Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief, Fatigue.
Based at Harley Street and Kensington Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.

About Me

My photo

My specialised areas include fertility, facial rejuvenation, acne, vulvodynia, various pain conditions, chronic fatigue, neurological conditions, digestive problems

Practice contact for appointments and addresses 

Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: for appointments  at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at info@aloclinic.com
Address
Suite 3 Harmont House
20 Harley Street, London W1G 9PH
5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor 25 years ago in Western medicine  in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Ji-sheng Han famous professor and neuroscientist in China and with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. Also I had training in fertility and had research experiences in uterine smooth muscles and blood vessels in China and the UK. I am dedicated to treat patients with acupuncture and am recognised as one of the world leading acupuncture specialists.

I obtained a PhD degree in the University of Leeds in the UK.
I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.
I had frequently presented my research findings in the top international conferences in the field.
I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practising, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, bladder pain, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, nerve pain, chronic prostatitis, insomnia, Parkison's disease, MS, acid reflex, IBS etc to achieve best treatment results. 

My devotion and skills are highly praised by my patients. 

My eBooks

Facial acupuncture Facial rejuvenation Acne treatment
Know your ovary to get pregnant
Know fertility and acupuncture to get pregnant
Vulvodynia, is vulval pain in your mind
Energy fatigue and acupuncture
Headaches, Neck pain and shoulder pain

Saturday, 29 December 2012

Which types of ovarian cysts can acupuncture treat?

Ovarian cysts are small fluid-filled sacs that develop in ovaries. Most of the cysts are harmless. Some of the cysts may cause bleeding and pain. There are two types of cysts: functional cysts (simple cysts) and pathological cysts. Functional cysts include folicular cysts, corpus luteum cysts. Pathological cysts include dermoid cysts and cystadenoma cysts. See http://www.amazon.com/Know-Your-Ovary-Get-Pregnant-ebook/dp/B00P4K5AUQ

Polycystic-apppearing ovary is enlarged ovary with small cysts present around the outside of the ovary. These cysts can be found in healthy women or women with polycystic ovarian syndrome.

The cysts develop if there is hormone imbalance. Acupuncture can reduce the functional ovarian cysts by correcting imbalance and restoring hormone harmony.

Success story of ovarian cysts treated with acupuncture
Sarah was 25 year old. She was suffering from lower tummy pain and lower back pain for a year, the pain was getting worse for recent 6 months. She also had period pain. She had painful intercourse. Sometimes she felt bloated. She went to see doctor. Ultrasound scan found that there were a few small cysts from 2 cm to 4 cm in her ovaries. Also she was diagnosed with endometriosis. She was told that the ultrasound scan will be repeated in a few months time; if the cysts grow larger, they have to be removed by surgery. She was so upset, but she decided to do something rather than waiting. She started acupuncture treatment. At the same time she changed her diet. After a few acupuncture treatments she felt much less pain on the tummy and back. There was no intercourse pain. After 5 month acupuncture treatment, there was no sign of ovarian cysts on the ultrasound scan. All ovarian cysts were disappeared.

Thursday, 20 December 2012

Chronic cough, acupuncture can help

Persistent coughs caused by mild chest infections were not benefit from antibiotic treatment. There was a study led by Prof Paul Little from the University of Southampton about antibiotic treatment for patients with persistent cough lasting more than 28 days. This study including about 2000 patients across European countries showed that the severity and duration of symptoms in these patients treated with antibiotics were no different to those given a sugar placebo. Unless pneumonia is suspected, using antibiotic to treat some respiratory infections is not helpful and could cause harm such as developing resistance and other side effects including diarrhoea, rash and vomiting. Most of mild chest infections are mainly caused by viruses which are not responding to antibiotic treatment. These infections will settle by themselves. This is because body defence system will fight against virus infection and eventually get rid of those viruses.

Do you know acupuncture can help chronic cough condition? Patients with such condition have difficulty to fight off virus infections, because their body defence system is relatively weaker. Acupuncture can strength body defence system by stimulating particular acupuncture points. As a result, this will reduce the severity of the symptoms, shorten the duration of the illness and help recovery from the chronic infection condition.

Acupuncture is effective for COPD

Chronic obstructive pulmonary disease (COPD) is one of the most common disorders and one of the most common causes of death worldwide. Chronic obstructive pulmonary disease (COPD) is a general term of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have difficulties breathing, primarily due to the narrowing of their airways. Irreversible airflow limitation in COPD is caused by damage to the airways and lung tissue. COPD is usually caused by smoking. Symptoms include cough with phlegm and breathlessness which is increasing when active. There are also frequent chest infections. These symptoms are progressing over time. Respiratory failure or right heart failure may occur in the end. The main aims of the treatments are to reduce symptoms, to prevent symptoms worsening, preserve lung function and improve daily quality life. The most important treatment is to stop smoking. Inhalers are commonly used to ease symptoms. Other treatments such as steroids, antibiotics, oxygen, and mucus-thinning (mucolytic) medicines are sometimes prescribed in more severe cases, or during a flare-up (exacerbation) of symptoms. Acupuncture is used in treating COPD in China. Clinical data to date suggest that acupuncture may be an effective treatment which contributes to medical care for COPD. Acupuncture reduces inflammation in respiratory system and improves mucus clearance.

