MenstruEase : A Closed‐Loop Smart TENS System for Personalized Management of Primary Dysmenorrhea

ABSTRACT Primary dysmenorrhea (PD) causes recurrent pelvic pain in women of reproductive age. Current treatments rely heavily on pharmacological agents or open‐loop TENS devices that provide “one‐size‐fits‐all” therapy and are prone to analgesic tolerance. Here, we present MenstruEase, a wearable closed‐loop TENS system integrating multimodal biosensing and intelligent control for personalized menstrual pain management. MenstruEase continuously monitors uterine surface electromyography (sEMG) and electrodermal activity (EDA) to detect signatures of uterine contraction and pain‐related autonomic activation. This enables responsive stimulation rather than fixed, user‐dependent settings. The system incorporates a stimulation engine supporting multiple TENS patterns and a microcontroller‐based controller that triggers closed‐loop intervention. A companion mobile application provides real‐time biofeedback, therapy logging, and longitudinal analytics to support individualized optimization. In a proof‐of‐concept study, TENS equivalent to MenstruEase increased paw‐withdrawal latency in female mice from 7.3 ± 0.2 s to approximately 10.7 s (∼45% increase; p = 0.012) in a hot‐plate model, with no noticeable adverse effects. We further outline a structured roadmap for AI integration to enable real‐time pain detection, prediction, and adaptive dose selection. MenstruEase thus represents a shift from reactive, static TENS therapy toward adaptive and data‐driven neuromodulation, establishing an AI‐ready platform for personalized dysmenorrhea management.