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Dr. Daniel Neides, Cleveland Clinic
LYNDHURST, Ohio--One patient encounter this year allowed me to really understand the inherent value in Eastern medicine practices – specifically acupuncture.
As I have mentioned before in this column, I attended medical school at THE Ohio State University, steeped in a Western medicine practice known as allopathic medicine. Any exposure to Eastern practices that would complement my training was limited. Which brings me back to my original point (pun intended – remember acupuncture).
The patient was a 36-year-old woman who I have cared for over the last several years. We had discussed concerns about infertility after she had previously met with her OBGYN. They had discussed hormonal therapy to try and induce ovulation but she did not want to put any type of medication into her body. She wanted to know if there were alternative or integrative approaches to hormones to assist with her desire to get pregnant.
Having looked at several studies on acupuncture and infertility, I offered the patient an opportunity to work with one of our acupuncturists. After several months of treatment, she stopped me in the hallway and almost jumped into my arms. She was pregnant and was so thankful that I had respected her concerns about hormonal therapy and that I found an integrative approach that worked for her.
For more than 3,500 years, acupuncture has been providing relief to people around the world. Originally developed and practiced in China, this soothing therapy is today embraced by all patients who seek to alleviate symptoms caused by ailments that range from arthritis to migraines to the aftereffects of chemotherapy. It has even been proven effective in helping people stop smoking.
Acupuncture draws on the belief that an energy called Qi (pronounced "chee") circulates throughout our body, from the top of our head to the soles of our feet. When we experience good health, this energy flows unobstructed along pathways in the body called meridians. Each meridian is believed to be connected to a specific organ system, and when an energy flow is disrupted by a disease or an injury, illness or pain occurs. Acupuncture is then used to balance the flow of Qi and stimulate our body's natural ability to heal.
Acupuncture treatments involve placing hair-thin needles of varying lengths into certain areas of the skin. The number of slender needles – as few as three, as many as 20 – and the length of time they are kept in place depends on the ailment being treated. During the treatment, the needles may be twirled, warmed or electrically energized to intensify healing effects. Sessions with the acupuncturist take up to 60 minutes. Patients lie on a padded table, and soothing music, which allows for deep relaxation, plays in the background. Some patients may feel an electrical sensation during a treatment, which is good – that means healing energy is moving through the body.
How does acupuncture work to provide relief for so many painful conditions, you ask? Most acupuncture points are near nerves. When stimulated, the point sends a message along the nerve to the brain and spinal cord. This causes the release of serotonin, dopamine and endorphins – chemicals our own body produces that alter or eliminate the message of pain being delivered to the brain. The release of these "feel-good" mood-regulating chemicals makes people feel better physically and emotionally. And when someone's emotional outlook improves, their quality of life improves. Clinical studies have shown that acupuncture bolsters the body's nervous and endocrine (glandular) systems, and has an anti-inflammatory effect. And for my faithful readers, you know how much I preach about lowering inflammation to reverse disease. Acupuncture decreases the inflammation associated with different diseases and relieves muscle spasms and strain.
The World Health Organization endorses acupuncture, and clinical studies have shown it to be a beneficial treatment for many conditions, including chronic pain - migraines, neck and back pain, tendonitis, sciatica, carpal tunnel syndrome, fibromyalgia and rheumatoid arthritis. Digestive disorders like irritable bowel syndrome, colitis, gastritis and constipation can be alleviated with acupuncture.
This practice has become a popular alternative for women's health issues like menstrual cramps, irregular or heavy periods, infertility and menopausal symptoms.
I have referred patients with emotional disorders like depression, anxiety, stress and insomnia for acupuncture – and have seen great success. Many of my oncology colleagues will refer patients for acupuncture to assist in reducing adverse reactions to chemotherapy, including fatigue, generalized pain, dry mouth, peripheral neuropathy, nausea and vomiting.
Acupuncture can also be a helpful tool in treating addictions to nicotine, alcohol, drugs, and food. When coupled with diet and exercise, acupuncture can be very helpful in decreasing one's appetite, allowing for intended weight loss.
I think it is important to remind ourselves that acupuncture is not intended to replace Western medicine practices. My practice is a "bridge" between the best of Western and Eastern practices. Acupuncture and traditional medicine complement one another. In many instances, patients appreciate that integrative medicine like acupuncture can work as an adjunct to a traditional treatment plan. Going back to my original example, my patient who used acupuncture to conceive will now see my colleague trained in allopathic medicine for her prenatal care and eventually delivery. For me professionally, this is a beautiful complement between two very different practices of medicine.
