Acupuncture for PMS and PMDD in Denver

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Design

A common-questions review for family physicians on diagnosing and treating premenstrual syndrome and premenstrual dysphoric disorder. The abstract does not describe a literature search or evidence grading.

Result

It says SSRIs are first-line treatment with rapid onset of improvement, though side effects can limit their use. Cognitive behavior therapy, exercise, acupuncture or acupressure, and the herb Vitex agnus castus may be used to ease PMS and PMDD symptoms. It advises recording symptoms for at least two cycles.

Limit

The wording is "may be used", not a strong recommendation, and the abstract gives no trial numbers for acupuncture. It advises looking for another cause if symptoms are not controlled or persist throughout the month.

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Design

Systematic review and meta-analysis of randomized trials comparing acupuncture with medication, imitation acupuncture or no treatment, searching 9 databases to September 2018.

Result

Acupuncture significantly increased the effective rate for PMS compared with medicine and with imitation acupuncture. Starting treatment earlier or later made no significant difference. The most commonly used acupoints were SP6, LR3 and RN4.

Limit

The authors call for large-scale studies with more rigorous designs.

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Design

Systematic review and meta-analysis of randomized trials of acupuncture versus imitation acupuncture, medication or no treatment for PMS.

Result

Acupuncture was superior to all controls (8 trials, pooled risk ratio 1.55, 95% CI 1.33 to 1.80), to progestin and anxiolytic drugs (4 trials, 1.49, 95% CI 1.27 to 1.74) and to imitation acupuncture (2 trials, 5.99, 95% CI 2.84 to 12.66). No evidence of harm emerged.

Limit

Most trials had a high risk of bias in how people were assigned and how treatment was concealed or masked.

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Design

Systematic review and Bayesian network meta-analysis of randomized trials of external Traditional Chinese Medicine therapies for PMS, used alone or in combination. Eight databases were searched through March 10, 2025. The main outcomes were the overall effective rate and symptom severity scores.

Result

For overall effective rate, Jianpi-Shugan acupuncture had the highest ranking value (SUCRA 95.7). For symptom and sign scores, ear acupressure ranked first (SUCRA 71.2). The authors conclude that external TCM treatments for PMS are effective with almost no side effects.

Limit

Most studies had an unclear risk of bias and six were rated high risk for inadequate randomization reporting. The review covers several kinds of external therapy, not acupuncture alone, and the authors say many high-quality studies are still needed for more direct evidence.

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Design

Single-blind trial in which 30 volunteers with PMDD were assigned alternately to acupuncture or imitation acupuncture, twice a week for two menstrual cycles (16 sessions in total). Anxiety and depression were rated with the Hamilton scales.

Result

Anxiety scores fell 58.9% with acupuncture versus 21.2% with imitation acupuncture (p<0.001). Depression scores fell 52.0% versus 19.6% (p=0.012). Both groups improved, with larger gains in the acupuncture group.

Limit

Only 30 women, assigned alternately rather than by random draw, and measured with anxiety and depression scales rather than a full PMDD symptom diary.

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Design

Systematic review of randomized trials of acupuncture or acupressure for PMS or PMDD, searching English and Chinese databases to 2017.

Result

On the DRSP symptom diary scale, acupuncture may reduce mood symptoms (mean difference -9.03, 95% CI -10.71 to -7.35) and physical symptoms (-9.11, 95% CI -10.82 to -7.40) more than imitation acupuncture, and may improve quality of life. Both came from one trial of 67 women.

Limit

Evidence quality was low to very low because of small samples and risk of bias. Response rates showed no clear benefit once variation between trials was accounted for, and no trials compared acupuncture with SSRIs.

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Design

Single-blind randomized trial in Curitiba, Brazil. 91 women were assigned to ear acupuncture with microneedles at seven points related to PMS symptoms, a placebo group with needles at seven unrelated points, or a control group. Treatment was once a week for 8 weeks.

Result

PMS symptom, musculoskeletal pain and anxiety scores were significantly lower in both the ear acupuncture group and the placebo group. For quality of life and the one-month follow-up, significance was seen only in the placebo group. The authors say auriculotherapy can be used as adjunctive therapy for physical and mood PMS symptoms.

Limit

The placebo group improved as well, so the abstract shows no clear advantage for the PMS-specific points, and it gives no between-group numbers. Ear microneedles are a related technique, not the body acupuncture most clinics use.

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Design

Systematic review of randomized trials of acupuncture and of herbal medicine for PMS and PMDD, published between 2002 and 2012. 8 acupuncture studies and 11 herbal medicine studies were included, and results were summarized in tables or text rather than pooled.

Result

The acupuncture and herbal treatment groups had significantly improved results for PMS and PMDD. Treatments showed a 50% or better reduction of symptoms compared with the starting point, and no serious adverse events were reported.

Limit

The authors describe the evidence as limited. Results depended on symptom severity and on diagnostic criteria, and the review covers herbal medicine as well as acupuncture.

It may help, though the evidence is limited. A Cochrane review found acupuncture may reduce mood and physical PMS symptoms on a daily symptom diary more than imitation acupuncture, and a 2019 meta-analysis of 15 studies found that more women improved with acupuncture than with medication or imitation acupuncture. Certainty is low, and the one PMDD trial I found had only 30 women. I give you an honest estimate, and we check progress together.

The five trials in the Cochrane review used 7 to 28 sessions, a PMDD trial used 16 sessions across two menstrual cycles, and an ear microneedle trial used 8 weekly sessions. Because PMS follows your cycle, I look at one or two full cycles, and we review your symptom diary after the first five visits.

Yes, many people do. SSRIs, a common type of antidepressant, are first-line treatment for PMS and PMDD, and the Cochrane review found no trials comparing acupuncture with them, so I cannot say acupuncture replaces them. I treat acupuncture as an addition. Please do not stop or change any medication without talking to the doctor who prescribes it, and tell me what you take so we can plan together.

Yes. The 2023 ACOG guideline covers exercise, nutrition, counseling, medication and complementary treatments, and notes that many patients benefit from a multimodal approach. A 2025 review for family physicians lists cognitive behavior therapy and exercise alongside acupuncture. I work with your doctor and any therapist or trainer you see, and I ask you to keep a symptom diary so we can see what is helping.

See your doctor first for any thoughts of harming yourself or ending your life (call or text 988 right away), severe mood symptoms such as intense hopelessness, rage or panic, symptoms that disrupt your work, school or relationships, symptoms that last all month instead of clearing after your period starts, a missed or late period or possible pregnancy, new changes in your cycle, very heavy bleeding, bleeding between periods, or severe pelvic pain. 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.