Category Archives: Gynaecology
Gynaecology has a very long history in Chinese medicine: the earliest writings date from the Shang dynasty (1500-1000BC), infertility was being discussed two thousand years ago, the earliest obstetrics text was written during the Tang dynasty (618-907AD), and probably the earliest medical school department devoted entirely to gynaecology and obstetrics, was that of the Imperial Medical College during the Song dynasty (960-1279AD). The subject occupies a very special place in traditional Chinese medicine, and acupuncture in the twenty-first century can assist with many problems for which women often feel there is a lack of really satisfactory solutions.
Some of the conditions I most commonly see include PMS, painful periods, heavy periods and other menstrual irregularites, infertility, habitual miscarriage, endometriosis, polycystic ovary syndrome and menopausal symptoms. With most of these problems, the precise characteristics of your monthly cycle can offer a lot of clues about what lies behind your symptoms. I am likely to ask about your cycle length, its regularity, any variability, and other such matters, so it helps if you can consider these in advance. The history of your problem and any investigations and results are important too. As usual in traditional Chinese acupuncture, your health and well-being are looked at in the widest sense: any other health issues, aswell as the amount of energy you have to devote to both work and family, are all relevant to me.
For complaints related to your monthly cycle, I tell my patients as a rule of thumb, to be prepared to come for treatment more or less weekly, for three cycles ie. around three months. This gives acupuncture a proper opportunity to start to help, and is an appropriate length of time after which to review progress. We will usually track your cycle down to the day, because on each visit, treatment should be tailored not only to your main complaint, but also so as to harmonise with what your body is naturally trying to do at that point in your cycle; this way, acupuncture goes with the flow, and does not try to run counter to any perfectly natural aspect of your monthly rhythm.
I hope this has given you a little bit of background to Chinese medical gynaecology, but because this area spans so many different conditions, you are always welcome to just pick up the telephone and ask me more about anything specific. Meanwhile, we began this article with medicine 3000 years ago, and by contrast, you will find below the results of some modern research into acupuncture in the gynaecological sphere.
A systematic review by authors in Taiwan, suggests acupuncture treatment is associated with a significant reduction in menopause-related sleep disturbance. A total of 31 randomised, controlled trials were identified, involving 2433 women. Meta-analysis showed that acupuncture was associated with a significant reduction in sleep disturbance, along with increases in estradiol secretion, and reductions of FSH and LH secretion.
The authors conclude that their findings suggest that acupuncture should be adopted as part of a multimodal approach for improving sleep disturbances in perimenopausal and postmenopausal women.
(Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstetrics and Gynaecology, March 2016.)
Researchers in Italy have concluded that acupuncture with enhanced self-care is an effective intervention for managing hot flushes and improving the quality of life in menopausal women with breast cancer. A pragmatic, randomised, controlled trial involving 190 women, compared enhanced self-care plus acupuncture (85 women), with enhanced self-care alone (105 women). Both groups received a booklet on managing menopause, to be followed for at least 12 weeks. The acupuncture group in addition received 10 acupuncture sessions.
Compared with self-care alone, the acupuncture group by the end of treatment had a significantly lower hot flush score. This remained the case at three- and six-month follow-ups. Acupuncture was also associated with fewer other menopausal symptoms and higher quality of life.
(Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial. Journal of Clinical Oncology, 28 March 2016 epub ahead of print.)
Researchers at Wake Forest School of Medicine in North Carolina, have concluded that a course of acupuncture is associated with a significant reduction in menopausal hot flushes and night sweats, plus improvements in quality of life. Clinical benefits persisted for at least six months after treatment ended.
In a pragmatic trial, 209 women were randomised to receive up to 20 acupuncture treatments in either the first 6 months (the acupuncture group) or the second 6 months (the waiting list group). After the initial 6 months, symptom frequency had declined by 36.7% in the acupuncture group, and had increased by 6% in the waiting list group. At the 12 month point ie 6 months after their treatment had ended, the acupuncture group’s symptom reduction remained at 29.4%, suggesting that the reduction was largely maintained after treatment. Statistically significant improvement was observed after three acupuncture treatments, and maximal clinical effects occurred after a median of eight treatments. Persistent improvements were seen in many quality of life-related outcomes in the acupuncture group relative to the control group.
(Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Pubmed June 2016.)
American researchers suggest that electro-acupuncture may be more effective and have fewer adverse effects, than the drug gabapentin in managing hot flushes in women undergoing treatment for breast cancer.
A total of 120 women who were having hot flushes at least twice per day, were randomly assigned to one of four groups for 8 weeks of treatment: electro-acupuncture; gabapentin daily; sham acupuncture as a placebo; placebo pills. By the eighth week, the mean reductions in hot flush scores were -7.4, -5.2, -5.9 and -3.4 for the groups respectively, making electro-acupuncture significantly superior. Additionally though, the two pill groups reported significantly more adverse events than the two acupuncture groups. At follow-up after 24 weeks, the symptom reduction was still greatest in the electro-acupuncture group.
(Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial. Journal of Clinical Oncology, online 24 August 2015.)