Suspended Moxibustion for Primary Dysmenorrhea in Female Medical Students

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