For example, there was a case series study from Japan for COPD. There were 26 patients with COPD presenting with breathlessness on exertion due to COPD. All of these patients received acupuncture treatments once a week for 10 weeks plus standard medication treatments. At the end of 10 week acupuncture treatments all 26 patients showed significant improvement with reduced breathlessness on exertion. They suggested that acupuncture treatment is a useful treatment for patients with COPD.

A recent study is investigated the regulatory effects of acupuncture on exercise tolerance in patients with COPD at stable phase. Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The acupoints used were Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and so on. The total treatment period is 5 weeks. The exercise tolerance is measured by various methods including 6-min walking distance (6-MWD), exercise time, maximum oxygen uptake (VO2max) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), maximum ventilatory volume (MVV), St. George respiratory questionnaire (SGRQ). The results have shown that (1) exercise tolerance: the differences of 6-MWD and exercise time were statistically significant between groups, which were more superior in the treatment group; the VO2max was significantly increased after treatment in the treatment group. (2) Pulmonary ventilation function: the differences of FEV1%, FEV1/FVC and MVV% were statistically significant between groups, which were more superior in the treatment group. (3) SGRQ: the SGRQ was significantly improved after treatment in the treatment group (P<0.05), but there was no difference between two groups. This study suggested that the acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase, and shorten the onset time of aerobic exercise. Besides, acupuncture combined with aerobic exercise could effectively improve the pulmonary function.

Coyle ME et al analysed the effectiveness of acupuncture on COPD using existing studies. By analysing 16 clinical trials they found that the acupuncture therapies used in these studies improved health-related QoL. The team's conclusions, comparing results from the interventions with placebo, were based on data from 3 questionnaires that the studies used: (1) the St George's Respiratory Questionnaire (SGRQ), with a mean difference (MD) of -8.33 units (95% CI, -13.13 to -3.53); (2) dyspnea on the Medical Research Council's (MRC's) dyspnea scale, with an MD of -0.34 units (95% CI, -0.38 to -0.30); and (3) the Dyspnea Visual Analogue Scale (DVAS), with an MD of -8.85 mm (95% CI, -11.81 to -5.89). Compared with placebo, acupuncture therapies also increased the distance walked in 6 min (6MWT), with an MD of -28.14 (95% CI, 23.92 to 32.36) compared with placebo. No benefit was seen on measures of lung function when acupuncture therapies were compared with either placebo or drug therapy. They concluded that acupuncture therapies may result in clinically important improvements in QoL and dyspnea.

References

http://www.bbc.co.uk/news/health-20767470

Suzuki M Acupunct Med (2012) 30:96-102

Acupuncture improves exercises tolerance in patients with COPD

Tong J et al Zhongguo Zhen Jiu (2014) 34:846-50

Coyle ME et al (2014) Altern Ther Health Med 20:10-23

Tuesday, 4 December 2012

Morning sickness, a condition in pregnancy

When a woman is pregnant, she needs to be taken extra care: for example about what medicines to take which might be different from when she is not pregnant. How about using complementary and alternative therapies? There was a report by Stewart et al about healthcdare professional views and experiences of complementary and alternative medicine (CAM) therapies in obstetric practice in North East Scotland. They conducted a survey about the use of CAM therapies by UK healthcare professionals for pregnant women. The participants include midwives, obstetricians, and anaesthetists. 32.5% of the respondents had recommended (prescribed, referred or advised) the use of CAMs to pregnant women. The most frequently recommended CAM therapies were vitamins and minerals (excluding folic acid) 55%; massage 53%; homeopathy 50%; acupuncture 32%; yoga 32%; reflexology 26%; aromatherapy 24% and herbal medicine 21%. Midwives who had been in post for over 5 years, had received training in CAMs, were interested in CAMs and were themselves users of CAMs were more likely to recommend CAMs. Those who recommended CAMs were 8 times more likely using CAMs themselves.

Some NHS hospital hospitals provide maternity acupuncture service for paitents. Their survey of patient attitude to the maternity acupuncture service showed that 90% of patients were satisfied greatly about the maternity acupuncture service; 69% of women said that they were benefited from acupuncture and 65% said their wellbeing had significantly improved with acupuncture service; 88% said that presence of this service at the Whttington would ensure that they would preferentially re book at the Whitttington Hospital in future pregnancies rather than any other local hospital. From the back pain treatment 53% improvement in their symptoms was reported which provided pilot data for a research application and complies with the NICE recommendations for back pain.

