Suspended Moxibustion for Primary Dysmenorrhea in Female Medical Students

Evaluating the Analgesic Efficacy of Suspended Moxibustion in the Treatment of Primary Dysmenorrhea in Female Students at Can Tho University of Medicine and Pharmacy

This study evaluates the analgesic efficacy of suspended moxibustion applied at acupoints CV4 (Guanyuan), CV8 (Shenque), and bilateral SP6 (Sanyinjiao) in female students with primary dysmenorrhea at Can Tho University of Medicine and Pharmacy. In this single-arm pre-post clinical intervention (N=48), participants received daily 20-minute moxibustion sessions starting 7 days before menstruation through the end of the menstrual period, across three consecutive treatment cycles. The primary outcome was change in VAS pain score; secondary outcomes included RSS-COX symptom burden, number of pain days per cycle, and abdominal skin temperature measured by thermal imaging (FLIR C5).

Primary dysmenorrhea (PD) affects up to 88.2% of female students at Can Tho University of Medicine and Pharmacy, yet fewer than 10% receive structured treatment. Moxibustion, a traditional Chinese medicine thermal therapy, has shown promise in regulating prostaglandin synthesis and improving uterine microcirculation, but no controlled study had previously evaluated a standardized moxibustion protocol in Vietnamese medical students.

Eligible participants were female students and postgraduate trainees aged 18-35 years with regular menstrual cycles (28±7 days) and a history of moderate-to-severe dysmenorrhea (VAS ≥ 4) in at least 3 consecutive cycles prior to enrolment. Exclusion criteria included secondary dysmenorrhea, neurological or bleeding disorders, use of prostaglandin synthesis inhibitors within 2 weeks of enrolment, pregnancy/lactation, and current use of NSAIDs or oral contraceptives.

Suspended moxibustion (moxa stick held 2-3 cm above skin, target skin temperature 40-45°C) was administered once daily at CV4, CV8, and bilateral SP6 for 20 minutes/session, from 7 days before menstruation through the last day of menstruation (approximately 7-10 sessions per cycle), across 3 active treatment cycles. Outcomes (VAS, RSS-COX, pain days, abdominal skin temperature) were assessed at baseline and after each of the three treatment cycles. Statistical analysis used Wilcoxon Signed-Rank tests for paired comparisons, Spearman correlation, and Kruskal-Wallis tests, with Bonferroni correction (SPSS v26).

Inclusion Criteria:

• Aged 18-35 years with a regular menstrual cycle (28 ± 7 days)
• History of moderate-to-severe dysmenorrhea (VAS ≥ 4) in at least 3 consecutive menstrual cycles prior to enrolment
• Willing to participate and providing written informed consent

Exclusion Criteria:

• Secondary dysmenorrhea attributable to endometriosis, pelvic inflammatory disease, or uterine fibroids (confirmed by abdominal ultrasound)
• Neurological disorders, immunodeficiency, or uncontrolled bleeding disorders
• Any systemic medical condition contraindicating moxibustion
• Use of prostaglandin synthesis inhibitors (PGSIs) within two weeks prior to enrolment
• Pregnancy, lactation, or planned pregnancy within the following 6 months
• Current use of NSAIDs or oral contraceptives
• Ongoing or recent moxibustion treatment within 2 weeks prior to registration