Gynaecology, Fertility and Obstetrics

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Peony lactiflora; The root is frequently used in gynaecology, particularly for cramping pain

Period Pain

Promising evidence supporting the use of Chinese herbal medicine for primary dysmenorrhoea

Thirty-nine randomised controlled trials involving a total of 3475 women were reviewed by researchers from the University of Western Sydney. However a number of the trials were of small sample size and poor methodological quality.

Dysmenorrhoea is a very common complaint that refers to painful menstrual cramps in abdomen. Primary dysmenorrhoea refers to pain of an unknown cause (i.e. no medical condition is identified). Nonsteroidal anti-inflammatory drugs or the contraceptive pill have been used successfully for treatment but more women are looking for non-drug therapies. Chinese herbal medicine has been used for centuries in China and it is currently used in public hospitals in China for the treatment of primary dysmenorrhoea. The review found promising evidence for the use of Chinese herbal medicine in reducing menstrual pain in the treatment of primary dysmenorrhoea, compared to conventional medicine such as NSAIDs and the oral contraceptive pill, acupuncture and heat compression. No significant adverse effects were identified in this review. However, the researchers say, the findings should be interpreted with caution due to the generally low methodological quality of the included studies.

Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005288. DOI: 10.1002/14651858.CD005288.pub3.

Acupuncture produces improvement in pain and other symptoms.

In an experiment into the effect of acupuncture on dysmenorrhea the benefits from treatment with acupuncture were 90.9% compared with sham acupuncture at 36%
In addition to a significant decrease in cramping pain, patients receiving ‘real’ acupuncture also reported improvements in symptoms such as;nausea, headache, backache, breast tenderness and fluid retention. At the 6 months follow up, a 41% reduction in analgesic medication was achieved with ‘real’ acupuncture, the other, control, groups reporting either no change or increased use of medication.
Helms J M (1987) Acupuncture for the management of primary dysmenorrhoea. Obstetrics
and Gynaecology Vol.69 No.1:51-56

Helps pain not responsive to pain killers.

A study has found that acupuncture can significantly help women who suffer period pain that does not respond to conventional non-steroidal anti-inflammatory drugs.

After 8 treatments average pain duration was reduced by well over half and average NSAID use was similarly significantly reduced and ceased totally in nearly half the patients who were still asymptomatic six months after treatment. (Acupuncture Treatment of Dysmenorrhea Resistant to Conventional Medical Treatment. Evid Based Complement Alternat Med. 2008 Jun;5(2):227-230.)

Infertility

Acupuncture and herbal medicine are frequently used for infertility. Jennie has a particular interest in this very rewarding area of practice and combines Western Medicine's understanding with Chinese medicine's insights and techniques.

It is usual to put the emphasis on herbal medicine although acupuncture has a particularly use with IVF treatment.

In 10 controlled studies using acupuncture as adjunctive to IVF there was considerable agreement in the results: the acupuncture groups show an increase in pregnancy rates of about 15% over the control. ARRC Briefing Paper November 2006.

As to the possible mechanism; various studies have found that acupuncture can affect hormone levels such as
oestrogens, progesterone, LH, FSH, cortisol, prolactin. It has a regulatory effect via â -endorphin on the
hypothalamus-pituitary-ovarian-adrenal axis.

Hot flushes

A Norwegian study has found that acupuncture can contribute to a reduction in menopausal hot flushes. The research was a pragmatic, randomised, controlled trial comparing the effect of individualised acupuncture plus self-care against self-care alone for hot flushes and health-related quality of life in 267 postmenopausal women. Hot flush frequency decreased by 5.8 per 24 hours in the acupuncture group and 3.7 per 24 hours in the control group. Hot flush intensity decreased by 3.2 units in the acupuncture group and 1.8 units in the control group. The acupuncture group also experienced statistically significant improvements in vasomotor, sleep, and somatic criteria compared with the control group. (The Acupuncture on Hot Flushes Among Menopausal Women (ACUFLASH) study, a randomized controlled trial. Menopause. 2009 May-Jun;16(3):484-93).

Male infertility

Acupuncture improves sperm motility

The first randomised, single‑blind, placebo‑controlled study of the effect of acupuncture in infertile men with severe oligoasthenozoospermia has shown that acupuncture can improve sperm motility. The German study, involving 29 men compared TCM acupuncture with placebo acupuncture. A significantly higher percentage of motile sperm was found after real acupuncture.(A prospective randomized placebo‑controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril. 2009 Apr 24.


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