Multimodal Care for Headaches, Lumbopelvic Pain, and Dysmenorrhea in a Woman With Endometriosis: A Case Report

Objective

The purpose of this case report is to describe the conservative management of a patient with headaches, lumbopelvic pain, and dysmenorrhea.

Clinical Features

A 36-year-old woman presented with intense pelvic and daily lumbar pain. She had difficulty sleeping and focusing and had 3 to 4 headaches per week. Before, during, or after her menses, she would have migraine headaches. During her menses, she experienced severe lumbopelvic pain and dysmenorrhea with moderate bloating, constipation, nausea, and diarrhea. When she was 32 years old, her gynecologist diagnosed endometriosis and prescribed nonsteroidal anti-inflammatory drugs and hormonal oral contraceptives, which failed to alleviate her symptoms. She sought an alternative approach to help control her symptoms.

Intervention and Outcome

A multimodal approach was selected for this patient, which consisted of acupuncture combined with supplements of magnesium citrate, B-100 complex and botanicals turmeric (Curcuma longa/root extract), bromelain (Ananas comosus [pineapple stem]) and black cohosh (Cimicifuga racemosa). After an initial trial of care, her daily lumbopelvic pain was reduced, and she was sleeping better and feeling more focused and less fatigued. She rarely had tension headaches during the week or migraine headaches or dysmenorrhea before, during, or after menses. Her lumbopelvic pain and gastrointestinal symptoms were reduced.

Conclusion

A patient who was experiencing headaches, lumbopelvic pain, and dysmenorrhea responded favorably to a course of care that included a combination of botanicals, supplements, and acupuncture.