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Acupuncture improves sleep in postmenopause in a... [Climacteric. 2013] - PubMed - NCBI

Climacteric. 2013 Feb;16(1):36-40. doi: 10.3109/13697137.2012.698432. Epub 2012 Sep 3.Acupuncture improves sleep in postmenopause in a randomized, double-blind, placebo-controlled study.Hachul H, Garcia TK, Maciel AL, Yagihara F, Tufik S, Bittencourt L.Source

Departamento de Psicobiologia, Universidade Federal de S ã o Paulo (UNIFESP), São Paulo, Brazil.

AbstractBACKGROUND:

Insomnia increases in frequency as women approach and pass through menopause. Studies have not shown acupuncture efficacy for insomnia in postmenopausal women.

OBJECTIVES:

The aim of this study was to evaluate the effectiveness of acupuncture therapy on sleep parameters, depression symptoms and quality of life in postmenopausal women with insomnia.

METHODS:

This study included 18 postmenopausal women aged 50-67 years old. Participants had a body mass index ≤ 30 kg/m(2), presented a diagnosis of insomnia according to the DSM-IV criteria, had experienced at least 1 year of amenorrhea and had a follicle stimulating hormone level ≥ 30 mIU/ml. Participants were not using antidepressants, hypnotics or hormonal therapy. This study was randomized, double-blind and placebo-controlled. The sample was divided into two groups: acupuncture and 'sham' acupuncture. We performed ten sessions of acupuncture and 'sham' acupuncture during a period of 5 weeks. A polysomnography exam (PSG) and questionnaires (WHOQOL-BREF, Beck Depression Inventory and Pittsburgh Sleep Quality Index) were completed by all patients before and after the treatment period.

RESULTS:

Anthropometric, polysomnographic, and questionnaire data were similar among the groups at baseline. Comparison of baseline and post-treatment data of the acupuncture group showed that treatment resulted in significantly lower scores on the Pittsburgh Questionnaire and an improvement in psychological WHOQOL. The acupuncture group had a higher percentage of the N3 + 4 stage than the sham group in PSG findings.

CONCLUSION:

Acupuncture was effective in improving reported sleep quality and quality of life in postmenopausal women with insomnia.

PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Acupuncture for Vulvodynia

Acupuncture for Vulvodynia | Acupuncture and gynaecology - women's health | Scoop.it

This was a piece of research, published in the Journal of the Royal Society of Medicine, conducted on 12 patients who had suffered severe distress from this condition and who had not responded to the usual treatment. The patients were given 10 weekly acupuncture treatments. 2 patients experienced so much improvement that they considered themselves to have been cured of the condition; 3 considered themselves improved and wanted to continue treatment; 4 patients felt slightly better and considered acupuncture more effective than any other treatment that they had received and 3 patients did not perceive any improvement at all. Therefore 9/12 patients overall, considered that the treatment had been beneficial to them. I a few observations to add to this:

That while 10 treatments is a reasonable number, it is by no means unusual for a patient to require more than ten treatments for complete or near-complete resolution, especially for a condition like vulvodynia which which the authors of this study observe is, ‘notoriously difficult to treat’ (with the standard orthodox treatment).The number of acupuncture points used is only four- it is highly unusual to use only four points in a modern acupuncture treatment, therefore the treatment can be considered sub-optimal -meaning that if more points had been used one might expect even better results than have been reported here. The authors have not mentioned who designed and who administered the treatment (e.g. whether they were a qualified acupuncturist) or what the rationale was for the point selection, which is unorthodox.Lastly, and this is a point that applies to almost all acupuncture research- all 12 patients received exactly the same four acupuncture points. This would be extremely rare in actual practice (outside of a research setting), since it is a basic principle of acupuncture and Chinese medicine that since each patient is unique, no two patients receive the exact same treatment, but rather a treatment that is tailored to their individual presentation. The reason for the homogenisation of points in research settings is to make the results easier to compare and generalise across patients.

All of the above three reasons mean that real-life results with acupuncture for vulvodynia are extremely likely to be better than the results reported in this study, even though the results reported in this study are already quite impressive.

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Natural Cures for Pregnancy Pains - includes acupuncture

Natural Cures for Pregnancy Pains  - includes acupuncture | Acupuncture and gynaecology - women's health | Scoop.it
Pain during pregnancy is no news. If medication is not your idea, try these natural ways to cure them. Simple, effortless and effective! Pick your best option.

 

 

 

 

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GoLocalPDX | Health | Five Natural Ways to Calm the Symptoms of Menopause

GoLocalPDX | Health | Five Natural Ways to Calm the Symptoms of Menopause | Acupuncture and gynaecology - women's health | Scoop.it
Five Natural Ways to Calm the Symptoms of Menopause

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Thursday, December 25, 2014

Erin Brockmeyer, GoLocalPDX Natural Health Expert

 

 

Night sweats, insomnia, brain fog, loss of libido, fatigue, mood swings, weight gain...the list goes on and on when you ask a typical woman for the lovely little symptoms that have cropped up since peri- menopause/menopause began. And according to the American Congress of Obstetricians and Gynecologists,6,000 women reach menopause each day in the U.S. In the Western medicine model, options for treating menopausal symptoms are limited primarily to hormone replacement therapy (HRT).

 

For a while, it seemed as though HRT was the long-awaited answer for women suffering from moderate to severe menopausal symptoms. In 2002, however, findings from the largest study of HRT (to-date) were released, and the outcome was not good. The study showed that women who received HRT were at an increased risk for heart disease, stroke, blood clots, and breast cancer. Currently thoughts on HRT are a bit more mixed, with there being certain groups of people for whom the benefits of specific types of HRT may outweigh the risk. With that being said, there are an ever-increasing number of people (including doctors) who are looking for more natural and safe ways to calm menopausal symptoms. Read ahead for some ideas on how to treat 5 common perimenopausal symptoms.

Hot flashes / Night sweats

According to the ACOG, 75% of women experience hot flashes or night sweats during perimenopause, and approximately 25% of those who do experience them for more than 5 years. No one wants that. One of the most effective ways of treating this issue is with acupuncture. An article published on Medscape asserts that “Acupuncture is an effective treatment for women who are experiencing natural menopause.” Numerous studiesare coming out that are showing reduction in hot flashes, night sweats and increases in estrogen as a result of receiving acupuncture from a practitioner trained in Chinese Medicine.

Insomnia

This seems to be an exceedingly common complaint from perimenopausal and menopausal women, and it can be one of the most frustrating of the symptoms you experience. There are a number of options for sleep that are commonly held as safe ways to help yourself sleep. If hot flashes are waking you up, seek treatment for those first. If you are having trouble falling asleep, adding a magnesium and calcium supplement about 30 minutes before bedtime can increase drowsiness and help you sleep. Dr. Andrew Weil’s website suggests the use of valerian or melatonin to aid with sleep. It is also a good idea to get in 45 minutes of exercise/day and to establish a regular bedtime routine.

Loss of Libido

This symptom of menopause, more than all the others, can have a heartbreaking effect on women and their partners. There are several components to why libido decreases in women, the most common thoughts being an increase in vaginal dryness leading to discomfort during sex, and an increase in their partners’ sexual performance problems leading women to feel less desired or less affectionate towards their partners. Harvard Medical Schoolpublished a paper that suggested that one of the most effective treatments for midlife loss of libido comes in the form of talking with your partner openly about your needs and expectations, or meeting with a sex therapist.