Effect of acupuncture on nausea and vomiting in pregnancy

Up to 90% of pregnant women experience nausea and vomiting. Hyperemesis gravidarum is an extreme end of hyperemesis or morning sickness which is prolonged and severe nausea and vomiting in pregnancy. One of the main dangers of this condition is dehydration. Women with hyperemesis gradidarum could be constantly nausea and vomiting many times a day and it is difficult to keep fluids within the body. It could cause lot of weight loss, electrolyte imbalance and blood volume depletion. This condition is caused by hormone in pregnancy and is improved when the hormone levels go down as pregnancy turns to 13 weeks. Sometimes it could continue throughout of pregnancy. This condition is not likely to cause any harm to the baby. But there is a risk of the baby being born with a low birth weight if there is a significant weight loss during the pregnancy. Intravenous fluids and medication are used to control the vomiting and nausea.

Foods in rich carbohydrates and low fat and acid are recommended. Recommended foods include Light snacks, nuts, dairy products, beans and dry and salty biscuits. Electrolyte-replacement drinks and taking nutritional supplements are beneficial for maintenance of electrolyte balance and sufficient calories. Intake of food rich in protein is recommended. Use of ginger and vitamin B6 are effective though there is limited evidence.

Acupuncture was used in China to treat morning sickness. Carisson CP et al from University Hospital, Lund Sweden conducted a randomized placebo controlled trial to study the effect of acupuncture in treating morning sickness. Acupuncture treatments were given three times daily on treatment days. Each treatment lasted for 30 minutes. Acupuncture point PC6 was selected. Women in the acupuncture group had significantly quicker decrease in the amount of nausea they experienced compared with the placebo control group. There was also a significant difference in the amount of vomiting between the acupuncture and placebo groups. In acupuncture group there were fewer patients vomiting. There was no significant difference of food intake between the two groups. There were no side effects observed. The possible mechanisms for the acupuncture inhibiting nausea and vomiting include that acupuncture inhibits nociceptive transmission and autonomic reflexes; acupuncture decreases pain in the system; acupuncture has effect on gastric intestine tract; the effect of acupuncture is through somatovisceral reflexes.

Acupuncture releases pain in late pregnancy without serious side effects

Pain in the pelvic and low back areas during pregnancy is very common and sometimes serious. Up to about 70% of pregnant woman have pelvic and/or low back pain which often increases progressively during pregnancy. Pain is often left insufficiently treated because of fear of using pain killers during pregnancy. Acupuncture was found to reduce pelvic pain and low back pain with little side effects. Recently Nina Knoening et al from Malmo University Hospital, Malno Sweden studied the effect of acupuncture on pelvic pain and low back pain in patients in later pregnancy. 72 Pregnant women with pelvic low back pain during pregnancy weeks 24-37 were randomly allocated in acupuncture group (37 patients) and in control group (35) patients. The acupuncture points used included LR3, GV20 and local tender points initially. If the response was not enough, BL60, SI3 and BL22-26 points were selected. Acupuncture was received by the patients once or twice a week until delivery or completely recovery for acupuncture group. No acupuncture was received for control group. During the study period, the pain intensity was decreased 60% in acupuncture group which was significantly greater than that for the control group 14%. At the end of study, 43% patients in acupuncture group were less bothered by pain which was significantly greater than for the control group 9%. No serious side effects were found in the patients and no adverse effects were found in the infants. The authors suggested that acupuncture could release [elvic pain and low back pain without serious side effects in late pregnancy.

Acupuncture for labour pain

After months of anticipation, your baby will due. When will the labour begin, no one knows. The due date calculated is only a reference point and normal labour begins anytime between 2 weeks before the due date and 2 weeks after the due date. If you are in labour, you will be experiencing pain. The amounts of pain women are experiencing vary. Women can manage their pain wit breathing and relaxing techniques; some of them need take pain killers. Acupuncture is used to relieve pain in labour. There are many reports that show the effectiveness of acupuncture on labour and labour pain. For example, Liu YL and Jin ZG studied the effects and safety of electroacupuncture at SP6 point on labour pain. They recruited 111 cases. They found that in electroacupuncture group with acupuncture on SP6 point, the active phase of the first labour stage was shorter than that in the non treatment control group and sham acupuncture group. Ma W et al studied the effect of electroacupuncture on labour pain in women during labour. 350 women in labour in three different hospitals were randomly divided into three groups: acupuncture group, sham acupuncture group and control group. The acupuncture point was at SP6. The pain scores from women in acupuncture group were less than in the control group at needle retaining at 30 min, as well as 2 hour and 4 hour after needle withdrawal. No side effects were observed during labour process. Their concluded that acupuncture at SP6 could reduce pain in labour.

Acupuncture and acupressure at acupoint LI4 relives labour pain. Peng T et al conducted a clinical study on the effect of on transcutaneous electrical nerve stimulation (TENS) reliving labour pain. They used TENS on four acupoints Hegu (LI4), Neiguan (PC6), Danshu (BL19) and WEishu (BL21) for reducing pain in labour. They found that pain in TENS group was significantly decreased compared with control group. The incidence of postpartum hemorrhage in the TENS treatment group was less than the control group. There was no side effect recorded in TENS on acupoints. Hamidzadeh A et al studied acupressure on LI4 acupoint on reducing labour pain by conducting a randomized controlled trial. There were 50 women in the acupressure group received LI4 point acupressure and 50 in controlled group received touch at LI4 acupoint without pressure. There were significant differences between the groups in labour pain score immediately and 20, 60, and 120 minutes after intervention. Active phase duration (3-4 cm dilatation to full dilatation) and second stage duration (full dilatation to birth) in labour were shorter in the acupressure group. The women in the acupressure group reported greater satisfaction. No side effect was reported. LI4 acupoint is an important acupoint for relieving labour pain.

