Women’s Health

2021 Evidence-Based Complementary and Alternative Medicine

There is potential of acupuncture combined with conventional treatment for treating female chronic pelvic pain.

This review suggests the potential of acupuncture combined with conventional treatment compared to conventional treatment alone for treating female chronic pelvic pain. However, there is insufficient evidence to conclude that acupuncture can be recommended as a complementary and alternative (CAM) treatment for women with CPP. To draw a firm conclusion, future studies should require not only lager, more rigorously designed RCTs but also research on different acupuncture treatment types.

Acupuncture Treatment for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Sung, S.-H., Sung, A.-D.-M., Sung, H.-K., An, T.-E.-B., Kim, K. H., & Park, J.-K.

2021 Medicine

Acupuncture can effectively improve the post voided residual urine, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy.

There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy.

Efficacy and safety of acupuncture for urinary retention after hysterectomy Zhao, Q., Yan, C., Dan, M., & Jia, H.

2020 Journal of Maternal and Child Health

Acupuncture therapy can affect pain reduction in dysmenorrhea patients.

7 articles from South Korea, Taiwan, Spain, China, India, and Hong Kong were reviewed in this meta-analysis. This study showed that acupuncture therapy was -1.16 better in reducing pain in dysmenorrhea patients.

Effect of Acupuncture Therapy on Pain Reduction in Dysmenorrhea Patients: A Meta-Analysis Novitasari, E., Soemanto, R., & Prasetya, H.

2020 Medicine

Acupuncture could promote the recovery of menstrual cycles as well as downregulate the levels of LH and testosterone in patients with PCOS.

Twenty two studies with 2315 participants were included in this systematic review and meta-analysis. A pooled analysis showed a recovery of the menstrual period in the acupuncture group. Furthermore, there were significant decreases in the luteinizing hormone (LH) and testosterone in the acupuncture group. No significant differences were observed in the rates of live birth, pregnancy, and ovulation, and no significant differences were observed in the LH/follicle-stimulating hormone (FSH) ratio.

There was insufficient evidence to support that acupuncture could promote live birth, pregnancy, and ovulation. However, acupuncture could promote the recovery of menstrual cycles as well as downregulate the levels of LH and testosterone in patients with PCOS.

Effectiveness of acupuncture in polycystic ovary syndrome Wu, Jielei, Chen, Di, Liu, Nenghui

2020 Evidence-Based Complementary and Alternative Medicine

The current evidence suggests that acupuncture and moxibustion is more effective than ibuprofen or Fenbid in the treatment of primary dysmenorrhoea.

This overview provided a comprehensive overview of the evidence on the effectiveness and safety of acupuncture and moxibustion for PD. Evidence of moderate quality suggested that acupuncture and moxibustion had a positive effect on indomethacin or Fenbid in treating PD. Low-quality evidence showed that compared to NSAIDs, acupuncture and moxibustion could relieve PD related pain with less adverse effects, which needs to be further researched. The adverse effects related to the acupuncture and moxibustion were mild, and they included dizziness, fainting, or minimal bleeding after acupuncture.

Effectiveness and Safety of Acupuncture and Moxibustion for Primary Dysmenorrhea: An Overview of Systematic Reviews and Meta-Analyses Jun Yang, Jun Xiong, Ting Yuan, Xue Wang, Yunfeng Jiang, Xiaohong Zhou, Kai Liao, Lingling Xu

2020 Deutsches Arzteblatt International

Acupuncture may be considered in patients with persistent, idiopathic vulvar pruritus.

Vulvar pruritus is a complex symptom of multifactorial origin, frequently affecting the patient’s quality of life. The treatment of patients with chronic pruritus (>6 weeks) is particularly challenging and often requires a multimodal strategy with an interdisciplinary approach. Besides the elimination of potential triggers and continuous lipid-replenishing basic care, antifungal agents and glucocorticoids are paramount. Medical professionals not specialized in the field should refer patients with refractory and/or suspicious lesions to an experienced gynecologist. A specimen should be obtained by punch biopsy for histological evaluation to rule out (pre-) malignant lesions.

It is central to the management of vulvar pruritus to offer a detailed discussion of the condition and treat patients with empathy. Their complaints should be taken seriously and patients should be informed about what could cause their symptoms and which treatment options are available for them.

Vulvar pruritus-Causes, Diagnosis and Therapeutic Approach Woelber L, Prieske K, Mendling W, Schmalfeldt B, Tietz HJ, Jaeger A.

2020 Journal of Acupuncture and Tuina Science

The present study indicated that acupuncture had an advantage over hormone replacement therapy in reducing serum FSH level and increasing serum E2 level in women with premature ovarian insufficiency.

Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level and a remarkable elevation in the basal E2 level in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone and acupuncture plus HRT, while a remarkable elevation of E2 was only found in acupuncture plus HRT. There was no significant difference in the LH level between acupuncture and HRT, only one trial reported AMH, and no significant difference was found between acupuncture and HRT.

Acupuncture for premature ovarian insufficiency: a systematic review and meta-analysis Yin, Yq., Xu, Hf., Fang, Yg. et al.

2019 Evidence-Based Complementary and Alternative Medicine

This systematic review shows that the overall effectiveness of acupuncture treatment of premenstrual syndrome is superior to that of sham acupuncture and related medications.

Results. A total of 15 studies, comprising of 1103 cases, were included. Overall, acupuncture significantly increased the effective rate of PMS compared with medicine and sham acupuncture. Subgroup analyses showed no significant difference among different intervention time to start acupuncture treatment. Among the acupoints involved in the treatment of PMS, SP6, LR3, and RN4 were the most commonly used.

The current meta-analysis reveals that acupuncture leads to better effective rate, but the intervention time has no significant effect on the efficacy of acupuncture treatment for PMS. SP6, LR3, and RN4 are the most commonly used acupoints in treating PMS. However, large-scale, case-control studies with rigorous designs are required to provide more accurate evidence.

Acupuncture for Premenstrual Syndrome at Different Intervention Time: A Systemic Review and Meta-Analysis Jiayuan Zhang, Liu Cao, Yunxia Wang, Yuxia Jin, Xiao Xiao, Qi Zhang

2018 Cochrane Database of Systematic Reviews

Acupuncture may reduce overall mood and physical PMS symptoms when compared to sham. Acupressure may reduce the number of women having moderate to severe PMS symptoms when compared to sham acupressure.

The limited evidence available suggests that acupuncture and acupressure may improve both physical and psychological symptoms of premenstrual syndrome (PMS) when compared to a sham control. There was insufficient evidence to determine whether there was a difference between the groups in rates of adverse events.There is no evidence comparing acupuncture or acupressure versus current International Society for Premenstrual Disorders (ISPMD) recommended treatments for PMS, such as selective serotonin reuptake inhibitors (SSRIs). Further research is required, using validated outcome measures for PMS, adequate blinding and suitable comparator groups reflecting current best practice.

Acupuncture and acupressure for premenstrual syndrome Armour M, Ee CC, Hao J, Wilson TM, Yao SS, Smith CA.

2018 Medicine

Acupuncture might reduce menstrual pain and associated symptoms more effectively compared to no treatment or NSAIDs.

The results of this study suggest that acupuncture might reduce menstrual pain and associated symptoms more effectively compared to no treatment or NSAIDs, and the efficacy could be maintained during a short-term follow-up period. Despite limitations due to the low quality and methodological restrictions of the included studies, acupuncture might be used as an effective and safe treatment for females with primary dysmenorrhea.

The efficacy and safety of acupuncture in women with primary dysmenorrhea: A systematic review and meta-analysis. Woo, H. L., Ji, H. R., Pak, Y. K., Lee, H., Heo, S. J., Lee, J. M., & Park, K. S.

2017 Medicine

Acupuncture adjuvant to other active medications could affect hormonal levels such as LH, LH/FSH ratio, testosterone, and fasting insulin in women with polycystic ovarian syndrome.

Although limited by heterogeneity across studies, we found that acupuncture adjuvant to other active medications could affect hormonal levels such as LH, LH/FSH ratio, testosterone, and fasting insulin. Neuroendocrinological mechanisms of acupuncture have been extensively studied not only in pain research but also in reproductive medicine. Acupuncture is also known to modulate hypothalamic-pituitary-ovarian axis, which can affect menstruation cycles. Given that acupuncture stimulates pituitary beta-endorphin production, which has a tonic inhibitory effect on gonadotropin-releasing hormone pulse generator and pituitary LH secretion, it is possible that acupuncture may reduce ovulatory dysfunction and thus decrease the secretion of ovarian androgens in women with PCOS. Considering detected heterogeneity from our analysis, known variability in hormonal levels, the poor standardization of assays, and the specific PCOS phenotypic features, however, the currently available data from RCTs has yet to allow us to draw any firm conclusion whether acupuncture affects hormonal levels, thus recovering ovulatory function and menstruation cycle in women with PCOS.

Acupuncture for polycystic ovarian syndrome: A systematic review and meta-analysis Jo, J., Lee, Y. J., & Lee, H.

2017 PLOS One

The current literature suggests that acupuncture reduces endometriosis-related pain and serum CA-125 levels, regardless of the control intervention used.