Mood Swings

It is not uncommon for a woman to equate the mood swings she experiences during perimenopause with those she had when she first went through puberty. This is most likely due to the greater fluctuations in hormones that are happening during this time. Just as in other cases of treating mood swings and depression, exercise and diet can be one of your greatest allies. This is a good time to renew a commitment to a cardio routine and to cut out excess sugars, caffeine, and alcohol. It is also a great time to focus on yourself by picking up a new hobby or spending more time with friends.

Memory Problems (aka Brain Fog)

The common causes thought to be behind this perimenopausal symptom include hormonal imbalances, insomnia, and increased stress. Attend to your sleep issues first if you suspect those could be the cause. You can combat memory issues by continuing to challenge your brain by doing things like crossword puzzles and sudoku. It may also be worth it to visit someone who is well trained in herbal medicine. If there are hormonal imbalances behind your brain fog, a trained herbalist should be able to offer suggestions that are natural, safe and effective. A UCLA review also suggested that eating plenty of Omega-3 fatty acids and foods high in folic acid, such as spinach, can help to improve brain function.

As with all health issues, it is beneficial to speak with a qualified health care provider about your particular concerns before self-treating. The suggestions in this article will hopefully help you see that there are options for you, and that you do not need to suffer through to menopause.

 

Erin Brockmeyer, LAc, is owner and acupuncturist at Solstice Natural Health in downtown Portland.  She creates custom health plans for patients to help them tackle their most complicated health concerns, including infertility, prenatal care, fibromyalgia, thyroid conditions and chronic and acute pain conditions.  Visit herwebsite for more information and to download her free e-book 5 Simple Ways to Improve Your Health Today.

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Decrease of pregnant women's pelvic pain after acupuncture: a randomized controlled single-blind study, Acta Obstetricia et Gynecologica Scandinavica, Informa Healthcare

Decrease of pregnant women's pelvic pain after acupuncture: a randomized controlled single-blind study, Acta Obstetricia et Gynecologica Scandinavica, Informa Healthcare | Acupuncture and gynaecology - women's health | Scoop.it

Acta Obstetricia et Gynecologica Scandinavica 

ORIGINAL ARTICLE

Decrease of pregnant women's pelvic pain after acupuncture: a randomized controlled single-blind study

 

2006, Vol. 85, No. 1 , Pages 12-19 (doi:10.1080/00016340500317153)

Iréne Lund1†, Thomas Lundeberg2, Lena Lönnberg3 and Elisabeth Svensson41Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden2Rehabilitation Medicine University Clinic, Stockholm Danderyds Hospital AB, Stockholm, Sweden3Centre for Clinical Research, Centrallasarettet, Uppsala University, Västerås, Sweden4Department of Statistics, Örebro University, Örebro, Sweden†Correspondence: Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden Irene.Lund@fyfa.ki.se

 

 

Background. The efficacy of acupuncture on low-back and/or pelvic pain in late pregnancy is reviewed in few reports. Our aim was to evaluate the effects of two different acupuncturestimulation modes on pelvic pain intensity and some emotional symptoms due to the pain condition. Methods. In a prospective randomized controlled single-blind study, pregnant women with pelvic pain, median gestational age 26 weeks (range 18–35), were given 10 acupuncturetreatments. Needles were inserted subcutaneously over acupuncture points without further stimulation (superficial, n=22), or intramuscular and stimulated repeatedly until a perceived sensation of numbness, de qi, (deep, n=25). Self-reported pain intensity at rest and during daily activities was assessed on a visual analog scale. The variables pain, emotional reactions, and loss of energy were assessed according to the Nottingham Health Profile questionnaire. Changes in assessed variables were analyzed with a nonparametric statistical method allowing for analysis of systematic group changes separated from additional individual changes. Results. Afteracupuncture stimulation, significant systematic group changes towards lower levels of pain intensity at rest and in daily activities as well as in rated emotional reaction and loss of energy were seen. The results also showed additional individual changes in most variables. In this study, no differences between the effects induced by the superficial and deep acupuncture stimulation modes were observed. Conclusion. Acupuncture stimulation that is individually designed may be a valuable treatment to ameliorate suffering in the condition of pelvic pain in late pregnancy.

KeywordsAcupuncture, change, NHP, nonparametric statistics, pelvic pain, VAS

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Acupuncture for hot flushes: research

Acupuncture for hot flushes: research | Acupuncture and gynaecology - women's health | Scoop.it

MEDICATION FOR HOT FLASHES

Walsh, N.; Hot flash relief associated with use of acupuncture. (Pilot Study). OB/GYN News 2003.

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Acupunturist Zita West: "How my amazing mother inspired Call the Midwife"

Acupunturist Zita West: "How my amazing mother inspired Call the Midwife" | Acupuncture and gynaecology - women's health | Scoop.it

How my amazing mother inspired Call the Midwife: She was a cross between kind Nurse Jenny and Sister EvangelinaZita West's mother Ita Devanney was a midwife in the FortiesHelped to delivery hundreds of babies every yearHated being made to retire in 1984 aged 60Worked in a care home right up until her death

 

By ZITA WEST

PUBLISHED: 01:54, 24 December 2013

 

Excerpt:

"It was while working in a hospital in Warwick in the Nineties that I started using acupuncture alongside mainstream obstetrics to help women suffering from morning sickness.

 

I later moved to the Hale Clinic where Princess Diana was a patient, and then as my client base grew I decided to open my own clinic in Harley Street."


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Shaftesbury Acupuncture Clinic's curator insight, December 28, 2013 10:20 AM

This is an interesting article, Zita is a well known acupuncturist and midwife.

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Gynecological problems - Climacteric disorder and dysmenorrhea Auricular Acupuncture Treatment

Gynecological problems - Climacteric disorder and dysmenorrhea Auricular Acupuncture Treatment | Acupuncture and gynaecology - women's health | Scoop.it

Gynecological problems - Climacteric disorder and dysmenorrhea Auricular Acupuncture Treatment

 

M. L. Wang observed that “for the treatment of symptoms of climacteric syndrome, marked-to-good improvement was obtained in 37 out of 42 cases when the type of disorder was properly differentiated. The primary points used were Kidney, Internal Genitalia, Subcortex, and Endocrine. For Kidney Yin Deficiency with Liver Yang Rising, Lung, Liver, and Spleen were added.

 

For Kidney Yin Deficiency with disharmony of the Heart and Kidney, Liver, Heart, and Shenmen were used. For Kidney Yin and Yang deficiency with Spleen weakness, the Spleen and Small Intestine points were included. If hypertension presented, the Hypertension groove and Liver points were added. Pellets were retained in the ear for 3 days. Six sessions constituted a course of treatment and three courses were the average treatment time.”

 

D. Lewers et al.28 study on the treatment of primary dysmenorrhea resulted in an average pain relief of at least 50% immediately posttreatment using TENS electrostimulation. The study also suggested that auriculotherapy via acupressure may relieve the same pain.

Shaftesbury Clinic Bedford's insight:

NB: Climacteric disorder is another word for menopause.