Acupuncture treatment for depression during pregnancy

Manber et al in Stanford University in USA conducted a randomized controlled trial to investigate the efficacy of acupuncture in treating depression during pregnancy. 15 pregnant women who were diagnosed depression. The diagnosis met the criteria “Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) critieria for major depressive disorder. They were divided into three groups: specific acupuncture for depression group (52 patients), control non specific acupuncture group (49 patients) and massage group (49 patients). The treatments lasted 8 weeks with 12 sessions. Result showed that women who received acupuncture specific for depression had a greater rate of decrease in symptom severity and a greater response rate compared with the control groups (nonspecific acupuncture and massage groups). There was no significant difference between non specific acupuncture and massage groups. Their conclusion is that the short acupuncture in symptom reduction and a response rate for depression is comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.

Moxibustion at BL67 acupuncture point helps turn foetus around

Babies born in a breech position, the unfavoured position have an increased risk of birth complications. To minimise these risks, caesarean section deliveries have increased which results in health risks to the mother and baby and increased costs to health services. Strategies to promote normal birth are encouraged. Moxubustion at acupuncture points were used as one of the methods to correct foetal breech position. Recently Vas J et al reported a clinical trial of correcting foetal breech position to evaluate the conventional acupuncture point BL67 compared with SP1. There were 406 low-risk pregnant women with a fetus in breech presentation confirmed by ultrasound. The gestational age was range 33-35 weeks. These women were allocated into three groups: moxibustion at point BL67 plus usual care, moxibustion at SP1-a non specific acupuncture point plus usual care and usual care group alone. The results showed that 58.1% of the full-term presentations were cephalic (the correct position of birth) in moxibustion at point BL67 group, the highest in the three groups. There were no severe adverse effects found during the treatments. From this study, the authors concluded that moxibustion at acupuncture point BL67 is effective and safe approach to correct foetal breech position used between 33-35 weeks of pregnancy.

Reducing obesity is beneficial for pregnancy

Obesity is a major health problem. A recent survey showed that about a fourth of population is obese. About 50% of women in reproductive age are either overweight or obese. Obesity increases risk of maternal and fetal complications. About 20-40% women gain excessive weight during pregnancy. The maternal complications linked to obesity include miscarriage, hypertension, gestational diabetes, infection, caesarean section, instrumental and traumatic deliveries, wound infection and endometriosis. The fetal risks related to maternal obesity include stillbirths, neonatal deaths, preterm birth, congenital abnormalities and childhood obesity etc. Weight management during pregnancy need to have extra care, because reduction in weight gain or weight loss may be beneficial, but the weight loss itself or the interventions may potentially harm to the mother or bay. To evaluate the effectiveness of dietary and lifestyle interventions in reducing or preventing obesity in pregnancy and assess the beneficial and adverse effects of the interventions on obstetric, fetal and neonatal outcomes, Thagaratinam S et al did a systematic review. They searched database from 1950 to March 2011. There were 88 studies involving 182139 women. They found that weight management interventions in pregnancy significantly reduced hypertension during pregnancy and gestational diabetes. It also reduced preterm birth and should dystocia. Adverse effects were low. They concluded that weight management reduced weight gain during pregnancy. Dietary interventions were the most effective way to reduce weight gain in pregnancy and the risk of gestational hypertension and diabetes and shoulder dystocia. There were no adverse effects from dietary management.

References
Thangaratinam S et al Health Technol Assess (2012) 16:1-192
Nina Knoening et al Ata Obstet Gynecol Scand (2004) 83:246-250
Carisson et al J Pain Symptom Manage (2000) 20:273-9
Peng T et al Chin J Integr Med (2010) 16:234-8
Hamidzadeh A et al J Midwifery Womens Health (2012) 57:133-8
Liu YL and Jin ZG Zhongguo Zhen Jiu (2012) 32:409-12
Ma W et al Complement Ther Med (2011) 19 Suppl 1:S13-8
Manber R et al Obstet Gynecol (2010) 115:511-20
Vas J et al Acupunct Med (2013) 31:31-8
BJOG (2014) Feb11 doi:10.1111/1471-0528.12618
http://www.whittington.nhs.uk/default.asp?c=4243

Wednesday, 14 November 2012

Sperm DNA damage could be the cause for couples with unexplained infertility and miscarriage

Sperm DNA fragmentation is related to infertility

Male fertility is evaluated by sperm count, motility and morphology. This becomes a part of routine semen analyses. The basic semen analysis may provide useful information regarding male fertility potential. Sperm concentration, motility and morphology have been correlated with fertilization rates as a result of normal development during sperm production in the testes, normal maturation in epididymis and normal seminal plasma constituents. Abnormal sperm quality has been linked to several infertility problems. In certain cases, the initial semen examination can reveal some radical forms of sperm dysfunction, eg. azoospermia or globozoospermia that have serious negative consequences to natural conception. However limitations still exist in finding a cause of male infertility and a normal sperm parameter does not necessarily guarantee satisfactory fertilizing potential. An estimated 15% of men with normal basic semen analysis profiles have nonetheless been associated with infertility. A specialised test of sperm is checking sperm DNA damage measured by DNA fragmentation which may be linked to negative clinical outcomes. Recently there has been growing interest in the use of DNA integrity as a marker of male infertility.

