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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 some modern research into acupuncture in the gynaecological sphere.
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.)
A systematic review by Korean authors looking at acupuncture for menstrual pain shows it is an effective intervention. The review examined 60 randomised controlled trials covering over 3000 patients; 49 trials were subject to meta-analysis. The studies compared acupuncture to no treatment, placebo or medication.
Compared with both no treatment and nonsteroidal anti-inflammatory drugs, acupuncture was more effective at reducing menstrual pain. The benefits of acupuncture were also maintained during short-term follow-up.
(The efficacy & safety of acupuncture in women with primary dysmenorrhea. A systematic review & meta-analysis. Medicine (Baltimore), June 2018.)
A Cochrane Database systematic review by Australian authors, has concluded that acupuncture and acupressure may improve both physical and psychological symptoms of PMS. Five trial results, covering 277 women, were analysed. The results suggest acupuncture can improve overall mood and physical symptoms, compared with sham acupuncture. Quality of evidence was limited by small sample sizes.
(Acupuncture & acupressure for premenstrual syndrome. Cochrane Database of Systematic Reviews, 14 August 2018.)
A large American trial has shown that acupuncture can help postmenopausal women with breast cancer, who experience joint pain (arthralgia) as a side-effect of taking aromatase inhibitor drugs eg anastrozole/arimidex. Researchers randomised 226 such women, mean age 61, across 11 academic centres and clinics, to either true acupuncture, sham acupuncture or a waiting list control. Real or sham acupuncture was given twice a week for 6 weeks, then once a week for a further 6 weeks. All patients were followed up for a further 12 weeks.
Compared with the sham acupuncture and waiting list groups, the true acupuncture group at 6 weeks experienced a statistically significant reduction in their worst joint pain: 58% had at least a two-point pain reduction, compared with 33% in the sham group and 31% in the waiting list group. There were also improvements in average pain and joint stiffness in the true acupuncture group. Even at six month follow-up, average worst pain in the true acupuncture group was lower than in the other two groups.
(Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. Journal of the American Medical Association, 10 July 2018.)