Improvement of Lower Abdominal Cold Sensation and Dysmenorrhea after Ultrasound-Guided Deep Needling at Guanyuan (CV4) toward the Presumed Superior Hypogastric Plexus Region: A Case Report

Objectives: To report the clinical course after ultrasound-guided deep needling at Guanyuan (CV4) toward the presumed superior hypogastric plexus region.Methods: A 24-year-old woman received eight treatments over four weeks. A single needle was advanced from CV4 toward the anterior L5 region using a transverse out-of-plane approach after vessels were screened using power Doppler. Symptoms were assessed using numerical rating scale (NRS) scores; pain duration, ibuprofen use, and an author-defined 4-point menstrual-related activity limitation scale were monitored for three cycles.Results: The lower abdominal cold sensation score decreased from NRS 7 to 2, and the menstrual pain score decreased from NRS 8 to 3 and then to 2. Pain duration decreased from 36 to 4 hours, ibuprofen use decreased from 1,600 to 0 mg per cycle, and activity limitation decreased from 3 to 0. Mild soreness lasting 2 hours occurred after the first treatment; no other adverse events occurred.Conclusions: This case documents clinical improvement following ultrasound-guided deep needling at CV4 toward the presumed superior hypogastric plexus region and suggests the need for further studies to evaluate this approach.