DNA damage may exert its effect at different stages of the reproductive procedure, beginning from the pre-implantation development of the embryo to the achievement and sustaining of pregnancy and finally the creation of healthy offspring. An inverse relationship has been reported between the likelihood of achieving pregnancy either by natural intercourse or by application of ART and the presence of high sperm DNA fragmentation levels. Men with abnormal semen parameters have a higher risk of high levels of DNA fragmentation. Men with infertility have increased levels of fragmented sperm DNA and vice versa. Abnormal chromosome rate which triggers DNA fragmentation is higher in poor quality sperm samples. Research has shown that Sperm nuclear DNA fragmentation has been positively correlated with lower fertilization rates in IVF, impaired implantation rates, an increased incidence of abortion and disease in offspring. For example, a study investigated correlation of fertilization rate with sperm DNA fragmentation in A 85 couples undergoing infertility treatment with IVF/ICSI. The result has shown that fertilization rate was inversely correlated with DNA fragmentation. In addition, the slower embryo development and worst morphology on day 6 was correlated with higher sperm DNA fragmentation. There was a negative correlation between DNA fragmentation and the implantation rate. Analysis from a study including 2969 couples has shown that there was a significant increase in miscarriage in patients with high DNA damage compared with those with low DNA damage.

As mentioned above, sperm DNA damage is a useful biomarker for male infertility diagnosis and prediction of assisted reproduction outcomes. It shows more promise than conventional semen parameters from a diagnostic perspective. Another recent study has shown that it is associated with reduced fertilization rates, embryo quality and pregnancy rates, and higher rates of spontaneous miscarriage and childhood diseases; A study involved in 2,756 couples, 965 pregnancies has also shown that high-level sperm DNA fragmentation has a detrimental effect on outcome of IVF/ICSI, with decreased pregnancy rate and increased miscarriage rate. The analysis by type of procedure (IVF vs. ICSI) indicated that high sperm DNA damage was related to lower pregnancy rates in IVF but not in ICSI cycles, whereas it was associated with higher miscarriage rates in both IVF and ICSI cycles.

Sperm DNA damage is often the result of increased oxidative stress in the male reproductive tract, the potential contribution of antioxidant therapy. Do you know that acupuncture improves sperm quantity and quality? Acupuncture could reduce oxidative damage and is a potential useful therapy to treat sperm DNA damage.

References

Muriel et al Fertil Steril (2006) 85:371-83

Robinson et al HumRepord (2012) 27:2908-17

Zhao et al Fertil Steril (2014) 102:998-1005

Tuesday, 13 November 2012

Gynaecological pain, acupuncture can help

Gynaecological pain, acupuncture can help

Chronic pelvic pain (CPP) is recurrent or constant pain in the lower abdominal region that has lasted for 6 months or more. CPP can be caused by many conditions and the symptoms are similar and nonspecific. CPP is a common disorder with 3.8% population occurrence and it is as high as 40% in women with infertility. CPP is a heavy burden in women of reproductive age, with a direct affect of their quality of life. The treatment is focusing on identifying underlying cause and treatment. If there is no underlying cause identified, pain management is essential.

Gynaecological pain

Inflammation and injury can be a problematic for internal organs. The organs become highly sensitive to any stimulation and pain sensation is very common. In women pain associated with their reproductive system is prevalent, such as period pain, labour pain etc. There is a particular sensory receptor that responds to potentially harmful stimuli by sending nerve signals to the spinal cord and brain. The receptors respond not only to intense mechanical stimuli such as distension and overstretching but also to irritant chemicals especially to the products of inflammation. They are very important in signalling pain from inflamed area. The uterus, cervix and adnexa share the same visceral innervations as the lower ileum, sigmoid colon and rectum. Signals from these organs pass through the sympathetic nerves to spinal cord segments T10-L1. Because of the shared pathway, gynaecological pain is difficult to be distinguished from gastrointestinal pain. Gynaecological pain can be felt in places far from the location of the reproductive organs. This is known as referred pain. The pain can be felt in the abdomen, pelvic region, or lower back. This pain sometimes cannot be located very accurately. The pain can be sensitized by altering sensory neurons so that they respond more intensely to the stimuli; and also by enhancing sensitivity of the sensory pathways in the brain that modulate sensation.

Some gynaecological conditions cause acute abdominal pain: ectopic pregnancy which occurs in 1% of pregnancies; pelvic inflammatory diseases; endometriosis, when large chocolate cysts ruptured; ruptured ovarian cysts.