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Pain relief for women undergoing oocyte retrieval for assisted reproduction - The Cochrane Library - Kwan - Wiley Online Library

Pain relief for women undergoing oocyte retrieval for assisted reproduction - The Cochrane Library - Kwan - Wiley Online Library | Acupuncture and gynaecology - women's health | Scoop.it

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 31 JAN 2013

Assessed as up-to-date: 25 JUL 2012

DOI: 10.1002/14651858.CD004829.pub3

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004829.pub3/full

Discussion

 

Summary of main results

 

This review included 21 trials of five broad categories of pain relief methods of conscious sedation and analgesia that involved 2974 women undergoing oocyte retrieval. Women’s experience of pain showed conflicting results. No one particular modality of conscious sedation and analgesia was better than any other in providing effective pain relief. However, use of more than one method simultaneously, such as when combined with acupuncture or paracervical block, resulted in better pain relief than one modality alone. Patient-controlled sedation and analgesia was associated with more intra-operative pain compared with physician-administered sedation and analgesia. None of these methods appeared to affect pregnancy rates. However, the confidence intervals were wide in most comparisons and therefore the results should be interpreted with caution. High levels of satisfaction were reported in 12 studies.

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Acupuncture for treatment-related side effects in women with breast cancer - The Cochrane Library - Zhu - Wiley Online Library

Acupuncture for treatment-related side effects in women with breast cancer - The Cochrane Library - Zhu - Wiley Online Library | Acupuncture and gynaecology - women's health | Scoop.it

How the intervention might work

 

How acupuncture works to eliminate the side effects of cancer treatments for breast cancer is still unknown, however emerging literature suggests acupuncture might work through several pathways. For example, acupuncture may induce body signals that are transmitted to the central nervous system (CNS), which in turn activates anti-inflammatory signals and pain relief processes through both humoral and neural mechanisms (Cho 2006; Sekido 2003). This sheds some light on how side effects can be plausibly managed by acupuncture.

Since the 1970s, it has been established that acupuncture may influence pain mediators through the release of neurotransmitters, such as ß-endorphin and endogenous opioids in the CNS (Cabýoglu 2006; Lin 2008; Ma 2004). The endogenous opioid-mediated mechanisms of acupuncture seem to be well understood (Han 2004).

 

It has been suggested that acupuncture initiates anti-inflammatory pathways in addition to opoid-mediated pathways. Animal studies have demonstrated that electroacupuncture may induce anti-inflammatory properties at both peripheral and central pain (i.e. nociceptives) sites (Lee 2006; Moon 2007). Prostaglandin E2 produced in the local inflammatory site is essential in initiating and maintaining inflammatory hyperalgesia (Shahed 2001). Clinical research has shown that electroacupuncture therapy seems to have a pain relief effect which might be associated with decreased measures of prostaglandin E2 in urine samples (Lee 2009).

 

Immune functions may also be involved when using acupuncture. Some animal studies have shown that bilateral electroacupuncture stimulation (at acupuncture point ST36) for three consecutive days enhances splenic natural killer (NK) cell activity (Yu 1998), while acupuncture (at BL23 points) for 20 days increases the ratio of NK cells to T lymphocytes in the spleen of mice after day seven (Okumura 1999).

 

A Japanese study suggested that acupuncture influenced the immune system through leukocyte and lymphocyte subpopulations in human peripheral blood (Takahashi 2009). In addition, a Chinese study showed that patients assigned to adjuvant electroacupuncture with chemotherapy had no significant changes in their T cell subpopulations, NK activity, immunoglobulin and leukocyte counts at the end of the fourth course of chemotherapy, in comparison with those who had chemotherapy without electroacupuncture in a control group (Ye 2004). This adds value in supporting the hypothesis that electroacupuncture might minimise the potential side effects of chemotherapy.

 

Studies have shown that the attributive effects of acupuncture are comprehensive, spanning from modulating an immunosuppressed or immunoactivated condition through the immune system to having an impact on the CNS (Lewith 2005; Ma 2004).

 

Why it is important to do this review

 

Improvements in early diagnosis and treatment have increased the life expectancy of women with breast cancer. In turn, this has led to specific problems being encountered by long-term breast cancer survivors. There has been a shift of emphasis to focusing on the negative impact of treatment on patients' quality of life, especially from long-term side effects (Pinto 2011), as well as the increased use of healthcare resources (Loibl 2011).

 

The use of CAM amongst cancer patients or survivors is due to the desire to increase the body’s ability to fight cancer or improve physical and emotional well-being (Molassiotis 2005). An Australian survey on women with breast cancer reported that: "common reasons for use included improving physical (86.3%) and emotional (83.2%) well-being and boosting the immune system (68.8%)" with 49.2% specifically reporting to "reduce treatment side effects" (Kremser 2008). Another large survey stated that acupuncture was effective (40%) or very effective (7.7%) for modulating immune functions, relieving pain, alleviating menopausal symptoms or managing other discomforts in the breast cancer population (Cui 2004). However, there has been a lack of scientific evidence to support these claims or empirical experience reported by patients or survivors.

 

Furthermore, despite the popularity of acupuncture in cancer patients (de Valois 2010; Frisk 2011; Hervik 2010; Lu 2009; Shen 2000; Sima 2009), acupuncture has not met with wide approval amongst medical professionals and there has been poor communication between patients and medical carers (Lu 2009; Molassiotis 2005). Patients and healthcare professionals need more information on the effectiveness and safety of complementary medicine interventions.

 

A few systematic reviews on the role of acupuncture in managing side effects in women with breast cancer have been previously conducted (Chao 2009; Ezzo 2006; Lee 2009a). However, some reviews focused on specific symptoms and there was a lack of consideration of the unique features of TCM philosophy that underpin acupuncture, when the tools of evidence-based practice were applied to assess its effectiveness.

It has been suggested that acupuncture as a treatment to control side effects may potentially alleviate conventional therapy-induced side effects and improve quality of life (Price 2012).

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Acupuncture for premenstrual syndrome - The Cochrane Library - Yu - Wiley Online Library

Acupuncture for premenstrual syndrome - The Cochrane Library - Yu - Wiley Online Library | Acupuncture and gynaecology - women's health | Scoop.it

Intervention Protocol

 

You have full text access to this content
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005290/fullAcupuncturefor premenstrual syndrome

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 20 APR 2005

DOI: 10.1002/14651858.CD005290

Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Database Title

The Cochrane Library

 

Background

 

Premenstrual syndrome (PMS) is a group of symptoms that consistently occur in young and middle-aged women during the luteal phase of the menstrual cycle. In order to diagnose PMS, the symptoms should abate when menstruation starts or stops and not recur until ovulation two weeks before the next period (Backstorm 1991; Dickerson 2004). More than 200 premenstrual symptoms have been recorded and are usually divided into three broad categories: 


(1) behavioral symptoms including fatigue, insomnia, dizziness, changes in sexual interest, food cravings or overeating; 
(2) psychological symptoms including irritability, anger, depressed mood, crying and tearfulness, anxiety, tension, mood swings, lack of concentration, confusion, forgetfulness, restlessness, loneliness, decreased self-esteem, tension; 


(3) physical symptoms including headaches, breast tenderness and swelling, back pain, abdominal pain and bloating, weight gain, swelling of extremities, water retention, nausea, muscle and joint pain (Dickerson 2004; Reid 1986).

