Positive Health Online

Abstract

PROCTOR and colleagues, Department of Obstetrics and Gynaecology, National Women’s Hospital, Claude Road, Epsom, Auckland, New Zealand, 1003, E: m.proctor@auckland.ac.nz, reviewed (42 references) published reports of randomized controlled trials (RCTs) investigating the effectiveness of transcutaneous electrical nerve stimulation (TENS) or acupuncture for treating primary dysmenorrhoea (painful periods).

Background

Conventional treatment of dysmenorrhoea usually consists of either non-steroidal anti-inflammatory drugs (NSAIDs) or the oral contraceptive pill, both of which can result in unwanted side effects. There is therefore potential for an effective non-pharmacological treatment. Both TENS and acupuncture have been shown to be effective for relieving pain in a number of conditions.

Methodology

RCTs comparing TENS and/or acupuncture with each other, placebo, no treatment or medical treatment of primary dysmenorrhoea were identified by searching the following sources: the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials (CCTR; Cochrane Library Issue 3, 2001); MEDLINE; EMBASE; CINAHL; Bio extracts; PsychLIT; SPORTDiscus; the Cochrane Complementary Medicine Field’s Register of controlled trials (CISCOM); the UK National Research Register; the Clinical Trial Register; the citation lists of review articles and publications of included trials; and contact with the first or corresponding author of included trial publications. Data were analysed using meta-analysis where possible or were reported as descriptive data. Outcome measures analysed were: pain relief, adverse events, adjunctive use of analgesics and absence from work or school.

Results

Nine RCTs met the predetermined inclusion criteria: seven involving TENS, one involving acupuncture and one involving both treatments. The analyses revealed that high-frequency TENS was more effective at relieving pain than placebo TENS. Low-frequency TENS appeared to be no more effective than placebo. However, data were inconclusive with regard to whether high-frequency TENS was more effective than low-frequency TENS. In one small but well-designed study, acupuncture was found to be significantly more effective at relieving pain than placebo acupuncture or no treatment.

Conclusion

High-frequency TENS appears to be effective for relieving pain of primary dysmenorrhoea. One trial of high-frequency TENS reported some minor adverse events – these require further study. Data regarding the effectiveness of low-frequency TENS were inconclusive. The results of just one small trial of acupuncture indicated that this intervention may be effective in relieving pain of primary dysmenorrhoea and deserve confirmation in larger studies.

References

Proctor ML et al. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea. The Cochrane Database of Systematic Reviews 2002 (1): CD002123.