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Women’s Health

 

Dysmenorrhea (period pain)
Roughly half of the women with dysmenorrhea, or period pain, require medication for up to several days a month. In a randomized and controlled clinical study, the effectiveness of acupuncture in managing this pain was investigated. Forty-three women were followed for one year in one of four groups.

• In the Real Acupuncture group, 10 of 11 women showed improvement (after 3 months of treatment), and there was a 41%c reduction of analgesic medication used by these women after their treatment series, while no change or increased use of medication was seen in the other groups.

Acupuncture is also indicated for gynecologic and obstetric problems such as amenorrhea, menorrhagia, and infertility. Obstet Gynecology 69; 51, 1987)

 

Infertility

1) A study, published in the April edition of the medical journal Fertility and Sterility, found that acupuncture medicine increases the chance of pregnancy for women undergoing in-vitro fertilization (IVF). The researchers found the technique enhanced the chances of becoming pregnant for a significant number of the women.

Researchers included 160 patients undergoing in-vitro fertilization for the study. The patients, who were all required to have good quality embryos, were evenly and randomly divided into two groups similar in age and diagnosis.

• When the patients were examined using ultrasound six weeks after their IVF procedures, the differences in pregnancy rates were notable. In the control group, 26 percent of the women, or 21 out of 80 patients, became pregnant. Of the patients who had received acupuncture treatments, 42 percent of the women, 34 out of 80, became pregnant.

The group receiving acupuncture treatments had one treatment before the embryos were transferred and another treatment after the transfer. The researchers used acupuncture to stimulate blood flow and direct energy to the uterus, and to produce a relaxing effect, making it easier for the embryos to take hold.

The study backs up what doctors have heard anecdotally for years: that by relaxing, a woman can increase her chances of becoming pregnant. This may be the evidence to prove it that has been lacking.

2) Another study involved 45 infertile women suffering from oligoamenorrhea ( 27 cases ) or luteal insufficiency (18 cases ).

Following a complete gynecologic-endocrinologic examination, the women were treated with auricular acupuncture (treatment of points on the ear).
Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with acupuncture had 22 pregnancies whereas women treated with hormones had 20 pregnancies. It was also noted that side-effects were observed only during hormone treatment and various disorders of the autonomic nervous system normalized during acupuncture.
The study concluded that "auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders" being more effective than hormone therapy and with no side effects.

Menopause
Several recent research studies on menopause and hot flashes:

1) Acupuncture Against Climacteric (Menopausal) Disorders
Vasomotor symptoms (hot flashes) are very common among peril-menopausal women. The cause of the symptoms is not the low steroid concentrations per se, but probably changes in central neuropeptide activity. 24 healthy women with natural menopause, suffering from hot flushes, were included in the study and randomly assigned to either of two groups, one group received treatment with electro-acupuncture (EA), the other with superficial needle acupuncture.

• Treatment was given for totally of 8 weeks, twice a week during the first 2 weeks, and then once a week for the remaining 6 weeks. As recorded in logbooks kept by the participants, the frequency of flushes decreased significantly by more than 50 per cent in both groups. Values for the Kupperman Index decreased in both groups during treatment and changes were still evident at 3 month follow-up.
Lindgren, Hammnr, Lundeberg, Halso University, Sweden

2) Acupuncture Treatment of Hot Flushes in Breast Cancer Patients
Summary: A common treatment for post-menopausal hot flushes is to raise estrogen levels with hormone replacement therapy. However this option is not considered suitable for breast cancer patients with hormone sensitive carcinoma, since an increase in estrogen is contraindicated.
There has been some evidence that acupuncture is a suitable treatment for hot flushes, so a series of 22 consecutive breast cancer patients referred by an oncologist for treatment of hot flushes were given a course of acupuncture with two treatment sessions per week for up to 7 weeks.

The frequency of recorded hot flushes (both day and night) had improved significantly by the end of treatment. All patients claimed some benefit and 82% had effective relief.
Acupuncture in Medicine, June 2000 E. Tukmachi

3) Acupuncture for Tamoxifen Side Effects (Hot Flashes)
U.K Complementary Health Care Conference, December 5th, 2002
A study carried out at the hospital in Middlesex, England, has found that acupuncture is able to relieve the hot flashes many women experience when taking tamoxifen to prevent breast cancer. Of 54 women on tamoxifen suffering from side effects of flushes or sweats before the treatment, 36% reported that their symptoms had decreased by 50% of more, while 89% reported some improvement. These positive results were maintained after treatment had ended. Personal accounts also showed that the women felt their energy levels had increased, that they could do more, and that their overall quality of life had improved after acupuncture.