 

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. It is a condition characterized by intense emotional symptoms that occur between ovulation and menstruation. Symptoms associated with PMDD are similar to those experienced with PMS; however, they are much more severe. Symptoms include severe depression, irritability and/or mood swings which interfere with relationships, social functioning, and work or school (Bancroft 1993; Medem 2004). PMDD should be diagnosed only when mood symptoms seriously impact on relationships and impair functioning at work or school (Medem 2004).

 

It is reported that approximately 95% of women have one or more premenstrual symptoms. Fifty percent of these women have slight symptoms, 30% have moderate symptom, with about 5% of women reporting severe PMS symptoms that disrupt their lives in the two weeks before their periods (Hylan 1999). It is estimated that only 3% to 8% of women are affected by PMDD (Medem 2004).

 

Description of the condition

 

The etiology of PMS is still not completely understood. Sex hormones produced by the corpus luteum are thought to be crucial since the cyclical nature of the symptoms disappears in anovulatory cycles. The theory that PMS might simply result from a relative excess of either progesterone or oestrogen during the luteal phase no longer seems tenable since progesterone, oestrogens and progestogens can induce similar symptoms to those seen in PMS; the severity of symptoms is dose sensitive (Backstrom 2003). 


In recent years, it has been found that the sexual hormones are neuroactive and modulate neural excitability and brain function. Some progesterone metabolites, in particular allo pregnenolone, are GABA-A agonists, with anxiolytic and anticonvulsant properties. By contrast, pregnenolone-sulphate and DHEAS-sulphate are anxiogenic and pro-convulsant (Reddy 2003).

 

There is recent evidence that levels of oestrogens and progesterone affect the transport of serotonin in the CNS, profoundly affecting the brain serotonergic system (Cameron 2004), and that, conversely, serotonin might affect ovarian levels of oestrogens and progesterone.

Some evidence suggests that an underlying serotonin deficiency makes women more sensitive to progesterone (O'Brien 2000). Deficiencies in prostaglandins, which cause an inability to convert linoleic acid to prostaglandin precursors, may be related to the onset of PMS (Daugherty 1998). Genetic factors also seem at work as the concordance rate is two times higher in monozygotic twins than in dizygotic twins (Kendler 1998). A more complex relationship between PMS and magnesium and calcium than either element alone was indicated by the highly significant high? Mg/Ca ratio in blood cells in women with severe PMS. The significantly lower calcium level in blood cells found in studies may provide additional evidence that PMS may be involved in a calcium-deficiency state or a metabolic maladjustment involving calcium (Shamberger 2003). One cross-sectional study reported that high intake of fats and low intake of foods with high concentration of carbohydrate may be associated with premenstrual symptoms (Nagata 2004).

 

Description of the intervention

 

Many different treatments have been suggested as possible therapies for PMS due to the uncertainty of its pathogenesis and the range of its manifestations. Because serotonin has been implicated in the pathogenesis of PMS, luteal phase dosing of selective serotonin reuptake inhibitors (SSRIs) have been tested in these disorders (Freeman 2004; O'Brien 2000). The U.S. Food and Drug Administration (FDA) has labelled fluoxetine (sarafem and sertraline (Zoloft, Pfizer Inc.)) for the treatment of PMS (Halbreich 2003).

 

Ovarian function appears to play a fundamental role in PMS, accordingly, treatment strategies designed to suppress ovulation have generally been found to be effective for treatment of menstrually-related syndromes and symptoms. Gonadotrophin-releasing hormone analogues (GnRHa) appear to be an effective treatment of premenstrual syndrome (Backstrom 2003; Kouri 1998; Wyatt 2004).

 

In other studies, women with PMS who practiced aerobic exercise reported fewer symptoms than participants in the control group (O'Brien 2000; Steege 1993). Dietary restrictions or supplements may also be useful in women with PMS (Kessel 2000; Moline 2000). Sodium restriction has been proposed to minimize bloating, fluid retention, and breast swelling and tenderness. Caffeine restriction is recommended because caffeine intake is related to premenstrual irritability and insomnia. A systematic review of placebo-controlled trials of evening primrose oil suggested lack of benefit in PMS, although mild relief was demonstrated in women with breast tenderness (Budeiri 1996).

A randomised placebo-controlled study reported there were significant improvements in the symptoms of negative feeling, pain, water retention, and total PMS symptoms in women receiving qigong therapy compared to placebo controls (Jang 2004). Qigong consists primarily of meditation, relaxation, physical movement, mind-body integration, and breathing exercises. Practitioners of qigong develop an awareness of qi sensations (energy) in their body and use their mind to guide the qi. When the practitioners achieve a sufficient skill level (master), they can direct or emit external qi for the purpose of healing others.

 

Some studies also indicate Chinese herbs (particularly preparations containing the herbs Paeonia lactiflora and Dong Quai), homeopathy, aromatherapy, reflexology, Gingko biloba, kava kava, black cohosh, and agnus castus can relieve the symptoms of PMS such as anxiety, depression and irritability (Jones 2003; NAPS 2004; Tesch 2003). Practitioners of Western herbal medicine routinely use a group of herbs known for their hormonal modulation effect as core treatment for pre-menstrual symptoms. Vitex agnus castus (Chaste tree berries) is a particularly effective treatment for many forms of PMS. This plant has also been the object of several randomised studies (Loch 2000).

Other treatments for PMS, for which there is inconclusive evidence, include cognitive behavioral therapy, relaxation therapy, vitamin B6, L-tryptophan, stress reduction, spironolactone, or a complex carbohydrate drink. Although evidence for relief of PMS symptoms is inconclusive, it is reasonable to recommend these as healthy lifestyle changes which may give people a more general benefit (Douglas 2002; Girman 2003; Rapkin 2003).

 

 Why it is important to do this review

 

Acupuncture is a form of therapy based on traditional Chinese medicine (TCM) and dates back thousands of years. To bring about healing it involves inserting fine needles into specific points on the skin in order to stimulate corresponding meridians points, as defined by TCM theory. Other methods of stimulation of these points are also traditionally used, such as the burning of moxa (the plant Artemisia vulgaris or Mugwort) and applying pressure (acupressure). Other methods developed more recently include electronic stimulation, laser acupuncture and medicament.

 

The traditional concepts involve the regulating of imbalances of qi (vital energy) along with the theories of yin and yang, the five elements, meridians, vital substances, pathogenic factors, and the eight principle patterns (Beal 1999). As the use of acupuncture has become more prevalent in the West these theories have been developed to fit in with a Western understanding of physiology, for example, needling is thought to reduce local muscle tension or release pain-killing endorphins (Green 2004). The temperature in the cortex can be changed by electroacupuncture; the response could be taken as the indication of the change in nervous activity (Zhang 1997). Recent data suggest that acupuncture has regionally specific, quantifiable effects on relevant brain structures. Acupuncture may stimulate gene expression of neuropeptides (Kaptchuk 2002).

