Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials
Article first published online: 24 MAY 2011
© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 8, pages 899–915, July 2011
How to Cite
Kim, S.-Y., Park, H.-J., Lee, H. and Lee, H. (2011), Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 899–915. doi: 10.1111/j.1471-0528.2011.02994.x
- Issue published online: 10 JUN 2011
- Article first published online: 24 MAY 2011
- Accepted 1 March 2011. Published Online 24 May 2011.
- premenstrual syndrome;
- systematic review
Please cite this paper as: Kim S-Y, Park H-J, Lee H, Lee H. Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJOG 2011;118:899–915.
Background Although acupuncture is widely applied in obstetrics and gynaecology, evidence for its efficacy in treating premenstrual syndrome (PMS) is equivocal.
Objective To summarise and evaluate the current evidence for acupuncture as a treatment for PMS.
Search strategy Ten databases were searched electronically, and relevant reviews were searched by hand through June 2009.
Selection criteria Our review included randomised controlled trials (RCTs) of women with PMS; these RCTs compared acupuncture with sham acupuncture, medication, or no treatment.
Data collection and analysis Study outcomes were presented as mean differences (for continuous data) or risk ratios (RRs) (for dichotomous data) with a 95% confidence interval (95% CI). The risk of bias was assessed using the assessment tool from the Cochrane Handbook.
Main results Ten RCTs were included in our review. The pooled results demonstrated that acupuncture is superior to all controls (eight trials, pooled RR 1.55, 95% CI 1.33–1.80, P < 0.00001). A meta-analysis comparing the effects of acupuncture with different doses of progestin and/or anxiolytics supported the use of acupuncture (four trials, RR 1.49, 95% CI 1.27–1.74, P < 0.00001). In addition, acupuncture significantly improved symptoms when compared with sham acupuncture (two trials, RR 5.99, 95% CI 2.84–12.66, P < 0.00001). No evidence of harm resulting from acupuncture emerged. Most of the included studies demonstrated a high risk of bias in terms of random sequence generation, allocation concealment, and blinding.
Author’s conclusions Although acupuncture seems promising for symptom improvement in women with PMS, important methodological flaws in the included studies weaken the evidence. Considering the potential of acupuncture, further rigorous studies are needed.