Polycystic ovary syndrome (PCOS) is a syndrome characterized by excess androgen secretion manifested by hirsutism, ovarian dysfunction with or without polycystic ovaries. If you are here, it means that you have been actively searching for natural alternatives to treat PCOS as compared to the conventional oral contraceptives.
In this article, I have sourced the latest researches regarding acupuncture and PCOS. Although more clinical studies would be preferred, the current studies have already provided promising evidence regarding its efficacy and effectiveness. You can always book an appointment with me for a whole course of acupuncture to treat your PCOS. However, I always tell my patients that acupuncture takes time, and your diet and lifestyle plays an pivotal part in treating your PCOS. Compliance is essential.
Now let's go back to our main topic for today: PCOS.
Currently, the prevalence rate of PCOS among females in the reproductive period is 4– 12%. Among females with menstrual disorders, the rate rises to 37–90% [1]
What is acupuncture?
Acupuncture is a form of Traditional Chinese medicine (TCM) which stimulates specific points on the body known as acupoints to remove blockage of vital energy (Qi) flow. TCM views the body as a wholesome system which is regulated by proper flow of Qi flow. When flow is disrupted, illnesses start to occur. In this case, we limit the discussion to PCOS and reproductive endocrinology.
How does acupuncture helps with PCOS?
1) Increase B-endorphin
Previous studies suggested that PCOS patients display hypothalamic–pituitary–adrenal axis (HPA axis) abnormalities, resulting in anovulation due to disturbed feedback from the ovarian hormones to hypothalamus and pituitary gland. Gonadotrophin releasing hormone (GnRH) pulsatility is also disrupted with subsequent increase in Lutenizing Hormone(LH) to Follicular Stimulating Hormone(FSH) release.
A paper suggests two theories that may cause PCOS. One is insufficient central b-endorphin inhibition of GnRH while a second theory suggests PCOS is caused by elevated sympathetic tone in the ovaries leading to hormonal hyper-responsiveness [2].
The good news is..
Several studies have showed that acupuncture can significantly increase b-endorphin levels for 24 h after treatment [3]. This led the authors to suggest that acupuncture can also reduce stress and anxiety thus, decreases the HPA axis activity with subsequent increase in ovarian sympathetic tone to improve reproductive functions.
Acupuncture can possibly increase B-endorphin, helping to treat PCOS as well as reduce stress in PCOS patients.
2) Reduce ovarian androgens
Stener-Victorin et al. [4] summarized that if acupuncture needles were inserted in the same somatic segment of the ovary, oxytocin axis was stimulated, resulting in decreased release and secretion of ovarian androgens. In females with PCOS, it suggested an increased sympathetic nerve activity and an increased b-endorphin production or release.
3) Regulate hormonal balance
Takeshi et al. [5] found out that fifteen minutes after acupuncture stimulation, plasma levels of LH, FSH and oestradiol dropped while the progesterone level rose. After 30 min, the progesterone level begun to drop while the LH and FSH levels returned to normal levels. The progesterone level rose again and LH and FSH levels dropped after 60 min of stimulation, but oestradiol levels would also decrease. Authors therefore concluded that acupuncture can help regulate ovulation mechanism and/or ovarian luteal functions if properly performed.
4) Induce ovulation and regulate menstrual cycles
Gerhard and Postneek [6] performed an auricular acupuncture study in the treatment of female infertility where 45 infertile women suffering from oligomenorrhoea or luteal insufficiency were treated with auricular acupuncture. They were compared to another group of 45 women (control) who received hormonal treatment e.g. bromocriptine, dexamthasone, levothyroxine or clomiphene.
They found that women treated with acupuncture had 22 pregnancies, in which 11 after acupuncture, four spontaneous and seven after other additional medications of clomiphene or gonadotropin was given. Women treated with hormones had 20 pregnancies, 5 spontaneously and 15 by hormonal therapy. Four women of each group had spontaneous abortions.
Authors concluded that acupuncture was able to induce more physiologic regular menstrual cycles than those by hormone therapy which may also explain the lower abortion rate in acupuncture patients. Further results showed that acupuncture and electroacupuncture has little or no adverse effects in the study
In another study, Stener-Victorin et al. [7] investigated whether electroacupuncture could affect oligo-ovulation and/or anovulation and other related endocrine features in PCOS. The results showed that treatment with repeated electroacupuncture induce regular ovulations in more than 1/3 of the 24 women with PCOS. This suggests that acupuncture can be used to stimulate and regulate ovulation with repeated sessions of acupuncture without any reported adverse effects such as nausea and vomiting commonly associated with drug induction of ovulation.
Bottom Line
The current conventional medical treatment for patients with ovulatory disorders, whether or not they want to become pregnant, is prescription medications, surgery and lifestyle changes. However, there are many problems with current western therapies: the cost, risk of multiple pregnancies, undesirable side effects and inconsistent effectiveness. Therefore, natural therapies such as acupuncture has been on the rise in recent times, and with more clinical studies coming up, the verdict will soon be out whether acupuncture can help with PCOS. Meanwhile, why not book an appointment to treat your ovulatory disorders while waiting?
[1] Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. ‘‘The prevalence and features of the polycystic ovary syndrome in an unselected population.’’ J Clin Endocrinol Metab 2004;89:2745–2749.
[2] Marshall K. Polycystic ovary syndrome: clinical considerations. ‘Polycystic ovary syndrome: clinical considerations.’ Altern Med Rev 2001;6:272–292.
[3]. Chang R, Chung PH, Rosenwaks Z. ‘Role of acupuncture in the treatment of female infertility.’ Fertil Steril 2002;78:1149– 1153
[4] Stener-Victorin E, Jedel E, Mannera L, Lundeberg T. ‘‘Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.’’ J Neuroendocrinol 2008;20:290–298.
[5] Takeshi A, Toru M, Masayoshi M, Toshio N, Kaname K, Seiya K. The influence of acupuncture stimulation on plasma levels of LH, FSH, progesterone and oestradiol in normally ovulating women. Am Journal of Chin Med 1976;4:391–401.
[6] Gerhard I, Postneek F. Auricular acupuncture in the treatment of female infertility. Gynecol Endocrinol 1992;6:171–181.
[7] Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO. Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2000;79:180–8.