Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial

Background: Dry cupping has been used as a treatment for abnormal uterine bleeding in Iranian traditional medicine. Objectives: The present study aimed at evaluating the usefulness of dry cupping on excessive menstrual blood loss in menorrhagia with a wellvalidated menstrual pictogram compared to medroxyprogesterone acetate. Methods: A total of 162 women with menorrhagia were enrolled in this prospective, randomized, controlled trial in Iran from 2015 to 2016. Written informed consent was obtained, then, patients were randomly allocated into dry cupping (3 sessions of interrupted and kinetic dry cupping during menstrual bleeding) or medroxyprogesterone acetate (10 mg/day throughout the luteal period) groups using a random number sequence. The number of bleeding days and objective estimation of menstrual blood loss using a pictorial blood loss assessment chart (PBAC) were recorded before the intervention and at specific intervals (1 and 3 months post intervention). Results: At 1 and 3 months, PBAC scores were significantly lower in women treated with cupping compared with women treated with medroxyprogesterone acetate. These reductions in PBAC score were 214.9 mL with 95% CI (120.5 to 309.2) greater than medroxyprogesterone acetate at 1 month and 237.3 with 95% CI (143.0 to 331.7) at 3month followup period. Reduction in the number of bleeding days in the cupping group for almost one day was better than the control groups at 1 and 3 months followup (Mean difference:-1.03, 95% CI (-1.78 to -0.26), P = 0.007). Conclusions: Dry cupping is an effective treatment in reducing the intensity of bleeding during menstrual period compared to medroxyprogesterone acetate.