 

Based on this theory, acupuncture may have potential benefits for the premenstrual syndrome. There were more than 20 studies reporting its effects in the treatment of premenstrual syndrome. One study (You 1997) classified the patients into one group with yang deficiency of the spleen and the kidney and another group with stagnation of the liver qi (the spleen, kidney and liver in TCM is different from in western medicine); it used Taichong, Taixi, Qihai, Ganshu, Tanzhong, and Sanyingjiao as the main acupuncture points in the first group and Zusanli, Pishu, Shenshu, Taixi, Sanyingjiao, Guanyuan (moxibustion) in another. Acupuncture in treating edema during menstruation was also reported effective in two studies (Li 2002, Liu 2002). The first study only used Fuliu as the point, and the second study used Zhongwan, Qihai, Hegu, Zusanli, Sanyingjiao, Xuehai, Shenshu, and Yongquan as the main points. Headache during menstruation could also be treated by acupuncture, one study (Zhang 2001) selected Fengchi and Zhengying as the points and another study (Sun 1999) used Baihui, Qihai, Guanyuan, Zigong, Sanyingjiao, and Zusanli as the acupuncture points, in conjunction with Chinese herbs. These studies demonstrated that PMS symptoms may be alleviated by acupuncture or acupuncture in conjunction with other means; a systematic review is required.

 

Objectives

 

To evaluate the effectiveness and safety of acupuncture or electroacupuncture in the treatment of women with premenstrual syndrome.

 

Comparisons between groups intended for treatment with any type of acupuncture and groups allocated to 'sham' acupuncture, no treatment, Chinese medicine, Western medicine or other treatments. The following hypotheses will be tested: 
(1) acupuncture is superior to 'sham' acupuncture or no treatment in treating PMS; 
(2) acupuncture is superior to other treatments or Western medicine or Chinese medicine in treating PMS; 
(3) there are less adverse events in the acupuncture group than in the Chinese medicine or Western medicine groups.

 

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Acupuncture Normalizes Dysfunction of Hypothalamic-PituitaryOvarian Axis By Bo-Ying Chen M.D. Professor of Neurobiology

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Weather girl, Clare Nasir success with fertility by acupuncture

Weather girl, Clare Nasir success with fertility by acupuncture | Acupuncture and gynaecology - women's health | Scoop.it
The journey to motherhood wasn't easy for Clare.  For many years she suffered with acute fibroids in her womb that swell to the size of a rugby b...
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Fertility Problems - "treatments include Acupuncture, which may be effective for enhancing IVF success rates"

Fertility Problems - "treatments include Acupuncture, which may be effective for enhancing IVF success rates" | Acupuncture and gynaecology - women's health | Scoop.it
Learn about Fertility Problems. Includes overview, cause, symptoms, diagnosis, treatment, exams and tests, prevention, and medications.

 

Complementary and alternative treatments

These treatments include:

Acupuncture, which may be effective for enhancing IVF success rates

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Infertility and Acupuncture | American Pregnancy Association

Infertility and Acupuncture | American Pregnancy Association | Acupuncture and gynaecology - women's health | Scoop.it

Acupuncture is the insertion of ultra-thin, sterile needles into specific acupuncture points on the body which reside on channels or meridians; these are pathways in both the exterior and interior of the body. These points, when needled, can regulate the way in which the body functions. Acupuncture helps by addressing problems that affect fertility such as an under-functioning thyroid (hypothyroidism) or over-functioning thyroid (hyperthyroidism).

Find an Acupuncturist in Your Area

Can Acupuncture Be Used To Treat Infertility?

Acupuncture, frequently combined with herbal medicine, has been used for centuries to treat some but not all causes of infertility. For example, acupuncture and herbs will not work to address tubal adhesions which can occur as a result of pelvic inflammatory disease orendometriosis. However, in this situation, an individual could still benefit from acupuncture and herbs because of the potential effect of improved ovarian and follicular function. Additionally, acupuncture can increase blood flow to the endometrium, helping to facilitate a thick, rich lining.

When Should Acupuncture Treatment Begin?

Acupuncture is similar to physical therapy in that it is a process-oriented method of medical intervention. It is better to do more than less. Patients are commonly treated for three to four months before progressing to insemination, in vitro fertilization (IVF), or donor-egg transfer. This pacing of treatment seems to have a therapeutic effect.

In a study by Stener-Victorin et al from the Departments of Obstetrics and Gynecology Fertility Centre, Scandinavia and University of Gothenburg, women are encouraged to receive acupuncture treatments pre and post embryo transfer. Clinical observations from the Berkley Center for Reproductive Wellness suggest that the most effective fertility treatments involve a combination of acupuncture, herbal medicine, and traditional medicine. However, conception occasionally occurs when acupuncture and herbal medicines are used without traditional medical interventions.

Infertility And Acupuncture: When Should I Stop?

Typically most miscarriages occur within the first three months of pregnancy. Consequently, treatment of patients may often last through week twelve to help prevent miscarriage.

Are The Acupuncture Points Different After An Insemination, IVF,< Or Donor-Egg Transfer Than Before?

Acupuncturists should not place needles in the abdomino-pelvic area after insemination or transfer. There are 6 contraindicated acupuncture points which should be avoided when the patient is pregnant or pregnancy is suspected. These include Gallbladder 21, Stomach 12, Large Intestine 4, Spleen 6, Bladder 60, Bladder 67 and any points on the lower abdomen.

What Are The Risks Of Using Acupuncture With Infertility?

There are minimal risks in using acupuncture for fertility treatment. The risk of miscarriage may increase if incorrect acupuncture points are used during pregnancy. This is one reason why those choosing to include acupuncture in their treatment regimen should only be treated by an acupuncturist who specializes in treating fertility disorders. Acupuncture is generally safe regardless of a person’s medical history.

Infertility And Acupuncture: Who Make Up Typical Patients?

Acupuncture can be used to treat any type of fertility disorder including spasmed tubes. Spasmed tubes are often de-spasmed with acupuncture, though blocked tubes will not respond to acupuncture. Acupuncture is often combined with herbal remedies to treat elevated follicle stimulating hormone (FSH), repeated pregnancy loss, unexplained (idiopathic) infertility, luteal phase defect, hyperprolactinemia (when not caused by a prolactinoma), polycystic ovarian syndrome (PCOS) with annovulatory cycles, and male factor including men affected with sperm-DNA-fragmentation.

Is Acupuncture A Licensed Profession?

In most states acupuncture is a licensed profession. You can visit www.nccaom.org to find a licensed and Board certified acupuncturist in your area. However, it is important to understand that being licensed and Board certified does not guarantee expertise in reproductive disorders.

Last Updated: 04/2013
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Dr Elisabet Stener-Victorin - Fysiologi, Göteborgs universitet

Dr Elisabet Stener-Victorin - Fysiologi, Göteborgs universitet | Acupuncture and gynaecology - women's health | Scoop.it
Dr Elisabet Stener-VictorinA Molecular Link between Androgen Excess and Development of Polycystic Ovary Syndrome? 
Effect and mechanisms of non-pharmacological treatment


Background: With a prevalence of 8–17%, PCOS is the most common endocrine and metabolic disorder in women1. PCOS is usually diagnosed during the early reproductive years, and clinical and biochemical signs include hyperandrogenism, ovulatory dysfunction, and polycystic ovaries2. The main metabolic phenotype is hyperinsulinemia and insulin resistance, which often preceed the development of type 2 diabetes (T2D), and these occur independently of body weight although obesity worsens all symptoms3. PCOS is also associated with affective symptoms and reduced health related quality of life (HRQoL). Therefore, if ovulation can be induced, hyperandrogenism decreased, and insulin sensitivity maintained in these women then the symptoms of PCOS and development of T2D can be prevented. 
The etiology of PCOS is poorly understood. The heterogeneity of the syndrome may reflect multiple underlying mechanisms, and both genetic and environmental factors have been implicated in the occurrence and progression of PCOS. Current treatment options are symptom oriented and, although effective, they often result in multiple pregnancies and can have severe metabolic and gastrointestinal side effects. Thus, PCOS places a large burden on these women, their families, and the healthcare system and the costs of PCOS exceed several billion Euros annually not even counting PCOS-associated morbidities in menopause. Because women with PCOS require long-term treatment, an important goal is to evaluate the effects and possible mechanisms of action of treatment strategies with few side effects, such as acupuncture.
The overarching aim of Stener-Victorin’s groups research is to yield new key information on the pathophysiology of PCOS with specific focus on metabolic dysfunction. A further aim is to elucidate if new treatment strategies such as acupuncture and physical exercise can improve PCOS related symptoms with main focus on metabolic dysfunction but also reproductive function.
A central hypothesize is that hyperandrogenism, the central feature of PCOS, contributes to the development of PCOS and metabolic disturbances via epigenetic changes to the genomic DNA in adipose and skeletal tissue and that acupuncture treatment can modify these epigenetic changes and reverse insulin resistance via restoration of key signaling molecules.

