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Category Archives: Gynaecology
Gynaecology has a very long history in Chinese medicine. The earliest writings date from the Shang dynasty (1500-1000BC), and infertility was being discussed two thousand years ago. The earliest obstetrics text was written during the Tang dynasty (618-907AD). 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 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 satisfactory solutions.
Conditions I often see include PMS, painful periods, heavy periods and other menstrual irregularities, infertility, habitual miscarriage, endometriosis, polycystic ovary syndrome and menopausal symptoms. With most of these problems, the characteristics of your monthly cycle can offer clues about what lies behind your symptoms. I am likely to ask about your cycle length, its regularity and any variability. The history of your problem and any investigations and results are important too.
Menopausal symptoms may include joint pains, fatigue, anxiety, loss of confidence, disturbed sleep, flushes, night sweats, and feeling perpetually “premenstrual”.
For complaints related to your monthly cycle, I tell my patients as a rule, 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 track your cycle, 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 the month. In this way, acupuncture does not try to run counter to your monthly rhythm.
As usual in traditional Chinese acupuncture, I will look at your health and well being in the widest sense. Any other health issues, as well as the amount of energy you have to devote to both work and family, are all relevant to me.
I hope this has given you a little bit of background to Chinese medical gynaecology. This area spans many different conditions, so you are always welcome to telephone and ask about anything specific. Meanwhile, we began this article with medicine 3000 years ago. By contrast, you will find below the results of current acupuncture and other research in the gynaecological sphere.
Danish researchers studying acupuncture for hot flushes and night-sweats, have shown even a brief, standardised course of treatment can offer fast and clinically relevant symptom reductions. Seventy women aged 40 to 65 with moderate to severe menopausal symptoms, and recruited from nine primary care practices, were randomised to either an acupuncture group or a waiting list control group. Acupuncture was given once a week for five weeks.
At week 6, and compared with the control group, the acupuncture group displayed significantly decreased hot flushes, night-sweats, sleeping problems, emotional symptoms and physical symptoms. Some improvements were already apparent by week 3. The study authors conclude that acupuncture for menopausal symptoms is a realistic option for women who cannot or do not wish to use hormone replacement therapy.
Bone density in postmenopausal women can be improved with a 12-month daily oral administration of 5g of specific collagen peptides, say researchers in Germany. A total of 131 women aged 46 to 80, were randomised to receive either a daily dose of collagen peptide or a placebo powder. The substances were dissolved in a glass of water and taken before breakfast. All subjects were given information on the importance of regular physical activity and balanced nutrition. They were also encouraged to take a daily dose of calcium (500-800mg) and vitamin D (400-800iu). A DEXA scan of the lumbar spine at L1-L4, and at the neck of the thigh bone, was performed at baseline and after 12 months. Blood levels of bone markers were also monitored.
In the 102 women who completed the study, there were significant improvements in bone mineral density in the peptide group: 3% in the spine and 7% in the femoral neck. In the placebo group, bone density actually fell by around 1%. Similarly, blood levels of bone markers suggested increased bone formation in the treatment group, and increased bone degradation in the placebo group.
The authors say there is insufficient knowledge about which type of collagen peptides (marine, porcine, bovine etc) exerts the most favorable effect. The manufacturing process could also influence the properties of collagen peptides and thus their effectiveness. More human studies and additional data on optimal timing and dosage are needed.
(Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women—A Randomized Controlled Study. Nutrients Journal, online 16 January 2018.)
Acupuncture after laparoscopy reduces the time to discharge for patients who have undergone the procedure plus anaesthetic. Research teams based in Germany and Switzerland, randomly allocated 75 women to receive either acupuncture with standard anaesthetics, acupressure, or standard anaesthetics alone.
In the acupuncture group, median time to discharge was 35% shorter than in the standard anaesthetics alone group. It was also shorter than in the acupressure group. Median time to removal of the endotracheal tube was 7 minutes shorter in the acupuncture and acupressure groups, compared with the standard anaesthetics alone group. The researchers point out that modern surgery management requires increasing operating theatre turnover and more ambulatory procedures. Post-anaesthetic recovery therefore needs to be optimised, and further work should be encouraged to consider a role for acupuncture.
(Acupuncture reduces the time from extubation to “ready for discharge” from the post anaesthesia care unit: results from the randomised controlled AcuARP trial. Scientific Reports, 24 October 2018.)
A team of researchers in Turkey looking at the possibilities of acupressure for nausea and vomiting after gynaecological surgery, have concluded it represents a viable alternative to drugs. They randomised 97 women to receive either standard drugs during and after surgery, or to receive acupressure to the point Neiguan using a wristband. The latter was left in place during the first 12 hours following surgery.
Acupressure was associated with preventing vomiting and a significant reduction in nausea. Patients’ general comfort level also improved. The study authors say that because of its effectiveness and feasibility, wristband acupressure is a great alternative to pharmacologic methods in the gynaecological surgery population.
(The Effect of Neiguan Point (P6) Acupressure With Wristband on Postoperative Nausea, Vomiting, and Comfort Level: A Randomized Controlled Study. Journal of PeriAnesthesia Nursing, December 2018.)