Acupuncture for Period Pain and Menstrual Cramps in Denver

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Design

Systematic review and meta-analysis of randomized trials in women with primary dysmenorrhea, comparing acupuncture with no treatment, control treatments or medication. Ten databases were searched for articles published before December 2017.

Result

Manual acupuncture (SMD -1.59, 95% CI -2.12 to -1.06) and electroacupuncture reduced menstrual pain more than no treatment. Manual acupuncture (SMD -0.63, 95% CI -0.88 to -0.37) and warm acupuncture (SMD -1.12, 95% CI -1.81 to -0.43) reduced it more than anti-inflammatory drugs. Some studies showed the effect was kept at short-term follow-up.

Limit

The authors cite low quality and methodological limits in the included studies.

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Design

Systematic review and network meta-analysis of 29 types of acupuncture-related therapy for primary dysmenorrhea, based on Korean and Chinese clinical practice guidelines. Ten databases were searched to November 1, 2024, and 120 studies with 9,571 participants were included.

Result

Overall risk of bias was rated low. Acupuncture-related therapies appeared more effective than Western medicine for visual analogue scale pain scores during treatment and at 3 months, and for regulating prostaglandin levels. The top-ranked therapies were acupoint catgut embedding with moxibustion, warm acupuncture with acupressure, and warm acupuncture with Western medicine.

Limit

Many of the top-ranked therapies are combinations or other techniques, such as catgut embedding, moxibustion and acupressure, so the ranking does not show how needling alone compares. The abstract gives no effect sizes for the comparison with Western medicine.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture and moxibustion for primary dysmenorrhea. Databases and trial registries were searched from inception to February 2021.

Result

Thirteen trials with 675 participants reported pain on the visual analogue scale. Acupuncture and moxibustion each reduced pain more than the control group (mean differences -1.93, 95% CI -2.80 to -1.06, and -2.67, 95% CI -4.96 to -0.38). Menstrual symptom scores on the Cox scale also improved. The authors say these treatments relieved pain effectively with fewer adverse events.

Limit

The abstract describes the clinical evidence before this review as inadequate, and it does not report how certain the findings are. The pain result includes moxibustion as well as needling, and combines different control groups.

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Design

Systematic review and Bayesian network meta-analysis of randomized trials of non-drug treatments for primary dysmenorrhea. Four databases were searched to October 2022, and 33 studies of eight interventions were included. Pain was measured on the visual analogue scale.

Result

All eight interventions reduced menstrual pain compared with placebo or no treatment. In the network analysis, exercise (-3.20, 95% CI -4.01 to -2.34), acupuncture (-2.90, 95% CI -3.97 to -2.85) and topical heat (-2.97, 95% CI -4.66 to -1.29) probably reduced pain intensity.

Limit

The authors say the non-drug treatments may reduce pain only slightly in some comparisons, that exercise and acupuncture look potentially effective in short-term treatment, and that larger research of better methodological quality is needed.

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Design

Systematic review and meta-analysis of the durable effect of acupuncture for primary dysmenorrhea after treatment ended. Eight databases were searched to January 2025, and 14 randomized trials with 970 patients were included.

Result

Three menstrual cycles after treatment, acupuncture beat no intervention on the visual analogue scale (MD -47.80, 95% CI -48.63 to -46.97) and beat anti-inflammatory drugs (MD -29.89, 95% CI -37.63 to -22.15). It also added to the pain relief from those drugs (MD -19.95, 95% CI -24.23 to -15.66).

Limit

Acupuncture showed no advantage over imitation acupuncture at three cycles. The authors say the durable effect was limited by a high risk of bias and low certainty of evidence.

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Design

Systematic review and meta-analysis of randomized trials comparing acupoint stimulation with anti-inflammatory drugs (NSAIDs) for primary dysmenorrhea. Six databases were searched to December 2014, and 16 studies with 1,679 patients were included.