 

Fig. 1. Schematic presentation of hypotheses and aims. LH, luteinizing hormone; SNS, sympathetic nervous system.



Ongoing Projects:

Mechanisms of acupuncture with low-frequency electrical stimulation on insulin sensitivity in female rats with dihydrostestosterone-induced PCOS (rat)
 Does acupuncture improve insulin sensitivity in women with PCOS? This study will be the first to study the effect and possible mechanisms of acupuncture on insulin sensitivity in overweight and obese women with PCOS compared with controls.
The primary outcome measure is insulin sensitivity i.e. glucose disposal rate measured by euglycemic hyperinsulinemic clamp.Secondary outcome measures are health related quality of life, and symptoms of anxiety and depression. Exploratory outcome measures include molecular mechanistic studies in fat and muscle biopsies, anthropometrics, body fat distribution, circulating sex steroids, adipokines, lipids and inflammatory markers.
 Determine if hyperandrogenism in women with PCOS induces epigenetic alterations in adipose and skeletal muscle tissue and contributes to insulin resistance (human). This study will be the first to determine genome-wide methylation profiles as a way of detecting epigenetic modifications to the genomic DNA in adipose and skeletal muscle tissue in women with and without PCOS.
Project 1: Differences in genome-wide DNA methylation profiles in adipose and skeletal muscle tissue between women with and without PCOS 
Project 2: Determine if acupuncture treatment modifies genome-wide methylation patterns in adipose and skeletal muscle tissue of women with and without PCOS
 Impact of maternal androgen excess and polycystic ovary syndrome (PCOS) on placental metabolic pathways and long-term health effects on their female offspring (rat and human)
 Continuous Administration of a P450 Aromatase Inhibitor Induces PCOS with a Metabolic and Endocrine Phenotype in Female Rats at Adult Age – Effect of cyclic estrogen treatment, propranolol or acupuncture (rat)
 To estimate the prevalence of PCOS in obese premenopausal women and elucidate how they respond to a weight reduction treatment program (human)
 To assess the efficacy of acupuncture with or without clomiphen citrate (CC) in achieving live births among 1000 infertile Chinese women with PCOS (human)
 Sex steroids and symptoms of depression and anxiety in women in the transition into menopause – from Q56 population (human)
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Systematic review of clinical trials of acupuncture-related therapies for primary dysmenorrhea, Acta Obstetricia et Gynecologica Scandinavica, Informa Healthcare

Systematic review of clinical trials of acupuncture-related therapies for primary dysmenorrhea, Acta Obstetricia et Gynecologica Scandinavica, Informa Healthcare | Acupuncture and gynaecology - women's health | Scoop.it

Acta Obstetricia et Gynecologica ScandinavicaACTA REVIEWSystematic review of clinical trials ofacupuncture-related therapies for primary dysmenorrhea

 

2008, Vol. 87, No. 11 , Pages 1114-1122 (doi:10.1080/00016340802443798)HTMLPDF (71 KB)PDF Plus (72 KB)ReprintsPermissionsHuan Yang1, Cun-Zhi Liu1, Huan Yang1, Cun-Zhi Liu1, Xu Chen1, Liang-Xiao Ma1, Jie-Ping Xie1, Nan-Nan Guo1, Zeng-Bin Ma1, Yuan-Yuan Zheng1, Jiang Zhu1† and Jian-Ping Liu2†1School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, China2Center of Evidence Based Medicine, School of Pre-Medicine, Beijing University of Chinese Medicine, Beijing, China

aThese two authors contributed equally to this work

†Correspondence: Jiang Zhu, School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, 11 Bei San Huan East Road, Chao Yang District, Beijing, 100029, Chinajzhjzh@263.net†Correspondence: Jian-Ping Liu, ; Center of Evidence Based Medicine, School of Pre-Medicine, Beijing University of Chinese Medicine, Beijing, China jpliutcm@yahoo.co.uk

 

 

Background. Acupuncture-related therapies might be an effective intervention for primary dysmenorrhea. Objective. To evaluate the effects of acupuncture-related therapies for treating primary dysmenorrhea. Search Strategy. A specified literature search was performed of the Cochrane Library, MEDLINE, EMBASE, CNKI, and CBM databases. Selection criteria. All clinical controlled trials pertaining to acupuncture-related therapies for primary dysmenorrhea were included, and the quality of the trials was assessed. Data collection and analysis. Two independent reviewers were responsible for data extraction and assessment. The original data of each trial were analyzed with software (Revman 4.2), but a meta-analysis could not be carried out because of the heterogeneity of the trials. Main Results. Thirty randomized controlled trails (RCTs) and two controlled clinical trials (CCTs) were identified. Most of the trials were of low methodologic quality (six trials were Grade B and 26 trials were Grade C). Data analysis indicated that there were conflicting results regarding whether acupuncture-related therapies were more effective than control treatments. However, there was a small, methodologic sound trial of acupuncture which suggested that acupuncture was more effective than control groups (placebo acupuncture: WMD=−0.57 and 95% CI=−0.76–0.38; standard control: WMD=−.19 and 95% CI=−0.37–0.01; visitation control: WMD=−1.04 and 95% CI=−1.28–0.80). Conclusions. Because of low methodologic quality and small sample size, there is no convincing evidence for acupuncture in the treatment of primary dysmenorrhea. There is an urgent need for randomized, blinded, placebo-controlled trials to assess the effects of acupuncture.

KeywordsAcupuncture, primary dysmenorrhea, systematic review

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Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial.

Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial. | Acupuncture and gynaecology - women's health | Scoop.it
J Altern Complement Med. 2013 Sep;19(9):740-5. doi: 10.1089/acm.2012.0429. Epub 2013 May 15.Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial.Zheng YH1, Wang XH, Lai MH, Yao H, Liu H, Ma HX.Author informationAbstractOBJECTIVE:

To assess the effectiveness of abdominal acupuncture at the endocrine and metabolic level in patients with obesity-type polycystic ovary syndrome (PCOS). METHODs: Eighty-six women from the First Affiliated Hospital of Guangzhou Medical College with a diagnosis of PCOS (body-mass index [BMI] ≥25 kg/m(2)) were randomly assigned to receive 6 months of abdominal acupuncture (once a day) or oral metformin (250 mg three times daily in the first week, followed by 500 mg three times daily thereafter). BMI, waist-to-hip ratio (WHR), ovarian volume, menstrual frequency, homeostasis model assessment for insulin resistance (HOMA-IR), and Ferriman-Gallwey score were measured at the beginning of the study and after 6 months of treatment. Luteotrophic hormone (LH), testosterone, follicle-stimulating hormone (FSH), fasting blood glucose, 2-hour Postprandial blood glucose, fasting insulin, 2-hour postprandial blood insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were also assessed.