I am so blessed to have learned from and have access to some of the most talented integrative medical professionals in the United States. If you or a loved one suffers from any of the conditions listed above, consider a consult with me!
New research from the University of Maryland School of Medicine concludes that acupuncture increases pregnancy rates for women receiving IVF at medical clinics that otherwise have low success rates with the fertility procedure. The study was a systematic review of 16 clinical trials with a total of 4,021 subjects. Acupuncture was compared with IVF as a standalone treatment and also with IVF combined with simulated-sham acupuncture. The researchers discovered some very interesting results.
Across the 16 separate and independent clinical trials, acupuncture was successful in increasing pregnancy rates in clinics with a lower than 32% IVF success rate. On the other hand, acupuncture did not enhance the IVF procedure in clinics wit a higher than 32% success rate. Lead author Eric Manheimer notes that this may be due to the fact that acupuncture and other fertility enhancement procedures have a lessened clinical value for IVF when the pregnancy rates are already high. The study concludes that in cases where pregnancy rates are low, acupuncture offers a significant clinical benefit to those receiving IVF by increasing the pregnancy rate.
Another recent study concludes that acupuncture and moxibustion significantly increase pregnancy rates for women receiving IVF fertility treatments. The study investigated infertile women who had at least 2 unsuccessful IVF fertility treatments. True acupuncture, sham acupuncture and a control group were compared. The acupuncture group showed a significantly higher clinical success rate the IVF procedure than both the sham acupuncture and control groups. The acupuncture group had a 35.7% success rate whereas the sham group had a 10.7% success rate and the control group had a 7.1% success rate. These findings are consistent with the University of Maryland Study in that acupuncture has been shown to significantly increase IVF success rates for individuals and clinics with a prior history of failed IVF procedures respectively.
This second study investigated both acupuncture and moxibustion for the enhancement of IVF success rates. Acupuncture points on the Conception Vessel, Governing Vessel and Urination Bladder Channel were chosen: UB18, UB22, UB23, UB52, CV3, CV4, CV5, CV7 and GV4. Acupuncture needling was administered on the first and seventh days during which ovulation was medically induced. Acupuncture was also administered on the day prior to medical intervention of the ovary and on the day after the embryo transfer.
Yet another study presented conclusive evidence showing that acupuncture is more effective than clomifene (Clomid, Omifin) for the treatment of infertility. Acupuncture had a 76.8% success rate for the induction of ovulation and clomifene demonstrated a 48.1% success rate. More than this, an important study discovered that acupuncture increases live birth rates. Women receiving IVF treatments had significantly higher live birth rates if acupuncture was applied on the day of embryo transfer. Researchers from the University of Washington (Seattle), Oregon College of Oriental Medicine (Portland) and the Northwest Center for Reproductive Sciences (Kirkland, Washington) applied acupuncture prior to the IVF procedure to GV20, CV6, ST29, SP8, P6, and LV2 along with auricular points: uterus, endocrine, shenmen, brain. Afterwards, acupuncture points LI4, SP10, ST36, SP6 and K3 were applied along with the same auricular points. Notably, prior to IVF the uterus and endocrine points were applied to the right ear and the shenmen and brain auricular acupuncture points were applied to the left ear. After the IVF procedure, the auricular points were applied to the opposite ears.
Another study study also concluded that acupuncture increases live birth rates for women who get IVF treatments. Scientists sought to measure the histological mechanisms by which acupuncture exerts its effective action. They were successful in discovering that acupuncture increases blood and embryo levels of HLA-G, a protein that is predictive of higher pregnancy and live birth rates when in higher concentrations. It is important to note that this biochemical research concluded that acupuncture increased both pregnancy rates and live birth rates.
At Health On Point we offer supporting treatments to complement your reproductive care. Mention today's article and receive a 30% discount on herbal teas that benefit moms to be!
References:
Manheimer, Eric, Daniëlle van der Windt, Ke Cheng, Kristen Stafford, Jianping Liu, Jayne Tierney, Lixing Lao, Brian M. Berman, Patricia Langenberg, and Lex M. Bouter. "The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis." Human reproduction update (2013).
di Villahermosa, Daniela Isoyama Manca, Lara Guercio dos Santos, Mariana Balthazar Nogueira, Fabia Lima Vilarino, and Caio Parente Barbosa. "Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial." Acupuncture in Medicine (2013).