In women, two conditions are very common: endometriosis related pelvic pain and pelvic inflammatory diseases and adhesions.

Endometriosis related pelvic pain. Endometriosis is an estrogen-dependent inflammatory disorder that occurs in women during reproductive years. CPP is one of the most common symptoms of endometriosis. The pelvic pain caused by endometriosis may vary with menstrual cycle, typically with severe pain toward the end of the cycle and pain declined during menstruation. Some women may have constant pain with various severities without association with menstrual cycle changes. Period pain, pain during intercourse, irregular period and infertility may coexist in these women with endometriosis. The causes for CPP in endometriosis are not clear. There are a few theories. One of them is that the lesions cause pain, but how they contributing to the pain remains mystery. Another hypothesis is that local inflammation contributes to the pain in endometriosis in which prostaglandins are activated. This established a foundation for new treatments involving agents and methods that can inhibit immunological and inflammatory factors. Recent studies suggested that innovation by newly sprouted nerve fibres underlies pain in endometriosis. This is supported by some clinical findings and studies from animal experiment. In animal experiment, transplanted pieces of uterine tissue become vascularised and grow rapidly and innervations and pain symptoms are seen. In clinical studies, various neuronal fibre types are found in different types of lesions and nerve fibre densities are associated with severity of pelvic pain.

Pelvic inflammatory diseases and adhesion: If women with pelvic pain have a history of previous sexually transmitted infection, intercourse pain, backache, infertility, ectopic pregnancy or fever, pelvic inflammatory disease is very likely an underlying cause of CPP. If the pain is associated with stretching movements or organ distension, adhesion may exist.

Acupuncture may benefit. There are some good reasons to choose acupuncture to treat CPP. First, acupuncture is effective to treat some underlying causes of CPP, such as endometriosis, pelvic inflammatory diseases; second, acupuncture is effective way to release the pain in CPP; third, acupuncture has no side effect.

Acupuncture reduces back and pelvic pain in pregnant women

More than two-thirds of pregnant women have low back pain (LBP) and one-fifth have pelvic pain. With pregnancy advanced pain increases which could affects work, daily activities and sleep. Pennic V and Liddle SD assessed the effects of different interventions for preventing and treating pelvic and back pain in pregnancy. They studied 26 randomised trials involved in 4093 pregnant women in the review. Usual prenatal care was added to the interventions. For LBP exercises significantly reduced pain and disability, though the evidence was low quality. Water-based exercise significantly reduced LBP-related sick leave. There was no significant difference in pain or function between two types of pelvic support belt, between osteopathic manipulation and usual care or sham ultrasound. Specially-designed pillow may relief night pain better than a regular pillow. For pelvic pain, the quality evidence was moderate which showed that acupuncture significantly reduced evening pain better than exercise; both approaches were better than usual care. A rigid belt plus exercise improved average pain. An eight to twenty wee exercise program reduced the risk of having lumbo-pelvic pain. Exercise and significantly reduced lumbo-pelvic-related sick leave and improved function. Osteopathic manipulation reduced pain and improved physical function. Acupuncture was started at 26 rather than 20 weeks of pregnancy improve pain and function more. Adverse events were minor and transient.

Acupuncture is as effective as pain killers for period pain (dysmenorrhoea).

Dysmenorrhoea is the medical term for the painful period cramps. It is also known as period pain. Period pain is very common affecting about over 50% women. The pains can be mild dull pain which may rarely noticeable or severe which may affect women’s daily life. They can be periodic or continual. It presents cramping pain in the abdomen before or during the menstrual period. Women with period pain may also feel pressure in the abdomen, pain in the hips, lower back and inner thighs. They may have other symptoms including upset stomach with or without vomiting and loose stools or constipation. Period pain may be accompanied by a headache, dizziness, fainting and fatigue and urgent frequent urination. Period pain is caused by uterine muscle contractions in response to prostaglandins and other chemicals. Uterine lining is shed off during menstruation and uterus contracts to squeeze the tissue out of the uterus.

Symptoms could start as early as immediately after ovulation and last until the end of menstruation. Common period pain often starts immediately before or at the beginning of the period and last for one to three days. Period pains generally begin one to two years after a woman starts getting her period and they become less painful as a woman ages and may stop entirely after the woman has a baby.

Why some women get more painful periods than others? Painful period is associated with changing of hormonal levels with ovulation. Prostaglandins produced in the endometrium of uterus cause uterine contraction which causes pain. Compared with other women, women with severe painful periods have increased uterine contractibility and more frequency of contraction. Women with more painful periods have higher level of prostaglandins compared with those with less painful period. Some factors including narrow cervical canal, backward tilting uterus, lack of exercises and emotional stress increase the period pain.

There are two types of period pain: primary period pain and secondary. In primary period pain, there is no cause of underlying gynaecological condition. Normally period pain occurs in the ovulatory cycles. In secondary period pain, some gynaecological conditions such as endometriosis or ovarian cysts are underlying causes of the period pain.