4) Study of Acupuncture on the Quality of Life and Reproductive Hormone Secretion in Menopausal Women.
The purpose this study was to assess the effects of acupuncture on the quality of life and reproductive hormone secretion in menopausal women. Eleven menopausal women with menopausal symptoms entered this prospective study. The Menopause specific Quality of life Questionnaire was filled out by the patients before the first acupuncture session, after the last one (5 weeks later), and 3 months after the last acupuncture session.
Conclusion: Acupuncture significantly improved vasomotor and physical disturbances of menopausal women with effects lasting at least up to 3 months after termination of the treatment.
Dept. of Obstetrics/Gynecology, University Hospital of Geneva, Switzerland

5) Acupuncture Shows Promise for Menopausal Relief
In a randomized, two-group clinical study, researchers applied acupuncture for menopausal hot flushes, sleep disturbances and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic.

Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study.

The researchers conclude that acupuncture using menopausal-specific sites holds promise for non-hormonal relief of hot flushes and sleep disturbances.
Cohen, S.M. et al. Can acupuncture ease the symptoms of menopause?
Holistic Nursing Practice 17(6):295-9.

Morning Sickness and Nausea
1) Acupuncture "Clinically Useful" for Morning Sickness
Several studies have documented the use of acupuncture to combat nausea and vomiting. A randomized, placebo-controlled crossover study published in the Journal of Pain and Symptom Management has found that Acupuncture appears to ease the symptoms of morning sickness, and that acupuncture has a "clinically useful effect" in treating hyper emesis (vomiting).

• In the study, 33 women were divided into two groups. Group A received normal acupuncture. Group B received a form of placebo acupuncture. The treatment session lasted a total of eight days.

RESULTS: The study showed that women given active acupuncture experienced a "significantly faster reduction of nausea” compared to those who received a placebo, and the incidence of vomiting was also reduced.

2) Nausea and Vomiting
Convincing evidence for the efficacy of acupuncture in the treatment of nausea comes from studies done by l.W. Dundee of the Department of Anesthesiology of Queens University.

• Studies took place over 5 years and involved some 500 women.
• The efficacy of acupuncture was evaluated as an anti emetic in patients receiving a variety of cancer chemotherapeutic drugs. In this case acupuncture at Pericardium 6 was used as an adjunct to standard chemical anti emetics.
• Under optimum conditions, Pericardium 6 stimulation always produced a highly significant reduction of peri-operative emetic sequelae.
Of 170 patients treated over several years, 93 percent experienced good to very good results, and 7 percent poor to nil. In all, 65 percent experienced a complete abolition of sickness.

Osteoporosis
The Influence of Acupuncture on Postmenopausal Female Bone Density
This article is based on a clinical trial involving 42 postmenopausal women 50-70 years of age, between Mar. 1999 and Jan. 2000 and all of whom had been diagnosed with osteoporosis. Women suffering from thyroid function disturbances, diabetes mellitus, osteomalacia, fibrous osteitis, and osteoblastic diseases, liver and kidney diseases, and anyone who had used estrogen or corticosteroids in the previous three months were excluded from this study.
Twenty-five of these 42 women were assigned to the so-called treatment group, and 17 women were assigned to the comparison group. In terms of the average age (56 years) and the severity of the osteoporosis (which was mostly slight), there was no significant statistical difference between these two groups.
Acupuncture treatment was given once every other day for three months, which constituted one course of treatment. After a 10-day rest, a second course of therapy was administered. In addition, one pill of a calcium and vitamin D supplement was administered orally once per day continuously for six months to both groups.
After six months of the above-described therapy, all the women in this study were examined again to measure their bone density.

• In the treatment group bone density went from 0.907 [+ or -] 0.072 to 0.923 [+ or -] 0.070, for a mean change of 0.013 [+ or -] 0.012 g/ [cm.sup.2].
• In the comparison group, bone density went from 0.908 [+ or -] 0.072 to 0.913 [+ or -] 0.066, for a mean change of 0.005 [+ or -] 0.013 g/ [cm.sup.2].

Thus there was a significant improvement and increase of bone density in the acupuncture group compared to the control group (P <0.05).
February 2004 issue of the Journal of Chinese Medicine, #2, 2001, p. 88)

Post-partum Depression
Sixty-one pregnant women with major depressive disorder were randomly assigned to one of three treatments over an eight week period. Twenty women received active acupuncture, twenty-one received active control acupuncture, and twenty received massage. Acupuncture treatments were standardized, but individually tailored, and were provided in a double-blind fashion.

