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Acupuncture Use In Gynecology

Traditional Chinese medicine which includes acupuncture has been used for over the past 2000 years. It is an approach that is holistic and comprehensive in perspective whereas western medicine is based on a clinical and scientific approach. These differences have led to a slow acceptance of traditional Chinese medicine in combination with western medicine. In the U.S. skepticism has been common due to the lack of research methods that western medicine is used to to having performed. It has been difficult for evidence-based physicians to incorporate traditional Chinese medicine into their daily practice routine. However it has become more accepted and women are now turning to alternatives to western practices to help with gynecological issues.

Vasomotor symptoms
Hot flashes and night sweats probably produces the greatest degree of discomfort for most women as they approach menopause. Many women are not able to take hormone therapy either due to medical conditions or their fear of hormones causing an increased risk of breast cancer. For this reason many women are looking for alternatives to hormones. The use of acupuncture has increased as more women are searching for other therapies. The results of acupuncture seem to be directly in proportion to the expertise of the acupuncture therapist. Studies have shown that the benefit of acupuncture seems to be a mechanism of increasing the amounts of the serotonin from the nervous system. Overall the therapy appears to be effective with minimal side effects. It has helped to decrease depression associated with menopause, as well as increasing the quality of life.

Premenstrual syndrome
PMS is a syndrome of mental and physical symptoms occurring in the second half of the menstrual cycle. The cause of the symptoms is not understood; therefore multiple medications have been used varied results, including the use of birth control pills, antidepressants, diuretics, and vitamin and mineral supplements. These approaches usually report a 40% failure rate in improving symptoms. Six recent studies have shown that acupuncture has been superior to medications for control of symptoms.

Dysmenorrhea
Dysmenorrhea is the pain that occurs once a month during the menstrual cycle, with up to 75% of women reporting having some degree of discomfort and 50% requiring medications monthly. It is increased uterine muscular activity leading to irregular contractions of the muscles in the uterine wall. It is usually associated with an increase in a chemical produced in the lining of the uterus called prostoglandins. It may also produce other symptoms including headaches, backache, nausea, diarrhea, and bloating and is usually treated with anti-inflammatory drugs, such as Tylenol. A recent study showed that 90% of women receiving acupuncture showed improvement in symptoms. The study also revealed that there was over a 40% reduction in the use of medications. It appears to be an excellent alternative for women who do not want to take medications.

Infertility
Recent data has shown that up to 10% of women of reproductive-age have difficulty getting pregnant. A recent study of women in California who were undergoing infertility treatments, nearly 30% used acupuncture to assist with IVF had an increase in success. Another study was done comparing the use of acupuncture verses IVF and both groups had comparable pregnancy outcomes. Many reproductive endocrinologists are now using acupuncture as part of the preparations for IVF having the patient receive treatment twice weekly from day two until egg retrieval.

Endometriosis
Endometriosis is a disorder caused by the presence of endometrial tissue outside the uterus and produces symptoms such as period pain, abnormal bleeding with periods, pain during intercourse, and infertility. Current western therapies include medications and surgery. A regimen of acupuncture twice a day, starting four days prior to the period, for five days has shown symptoms decrease by 95%. Studies have shown that acupuncture can assist in improving symptoms associated with endometriosis.

Polycystic ovarian syndrome
PCOS is an endocrine disorder associated with absence or infrequent ovulation, high testosterone levels, insulin resistance and obesity. A study was done, in which women diagnosed with PCOS received acupuncture twice a week for two weeks and weekly thereafter for a total of 14 treatments. Over one third of the patients had a return of ovulation and a significant decrease in testosterone. The study showed that repeated acupuncture treatments have long-lasting effects and decreased the metabolic disorder associated with PCOS.

Overactive bladder
OAB has been reported to affect up to 15% of all women. It can produce psychological distress, social isolation, and a decrease in self-esteem. Current therapies including medications and behavioral therapies have been only moderately effective. A recent case study divided 74 women in two groups, of which half received medication and the other half received acupuncture for a period of four weeks. The acupuncture group showed significant reduction in urinary frequency and urgency.

In spite of only a few studies done with acupuncture, the large number of women seeking alternatives to traditional western medicine can not be ignored. It has been shown that acupuncture can be a valuable addition to gynecologic issues.

More about Dr. Aulds

Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.

Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.