Acupuncture combined with Guizhi Fuling Wan decoction for adenomyosis-associated dysmenorrhea: A case report

BACKGROUND: Adenomyosis (AM) is a common gynecological disorder frequently observed in women of reproductive age. It is characterized by the invasion of endometrial glands and stroma into the myometrium, often manifesting as secondary dysmenorrhea, menorrhagia, and infertility. Although hormonal therapy and nonsteroidal anti-inflammatory drugs (NSAIDs) remain the mainstream treatments, their long-term efficacy and side effects pose significant clinical challenges. Traditional Chinese Medicine (TCM), particularly herbal medicine and acupuncture, has emerged as a safer alternative therapy. CASE SUMMARY: A 39-year-old Asian woman presented to our hospital with a 10-year history of progressively worsening menstrual pain, accompanied by menstrual hypermenorrhea over the past 2 years. She was diagnosed with adenomyosis. According to traditional Chinese medicine theory, the diagnosis was dysmenorrhea associated with the Qi stagnation and blood stasis syndrome. Notably, despite treatment with nonsteroidal anti-inflammatory drugs, her dysmenorrhea remained unresponsive. The patient was treated with a modified herbal formula, Guizhi Fuling Wan (GZFLW), and acupuncture. After three menstrual cycles of treatment, her dysmenorrhea and other systemic symptoms significantly improved. At the time of writing this report, no recurrence had been observed during follow-up, and no adverse reactions occurred throughout the entire treatment period. CONCLUSIONS: The success of this case indicates that traditional Chinese medicine can serve as an independent treatment option for secondary dysmenorrhea caused by adenomyosis, offering a viable alternative to nonsteroidal anti-inflammatory drugs (NSAIDs). It holds unique value and significant clinical importance for patients who are unresponsive to NSAIDs and refuse hormone-based therapies. However, further rigorous clinical trials are needed to validate these findings.