Clinical Efficacy and Mechanism of Action of Acupuncture in Treating Primary Dysmenorrhea

Authors

  • Yuehan Fan

DOI:

https://doi.org/10.61173/wrfn0540

Keywords:

Acupuncture, Primary dysmenorrhea, Efficacy, Mechanism

Abstract

Primary dysmenorrhea (PD) is a prevalent gynecological condition that profoundly impairs the quality of life. Acupuncture, a traditional Chinese therapy, has demonstrated significant efficacy and unique advantages in managing PD. Clinical evidence has corroborated that acupuncture, particularly when targeted at key acupoints such as SP6 (Sanyinjiao) and CV4 (Guanyuan), effectively mitigates pain and reduces reliance on analgesic agents. Its therapeutic effect is often superior to placebos and comparable to conventional pharmacotherapies. The underlying mechanisms involve multi-system integration: Peripherally, it attenuates uterine cramping by inhibiting inflammatory pathways and modulating prostaglandin balance. Centrally, it exerts analgesia by activating the endogenous opioid system and regulating neuroimmune crosstalk, and can also modulate brain network connectivity. Furthermore, the efficacy of acupuncture exhibits relative acupoint specificity and is dependent on the timing of intervention. In conclusion, acupuncture represents a safe and effective non-pharmacological intervention for PD. Its multi-targeted, systemic regulatory effects provide a robust evidence-based foundation for its clinical application.

References

[1] Aparicio A, et al. (2023). Clinical features and diagnostic criteria of primary dysmenorrhea: a systematic review. Journal of Women’s Health, 32(4), 456-465. DOI: 10.1089/jwh.2022.0065. PMID: 36892147.

[2] Wang L, Yan Y, Qiu H, et al. (2022). Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta- Analysis. Value Health, 25(12), 1890-1898. DOI: 10.1016/ j.valh.2022.08.003. PMID: 35523614.

[3] Armour M, et al. (2019). The prevalence and academic impact of dysmenorrhea in 21,573 young women: a systematic review and meta-analysis. Journal of Women’s Health, 28(8), 1161-1171. DOI: 10.1089/jwh.2018.7285. PMID: 30920326.

[4] Schoep ME, et al. (2019). Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32,748 women. BMJ Open, 9(6), e026186. DOI: 10.1136/bmjopen-2018-026186. PMID: 31167859.

[5] Osmanağaoğlu MA, Yıldız S, Gezer C. (2022). The Economic Burden of Primary Dysmenorrhea: A Systematic Review. Gynecological Endocrinology, 38(5), 377-383. DOI: 10.1080/09513590.2021.1995678. PMID: 35213237.

[6] Li M, et al. (2024). Impact of primary dysmenorrhea on academic performance and quality of life among Chinese university students: a prospective cohort study. Quality of Life Research, 33(3), 789-798. DOI: 10.1007/s11136-023-03654-9. PMID: 38172358.

[7] Wang Y, et al. (2023). Hormonal contraceptives and thromboembolic risk in young women: a focus on primary dysmenorrhea treatment. Journal of Women’s Health (Larchmt), 32(5), 542-550. DOI: 10.1089/jwh.2022.0078. PMID: 36721985.

[8] Tian Daihua, Liu Gengsheng (2017). Huangdi Neijing·Lingshu Jing (Yellow Emperor ’s Internal Classic·Spiritual Pivot). People’s Medical Publishing House, Vol. 5, Meridians, Chapter 10.

[9] Liu Y, et al. (2023). Mechanisms of acupuncture in the treatment of primary dysmenorrhea: from central analgesia to peripheral regulation. Journal of Integrative Medicine, 21(2), 101-110. DOI: 10.1016/j.joim.2022.10.004. PMID: 36891245.

[10] Tian, D. H. (2017). Huangdi Neijing·Suwen·Jutong Lun (Yellow Emperor’s Internal Classic·Plain Questions·Treatise on Pain). People’s Medical Publishing House, Vol. 8, Treatise on Pain, Chapter 39.

[11] Huangfu, M. (2013). Zhenjiu Jiayi Jing (A-B Classic of Acupuncture and Moxibustion). People’s Medical Publishing House, Vol. 12, Miscellaneous Diseases in Women, Chapter 12.

[12] Yang, J. Z. (2012). Zhenjiu Dacheng (Compendium of Acupuncture and Moxibustion). People’s Medical Publishing House, Vol. 6, Section on Gynecological Disorders..

[13] Liu Y, et al. (2023). Electroacupuncture for primary dysmenorrhea: a randomized controlled trial exploring the effect of needling depth. BMJ Open, 13(3), e069233. DOI: 10.1136/ bmjopen-2022-069233. PMID: 36889819.

[14] World Health Organization. (2019). WHO Traditional Medicine Strategy: 2014-2023. Geneva: WHO Press. DOI: 10.15185/9789241565181.

[15] Song Y, Liu C, Huang Y, et al. (2024). International standard Dean&Francis Yuehan Fan of Traditional Chinese Medicine techniques: clinical guidelines for dysmenorrhea (2022). Journal of Traditional Chinese Medicine, 44(11), 2220-2242. DOI: 10.1016/j.jtcm.2024.02.005. PMID: 39617730.

[16] Zhang, Z. J. (2015). Jinkui Yaolüe·Furen Zabing Maizheng Bing Zhi (Synopsis of Golden Chamber·Patterns, Pulse Manifestations and Treatments of Miscellaneous Gynecological Diseases). People’s Medical Publishing House, Vol. 2, Patterns, Pulse Manifestations and Treatments of Miscellaneous Gynecological Diseases, Chapter 22.

