Acupuncture for Women’s Conditions

Acupuncture for Women’s Conditions:

Ancient Wisdom and Scientific Research

By Changzhen Gong, Ph.D.

Acupuncture and traditional Chinese medicine have become increasingly popular in the United States for the treatment of many gynecological conditions, such as irregular menstruation, dysmenorrhea, premenstrual syndrome, menopausal syndrome, pelvic inflammatory disease, polycystic ovary syndrome, infertility, miscarriage, endometriosis, and fibroids. In part, this is because acupuncture itself is more widely-known and used in this country. Another important reason is that decades of scientific research have demonstrated the effectiveness of acupuncture in treating the conditions mentioned above. Physicians are increasingly informed about the benefits of acupuncture and are willing to refer patients for acupuncture treatment. Evidence-based healthcare emphasizes the application of the highest-quality research to clinical practice. A large body of positive science-based evidence has emerged in the field of acupuncture and traditional Chinese medicine. The hierarchy of evidence in evidence-based medicine progresses from expert opinion, pilot studies, and randomized clinical trials to systematic reviews and meta-analysis of scientific data and research. Findings in the field of acupuncture and traditional Chinese medicine are routinely published in conventional and mainstream medical journals. How does acupuncture and Chinese medicine work for women’s conditions? There are now two versions of an explanation available: the classical Chinese medicine version and the modern scientific version.

In classical Chinese medicine, practitioners assess and diagnose their patients in terms of yin and yang, external and internal causes, excess and deficiency conditions, the state of the internal organs and the fundamental substances such as qi and blood, etc. A woman’s menstrual cycle provides a wealth of information regarding these systems, and TCM practitioners always pay particular attention to this aspect of a woman’s overall health condition. Any irregularity or pain associated with the menses is seen as an indication of an internal imbalance. The Liver, which has the function of storing blood and regulating the emotions, is often associated with gynecological problems. A healthy menses should be regular and not painful. Excessive pain is generally due to qi stagnation or blood stasis. Using Chinese medicine theory, TCM practitioners focus on recognizing and correcting the imbalances which result in gynecological problems.

Chinese medicine is holistic and does not separate symptoms of a physical nature from those of a mental-emotional nature. Chinese medicine theory associates specific mental/emotional conditions with certain physical disease patterns, and expects both the emotional symptoms and the physical symptoms to respond to treatment. Further, in Chinese medicine each and every sign and symptom is understood and interpreted in relationship to all the others. While a Western doctor might choose to send a patient with a variety of symptoms to two or three different specialists, a good practitioner of traditional Chinese medicine sees and understands all the symptoms together as a single pattern. Any treatment prescribed is designed to work effectively with the entire pattern and all its symptoms. Chinese medicine does not, indeed cannot, separate a person into segmented parts, treating one symptom or part at the expense of another. It is designed to treat the person, not just the disease.

Because of its individualized diagnostic and treatment techniques, Chinese medicine is able to be more specific for each patient’s needs than is Western medicine. For example, five women may come into a clinic with hot flashes, but each of these women’s hot flashes is accompanied by a variety of different signs and symptoms, no two of which are exactly alike. Instead of each woman getting the same hormone replacement therapy, in a TCM clinic each of these five women will receive an individually tailored treatment plan with different herbs, different acupuncture therapy, and different lifestyle suggestions. Because treatment is so specifically tailored to each person, if the diagnosis has been correct, the treatments prescribed by Chinese medicine should have no side effects. Any mild side effects that may arise in the initial stages of herbal treatment can be corrected by adjustments to the herbal formula, and acupuncture rarely has any unwanted side effects at all. In contradistinction, most drugs have at least some expected and normal side effects and many have potentially serious, irreversible ones.

The last thirty years has witnessed an ever-increasing volume of scientific studies and clinical research on acupuncture. The ability of acupuncture to control pain has been of particular interest to researchers. Considerable evidence has been compiled on how acupuncture works for pain from dysmenorrhea, premenstrual syndrome, pelvic inflammatory disease, and endometriosis. It is accepted that acupuncture stimulates nerve fibers in the muscle, sending impulses to the spinal cord and activating three neurological areas (spinal cord, midbrain, and hypothalamus-pituitary) to produce an analgesic effect. In the spinal cord, the neuropeptides enkephalin and dynorphin act to block incoming messages. In the midbrain, enkephalin acts to activate the raphe descending system, which inhibits spinal cord pain transmission by a synergistic effect of monoamines, serotonin, and norepinephrine. In the hypothalamus-pituitary, β-endorphins are released into the blood and cerebrospinal fluid (CSF) to produce analgesia at a distance.

In addition to its proven ability to regulate pain responses, acupuncture has also effectively addressed disorders associated with hormone imbalances, such as polycystic ovary syndrome and menopause. Researchers are seeking the underlying mechanism that allows acupuncture to treat hormone balance disorders effectively. Studies show that stress decreases reproductive functions by increasing the activity of the hypothalamic–pituitary–adrenal (HPA) axis, which is a complex set of direct influences and feedback interactions among three endocrine glands: the hypothalamus, the pituitary gland, and the adrenal glands. There is a close relationship between hormones of the HPA axis and those of the hypothalamic–pituitary–gonadal (HPG) axis which is a critical part in the development and regulation of a number of the body's systems, such as the reproductive system. Acupuncture is considered to influence both the HPA axis and the HPG axis. Existing research shows that acupuncture may be able to regulate the hypothalamic-pituitary-ovarian axis in many ways, and correct abnormal functioning.

Whether one chooses to explain the effectiveness of acupuncture and Chinese medicine in terms of its traditional theoretical foundations or in terms of modern scientific research, the fact remains that acupuncture continues to be one of the best modalities available for treating women’s health conditions.