Efficacy of acupuncture in management of premenstrual syndrome: A systematic review

Background: The effectiveness of acupuncture in the case of premenstrual syndrome (PMS) is not fully understood. Objectives: To assess the effectiveness and adverse effects of acupuncture for the symptomatic treatment of PMS from randomised controlled trials (RCTs). Search strategy: Electronic databases, including English, Korean, Japanese and Chinese, were systematically searched up to January 2009 with no language restrictions. Selection criteria: RCTs comparing acupuncture with control investigating acupuncture for PMS were considered. Data collection and analysis: Study collection and quality assessment were performed by two reviewers using the criteria described in the Cochrane Handbook. Main results: Nine studies were systematically reviewed. Only two of the nine trials reported details regarding sequence generation and allocation concealment. Four studies reported a significant difference in reduction of PMS symptoms for acupuncture treatment compared with pharmacological treatment. Two studies reported the improvements in primary symptoms within the acupuncture and herbal medications groups compared with baseline. Only two RCTs reported information regarding acupuncture-related adverse events, which included one case of a small subcutaneous haematoma. Conclusions: Although the included trials showed that acupuncture may be beneficial to patients with PMS, there is insufficient evidence to support this conclusion due to methodological flaws in the studies, including unknowns in sequence generation, concealment of allocation, blinding and outcome measures.