The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial

https://doi.org/10.1016/j.ctim.2017.02.003Get rights and content

Highlights

  • Acupressure at LIV3 and LI4 is effective method to decrease the severity of PMS symptoms.

  • Acupressure at LIV3 and LI4 is effective method to decrease anxiety and depression and improvement of quality of life.

  • Acupressure at LIV3 and LI4 appear to be equally effective.

Abstract

Objective

To evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS).

Method

This paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20 min acupressure on different acupoints for 14 days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure). The acupoints were LIV3 and LI4; one group received acupressure at a placebo point. Each participant completed the PSST scale (to determine PMS severity), HADS scale (for depression and anxiety), and quality of life SF12.

Results

The number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group (p < 0.04).

Moreover, depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the placebo group (p < 0.05).Analyzing the score of SF12 fields in the second and third cycles showed a significant difference in all dimensions between the intervention and placebo groups. There was no significant difference between LIV3 and LI4 acupressure groups in decrease of PMS symptoms, anxiety and depression and improving SF12scores (p < 0.05).

Conclusion

Performing the simple acupressure protocol at LIV3 and LI4 is an effective method to decrease the severity of PMS symptoms, anxiety and depression, and to improve the QOL. Pressure at LIV3 and LI4 appears to be equally effective.

Introduction

Premenstrual syndrome (PMS) is the periodic recurrence of physical, cognitive, and behavioral symptoms which occurs during the luteal phase of menstruation and ends a few days' afterbleeding starts. 70–90% of women show different levels of PMS signs among which 20–40% result in dysfunction in daily activities.1 In addition, PMS results in increasing adverse educational, economic (absence of the work), and social (committing murder and crime) consequences, as well as decreasing quality of life (QOL).2

The cause of PMS is multi-factorial and no cure is known. Therefore, only symptomatic treatment is available. Medical treatments include selective serotonin reuptake inhibitors (SSRIs) and oral contraceptives.3 Complementary and alternative medicine is treatment methods proposed to diminish the severity of PMS symptoms.4, 5

In complementary and alternative medicine, the etiology and pathogenesis of PMS can be explained as stagnation of energy in the liver and pathological changes in energy level (qi) which affect other body organs. By regulating the liver function, one's mind and mood is regulated then. Therefore, when the liver qi is stagnated and cannot move easily, one's mind and mood is disturbed and psychological and emotional signs appear.4

It's proposed several acupoint may be used for alleviate of PMS including GV246,LI46,LR36,SP66,GV207,CV3,4,67,PC67,GB347,BL237,Shenman.7,CV98,CV179,A5,6,8,12,16,1810,N1810,F610,GV2411,ST3612,BL18,19,20,21,22,47,48,49,50,51,5213 However, there are no studies done to evaluate the effects of acupressure on PMS symptoms. The purpose of this study was to evaluate the effect of acupressure in the third hepatic (taichung), fourth large intestine (HUGO), in comparison with placebo acupressure, on PMS symptoms and QOL in females with PMS.

Section snippets

Design and data collection

The present study is a randomized single blinded clinical trial; we recruited students through advertisements in the campus accommodation of Hormozgan University of Medical Sciences, Iran. Sampling and allocation to groups was randomized and the sample size calculated at 30 per each group with α = 0.5, 1-β = 0.8, and S2p = 2.22. Except several cases with loss to follow up, treatment compliance for the three cycles was 100%. There are not any reported adverse effects. The researcher telephoned the

Results

The process of allocating participants during 2015–2016 is shown in Fig. 1.

Discussion

The current study is the first study which evaluates the effect of applying acupressure in two separate acupointsLIV3 and LI4 in comparison with placebo on QOL in women with PMS. The results show the number of PMS cases (moderate/severe) according to PSST scale significantly decreased in acupressure groups compared with the placebo in the second and third menstrual cycles. In other words, the severity of PMS symptoms according to PSST scale dramatically decreased in acupressure groups. In a

Funding

This study was funded by a grant from Hormozgan University of Medical Science in Iran.

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