The response rates at the end of the acute phase were statistically significantly higher for the group that received active acupuncture (69%) than for the women who received massage (32%), with an intermediate response rate (47%). The active acupuncture group also showed a significantly higher average rate of reduction in BDI scores from baseline to the end of the first month of treatment than the massage group.
In conclusion, acupuncture holds promise for the treatment of depression during pregnancy.
Manber R, et al. Dept. of Psychiatry and Behavioral Sciences, Stanford Univ.

Premenstrual syndrome (PMS)
1) Using Acupuncture to treat Premenstrual Syndrome
More than 60% of the women in both groups suffered from premenstrual syndrome (PMS) symptoms, such as anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, whereas a smaller number of women suffered from phobic disorders, premenstrual headaches and migraines.

There were three women from the first group and seven women from the second group who continued the medication treatment with progestins, whereas one woman from the first group and nine women from the second group continued to take fluoxetine.
In the first group, nine women stopped having PMS symptoms after two Acupuncture treatments, eight women stopped having them after three treatments and one woman stopped having them after four treatments. In four women from the first group and 16 women from the second group, PMS symptoms appeared during the following period (cycle) or continued even after four treatments, so the medication was continued.

There was a statistical and relevant reduction in PMS symptoms with the Acupuncture treatments in the first group (P<0.001), whereas their reduction was irrelevant in the placebo AP group (P>0.05). The success rate of Acupuncture in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of Acupuncture in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. The initial positive results of PMS symptoms with a holistic approach are encouraging and Acupuncture should be suggested to the patients as a method of treatment.
Habek D, Habek JC, A. Department of Gynecology and Obstetrics, Health Centre, Bjelovar, Croatia.

2) Sixty one cases of PMS were divided into acupuncture group (n=30) and medicine control group (n=31) according to the sequence of visiting. The acupuncture group was treated with acupuncture at corresponding points and the medicine control group was treated by provera. After treatment of 3 months, their therapeutic effects were compared.
RESULTS: There was a significant difference between the two groups in the therapeutic effect (P< 0.05)
CONCLUSION: “Acupuncture therapy in clinical therapeutic effect is superior to the medicine treatment"
Institute of Acupuncture & Moxibustion

Uterine Fibroids
Treatment of Uterine Fibroids: a pilot study. Mehl-Madrona, L.
Program in Integrative Medicine of the University of Arizona

Thirty-seven menstruating women, aged 24 to 45 years, with palpable uterine fibroids, were matched with controls that were enrolled in conventional treatment. The treatment program consisted of weekly Acupuncture treatments, bodywork, and guided imagery. Treatment lasted as long as 6 months.

Results: Fibroids shrank or stopped growing in 22 patients among the Acupuncture treatment group and 3 among the comparison group (P <.01). Bothersome symptoms of fibroids responded equally well to pharmacological or non-pharmacological therapies. All measures of patient satisfaction were significantly higher among the treatment group compared to those receiving conventional care.
CONCLUSIONS: As reported in the Chinese medical literature, alternatives exist to pharmacological and surgical methods for treating many uterine fibroids.

Urinary Tract Infections
Urinary Tract Infections - Acupuncture May Break Cycle
The emerging threat of antibiotic resistance has led researchers to investigate other, non pharmaceutical means of reducing the frequency and duration of urinary tract infections. A study conducted using acupuncture to treat the condition in women was published in the October 2002 issue of the American Journal of Public Health. It found that the therapy was highly successful, and reduced the infection rate by more than 50% in the six months following treatment.

Alraek and a team of medical doctors recruited 94 women aged 18-60 for the trial. To be included in the study, each woman had to have experienced at least three urinary tract infections in the previous 12 months, at least two of which had been diagnosed and treated as a UTI by a physician. Women were excluded if they were pregnant or had other complications.
After obtaining written consent, the women were given a traditional Chinese medicine diagnosis and randomized into acupuncture and control groups. Control subjects received no treatment. In the acupuncture group, treatments were given twice weekly for four weeks. The researchers documented any incidence of UTI for six months following the last treatment. They also collected urine samples and measured the amount of residual urine in each woman's bladder at two, four and six-months.

