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Context: Vitamin K acupuncture point injection, a menstrual pain treatment derived from TraditionalChinese Medicine, has been a standard treatment in some hospitals in China since the 1980s.Objectives: to investigate the effects of Vitamin K acupuncture point injection on menstrual pain inyoung women ages 14-25 from different countries and cultural backgrounds who have had unmitigatedmenstrual pain for 6 months or more.Design: prospective observational clinical pilot studySettings: one site in China (a hospital outpatient clinic in Shanghai), and two sites in Italy (a hospitalclinic in Milan and a private gynecology practice in Verona).Interventions: all subjects were treated with bi-lateral acupuncture point injection of Vitamin K on the1st or 2nd day of menstrual pain. Vitamin K3 was used in China and Vitamin K4 in Italy.Main Outcome Measures: pain intensity, total duration and average intensity of menstrual distress, hoursin bed, normal daily activity restrictions and numbers of analgesic tablets due to pain were recordedbefore the treatment and for the following four menstrual cycles.Results: Noticeable pain relief was observed 2 minutes after treatment, and subsequent pain reduction occurred at 30 minutes (p<.001). Subjects reported significantly fewer daily life restrictions, hours in bed, consumption of analgesic tablets, and lower scores of menstrual pain duration and intensity (p<.001). There were no adverse events. Some women experienced mild self-limited pain at the injection site.Conclusion: Acupuncture point injection with Vitamin K alleviated acute menstrual pain, and relief extended through the non-treatment follow-up cycles in this uncontrolled pilot study conducted in two countries. Further investigation employing controlled experimental designs is warranted.