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J Pain Res
J Pain Res
jpr
Journal of Pain Research
1178-7090
Dove

492295
10.2147/JPR.S492295
Letter
Exploring the Potential Benefits of Acupuncture for Dysmenorrhea [Letter]
Zhang
Zhang
http://orcid.org/0000-0002-6390-9591
Zhang Jiale 1
1 Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
Correspondence: Jiale Zhang, Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China, Email zhang_tcm@163.com
26 8 2024
2024
17 27752776
20 8 2024
22 8 2024
© 2024 Zhang.
2024
Zhang.
https://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
author received no financial support for this communication’s research, authorship, and publication The author received no financial support for this communication’s research, authorship, and publication.
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pmcDear editor

I recently read the article “Dysmenorrhea, a Narrative Review of Therapeutic Options”,1 I commend the authors for their comprehensive and informative overview of the pathophysiology and treatment options for dysmenorrhea. Their contribution to the field is invaluable.

However, I noticed that while the authors discuss the use of acupuncture as a potential treatment for dysmenorrhea, they primarily rely on an earlier Cochrane review2 as their source of evidence. Given the rapid advancements in acupuncture research in recent years, it would be beneficial to supplement this discussion with more up-to-date findings from recent systematic reviews and randomized controlled trials (RCTs).

Recent developments in acupuncture research for primary dysmenorrhea have showcased three pivotal studies, prominently contributing to a deeper and more refined understanding of its efficacy. Liu et al3 conducted a systematic review and meta-analysis incorporating 13 RCTs with 675 participants, demonstrating that acupuncture and moxibustion surpassed controls in managing dysmenorrhea, as evidenced by significant improvements in both Visual Analog Scale (VAS) and Cox Menstrual Symptom Scale (CMSS) scores. This underscores the potential analgesic advantages of these traditional modalities.

Building upon this foundation, in 2024, Chen et al4 conducted a comprehensive network meta-analysis of an impressive 70 RCTs, encompassing 5772 patients and examining 25 diverse acupuncture techniques. Their findings revealed massage therapy combined with acupoint patching, acupuncture coupled with acupoint patching, and acupoint patching alone to be the most efficacious treatments for enhancing clinical outcomes and mitigating pain scores in primary dysmenorrhea. This study further diversifies the therapeutic landscape by highlighting the potential benefits of integrating various acupuncture-based interventions.

Recognizing the significance of the placebo effect in acupuncture trials, Sun et al5 conducted a meta-analysis of 13 RCTs, specifically investigating the placebo response to sham acupuncture in patients with primary dysmenorrhea. Their analysis documented a substantial placebo response, particularly for pain relief, and identified key factors associated with a diminished placebo effect, such as using blunt-tip needles and studies with a lower risk of bias. This insight underscores the importance of considering the placebo response when interpreting acupuncture outcomes and emphasizes the need for rigorous methodology in future trials.

Collectively, these studies underscore the potential therapeutic value of acupuncture and related techniques in managing primary dysmenorrhea while also highlighting the complexities involved in assessing their true efficacy. As the field continues to evolve, it becomes increasingly crucial to integrate such diverse findings into a coherent narrative that informs both clinical practice and future research endeavors.

Integrating these recent advancements into the article would fortify the discourse on acupuncture and offer readers a more contemporary and nuanced perspective on its potential benefits and limitations in managing dysmenorrhea. While acupuncture may not currently occupy a first-line position in treatment protocols, it emerges as a valuable complementary and alternative therapy, particularly resonating with those adhering to Eastern traditional medicine principles. Acknowledging acupuncture as an additional therapeutic avenue underscores the expanding evidence base that portends a promising future for its potential impact. Given the inherent challenges in standardizing trials, ongoing efforts to enhance research quality and reporting rigor are paramount. Incorporating these insights into the article fosters a broadened view of acupuncture’s role, spurring further exploration and potential optimization within clinical practice, ultimately benefiting current and future readers and researchers.

Disclosure

The author declares that there is no conflict of interest in this communication.
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References

1. Kirsch ERS, Kerolus K, Hasan R, Kowalska DB, Desai A, Bergese SD. Dysmenorrhea, a narrative review of therapeutic options. J Pain Res. 2024;17 :2657–2666. doi:10.2147/JPR.S459584 39161419
2. Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;4 (4 ):Cd007854. doi:10.1002/14651858.CD007854.pub3 27087494
3. Liu W, Wang CC, Lee KH, Ma X, Kang TL. Efficacy and safety of acupuncture and or moxibustion for managing primary dysmenorrhea: a systematic review and meta-analysis. Clin Nurs Res. 2022;31 (7 ):1362–1375. doi:10.1177/10547738221086984 35499150
4. Chen B, Liu S, Jin F, et al. Efficacy of acupuncture-related therapy in the treatment of primary dysmenorrhea: a network meta-analysis of randomized controlled trials. Heliyon. 2024;10 (10 ):e30912. doi:10.1016/j.heliyon.2024.e30912 38770299
5. Sun CY, Xiong ZY, Sun CY, et al. Placebo response of sham acupuncture in patients with primary dysmenorrhea: a meta-analysis. J Integr Med. 2023;21 (5 ):455–463. doi:10.1016/j.joim.2023.08.005 37620224