RESULTS:

According to the results at baseline and 6 months, BMI, WHR, Ferriman-Gallwey score, ovarian volume, luteotrophic hormone, ratio of luteotrophic hormone to follicle-stimulating hormone, testosterone, LDL-C, triglycerides, total cholesterol, fasting blood glucose, 2-hour postprandial blood glucose, fasting insulin, 2-hour postprandial blood insulin, and HOMA-IR were reduced significantly in the two groups (p<0.05). Menstrual frequency and HDL-C (p<0.05) increased significantly in both groups; follicle-stimulating hormone also increased in both groups, but the change was not significant (p>0.05). The acupuncture group showed considerable advantages over the metformin group in terms of reduced BMI and WHR and increases in menstrual frequency (p<0.05).

CONCLUSION:

Abdominal acupuncture and metformin improved the endocrine and metabolic function of patients with obesity-type PCOS. Abdominal acupuncture may be more effective in improving menstrual frequency, BMI, and WHR, with few adverse effects.

PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
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My ten-year menopause agony is over, says Julie: Actress speaks of huge relief after enduring as many as 15 hot flushes a night: acupuncture helped her

My ten-year menopause agony is over, says Julie: Actress speaks of huge relief after enduring as many as 15 hot flushes a night: acupuncture helped her | Acupuncture and gynaecology - women's health | Scoop.it
Julie Walters has revealed how liberated she feels after at last coming through a near ten-year battle with the menopause.

 

Miss Walters came through the menopause tunnel two years ago and credits acupuncture and avoiding alcohol for helping her manage. 

Read more: http://www.dailymail.co.uk/tvshowbiz/article-2528188/My-ten-year-menopause-agony-says-Julie-Andrews-Actress-speaks-huge-relief-enduring-15-hot-flushes-night.html#ixzz2omiELMqf ;
Follow us: @MailOnline on Twitter | DailyMail on Facebook

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Acupuncture Could Ease Joint Pain From Breast Cancer Treatment

Acupuncture Could Ease Joint Pain From Breast Cancer Treatment | Acupuncture and gynaecology - women's health | Scoop.it

Acupuncture could ease an extremely common side effect of breast cancer treatment, a new study suggests.


Researcher from the University of Pennsylvania Perelman School of Medicine found that acupuncture seems to decrease symptoms of arthralgia -- or joint pain -- from taking aromatase inhibitors. The findings are published in the European Journal of Cancer.

 

"This study is not the final answer, but it does provide strong evidence thatacupuncture can play a role in controlling pain for breast cancer patients with AI related arthralgia," study researcher Dr. Jun Mao, M.D., MSCE, who is an associate professor of Family Medicine and Community Health at the university, said in a statement. "We saw a significant reduction in pain levels in the acupuncture groups with only very mild, short-term adverse effects."

 

Past research has suggested that 50 percent of people taking aromatase inhibitorsexperience joint pain, and as many as 20 percent of people taking the drugs will stop treatment due to the pain.

Sixty-seven early breast cancer patients, who were all taking an aromatase inhibitor medication, participated in the study. All of them had reported joint pain as a result of the treatment, and the pain was experienced for at least three months at a pain level of at least 4 out of 11. (Researchers chose this specific pain level because past research suggested discontinuation of this medication is more common among people with pain levels of 4 or higher.)

 

The study participants were broken up into three groups. The first group got electro-acupuncture, which involved receiving 10 acupuncture treatments over a 10-week period; the second group got sham acupuncture, where they received the same number of "treatments," but the needles weren't real (they retracted back when put into the skin, similar to a stage dagger); the third group was the control group who didn't get acupuncture (but, for purposes of the study, were told they'd get the acupuncture treatments at a later date). All of the study participants continued their treatment with the aromatase inhibitors during the study.

 

After the eight weeks, people who received the electro-acupuncture had a 43 percent decrease in their pain from before they started the study. And people who received acupuncture, versus those who were in the control group, were more likely to report "much improved" or "very much improved" pain.

 

However, researchers noted that those in the sham acupuncture group also experienced decreases in pain after the study period. They noted that sham acupuncture is not a true placebo because it still causes a physical sensation, so more studies will be needed to really examine its effects.

 

The findings follow a 2010 study in the Journal of Clinical Oncology and conducted by NewYork-Presbyterian Hospital/Columbia University Medical Center researchers, which showed that acupuncture seemed to improve joint pain and stiffness associated with aromatase inhibitor therapy.

 

Acupuncture has been shown in other research to help with other side effects of cancer treatments, too. A small Acupuncture in Medicine study showed that it helpeddecrease nerve pain caused by certain cancer drugs. Another study, presented at a 2008 meeting of the American Society for Therapeutic Radiology and Oncology, showed that acupuncture could decrease excessive sweating, night sweats and hot flashes among breast cancer patients.

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Treatments for breast engorgement during lactation - The Cochrane Library - Mangesi - Wiley Online Library

Treatments for breast engorgement during lactation - The Cochrane Library - Mangesi - Wiley Online Library | Acupuncture and gynaecology - women's health | Scoop.it
Shaftesbury Clinic Bedford's insight:

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006946.pub2/full

 

Studies examining various treatment approaches are included in the review.

 

With regards to acupuncture, the following is an excerpt "

Acupuncture to treat breast engorgement: two studies with 293 women

 

Primary and secondary outcomes

Two studies examined the effects of acupuncture on breast engorgement (Kvist 2004; Kvist 2007). In both studies there were three treatment groups: advice and usual care (which might include the use of oxytocin nasal spray at the discretion of the midwife); advice and acupuncture (excluding the SP6 acu-point); and advice and acupuncture including the SP6 point. Results for resolution of symptoms were very similar for women in the two acupuncture groups in the Kvist 2007 study, and we have combined them in the data tables.

 

We were not able to include data from the Kvist 2004 study in analyses because results were not set out separately for the three randomised groups in the published report and were not available from the author.

 

Neither study provided information on the review's primary outcomes (cessation of breastfeeding and mastitis). The number of women prescribed antibiotics may represent a proxy measure of mastitis; results from Kvist 2007 show that, while women in the acupuncture group were less likely to be prescribed antibiotics, the difference between the acupuncture and control group was not statistically significant ( Analysis 1.1).

 

The number of women with breast abscess was reported in Kvist 2007; women in the acupuncture group were less likely to have abscess compared to women receiving routine care, but the difference between groups did not reach statistical significance (risk ratio (RR) 0.20. 95% confidence interval (CI) 0.04 to 1.01, P = 0.05)."

 

Conclusion "In a study examining acupuncture there was some evidence that, compared with women receiving routine care, women in the acupuncture groups had greater improvements in symptoms in the days following treatment, although symptoms had resolved in most women by six days, and the study did not have sufficient power to detect meaningful differences between groups for other outcomes (such as breast abscess)."

