What gynaecological diseases are suitable for acupuncture treatment
70Acupuncture is very effective for some common gynaecological disorders.
Endometriosis: Endometriosis is a condition in which endometrial cells grow outside of uterus. These misplaced tissues are mostly found on the ovaries and fallopian tubes and in the pelvic cavity etc. These cells respond to the ovaries hormonal cycles each month, but are inseparable from the tissues, which cause scarring and adhesions. Endometriosis does not always produce symptoms. When it does, it mainly causes pain, irregular menstrual bleeding and infertility. Many women experience period pain, dyspareunia and pelvic pain which is unrelated to menstruation and intercourse. Irregular menstruation, excessive bleeding and clot are common. About 50% infertile women suffer from endometriosis. There are different treatments available, such as pain relief, hormonal treatments and surgery etc. Some women may benefit from alternative medical treatments. Acupuncture reduces pain by producing endorphins. Acupuncture is proven an effective complimentary management for endometriosis in patients with infertility. Acupuncture improves local circulation, balances hormonal levels, reduces inflammation and improves immune function. Recent studies showed that the ectopic tissues were reduced and the invasion of ectopic tissue to extracellular matrix was inhibited. The symptoms such as dysmenorrhea, irregular menstruation and chronic pelvic pain in endometriosis were significantly improved.
Polycystic ovary syndrome (PCOS): PCOS is characterised by chronic anovulation and hyperandrogenism. Ovulation is much improved in acupuncture treatment. (See hubpage article What is Polycystic Ovary Syndrome (PCOS) and its treatment with acupuncture, http://maggieju.hubpages.com/hub/Polycystic-Ovary-Syndrome-PCOS ).
Infertility: Acupuncture is a valuable therapy for female infertility caused by hormone disorders. (See hubpage article Why not try acupuncture for your infertility treatment? )http://maggieju.hubpages.com/hub/acupuncturistmaggie
Dysmenorrhea: Dysmenorrhea or period pain is the most common gynaecological complaint among adolescent females and the leading cause of recurrent short-term or work absenteeism. Lower abdominal chronic pain is the most common symptom accompanied with or without other symptoms such as headaches, nausea and vomiting. Typically symptoms occur at around the onset of menstrual flow and last for the first 24-48 hours. Smoking may prolong the duration of dysmenorrhea due to nicotine-induced vaso-constriction. The majority of dysmenorrhea is primary or functional, associated with normal ovulatory cycles without pelvic pathology and has a clear physiological etiology. The pain for primary dysmenorrhea is caused by over-production of prostaglandins (PGs) and leukotrenes (LTs) within the endometrium after ovulation. PGs and LTs are inflammation modulators which cause myometrial contractions and vasoconstriction resulting in local tissue ischemia, which is involved in crampy pain.
Treatment for primary dysmenorrhea is divided into two categoies: traditional (ie, medical and surgical) and nontradtional (ie alternative and adjuvant). Traditional approach includes nonsteroidal anti-inflammatory drugs,which inhibits PG synthesis, combined oral contraceptives and long-acting hormonal therapies. Alternative approach is as follows: vitamins including vitamin E and B1, previous research suggested that vitamin E and B1 significantly reduce dysmenorrhea through hibition of PG synthesis; minerals such as magnesium; diet containing omega-3 fatty acids (such as fish) which lead to the uterine production of less potent PGs; transcutaneous electrical nerve stimulator; and last but not least, acupuncture which is analgesic. There is one study which investigated the effect of acupuncture in the treatment of primary dysmenorrhea. The result showed significant difference of pain relief between acupuncture group and control group (without acupunctureAcupuncture is very effective on primary dysmenorrhea probably by regulating prostaglandin F2α (PGF2α) level in menstrual fluid and also regulating hormones related receptors.
Uterine fibroids: Uterine fibroids are most common benign tumours in uterine, occurring predominantly in middle or late reproductive ages in women. They may be asymptomatic or may cause series of symptoms, such as, irregular vaginal bleeding, heavy menstruation, severe period pain, intercourse pain, lower abdominal discomfort, lower back pain and urinary frequency and retention. They may also be a cause of infertility. They may interfere embryo implant and may cause miscarriage or premature labor during pregnancy.
