A pilot study on the use of transcutaneous auricular vagus nerve stimulation to relieve dysmenorrhea in patients with adenomyosis and endometriosis

This pilot study evaluated transcutaneous auricular vagus nerve stimulation (taVNS) for feasibility, tolerability, and changes in dysmenorrhea severity in six treatment-naïve reproductive-age patients (four with adenomyosis and two with unilateral ovarian endometrioma). Participants received taVNS once daily for 30 minutes over 6 months, with outcomes assessed at baseline, 3 months, and 6 months using visual analog scale (VAS) scores for dysmenorrhea, menstrual blood loss, hemoglobin, and heart rate variability (HRV) measures of vagal tone. Median dysmenorrhea VAS scores decreased significantly at both 3 and 6 months, and HRV showed a progressive improvement in vagal tone (increased RMSSD, pNN50, and high-frequency power; decreased low-frequency power and LF/HF ratio), while uterine volume, lesion size, menstrual blood loss, hemoglobin, and several blood markers did not change. The authors explicitly frame this as a small, non-randomized pilot and emphasize the need for larger randomized sham-controlled trials; this paper is centrally about endometriosis and adenomyosis — it tests taVNS as a neuromodulatory approach to relieve dysmenorrhea in patients with these conditions.

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