Of the 10 studies included, only one pilot study used a placebo control and assessed blinding; the rest used various controls (medications and herbs), which were impossible to blind. The sample sizes were small in all studies, ranging from 8 to 36 patients per arm. The mean difference (MD) in pain reduction (pre- minus post-interventional pain level—measured on a 0–10-point scale) between the acupuncture and control groups was 1.36. Acupuncture had a positive effect on peripheral blood CA-125 levels, as compared with the control groups. Similarly, the effect of acupuncture on clinical effective rate was positive, as compared with the control groups.

Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis Yang Xu , Wenli Zhao , Te Li, Ye Zhao, Huaien Bu , Shilin Song

2017 BMC Complementary Medicine and Therapies

Acupoint-stimulation can relieve pain effectively in the treatment of primary dysmenorrhea and offers advantages compared with treatment by NSAIDs.

The current evidence reveals that acupoint-stimulation in the treatment of primary dysmenorrhea has some obvious advantages compared with treatment by NSAIDs. The advantages are that acupoint-stimulation can alleviate the symptoms of dysmenorrhoea, reduce the level of peripheral blood PGF2α and has fewer side effect, so it can be used to treat primary dysmenorrhea patients, especially individuals with NSAIDs contraindication.

Effects of acupoint-stimulation for the treatment of primary dysmenorrhoea compared with NSAIDs: a systematic review and meta-analysis of 19 RCTs Xu, Y., Zhao, W., Li, T. et al.

2015 Journal of Acupuncture and Meridian Studies

Acupressure showed evidence of pain relief while acupuncture improved both the mental and the physical components of quality of life associated with primary dysmenorrhea.

This study involved three reviewers who dependently and independently performed study selection, quality assessment, and data extraction and management. Several interventions indicated statistical significance. Insights into the efficacies of the interventions were identified in correlation to themselves and with one another. The systematic review highlighted promising evidence in the form of studies done to establish the effectiveness of acupuncture and acupressure in the management of primary dysmenorrhea. However, the results were limited and had methodological flaws. The review and the meta-analysis indicated that acupressure significantly reduced the pain associated with primary dysmenorrhea and that acupuncture improved both the physical and the mental components of quality of life. The magnitude of these effects may or may not be clinically worthwhile, but as the costs and the risks of these interventions is low, these results may be clinically useful.

As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis Abaraogu UO, Tabansi-Ochuogu CS

2015 The Journal of Sexual Medicine

Acupuncture appeared to reduce vulvar pain and dyspareunia with an increase in overall sexual function for women with vulvodynia.

This was the first randomized controlled pilot study to examine the use of acupuncture for the treatment of vulvodynia. The acupuncture protocol was feasible and in this small sample appeared to reduce vulvar pain and dyspareunia with an increase in overall sexual function for women with vulvodynia. This study should be replicated in a larger double-blinded randomized controlled trial.

Acupuncture for the Treatment of Vulvodynia: A Randomized Wait-List Controlled Pilot Study Schlaeger JM, Xu N, Mejta CL, Park CG, and Wilkie DJ.

2014 BJOG: An International Journal of Obstetrics & Gynaecology

Acupuncture seems promising for symptom improvement in women with premenstrual syndrome.

Ten RCTs were included in our review. The pooled results demonstrated that acupuncture is superior to all controls. A meta-analysis comparing the effects of acupuncture with different doses of progestin and/or anxiolytics supported the use of acupuncture. In addition, acupuncture significantly improved symptoms when compared with sham acupuncture. No evidence of harm resulting from acupuncture emerged. Most of the included studies demonstrated a high risk of bias in terms of random sequence generation, allocation concealment, and blinding.

Although acupuncture seems promising for symptom improvement in women with PMS, important methodological flaws in the included studies weaken the evidence. Considering the potential of acupuncture, further rigorous studies are needed.

Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials S-Y Kim, H-J Park, H Lee, H Lee

2013 Evidence-Based Complementary and Alternative Medicine

Our findings suggest that acupressure at the SP6 acupoint may provide more effective pain relief than that of control treatment.

This is the first systematic review to evaluate the effectiveness of acupuncture or acupressure at the SP6 acupoint for relieving pain associated with primary dysmenorrhea. Our findings suggest that acupuncture at the SP6 acupoint may not be more effective than acupuncture at an unrelated (GB39) acupoint for the relief of dysmenorrhea-associated pain (assessed using a VAS). In contrast, our findings suggest that acupressure at the SP6 acupoint may provide more effective relief from dysmenorrhea-associated pain than control interventions.

Clearly, there is a need for high-quality, randomized controlled trials to clarify the effectiveness of acupuncture/acupressure at the SP6 acupoint for the treatment of pain resulting from primary dysmenorrhea.

Acupuncture or Acupressure at the Sanyinjiao (SP6) Acupoint for the Treatment of Primary Dysmenorrhea: A Meta-Analysis Ma-Na Chen, Li-Wei Chien, Chi-Feng Liu