Integrated Traditional Chinese Medicine Protocol Shows Comparable Efficacy to Ibuprofen for Primary Dysmenorrhea with Markedly Lower Recurrence Rates

Primary dysmenorrhea is a common and often debilitating condition. While non-steroidal anti-inflammatory drugs such as ibuprofen provide effective short-term pain relief, high recurrence rates after stopping medication remain a significant clinical problem. Traditional Chinese medicine takes a more holistic approach, aiming to address underlying imbalances rather than symptoms alone, but robust trial evidence has been limited.

This randomised controlled trial recruited 80 patients diagnosed with primary dysmenorrhea of the Qi stagnation and blood stasis type at a hospital in Shanghai. Participants were assigned equally to either a structured traditional Chinese medicine protocol or standard ibuprofen treatment over three menstrual cycles. The traditional Chinese medicine approach combined cycle-phase-specific herbal formulas — using Chaihushugan San with Siwu Decoction between periods and a Stasis-Clearing and Meridian-Warming Formula around and during menstruation — whereas the ibuprofen group took standard doses only during menstruation.

Both groups achieved similarly high overall effectiveness rates after three cycles. Ibuprofen produced faster pain relief in the first cycle, but the traditional Chinese medicine group demonstrated continuous, progressive improvement across all three cycles, ultimately reaching comparable outcomes by cycle three. Most strikingly, the recurrence rate in the traditional Chinese medicine group was dramatically lower than in the ibuprofen group during follow-up. No serious safety concerns were highlighted.

Conclusion: This trial suggests that a tailored, cycle-based traditional Chinese medicine herbal protocol may offer a clinically meaningful advantage over ibuprofen in reducing recurrence of primary dysmenorrhea, though the relatively small sample size and single-centre design warrant further investigation.

Source: Xu B, Zhuang M, Wang X and colleagues. Frontiers in endocrinology (2026). View on PubMed (PMID 42222093) · doi:10.1016/j.ctim.2025.103272

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