriately powered randomised controlled trials.

Synergistic immunoreaction of acupuncture-like dissolving microneedles containing thymopentin at acupoints in immune-suppressed rats

“…Given that each acupuncture procedure lasts about 20 min 22 , blank and TP5-loaded DMNAs were manually applied onto depilated rat skin. At different time intervals, the base of DMNAs was removed from the rat and the remaining needles were visually counted under a microscope to determine the dissolution ability.…”

<p>Therapeutic Efficacy and the Impact of the “Dose” Effect of Acupuncture to Treat Sciatica: A Randomized Controlled Pilot Study</p>

“…37 Similar dose-finding studies reveal that changing in modes of stimulation such as whether to apply manual stimulation and the frequency of manipulation did not result in significant differences in the treatment of fibromyalgia or menstrual pain, respectively. 33,38 However, a meta-analysis on treating primary dysmenorrhea with acupuncture showed that needle location, number of needles used, and frequency of treatment may have dose-response relationships with menstrual pain outcomes. 23 A contradictory dose-response relationship can be attributed to the variable aspect of the "dose" of acupuncture, which involves both the physiological effects of needling and a patient's perception.…”

Resting-State Functional Connectivity Patterns Predict Acupuncture Treatment Response in Primary Dysmenorrhea

“…The National Institutes of Health has also recommended acupuncture as an effective tool for certain health problems, including menstrual pain (Campbell and McGrath, 1999). Subsequently, the efficacy and safety of acupuncture for PDM have been reported in our systematic review (Yu et al, 2017) and several randomized controlled trials (RCTs) (Witt et al, 2008;Ma et al, 2013;Armour et al, 2017).…”