Studies and use of acupuncture in women

Helms 1987, in a controlled study of 48 women, reported a significant improvement of pain scores for women with dysmenorrhoea with acupuncture using the tradition points on the legs, arms and abdomen. In a similar study, Thomas et al. 1995, of 31 patients that had experienced dysmenorrhoea for more than five years and were unable to use analgesics for a variety of reasons, were randomly treated over consecutive menses with acupuncture and electro-acupuncture (EA). A control group of 12 patients received either transcutaneous electrical nerve stimulators (TENS) or placebo TENS treatment. In the acupuncture group, there was significant improvement in pain, analgesic intake and subjective assessment.

In women, Yu et al. 1989 suggested that ovulation be induced by EA via a regulation on hypothalamic-pituitary function leading to normal secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH).

Ovarian function

Chen 1997 showed that electro-acupuncture at the proper acupoints could cure some anovulatory human patients in a highly effective rate and that electro-acupuncture might regulate the dysfunction of the hypothalamic-pituitary-ovarian axis, which could influence and normalize secretion of some hormones, namely gonadotropin-releasing hormone (GnRH), LH and estradiol.

Chang et al. 2002 reviewed the literature and found: "Although the definitive role of acupuncture in the treatment of human female infertility is yet to be established, its potential impact centrally on the hypothalamic-pituitary-ovarian axis and peripherally on the uterus needed to be systemically examined. Prospective randomized controlled studies are needed to evaluate the efficacy of acupuncture in female fertility treatment."

White 2003 reviewed studies concerning the use of acupuncture for women's gynecological conditions. He suggested that while acupuncture appeared promising for dysmenorrhoea and infertility, within the literature he found no controlled trials for other conditions including mastalgia (generalized breast pain or tenderness), menorrhoea, pelvic pain, premenstrual syndrome or vulvodynia (irritation and pain).

Dr. Elisbet Stener-Victorin, MD, Department of Obstetrics and Gynecology at Goteborg University in Sweden, and colleagues studied the use of EA in women undergoing oocyte aspiration or OPU (ovum pick-up). They found that the analgesic effects produced by EA are as good as those produced by conventional analgesics, and that the use of opiate analgesics with EA is lower than when conventional analgesics alone are used. They concluded that EA as anesthesia, as a method of pain relief during oocyte aspiration, works extremely well for patients who prefer trying this option to alfentanil (a fast-acting opiate), and is a valuable alternative to conventional anesthesia.

"We have recently finished a multi-center follow-up study with 280 patients," Stener-Victorin says. "These studies show that EA is as good an anesthetic method as conventional anesthesia during oocyte aspiration."

Women who receive EA have less abdominal pain and nausea and were less stressed two hours after aspiration. Also the hospitalization time is shorter, and the costs are lower. EA in combination with conventional anesthesia has been shown to reduce the consumption of anesthesia by 50 percent. At present, 50 percent of all OPU at their clinic are performed using the new short EA protocol as an analgesic method.

In other studies, both experimental and clinical, Stener-Victorin found that acupuncture may have a beneficial effect on women with polycystic ovary syndrome (PCOS) and anovulation, and that acupuncture may be a suitable alternative or compliment to pharmacological induction of ovulation in women with PCOS, with no negative side effects.

Ternov et al. 1998 studied the use of acupuncture in women during childbirth and concluded: "Acupuncture reduces the need for other methods of analgesia in childbirth."

They found that in women given acupuncture or a variety of conventional pain therapies (epidural analgesia using bupivacaine, pudenal nerve block, intramuscular meperidine, nitrous oxide/oxygen, intracutaneaous sterile water injections), 58 percent in the acupuncture group and 13 percent in the control group managed their deliveries without further need for pain treatment. Acupuncture treatment was found to have no major side effects, and 94 percent given acupuncture reported that they would reconsider acupuncture in future deliveries.

Tempfer et al. 1998 in further studies in women, concluded: "Prenatal acupuncture treatment significantly reduces the duration of labor and may be a valuable tool in prenatal preparation."

They also stated that "serum levels of Interlueukin-8, PGF2Alpha, and beta-endorphin are not significantly influenced by acupuncture and are therefore not likely to mediate acupuncture-related effects during labor."

In a randomized, unblinded, controlled study by Nesheim et al 2003, they concluded that acupuncture during labor reduced the requirement for other painkillers and had high patient satisfaction. The use of other analgesics was also lower in the acupuncture group. Patient satisfaction was high: 89 of 103 patients asked said they would want acupuncture during another labor.

—By Ed Kane, PhD