While there were no statistical differences among patient groups in the 12 months leading up to the start of the trial, there was a significant decrease among groups after the acupuncture sessions began. 73% percent of the women treated with acupuncture were free of UTIs during the six-month follow-up period, compared to 'only 52% of women in the control group. For the women in the acupuncture group, this translated into a 55% reduced risk of getting another urinary tract infection in the six months following the last treatment session. Women treated with acupuncture also experienced a 51 % reduction in the average amount of urine remaining in the bladder at the six-month examination compared to baseline, while the untreated women exhibited, "no significant change in residual urine."

In addition, the number of women in the treated group with residual urine levels of 10 milliliters or" below more than doubled by the six-month exam; in the untreated group, there was no change. These findings were especially important, as residual urine is one of the primary risk factors for recurrent urinary tract infections, particularly for postmenopausal women.

"Our results showed that acupuncture reduced the recurrence rate among cystis-prone women to half the rate among untreated women," the researchers note in their conclusion. In summary, our result, as well as previous findings, indicates that acupuncture treatment may be effective in preventing recurrent lower UTIs in healthy adult women."
Alrae T, Soedal L, et al. Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women.

 

Men’s Health

Male Infertility
Acupuncture May Improve Sperm Quality
According to a prospective study reported in the July issue of Fertility and Sterility, acupuncture may improve sperm quality in idiopathic male infertility. Of the 40 men in the study, 28 received acupuncture twice weekly for five weeks. Their semen samples were then randomized with semen samples from the 12 men in the untreated control group. The results showed a positive effect on sperm concentration and motility, an increase in testosterone, and some improvement in luteinizing hormone level.

Comment: "These studies have also shown an increase of normally shaped sperm and a significant decrease in the percentage of morphologically abnormal sperm. The treatment of idiopathic male infertility could benefit from employing acupuncture."
Laurie Barclay, MD, Medscape Medical News, July 25, 2005

Chronic Prostatitis
OBJECTIVES: To determine in a pilot study whether acupuncture improved pain, voiding symptoms, and the quality of life of men with chronic prostatitis/chronic pelvic pain syndrome.
METHODS: Men diagnosed with chronic prostatitis/chronic pelvic pain syndrome (National Institutes of Health [NIH] criteria) that were refractory to standard therapy (antibiotics, alpha-blockers, anti-inflammatories, phytotherapy) were referred for acupuncture therapy. The treatment protocol was twice weekly for 6 weeks. The patients completed the NIH Chronic Prostatitis Symptom Index (CPSI) at baseline and the CPSI and subjective global assessment at 6 weeks (end of treatment), 12 weeks, and at least 6 months after the baseline assessment.
RESULTS: Twelve men underwent a minimum of 6 weeks of acupuncture treatment. The average follow-up (from baseline) was 33 weeks (range 24 to 52). A significant decrease occurred in total NIH-CPSI (28.2 to 8.5), NIH-CPSI pain (14.1 to 4.8), NIH-CPSI urinary (5.2 to 1.3), and NIH-CPSI quality-of-life (8.8 to 2.3) scores after an average of 33 weeks of follow-up. Ten patients (83%) had a sustained greater than 50% decrease in NIH-CPSI at final visit (average 33 weeks). Ten patients (83%) reported marked improvement on the subjective global assessment at 12 weeks. At an average of 33 weeks, 8 patients (67%) had sustained marked improvement on subjective global assessment evaluation. No adverse events were reported in this pilot study. CONCLUSIONS: Acupuncture appears to be a safe, effective, and durable treatment in improving symptoms in, and the quality of life of, men with chronic prostatitis/chronic pelvic pain syndrome refractory to treatment. A larger controlled study is required to confirm these encouraging initial results.
Chen R, Acupuncture Foundation of Canada, Mississauga, Ontario, Canada.

Prostrate Post Operation
Acupuncture in the treatment of sensory urgency that persists after transurethral resection of the prostate: a preliminary report
This study evaluated whether or not acupuncture is able to treat the sensory irritative components of lower urinary tract symptoms that persist after transurethral resection of the prostate. In all, 42 patients were randomly allocated to three groups: 14 patients received placebo, 15 patients received oxybutynin and 13 patients were treated with electro-acupuncture.

The average number of daytime voidings decreased by 8% in patients who received oxybutynin and decreased by 20% in 13 patients who received acupuncture; the average number of nocturnal micturitions in patients who received oxybutynin decreased by approximately 20 and decreased by 60% in patients who received oxybutynin and acupuncture, respectively.
Ricci L, et al. Neurourol Urodyn 2004; 23: 58-62.

 
     
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