Dysmenorrhea can be debilitating and is considered the most common gynaecological condition in women regardless of age and nationality (Proctor & Farquhar, 2006).
Dysmenorrhea is classified as ‘primary dysmenorrhea’ where the symptoms cannot be explained by structural gynaecological disorders and ‘secondary dysmenorrhea’ where the symptoms are due to pelvic abnormalities (The Merck Manual, 2011). Symptoms can include cramping pain in the lower abdomen with pain radiating to the lower back, nausea, vomiting, diarrhea, headache and fatigue (Hillen, Grbavac, Johnston, Straton, & Keogh, 1999). It was first noted by Pickles in 1965 (Hillen et al., 1999) that the pain of dysmenorrhea is thought to be from uterine contractions and ischemia in the myometrium caused by prostaglandins produced in secretory endometrium (The Merck Manual, 2011).
Four systematic reviews on acupuncture for dysmenorrhea have been completed (Smith, Zhu, He, & Song, 2011, Yang et al., 2008, Cho & Hwang 2010, Chung, Chen, Yeh 2012). There is a combined opinion that the potential for dysmenorrhea to be treated with acupuncture is promising yet there are methodological research flaws. A unanimous call amongst the four reviews was given for further quality research using randomised controlled trials. The reviews all had different eligibility criteria and investigated different Chinese medicine techniques including acupuncture, acupressure, electro-acupuncture, Chinese herbs, auricular ear points and moxibustion.
Within the above reviews there is improvement to dysmenorrhea pain symptoms (Witt 2008, Helms 1987 and Li 2008 as cited in Smith et al. 2011, Yan-qing Bu 2011). Smith et al., (2011)’s completed a ‘low risk’ (Smith et al. 2011) trial on dysmenorrhea which showed improved menstrual mood symptoms. And Witt (2008) showed improvements in pain intensity and quality of life compared to those receiving standard care only.
Biomedical treatment has some options with the possibility of adverse effects and 20-25% of women do not improve (Proctor, Latthe, Farquhar, Khan, & Johnson, 2011). The main treatment options available from a western perspective are non-steroid anti-inflammatory drugs (NSAIDs) or the oral contraceptive pill (OCP). NSAIDs inhibit prostaglandins production which reduces the pain. NSAIDs are significantly more effective for pain reduction than paracetamol or placebo yet are associated with adverse effects including indigestion, headaches and drowsiness (Marjoribanks, Proctor, Farquhar, & Derks, 2010). The synthetic hormones in combined OCPs suppress ovulation. They too have adverse effects of nausea, headache and weight gain and there is limited evidence to suggest pain improvement from its use (Wong, Farquhar, Roberts, & Proctor, 2009).