A placebo controlled study assessed the comparative effectiveness of 4 different modes of acupuncture and 2 modes of transcutaneous electrical nerve stimulation (TENS) used prior to the onset of the recurrent pain of primary dysmenorrhea. 29 patients were treated on 2 occasions each month, 7 days and 3 days before the expected onset of their periods. 17 out of the 29 patients in one group were treated with a different mode of acupuncture each month for 4 months; then at the 5th month the mode which the patient preferred was repeated. 12 patients in another group were treated with 2 different active modes of TENS and an inactive placebo TENS, for each of 3 months, and then the patient's choice of mode was repeated at the 4th month. Pain records on VAS and 5 other measures of outcome were assessed and maintained by the patients. These related to the menstrual cycles previous to and during treatment, and then at follow-up 3 months after the final treatment. The results following the last treatment showed significant improvement on 3 measures: pain, tablet intake and the global subjective assessment in the acupuncture and TENS groups. At the 3-month follow-up significant improvement continued on pain and the subjective assessment in the acupuncture group, and on subjective assessment in the TENS group. Separately assessed, significant improvement was shown on pain and the subjective assessment with each of the acupuncture modes, but in the TENS group this was evident only with low frequency TENS. A reduction of the pain and discomfort of primary dysmenorrhea, a cyclic, visceral and hence nociceptive pain, was obtained by the preemptive use of different modes of acupuncture or low frequency TENS but not high frequency or placebo TENS.

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