Primary dysmenorrhea (PDM) is a prevalent gynecological disorder in young females, with limited treatment options despite its high prevalence and detrimental effects. Transcutaneous auricular vagus nerve stimulation (taVNS) has shown promise in alleviating PDM symptoms, but its long-term efficacy and individual variability remain uncertain. In this study, we utilized a single-blind, sham-controlled experimental design to investigate the long-term effects of taVNS on PDM. Sixty women with PDM wer