The treatment is aimed reducing pain. Non-steroidal anti-inflammatory drugs (NSAID) known as pain killers are common used to relieve the pain. These drugs decrease prostaglandins production and reduce pain. Contraceptive pills can be used to treat period pain because they stop ovulation.

Can acupuncture help period pain? Yes, acupuncture is well known to reduce pains in various conditions and it is very effective to relieve period pain. Acupuncture at particular points stimulates nerve ends producing pain releasing substances such as endorphins and neuropiptide which acts as endogenous painkillers.; acupuncture reduces inflammation by increasing blood flow and releasing vascular and immunomodulatory fators; acupuncture makes uterus relaxed.

Recently Kiran et al compared the effect of acupuncture and medicines (NSAID) for the treatment of primary period pain. The study is involved in 35 young women with a diagnosis of primary dysmenorrhea. They were divided into two groups: acupuncture group and medicine group. One month treatments were given to these women with dysmenorrhea and then the pain scores were assessed. They found that acupuncture is as effective as NSAID to reduce period pain.

When is a good time of acupuncture treatment for period pain

It is well known that acupuncture is effective in treating period pain. When is the best time to seek acupuncture treatment if you suffer from period pain? Ma YX et al studied this time related treatment. They recruited 600 patients with period pain. They compared the effect of acupuncture treatment with no treatment. They also compared the effect of acupuncture treatment before the period started with the effect of immediate acupuncture treatment as soon as pain occurrence. They found that acupuncture significantly relieves period pain compared with the control group with no treatment. The pain has been relieved within 5 min after acupuncture treatment. By comparing the pain scores used for the pain assessment, they found the acupuncture treatment before period has better effect than that when the pain occurred. This study suggests that acupuncture prevents period pain. Acupuncture reduces period pain by a few mechanisms. Acupuncture regulates hypothalamus-pituitary ovary axis; acupuncture relaxes uterine smooth muscles and inhibits uterine contraction; acupuncture increases relaxation and reduces tension; acupuncture releases endorphins and other neurohumoral factors and changes pain processing in the brain and spinal cord; acupuncture reduces inflammation by increasing release of vascular and immunomodulatory factors.

Which acupuncture points for women’s period pain

If you see an acupuncturist for period pain, you might like to know which acupuncture points were used. There is a lot variation for acupuncture points used. A study analysed research data from January 1978 to April 2014 to assess the acupuncture points for period pain. They found that there were 20 acupuncture points frequently used. Acupoints on lower limbs were most frequently used. Three points including Sanyinjiao (SP06), Guanyuan (CV04), and Qihai (CV06) were used most frequently. The most frequently used meridians were Conception Vessel, Spleen Meridian of Foot Taiyin, and Bladder Meridian of Foot Taiyang. 67.24% of acupoints used were specific acupoints.

Case report for period pain and endometriosis with acupuncture treatment

Alice is 27 years old. She had severe period pain and sometimes lower tummy pain between periods. She was diagnosed endometriosis one year ago. She took painkillers and antibiotics, but she still had unbearable pain in her lower tummy. And then she was advised to use birth control pills to inhibit ovulation in order to stop the pain and endometriosis. But she still suffers from pain. She never got pregnant before, but she wanted to have a baby some day. So she decided to stop taking birth control pills and seek help from acupuncture for period pain. After a few sessions of acupuncture treatment, her pain reduced markedly. With continuing a few month acupuncture treatments, she was no longer having pain in her periods.

References

Kiran G et al Eur J Obstet Gynecol REprod Biol. 2013 Mar 19

Ma YX J Ethnopharmacol. (2013) 148:498-504

Pennic V & Liddle SD Cochrane Database Syst Rev. (2013) Aug.

Yu S et al Evid Based Completment Alternat Med (2015) 2015:752194

Saturday, 6 October 2012

Acupuncture helps skin problem

Eczema is a very common inflammatory skin condition. In the UK, it affects up to 20% of children and 10% of adults. It is a chronic condition. The skin become itchy, red, dry and cracked. It is commonly found behind knees, the inside of the elbows, around the neck and around eyes and ears. The symptoms can be episodic and recurrent. Some triggers can flare up the symptoms, for example stress can trigger the symptoms or make them worse. The causes for eczema are involved in genetic and environmental factors. Itch is a major symptom of skin problem. This is often caused by allergy. It is very important to identify potential allergens and avoid contacting with them. Changing diet is necessary if certain food is reactive. Main treatments include emollients and topical corticosteroid creams.

