Acupuncture for Primary Dysmenorrhea: A Potential Mechanism from an Anti-Inflammatory Perspective

Figure 1

Possible anti-inflammatory effects of acupuncture-related therapies contributing to analgesia in menstrual pain. Progesterone withdrawal leads to the increased production of prostaglandins (PGs), leukotrienes (LTs), cytokines, chemokines, and matrix metalloproteinases (MMPs). These inflammatory factors promote the recruitment and activation of leukocytes, further increasing the inflammation and uterine hypoxia and ischemia, ultimately aggravating menstrual pain, which are considered as a vicious cycle. Acupuncture could reduce the release of PGs and downstream inflammatory cytokines by regulating nuclear factor-κB (NF-κB) signaling pathway, further relieving the inflammatory environment of uterus and uterine ischemia and hypoxia to alleviate menstrual pain. We suggest that further complexity is added to acupuncture-induced analgesia via interactions between chemokines and leukocytes. Symbols “↑” represent rising trend during menstrual pain. Symbols “—” represent inhibition of acupuncture. Abbreviations are listed at the end of the article.