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 research collaboration from Australia and New Zealand investigating the effects of acupuncture for period pain, has shown that it can reduce pain intensity, and its effects are still apparent one year later. A total of 74 women aged 18 to 45 were randomly allocated to one of four treatment combinations: once per week or three times per week, acupuncture or electro-acupuncture. A total of 12 treatments were given over three menstrual cycles. All groups received a treatment in the first 2 days of a period.
After three months of treatment, acupuncture was found to reduce period pain intensity and duration, and this improvement was sustained at one year follow-up. Compared to the electro-acupuncture groups, the manual acupuncture patients required fewer painkillers, otherwise there was little difference between the groups. The authors identify a “lack of satisfaction in standard treatment, leading to an increase in self-care, with women commonly using complementary therapies to deal with their menstrual pain in addition to, or instead of, pharmaceutical pain relief, due to a lack of perceived effectiveness or a dislike of using analgesic medication”.
Tear analysis following adjunctive acupuncture for menopausal dry eye shows that the treatment increases tear protein synthesis and secretion, and improves clinical symptoms. A Chinese research team randomly divided 28 post-menopausal women with dry eyes, into two groups. One group received artificial tears, whilst the other received artificial tears plus acupuncture. Acupuncture was given three times per week for eight weeks.
After treatment, symptom reduction was significantly greater in the acupuncture group compared with the artificial tears only group. The combined treatment was found to increase synthesis and secretion of tear proteins, which have a role in maintaining the ocular surface. The authors conclude that acupuncture may be a therapy for treating postmenopausal dry eye disease.
(Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry. International Journal of Nanomedicine, February 2017.)
A small Swedish feasibility study indicates that electroacupuncture can improve markers of glucose regulation and androgen levels in overweight women with polycystic ovary syndrome (PCOS). Seventeen women aged 18 to 38, were given electroacupuncture three times a week over a five week treatment period. Levels of both HbA1C and androgens decreased significantly, and these changes occurred without alterations in body weight or waist circumference.
The authors say that lifestyle management, including exercise and dietary changes, has the potential to improve most PCOS-related symptoms. For those who have difficulty performing exercise or following a diet, treatments such as acupuncture might be needed. Based on the findings of this study, a full randomised controlled trial has been initiated.
(Changes in HbA1c and circulating and adipose tissue androgen levels in overweight-obese women with polycystic ovary syndrome in response to electroacupuncture. Obesity Science & Practice, December 2016.)
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.)