 

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Research: Infertility and acupuncture briefing paper from 2006, via Acupunctureresearch.org.uk

Briefing paper:

"INFERTILITY AND ACUPUNCTURE: evidence for effectiveness"

 

 

Shaftesbury Clinic Bedford's insight:

Interesting paper summarising some of the earlier research papers. 

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Acupuncture for polycystic ovarian syndrome - The Cochrane Library - Lim - Wiley Online Library

Acupuncture for polycystic ovarian syndrome - The Cochrane Library - Lim - Wiley Online Library | Acupuncture and gynaecology - women's health | Scoop.it

full: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007689.pub2/full ;

 

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 10 AUG 2011

Assessed as up-to-date: 7 MAR 2011

DOI: 10.1002/14651858.CD007689.pub2

Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.  Database Title The Cochrane Library

 

[...]

Description of the intervention

Currently the first-line conventional therapy for infertile women with PCOS is the administration of oral anti-oestrogen agents (for example, clomiphene citrate). However, 50% of women with PCOS who take clomiphene citrate still fail to conceive (Raj 1977; Zarte 1971). For these women, often classified as having 'clomiphene-resistance', clinicians typically prescribe exogenous gonadotrophin preparations (ESHRE 1997) or alternatively a surgical option such as laparoscopic ovarian drilling (Gadir 1990). For those individuals who respond to clomiphene citrate therapy, a higher risk of developing hyperstimulation of the ovaries (ovarian hyperstimulation syndrome) and multiple pregnancies has been noted (Farhi 1996). In the last few decades, insulin sensitising agents such as metformin have been used as alternative therapeutic agents for women with PCOS. The theoretical explanation is that increasing the insulin sensitivity in PCOS patients eases the hyperinsulinaemia and will be associated with a reduction in serum androgen levels and an improvement in serum lipids, plasminogen activator inhibitor type I (PAI-1) levels, and gonadotropins (Acbay 1996). Currently the role of metformin in managing PCOS is under further investigation.

 

Scientific studies have investigated the acupuncture meridians and the neuro-endocrinological aspects of the meridians. Mayer 1977proposed that acupuncture may stimulate the production of endorphin, an effect antagonised (counteracted) by the narcotic antagonist naloxone, in order to provide an analgesic effect. Ku 2001, Petti 1998, and Ulett 1998 have carried out further research in this area and postulated that beta-endorphin and various neuropeptides (like protein pro-opiomelanocortin) within the nervous system may be implicated in producing the effects of acupuncture.

 

Aleem 1987 identified the presence of beta-endorphin in the follicular fluid from both normal and polycystic ovaries. Petraglia 1987demonstrated that the beta-endorphin level in ovarian follicular fluid of otherwise healthy women who were undergoing ovulation were much higher than the levels measured in plasma. Given that acupuncture has an impact on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion, it is postulated that acupuncture may have a role in ovulation induction and fertility. Different non-randomised preliminary observational studies have shown that acupuncture may normalise the production of luteinising hormone (LH) and follicle stimulating hormone (FSH) (Aso 1976; Cai 1997; Mo 1993). Chen 1991 considered that electroacupuncture has a role in normalising the hypothalamic-pituitary ovarian axis, which in turn affects the menstruation cycle pattern.

 

How the intervention might work

 

In Chinese medicine, the understanding of how body acupuncture may work was built on ancient Chinese philosophical thinking. Body acupuncture and ear acupuncture have been used as treatments for infertile women with PCOS. Body acupuncture involves stimulation of body acupuncture points through different sized sterile needles; whilst ear acupuncture involves points on the external ears that are stimulated either by needles or pellets. In RCTs of acupuncture RCT, sham acupuncture is also known as placebo acupuncture. However, how sham acupuncture should be performed still remains controversial and can be different from study to study. The general principle of administering sham acupuncture is not to stimulate the actual acupuncture point.

 

Gerhard 1992 (in a case series) used ear acupuncture on 45 infertile women with dysfunction of ovulation and compared the treatment group with women receiving conventional medical treatment (for example, dexamethasone, clomiphene citrate, and gonadotropin). They concluded that the rate of return of menstruation was comparatively better in the ear acupuncture group despite no difference between the two groups on pregnancy rates.

 

Electroacupuncture is also known as electrostimulation. It is done by using stimulation with electrical impulses of acupuncture needles on selected acupuncture points. Stener-Victorin 2000 (in a case series) investigated its efficacy on ovulation induction in women with PCOS. Although the sample size was small (24 participants), two-thirds of the women in the study reported a regular menstruation pattern for up to three months after cessation of the electroacupuncture treatment.

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The Influence of Acupuncture Stimulation on Plasma Levels of LH, FSH, Progesterone and Estradiol in Normallly Ovulating Women (World Scientific)

The Influence of Acupuncture Stimulation on Plasma Levels of LH, FSH, Progesterone and Estradiol in Normallly Ovulating Women (World Scientific) | Acupuncture and gynaecology - women's health | Scoop.it

Takeshi Aso et al, Am. J. Chin. Med. 04, 391 (1976). DOI: 10.1142/S0192415X76000494

 

The Influence of Acupuncture Stimulation on Plasma Levels of LH, FSH, Progesterone and Estradiol in Normallly Ovulating Women

 

This is the first attempt to elucidate the direct effect of acupuncture stimulation on plasma levels of LH, FSH, progesterone and estradiol in normally ovulating women. Four loci, which are known from experience to relate closely to female reproductive organs, were needled with electric stimulation and the responses to synthetic LH-RH with and without acupuncture stimulation were also analyzed in the same cases. Plasma hormone levels were measured by specific radioimmunoassy. All cases showed normal responses to LH-RH corresponding to the day of the menstrual cycle. During the initial part of stimulation, both progesterone and estradiol levels rose in follicular cases and declined in luteal cases. Plasma LH levels declined and FSH showed no change at this time. The analysis of plasma LH responses to LH-RH under acupuncture stimulation revealed extraordinary re-elevation in some cases. It is suggested tha properly performed acupuncture stimulation might affect the fermale endocrine function.

Shaftesbury Clinic Bedford's insight:

Historically interesting in the light of more recent research:

 

This is an early abstract, showing that right from the late 1970's researchers were looking into the effects of acupuncture on the female hormone system, and further research is being added all the time.

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A treatment with pinpoint accuracy

A treatment with pinpoint accuracy | Acupuncture and gynaecology - women's health | Scoop.it
Osteoarthritis, menstrual problems, chronic fatigue syndrome, neck and shoulder pain, morning sickness, stress, irritable bowel and endometriosis are...
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Chronic Female Pelvic Pain - "Acupuncture has also been used as a treatment for nonmenstrual chronic pelvic pain"

Chronic Female Pelvic Pain - "Acupuncture has also been used as a treatment for nonmenstrual chronic pelvic pain" | Acupuncture and gynaecology - women's health | Scoop.it
Learn about Chronic Female Pelvic Pain. Includes overview, cause, symptoms, diagnosis, treatment, exams and tests, prevention, and medications.

 

 

Alternative pain treatments

Alternative pain treatments for chronic female pelvic pain aren't well studied. But they are considered helpful for managing stress and building mental mastery over pain.

Acupuncture and transcutaneous nerve stimulation (TENS) have shown some success in relieving painful menstrual periods. Acupuncture has also been used as a treatment for nonmenstrual chronic pelvic pain, but it isn't yet well studied.1

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