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Acupuncture and acupressure for premenstrual syndrome (PMS)

Review question
Cochrane authors reviewed the evidence on the effectiveness and safety of acupuncture or acupressure in women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder.

Background
We wanted to know whether using acupuncture or acupressure therapy was better than receiving sham acupuncture, no treatment or currently recommended pharmaceutical medications for PMS such as serotonin reuptake inhibitors (SSRIs – a type of anti-depressant).

Study characteristics
We found five randomised controlled trials including 277 women that examined the effect of acupuncture or acupressure in women with PMS. The evidence is current to September 2017. We also ran a smaller search in November 2017 to see if we had missed any recently published studies. Three trials compared acupuncture with sham acupuncture, one compared acupuncture with no treatment and one compared acupressure with sham acupressure.

Key results
Acupuncture may reduce overall mood and physical PMS symptoms when compared to sham. Acupressure may reduce the number of women having moderate to severe PMS symptoms when compared to sham acupressure. There was not enough evidence to determine the safety of acupuncture or acupressure.

Quality of the evidence
The quality of the evidence ranged from low to very low.The main limitations were imprecision due to small sample sizes (too few women in the study) and risk of bias related to blinding (where researchers or participants knew what treatment they were getting).

Authors‘ conclusions:
The limited evidence available suggests that acupuncture and acupressure may improve both physical and psychological symptoms of PMS when compared to a sham control. There was insufficient evidence to determine whether there was a difference between the groups in rates of adverse events.There is no evidence comparing acupuncture or acupressure versus current ISPMD recommended treatments for PMS such as selective serotonin reuptake inhibitors (SSRIs). Further research is required, using validated outcome measures for PMS, adequate blinding and suitable comparator groups reflecting current best practice.

Authors: Armour M, Ee CC, Hao J, Wilson TMarie, Yao SS, Smith CA

Published in: Cochrane Library 14 August 2018

Quelle: https://www.cochrane.org/

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