Journal of Acupuncture and Tuina Science, 2012, 10(2), R246.3. Teng Hui, Liu Yu-lei, Wang Jun-ling, Xie Ying. Department of Traditional Chinese Medicine, Shenzhen Maternal and Child Healthcare Hospital, Guangdong, China.
Johansson, Julia, et al. "Acupuncture for ovulation induction in polycystic ovary syndrome: A randomized controlled trial." American Journal of Physiology-Endocrinology And Metabolism (2013).
New research demonstrates that acupuncture reduces both depression and anxiety in women with PCOS, polycystic ovarian syndrome. The researchers hailed from State University of New York, University of Gothenburg and the Heilongjiang University of Chinese Medicine. The findings show that acupuncture helps with the emotional component of PCOS. Overall, the researchers note that acupuncture improved the health related quality of life for the patients. Scores for social functioning, energy and vitality, and general health improved for the patients receiving acupuncture. In addition, the control group did not show any improvements in anxiety and depression, however, the acupuncture group showed significant improvements.
Acupuncture was applied 2 times per week for 2 weeks followed by 1 time per week for 6 weeks and another session of 1 acupuncture treatment every other weeks for 8 weeks. The total was 14 acupuncture treatments over a period of 16 weeks. Acupuncture points were selected on the abdomen, lower leg, hand and arm, bilaterally. Manual stimulation and electro-acupuncture were applied to the needles. All patients received the same acupuncture point prescriptions for their treatments.
In a related study, acupuncture successfully induced ovulation in women with PCOS. Acupuncture successfully normalized sex steroid and hormone levels while simultaneously increasing ovulation frequency. In yet another study, electro-acupuncture and manual acupuncture were shown to “improve menstrual frequency and decrease circulating androgens in women with polycystic ovary syndrome (PCOS).” Moreover, the electro-acupuncture group demonstrated effects in the central brain opioid receptors indicating that electroacupuncture may be “mediated by central opioid receptors….” The manual acupuncture group showed changes in brain steroid receptors indicating that acupuncture “may involve regulation of steroid hormone/peptide receptors.”
References:
Stener-Victorin, Elisabet, Göran Holm, Per Olof Janson, Deborah Gustafson, and Margda Waern. "Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: Secondary analysis from a randomized controlled trial." BMC Complementary and Alternative Medicine 13, no. 1 (2013): 131.
Journal of Acupuncture and Tuina Science, 2012, 10(2), R246.3. Teng Hui, Liu Yu-lei, Wang Jun-ling, Xie Ying. Department of Traditional Chinese Medicine, Shenzhen Maternal and Child Healthcare Hospital, Guangdong, China.
Johansson, Julia, et al. "Acupuncture for ovulation induction in polycystic ovary syndrome: A randomized controlled trial." American Journal of Physiology-Endocrinology And Metabolism (2013).
Electrical and manual acupuncture stimulation affects estrous cyclicity and neuroendocrine function in a DHT-induced rat polycystic ovary syndrome model. Yi Feng1,2, Julia Johansson1, Ruijin Shao1, Louise Mannerås Holm1, Håkan Billig1, Elisabet Stener-Victorin1,3 . Experimental Physiology. DOI: 10.1113/expphysiol.2011.063131.
Numerous studies have suggested that acupuncture may reduce pain, aches, tension or stress. Now, a report from the University of Gothenberg, Sweden, has determined that the ancient alternative remedy may partially treat women with polycystic ovarian syndrome (PCOS).
A study published in the American Journal of Physiology – Endocrinology and Metabolism found that four months of acupuncture treatment combined with electrical stimulation reduced the levels of testosterone in women with PCOS by 25 percent.
The syndrome is the most common cause of infertility in women, according to the Centers for Disease Control and Prevention.
The authors of the study estimated that PCOS affects 10 percent of women in the U.S. A hormone imbalance, the syndrome results in high levels of male hormones, particularly testosterone, making it difficult for a woman to conceive and causing side effects like obesity, acne and irregular menstruation.
The Swedish team found that a low-level electrical current run through acupuncture needles appeared to stimulate muscles in a way similar to exercise. Indeed, groups separately treated with exercise or acupuncture both experienced improvements in weight, testosterone levels, acne and menstrual regularity.
Full abstract (pdf format) available online here. At Health On Point we can support your fertility needs with acupuncture, lifestyle counseling and supplementation if needed. For additional information please call or email.
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