Chinese medicine has a very long history of helping with gynaecological problems: 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 and other menstrual irregularites, infertlity, 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 work, 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 of twenty-seven randomised controlled trials, examining data from nearly 3000 women, has shown that, compared with drug treatment or herbal medicine, acupuncture was associated with a significant reduction in period pain.

(British Journal of Gynaecology Feb 2010, Epub ahead of print.)

American researchers have found that acupuncture is just as effective as drug treatment in preventing hot flushes in breast cancer patients receiving long-term oestrogen-antagonist therapy. Moreover, they also found that acupuncture improved both their sex drive and overall sense of well-being.

Fifty patients were randomly assigned to receive twelve weeks of either acupuncture or standard drug treatment (in this case, venlafaxine). Both groups were found to exhibit significant decreases in hot flushes and depressive symptoms, together with improvements in mental health and quality of life. At follow-up two weeks after treatment had ended, the venlafaxine group were experiencing significant increases in hot flushes, whereas those in the acupuncture group remained low. Further, the drug treatment group reported 18 incidences of adverse effects (nausea, dry mouth, dizziness, anxiety), compared with the acupuncture group which reported none. Acupuncture had the additional benefit of increasing sex drive in some women, and most reported improvements in their energy, clarity of thought and general well-being.

(Acupuncture versus Venlafaxine for the Management of Vasomotor Symptoms in Patients with Hormone-Receptor Positive Breast Cancer: A Randomised Controlled Trial. Journal of Clinical Oncology Feb 2010.)

A multicentre randomised controlled study has concluded that acupuncture in addition to standard care, is associated with significant improvements in menopausal hot flushes and other menopause-related symptoms.

A total of 175 women were randomised to receive either twelve acupuncture treatments over four weeks in addition to usual care, or to usual care alone. In the acupuncture group, the average reduction in the 24 hour hot flush score was 17, compared to only 7 in the control group. The acupuncture group also showed significant improvements in other areas such as psychological and urogenital, compared to the control group.

(Effects of Acupuncture on Hot Flashes in Perimenopausal and Postmenopausal Women – A Multicentre Randomised Clinical Trial. Menopause Nov 2009. Epub ahead of print.)

Norwegian researchers have concluded that acupuncture can help reduce the frequency and severity of menopausal hot flushes. In a multicentre, randomised, controlled trial involving 267 women, the effects of acupuncture plus self-care, were compared with the effects of self-care alone.

In the acupuncture group, hot flush frequency decreased by 5.8 flushes per 24 hours, compared to 3.7 per 24 hours in the control group. Similarly, the acupuncture group experienced a decrease in hot flush intensity of 3.2 units, compared to 1.8 units in the control group.

Women in the acupuncture group also reported significant improvements in other quality of life indices such as sleep. (The Effects of Acupuncture on Hot Flushes among Menopausal Women (Acuflash) Study, A Randomised Controlled Trial. Menopause 2009 May-June.)