AURICULAR ACUPUNCTURE IN THE MANAGEMENT OF MENSTRUAL MIGRAINE: A PRELIMINARY OBSERVATIONAL STUDY

S. Sorrenti¹, M. Ciuffreda¹, E. Pisello¹, L. Brugiaferri², A. Federici², C. Piangatelli³, D. Galante⁴ | ¹U.O.C. Anesthesia, Resuscitation Pain Therapy, AST Ancona, Fabriano (AN); ²Residency School. Anesthesia, Resuscitation, Intensive and Pain Therapy, Università Politecnica delle Marche, Ancona; ³U.O.C. Anesthesia, Resuscitation Pain Therapy, Director, AST Ancona, Fabriano (AN); ⁴U.O.C. Anesthesia, Resuscitation, Director, Cerignola (FG)

INTRODUCTION
Menstrual migraine is a subtype of migraine closely linked to hormonal fluctuations, typically occurring in the two days preceding menstruation and persisting during the menstrual period. It is characterized by pulsating, unilateral pain of moderate to severe intensity, often accompanied by nausea, vomiting, photophobia, and phonophobia. Standard treatment includes symptomatic use of NSAIDs and triptans, which may not fully address symptom severity or recurrence. This study investigates the potential of auricular acupuncture as a supportive therapy to reduce symptoms and medication usage in women with regular menstrual cycles and a history of menstrual migraine.
METHODS
Twenty female patients aged 25 to 45 years with a confirmed diagnosis of menstrual migraine, according to the International Classification of Headache Disorders (ICHD-3) criteria, and regular menstrual cycles were enrolled. All were on symptomatic therapy with NSAIDs and triptans as needed. Patients underwent auricular acupuncture with sterile, single-use needles (0.2 × 40 mm), inserted bilaterally into specific auricular points: thalamus point, migraine area, cerebral cortex point, sympathetic point, and gonadotropin-related points. Needles were retained for 20 minutes per session. Sessions were performed approximately every three days, starting one week before the expected onset of menstruation and continuing until four days after the end of menses. Patients were evaluated using the Migraine Disability Assessment (MIDAS) questionnaire across three consecutive menstrual cycles. MIDAS scores were compared to baseline scores obtained one month prior to treatment initiation.
RESULTS
At baseline (pre-treatment), 13 patients reported moderate disability (Grade 3) and 7 reported severe disability (Grade 4) according to the MIDAS scale. During the three treatment cycles, all 20 patients improved, reporting mild disability (Grade 2). Clinically, patients described a reduction in both the intensity and frequency of migraine episodes, as well as a decreased need for symptomatic medication. No adverse effects or contraindications were observed, confirming the technique's safety and tolerability.
CONCLUSIONS
Auricular acupuncture appears to be a safe and well-tolerated adjunctive therapy in the management of menstrual migraine. The observed reduction in disability scores and symptomatic drug use suggests potential benefits in both quality of life and disease burden. Further controlled trials with larger cohorts are warranted to confirm these preliminary findings.