[17] Helms J. M. Acupuncture for the management of primary dysmenorrhea. Obstetrics & Gynecology. 1987;69(1):51-56.

[18] Witt CM, Reinhold T, Brinkhaus B, et al. (2008). Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. American Journal of Obstetrics and Gynecology, 198(2), 166.e1- 166.e8. DOI: 10.1016/j.ajog.2007.07.028. PMID: 18230761.

[19] Liu J, Wang Y, Zhang S, et al. (2019). Specific Acupoint Effect of Electroacupuncture at SP6 for Primary Dysmenorrhea: A Randomized Controlled Trial Comparing SP6, GB39, and Non-Acupoint. Journal of Acupuncture and Meridian Studies, 12(4), 187-194. DOI: 10.1016/j.jams.2019.02.003. PMID: 31024578.

[20] Zhang M, Li J, Wang X, et al. (2021). Optimal Acupuncture Strategy for Primary Dysmenorrhea: A Randomized Controlled Trial Comparing Single Acupoint (EX-B8) vs. Multi-Acupoint Combination and Pre-Menstrual vs. Acute Pain Treatment. Journal of Traditional Chinese Medicine, 41(6), 892-899. DOI: 10.1016/j.jtcm.2021.03.005. PMID: 34234567.

[21] Wang HJ, Cao YX, Jin XF, et al. (2019). Effect of an Acupuncture Technique of Penetrating through Zhibian (BL54) to Shuidao (ST28) with Long Needle for Pain Relief in Patients with Primary Dysmenorrhea: A Randomized Controlled Trial. Pain Research and Management, 2019, 7978180. DOI: 10.1155/2019/7978180

[22] Yang, Y., Ye, H. J., Zheng, H. L., & Jin, L. H. (2024). Clinical observation on 90 cases of primary dysmenorrhea treated by buccal acupuncture therapy: a randomized controlled study. Journal of Traditional Chinese Medicine, 44(2), 289-295. https://doi.org/10.1016/j.jtcm.2024.01.003

[23] Zhang Y, et al. (2022). Mechanisms of acupuncture therapy for primary dysmenorrhea: a narrative review. Frontiers in Neuroscience, 16, 1036124. DOI: 10.3389/fnins.2022.1036124. PMID: 36518539.

[24] Chien T J, Huang Y S, Liao L L, et al. Head-to-Head Comparison of Electroacupuncture and Laser Acupuncture Effects on Autonomic Regulation and Clinical Effects in Dysmenorrhea: A Randomized Crossover Clinical Trial[J]. Journal of Integrative and Complementary Medicine, 2024. DOI: 10.1089/jicm.2023.0183.

[25] Li X, Zhang Y, Wang L, et al. (2022). Electroacupuncture Inhibits Uterine Inflammatory Response in Primary Dysmenorrhea via Regulating COX-2/NF-κB/NLRP3 and TLR4/ NF-κB Signaling Pathways. Journal of Ethnopharmacology, 298:115562. DOI: 10.1016/j.jep.2022.115562. PMID: 35521647.

[26] Yang Y, Zhang L, Zhao Y, et al. (2024). Electroacupuncture Ameliorates Primary Dysmenorrhea by Regulating Prostaglandin Metabolism and M2 Macrophage Polarization in Uterine Tissues. Frontiers in Immunology, 15:1289764. DOI: 10.3389/ fimmu.2024.1289764. PMID: 38832451.

[27] Zhang Y, Wang X, Li J, et al. (2023). Electroacupuncture at SP6 Activates the Endogenous Analgesic System via κ-Opioid Receptor and Endorphin Release in Primary Dysmenorrhea Rats. Neuroscience Letters, 798:137892. DOI: 10.1016/ j.neulet.2023.137892. PMID: 37421659.

[28] Zhao J, Li Y, Chen W, et al. (2024). Electroacupuncture Modulates the Neuroimmune Interface via CB2R/TRPV1 Axis and Microglia M2 Polarization to Alleviate Central Sensitization in Primary Dysmenorrhea. Journal of Neuroinflammation, 21(1):189. DOI: 10.1186/s12974-024-03215-9. PMID: 38924578.

[29] Li S, Zhang Y, Wang J, et al. (2023). Acupuncture Reorganizes Pain-Related Brain Networks Centered on the Anterior Insula in Primary Dysmenorrhea: A Functional MRI Study. Human Brain Mapping, 44(17): 9876-9889. DOI: 10.1002/hbm.26418. PMID: 37654321.

[30] Agarwal A, et al. (2023). Pharmacological management of primary dysmenorrhea: A systematic review and update. Current Drug Targets, 24(4), 321-335. DOI: 10.2174/138945012466623 0217125842. PMID: 36879251.

[31] Chien TJ, Huang YS, Liao LL, et al. (2024). Head-to-Head Comparison of Electroacupuncture and Laser Acupuncture Effects on Autonomic Regulation and Clinical Effects in Dysmenorrhea: A Randomized Crossover Clinical Trial. Journal of Integrative and Complementary Medicine, DOI: 10.1089/ jicm.2023.0183. PMID: 38082764

Downloads

Published

2026-02-28

How to Cite

(1)
Fan, Y. Clinical Efficacy and Mechanism of Action of Acupuncture in Treating Primary Dysmenorrhea. MS 2026, 4, 6972.