Clinical evidence on integrated Chinese-Western medicine for primary dysmenorrhea

Primary dysmenorrhea (PD), a common gynecological disorder, adversely affects the quality of life, mental health, and overall well-being of many young women. Given concerns about adverse effects of some Western medications, Chinese medicine (CM) and integrated Chinese-Western medicine (ICWM) approaches have gained attention. This study aims to systematically identify PD-related clinical evidence on CM and ICWM treatments, appraise and categorize the evidence by study design, and provide evidence summaries based on pre-defined clinical questions to inform evidence-based practice.

As part of the AI-empowered Clinical Evidence for Integrated Chinese-Western Medicine (ACE-iMed) series, this study followed the ACE-iMed framework to systematically screen and identify PD-related evidence addressing 14 pre-defined clinical questions. We focused on clinical practice guidelines/consensus statements, systematic reviews, and randomized controlled trials, and searched databases and relevant websites from inception through September 6, 2025. The overarching methods are detailed in the series' methodological paper; the key and PD-specific methods are described in this article.

Of 5062 records identified, 219 met inclusion criteria: 4 clinical practice guidelines, 37 systematic reviews, and 178 randomized controlled trials. Almost eighty percent were published in Chinese. Mean quality assessment scores exceeded 50% of the maximum scale. The most frequently evaluated comparisons were oral Chinese herbal medicine versus Western medications and acupuncture versus conventional Western therapy.

CM and ICWM interventions for PD are actively studied. Interest-holders, including clinicians, patients, the public, policymakers, and researchers, can access curated PD evidence (http://www.aceimed.org) to identify relevant studies and further support evidence-based research and practice.