4546 El Camino Real, B6
Los Altos, CA 94022
ph: 650 868 6632
XL
The Physiological Basis of Complementary and Alternative Medicine for Polycystic Ovary Syndrome.
Polycystic ovary syndrome(PCOS) is a common endocrine disorder that is characterized by chronic hyperandrogenic anovulation leading to symptoms of hirsutism, acne, irregular menses and infertility. Multiple metabolic and cardiovascular risk factors are associated with PCOS, including insulin resistance, obesity, type 2 diabetes, hypertension, inflammation, and subclinical atherosclerosis. However, current treatments for PCOS are only moderately effective at controlling symptoms and preventing complications. This article describes how the physiological effects of major complementary and alternative medicine (CAM) treatments could reduce the severity of PCOS and its complications. Acupuncture reduces hyperandrogenism and improves menstrual frequency in PCOS. Acupuncture's clinical effects are mediated via activation of somatic afferent nerves innervating the skin and muscle, which via modulation of the activity in the somatic and autonomic nervous system may modulate endocrine and metabolic functions in PCOS. Chinese herbal medicines and dietary supplements may also exert beneficial physiological effects in PCOS, but there is minimal evidence that these CAM treatments are safe and effective. Mindfulness has not been investigated in PCOS but it has been shown to reduce psychological distress and exert positive effects on the central and autonomic nervous systems, hypothalamic-pituitary-adrenal axis, and immune system leading to reductions in blood pressure, glucose, and inflammation. In conclusion, CAM treatments may have beneficial endocrine, cardiometabolic and reproductive effects in PCOS. However, most studies of CAM treatments for PCOS are small, nonrandomized or uncontrolled. Future well-designed studies are needed to further evaluate the safety, effectiveness and mechanisms of CAM treatments for PCOS.
Raja-Khan N, Stener-Victorin E, Wu X, Legro R.
Am J Physiol Endocrinol Metab. 2011 Apr 12
Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial.
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by hyperandrogenism, oligo/amenorrhea, and polycystic ovaries. We aimed to determine whether low-frequency electro-acupuncture (EA) would decrease hyperandrogenism and improve oligo/amenorrhea more effectively than physical exercise or no intervention. We randomized 84 women with PCOS, aged 18-37 yr, to 16 wk of low-frequency EA, physical exercise, or no intervention. The primary outcome measure changes in the concentration of total testosterone (T) at week 16 determined by gas and liquid chromatography-mass spectrometry was analyzed by intention to treat. Secondary outcome measures were changes in menstrual frequency; concentrations of androgens, estrogens, androgen precursors, and glucuronidated androgen metabolites; and acne and hirsutism. Outcomes were assessed at baseline, after 16 wk of intervention, and after a 16-wk follow-up. After 16 wk of intervention, circulating T decreased by -25%, androsterone glucuronide by -30%, and androstane-3α,17β-diol-3-glucuronide by -28% in the EA group (P = 0.038, 0.030, and 0.047, respectively vs. exercise); menstrual frequency increased to 0.69/month from 0.28 at baseline in the EA group (P = 0.018 vs. exercise). After the 16-wk follow-up, the acne score decreased by -32% in the EA group (P = 0.006 vs. exercise). Both EA and exercise improved menstrual frequency and decreased the levels of several sex steroids at week 16 and at the 16-wk follow-up compared with no intervention. Low-frequency EA and physical exercise improved hyperandrogenism and menstrual frequency more effectively than no intervention in women with PCOS. Low-frequency EA was superior to physical exercise and may be useful for treating hyperandrogenism and oligo/amenorrhea.
Am J Physiol Endocrinol Metab. 2011 Jan;300(1):E37-45. Epub 2010 Oct 13.
Jedel E, Labrie F, Odén A, Holm G, Nilsson L, Janson PO, Lind AK, Ohlsson C, Stener-Victorin E. Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study.
Abstract
The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. The study was an observational, prospective, cohort study based at the University IVF center.
PATIENT(S): 57 infertile patients undergoing IVF or IVF/ICSI.
INTERVENTIONS(S): Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care.
MAIN OUTCOME MEASURE(S): Perceive Stress Scale scores, pregnancy rates.
RESULT(S): women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. CONCLUSIONS(S): The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
Balk J, Catov J, Horn B, Gecsi K, Wakim A.
SourceUniversity of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.
Acupuncture in clinical and experimental reproductive medicine: a review.
Abstract
Background: Acupuncture has been used as treatment for infertility for hundreds of years, and recently it has been studied in male and female infertility and in assisted reproductive technologies, although its role in reproductive medicine is still debated. Aim: To review studies on acupuncture in reproductive medicine, in experimental and clinical settings. Methods: Papers were retrieved on PubMed and Google Scholar and were included in the review if at least the abstract was in English. Results: There is evidence of benefit mainly when acupuncture is performed on the day of embryo transfer (ET) in the live birth rate. Benefit is also evident when acupuncture is performed for female infertility due to polycystic ovary syndrome (PCOS). There is some evidence of sperm quality improvement when acupuncture is performed on males affected by idiopathic infertility. Experimental studies suggest that acupuncture effects are mediated by changes in activity of the autonomic nervous system and stimulation of neuropeptides/neurotransmitters which may be involved in the pathogenesis of infertility. Conclusions: Acupuncture seems to have beneficial effects on live birth rate when performed on the day of ET, and to be useful also in PCOS as well as in male idiopathic infertility, with very low incidence of side effects. However, further studies are necessary to confirm the clinical results and to expand our knowledge of the mechanisms involved.
J Endocrinol Invest. 2011 Feb 4.
Franconi G, Manni L, Aloe L, Mazzilli F, Giambalvo Dal Ben G, Lenzi A, Fabbri A.Endocrinology Unit, S. Eugenio and CTO Hospitals, Tor Vergata University, Roma, Italy. giovanna.franconi@uniroma2.it.
Decreasing bleeding due to uterine fibroid with electroacupuncture.
OBJECTIVE:To report the usefulness of electroacupuncture (EA) for the management of menorrhagia due to submucous uterine fibroid.
DESIGN:Case report.
SETTING:University hospital.
PATIENT(S):A 48-year-old woman with a symptomatic submucous uterine fibroid, who presented with severe menorrhagia.
INTERVENTION(S):Electroacupuncture.
MAIN OUTCOME MEASURE(S):Doppler ultrasonographic assessment of uterine blood flow and number of pads used during menorrhagia.
RESULT(S):Doppler ultrasound revealed decreased blood flow of the uterine artery with EA stimulation. With repetitive sessions of EA fewer pads were used during menorrhagia.
CONCLUSION(S):We present the first human case in which decreasing uterine artery blood flow with EA improved menorrhagia due to uterine fibroma. Electroacupuncture could be a useful, alternative, and relatively noninvasive tool for the management of fibroids with menorrhagia as a severe complaint.
Fertil Steril. 2011 Jul;96(1):e13-5. Epub 2011 May 11.
Cakmak YÖ, Akpınar IN, Yoldemir T, Cavdar S.
Acupuncture Program for Physicians and Department of Anatomy, School of Medicine, University of Yeditepe, Kayisdagi, Istanbul, Turkey.
Copyright 2011 XL Acupuncture Clinic, 杏林针灸诊所. All rights reserved.
4546 El Camino Real, B6
Los Altos, CA 94022
ph: 650 868 6632
XL