The location of the tumour is an important factor of causing symptoms. Intramural fibroids are a most common type: they are located within the uterine smooth muscle wall either asymptomatic or causing symptoms, if they grow bigger. Submucosal fibroids are situated in the smooth muscle wall just underneath endometrial layer (inner layer) of the uterus, easily causing irregular vaginal bleeding. There are also two other types of fibroids: One type is subserosal fibroids growing under mucosal layer (outer layer) of the uterus, which can be very large without symptoms. The other uncommon type is cervical fibroids, found in the cervical wall. Transvaginal ultrasound, a non-invasive procedure is usually performed to diagnose the presence of uterine fibroids, which can be located and measured. Uterine fibroids could be single or multiple. Their growth is strongly stimulated by estrogen and prosgesterone. After menopause, the tumours shrink. Asymptomatic fibroids do not need treatments, however, intolerable symptoms do need to be treated. Medications are employed to control the symptoms and shrink the tumours, such as, danazol. Surgeries such as myomectomy and hysterectomy are applied to remove the fibroids. Apart from these methods of treatments, acupuncture is an effective method to reduce symptoms, such as vaginal bleeding, lower abdominal pain and lower back pain and it also makes the tumours shrink or vanish. Acupuncture is effective in treatment of uterine fibroids by regulating the pituitary gland, the thyroid gland system and the central nervous system.
Primary ovarian insufficiency (Premature ovarian failure): The ovary is unique in the female endocrine system in which follicle is developed every month and matured egg is released. Ovary produces sex steroids, which are necessary for development of reproductive organs and maintaining bone density and general health. Regular monthly menstruation after ovulation is an indication of healthy ovarian function. Menopause, permanent cessation of menses occurs at age of around 50. If menopause occurs before age 40, this is considered to be premature, called primary ovarian insufficiency which is a subclass of ovarian dysfunction. The main symptoms of this disorder are amenorrhoea for at 4 months, sex steroid deficiency and high follicle stimulating hormone (FSH). It is worth mentioning that about 50% of women with primary ovarian insufficiency have intermittent ovarian function causing irregular menses, instead of complete amenorrhea. Symptoms of estrogen deficiency are at present in many, but not all patients, which include vasomotor symptoms (hot flashes and night sweats), sleep disturbance, and dyspareunia due to vaginal dryness. Many causes lead to secondary amenorrhea, of which the polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia are three main causes. Hormone-replacement is first line therapy which physiologic estrogen and progestin are given to patients until the age when menopause usually occurs. Patients should take a pregnancy test if a menstrual period is late and therapy should be stopped, if the pregnancy test is positive. Oral contraceptive is another option. Calcium and vitamin D are recommended for maintaining healthy bone. Acupuncture help restoring body hormone balance by acting through meridian.
Dysfunctional irregular uterine bleeding or heavy period: This is a common condition in women's clinic which is caused by hormonal level changed. The diagnosis is to exclude underlying pathological conditions. Acupuncture is effective to normalise uterine bleeding and improve full blood court.
Chronic pelvic inflammation: Pelvic inflammatory disease is the infection and inflammation of the female upper genital tract, one of the most common diseases in reproductive age women, which associates with infertility, ectopic pregnancy and chronic pelvic pain. A broad spectrum antibiotic should be first considered. Acupuncture is very effective for treatment of chronic pelvic inflammation by analgesic and improvement of local circulation.
Premenstrual syndrome and Menopausal syndrome: a number of studies showed the effects of acupuncture in the treatment of premenstrual syndrome and menopausal syndrome and improvement of the symptoms.
Reference
Zhou and Qu. Afr.J.Trad. CAM (2009) 6: 494-517
Balen AH and Jacobs HS (2003). Infertility in Practice
Sanfilippo J and Erb T Clinical Obstetrics and Gynecology (2008), 51:257-267
Lawrence M. Nelson (2009), N Engl J Med, 360:606-614