Result

Overall effectiveness was higher with acupoint stimulation (odds ratio 5.57, 95% CI 3.96 to 7.83), and so was relief of symptom severity (MD 2.99, 95% CI 2.49 to 3.49). Side effects were less common than with the drugs (OR 0.03, 95% CI 0.00 to 0.22). The authors conclude it can relieve pain effectively and improve overall effectiveness.

Limit

The reduction in visual analogue scale pain did not differ significantly between the groups (MD 1.24, 95% CI -3.37 to 5.85, P = 0.60). Acupoint stimulation here covers more than needle acupuncture.

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Design

Cochrane review of randomized trials comparing acupuncture, electroacupuncture or acupressure with imitation or placebo control, usual care, drug treatment or no treatment in women with moderate to severe primary dysmenorrhoea. 42 trials with 4,640 women were included.

Result

Against anti-inflammatory drugs, seven studies reported pain scores, and in all of them the scores were lower with acupuncture (by 0.64 to 4 points on a 0 to 10 scale). Four trials found more pain relief with acupuncture (OR 4.99, 95% CI 2.82 to 8.82, 352 women), and adverse events were less common (OR 0.10, 95% CI 0.02 to 0.44). Against no treatment, pain scores were lower with acupuncture in all six studies that reported them.

Limit

The reviewers concluded there was insufficient evidence to say whether acupuncture or acupressure works, and rated the quality of evidence low or very low. Six trials against imitation or placebo control were inconsistent, and the only one at low risk of bias in every area found no difference at 3, 6 or 12 months.

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Design

Randomized trial plus a non-randomized group. Women with dysmenorrhea were assigned to 15 acupuncture sessions over three months or to a control group without acupuncture. Everyone could still receive usual medical care.

Result

After three months, average pain on a 0 to 10 scale was 3.1 with acupuncture versus 5.4 in the control group, a difference of 2.3 points (p < 0.001). Quality of life was also better with acupuncture.

Limit

The control group received no acupuncture rather than an imitation, and acupuncture added cost (about 3,011 euros per quality-adjusted life year, judged cost-effective by the authors).

It may help. A 2018 review of 49 trials found acupuncture reduced menstrual pain more than no treatment, and manual and warm acupuncture reduced it more than anti-inflammatory drugs. In a large trial, average pain after three months was 3.1 on a 0 to 10 scale with acupuncture versus 5.4 without it. The 2016 Cochrane review found the evidence insufficient and of low quality, so I give you an honest estimate and we check progress together.

Trials vary. One large trial gave 15 sessions over three months, and others treated across three menstrual cycles. Because period pain follows your cycle, I plan on a few cycles of care and review progress after your first cycle. If your pain has not changed by then, I will tell you.

Yes. A 2025 review found acupuncture added to the pain relief from anti-inflammatory drugs, and a 2018 review found manual and warm acupuncture reduced menstrual pain more than those drugs. Do not stop or change any medicine without talking to your doctor. I treat acupuncture as one tool alongside your usual care, not a replacement for it.

Yes. A 2024 review of eight non-drug treatments found exercise and topical heat probably reduced pain about as much as acupuncture did. I encourage gentle movement and a heating pad alongside your treatment. If your cramps are severe or changing, check with your doctor as well.

See your doctor first for pain that is new, severe or getting worse, pain that happens outside your period, heavy bleeding, fever, pain during intercourse, a possible pregnancy, or a suspicion of endometriosis or fibroids. If you have any of these symptoms and have not already told your doctor, please let them know.

At The Subtle Point a 90-minute first visit is $150 and follow-ups are $60 for 30 minutes of acupuncture, $95 for 60 minutes of acupuncture with Tuina massage, or $130 for 90 minutes of acupuncture with Tuina massage and cupping. HSA and FSA cards work, and you receive a superbill for your insurer.

Rarely, and never the way an injection does. Acupuncture needles are about the width of a human hair. Most people feel a brief tap, then a dull, heavy or warm sensation that fades in a few seconds. If any point feels sharp, tell me and I will adjust or remove it.