Premenstrual syndrome is a serial of symptoms occurred before woman’s monthly period. These include physical and emotional symptoms such as bloating, breast tenderness, insomnia, headache fatigue, mood swing, irritability, tension, stress and anxiety etc. 90% of women have experienced premenstrual symptoms (PMS). It occurs in the second half of the menstrual cycle and disappears when your periods arrive. PMS can range in severity from mild discomfort to severe form dysphoric disorder. It can cause significant disruption to your daily activities. Women in their 40s tend to be affected most severely. The symptoms of PMS include two aspects: emotional and physical symptoms such as anxiety, mood swings, tiredness, irritability, anger, aggression, depression, difficulty sleeping, headache, feeling bloated, increase in appetite or food cravings, water retention, pain in your joints, tender breasts, abdominal (tummy) pain, backache, spots, acne, tiredness, constipation, dizzness. If you think you have PMS, keep a diary of your symptoms for two or three menstrual cycles. The symptoms of PMS are non specific and the most important thing is the timing of the symptoms and its repetitive pattern which is related to your menstrual cycle. What causes PMS is not clear yet. One reason is that the body’s sensitivity to hormone levels which varies during the menstrual cycle and these hormones interact with brain mood controlling chemicals.
About a decade ago there was a survey about premenstrual syndrome in US. There was 1052 of women aged 21-64 involved. The result showed that 41% women said that they suffered from premenstrual syndrome and 42% of them took prescription or over counter medicine to release the symptoms. Fewer people used acupuncture. Recent years with research advance, acupuncture was proven to be effective to treat premenstrual syndrome.
Habek D et al Observed the effect of acupuncture in patient with premenstrual syndrome. They found 9 patients received two acupuncture treatments and their symptoms are disappeared completely; 8 patients received three acupuncture treatments and symptoms had gone completely; 1 patient had 4 acupuncture treatments and symptoms had gone. The total effect rate was 77.8% in acupuncture group while the effect rate was 5.9% in placebo group.
Kim SY et al analysed data available in the research to study the effect of acupuncture on premenstrual syndrome. Ten randomly controlled trials throughout of 2009 were included their study. These studies performed sham acupuncture control, medication and no treatment control. They found that 8 trials showed that effect of acupuncture was better than for the control. The improvement of symptoms in acupuncture was better than sham acupuncture. No side effects were observed. They concluded that acupuncture is a promising approach in treating premenstrual syndrome.
Anil A et al studied the effect of acupuncture on premenstrual syndrome. There were 11 participants (aged 23-40) with premenstrual syndrome diagnosed. Acupuncture points used were Ren2, Ren6, Ren12, LI4, LI11, P6, Liv3, SP6, ST36 and Du20. The treatment period was three menstrual cycles. The results showed that the symptoms such as muscle pain, period pain and breast tenderness in all patients were reduced or disappeared completely.
It is well accepted that pain sensation has changed in specific acupuncture points related to specific conditions. Chae Y et al analysed 46 participants to study acupuncture points sensation. These participants were divided into two groups: with premenstrual syndrome group, without premenstrual syndrome group (control group). Pressure pain threshold (PPT) was measured in acupuncture points in the leg and arm. The points chosen included three acupuncture points SP6, GB39, LR3 and one non acupuncture points in the leg and three acupuncture points P6, TE5 and LI4 and one non acupuncture point in the arm. And then the PPT was compared between the two groups. They found that PPT at SP6 for premenstrual syndrome group was significantly lower than for the control group and it was linked to the severity of the conditions. This finding provided a possible basis for the clinical diagnosis and acupuncture treatment.
Acupuncture for premenstrual dysphoric disorder.
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome. Symptoms start before the period and end shortly after period begins. It presents a cyclic pattern every month. Mood changes including anxiety and depression were dominant. Carvalho F et al studied the effects of acupuncture on the symptoms of anxiety and depression caused by PMDD. They compared the effect of acupuncture and sham acupuncture on these symptoms. 15 patients were in each group. Acupuncture was performed twice a week for two menstrual cycles. There were 16 sessions of treatments. There were no differences in the symptom assessment between the two groups before the treatments. After 16 sessions of treatments the symptoms of anxiety and depression were reduced in both groups, but the improvement was significantly better in acupuncture group compared with sham acupuncture group. They suggested that acupuncture could be treatment option for patients with PMDD.
A survey in US has shown that 80% of women preferred non-pharmacological interventions, such as vitamins and supplements or alternative methods of treatments.
Acupuncture is one of the preferred treatment options for patients with PMS. Recently Jang analysed existing data for the effectiveness of acupuncture on PMS. They found that acupuncture treatment improved physical symptoms including headache, cramps, backache, cold sweats, hot flashes, breast pain, skin disorders, swelling of hands and feet, sensitivity to cold, abdominal pain and bulging as much as 50%.
Anil A et al Clin Exp Obstet Dynecol (2012) 39:209-13
Kim SY et al BJOG (2011) 118:899-915
Chae Y et al J Physiol Sci (2007) 57:115-9
Habek D et al Arch Gynecol Obstet (2002) 267:23-6
Singh BB et al Altern Ther Health Med (1998) 4:75-9
Carvalho F et al Acupunct Med (2013) Sep 12 doi 10.1136
Jang SH et al BMC Complement Altern Med (2014) 10:14:11