Acupuncture is believed to be beneficial for eczema and recent research has a very positive view for the effects of acupuncture in the treatment of chronic inflammatory skin conditions. Acupuncture may help to relieve symptoms in people with eczema. For example the itching can be reduced by up to 50% after one treatment and the skin will be back to normal gradually after a course of treatment. This is because acupuncture reduces inflammation, regulates mediators of the allergic reaction to extrinsic allergens, regulates immune cell types and functions and increases local blood flow reducing swelling

There was a blinded, randomised controlled trial. 30 patients with ectopic eczema participated in the study and allocated into three groups: acupuncture group, sham acupuncture and no acupuncture group. The allergy stimulus was applied to these patients 30 min before and after the interventions: acupuncture or no acupuncture. Two acupuncture points were selected: Quqi (LI11) and xuehai (SP10). The result showed that itch intensity and skin rash were significantly lower in acupuncture group compared with sham acupuncture or no acupuncture group. A further study was done by the same group. They compared the effect of acupuncture with that of cetirizine, an antihistamine drug commonly used for treating skin allergic reaction. This trial involved 20 patients with ectopic dermatitis. They were tested in several interventions: acupuncture, placebo acupuncture, cetirizine, certirizine placebo and no interetion. The result showed that both acupuncture and cetirizine treatments have significantly lower mean itch intensity and skin rash compared with both placebo and control groups. These studies suggested that acupuncture is effective in treating allergic skin reactions and it is as effective as some antihistamine drugs. They investigated the mechanism of acupuncture treatment of atopic eczema. 10 patients were in two groups acupuncture group and no treatment group. Allergen-induced basiphil cell (related to allergy) activation was measured after allergy stimulation. Itch intensity was significantly lower in acupuncture group on day 15 (after five treatments) and day 33 of the treatments (after 10 treatments). Less basiphil cells after stimulation were found in patients in the acupuncture group after the acupuncture treatments.

Allergic contact dermatitis (ACD) is a chronic inflammatory skin disorder. The incidence of ACD has increased worldwide. It has been suggested that ACD is related to activation of inflammatory cells linked to various allergic immune responses. ACD has been treated with steroid therapy and immunosuppressive agents. However these medications may cause many adverse effects. The use of alternative medicine such as acupuncture and herbs is increasing. The effect of acupuncture has been proven in the clinical study; however the mechanism is still unclear. Park JY et al studied the mechanism of acupuncture on ACD. They found that acupuncture on LI11 point which is commonly used in the treatment of ACD significantly inhibited cutaneous hyperplasia, serum IgE levels and expression of proinflammatory cytokines and proteins which contributes to immune response. From this study, it can be seen that acupuncture regulates immune activities in the treatment of ACD.

References
Pfab F et al Allergy (2010) 65: 903-10
Pfab F et al Allergy (2010) 67:566-73
Pfab F et al J Alterm Complement Med (2011) 17:309-14
Park JY et al Evid Based Complement Alternat Med (2013) 2013:982095

Tuesday, 2 October 2012

Anxiety impairs immune function, acupuncture reverses it

Generalised anxiety disorder (GAD) is a psychological disorder together with a broad range of physiological symptoms. People with GAD feel anxious about a wide range of situations and they could have both psychological (mental) and physical symptoms. They feel worried, irritable, inpatients and easily distracted. They could have various physical symptoms such as dizziness, pin and needles, tiredness, shortness of breath etc. It is widely accepted that anxiety impaired immune system function. Immune system defended you from illness. If your immune system is compromised, it does no good to your health.

Arranz L et al studied the effect of acupuncture in 34 women aged 30-60 with anxiety diagnosed and impaired immune function. Acupuncture was performed manually on 19 acupoints. A single session 30 min was employed. Before acupuncture and 72 hours after acupuncture, immune function was measured by blood test. They found that the best effect was seen at 72 hours after a single acupuncture treatment. They also studied long term effect of acupuncture. 12 patients completed 10 sessions in a year until the anxiety symptoms disappeared. The immune function was measured after a month at the end of a year treatment. They found that the immune function in these women was returned to the level closed to that in healthy control women. This study suggested that acupuncture improve immune function in women caused by anxiety.

There was another report comparing acupuncture with clonazepam in treating GAD. 80 patients were participated the study. 40 patients were acupuncture group and another 40 patients were in clonazepam group. Twelve medridians acuppoints were applied. Meaning quick needling at the apecific acupoints of each meridian for example, LU7, LI4 and HT7were applied. The total treatments were 6 weeks. Hamilton Anxiety Scal (HAMA) and brain activity were used to evaluate the effects. The improvements of the total HAMA scores could be seen in 2, 4 and 6 weeks in both group but the improvements were greater in acupuncture group. The brain activity was improved in both groups. So acupuncture could be a potential option for treatment of GAD.

References
Arranz L et al Am J Chin Med (2007) 35:35-51
Zhou XF et al Zhongguo Zhen Jiu (2013) 33:395-8

Monday, 1 October 2012

Acupuncture is an effective treatment for dementia

Dementia is due to damage of the brain caused by many diseases. The symptoms of dementia are memory loss, communication problem, behaviour changing and having difficulty of everyday life. For example, you may forget what you said earlier in the day or where you put things etc. You may be having difficulty to recognise persons you are familiar with or unable to find familiar places etc. You may find it difficult to communicate with others and feel depressed etc. The symptoms might be different depending on individual, but generally the symptoms are getting worse over time.

Dementia is due to damage of brain, which is caused by many diseases. Alzheimer’s disease (AD) is a most common form of dementia, which accounted for 70% of dementia. Alzheimer’s disease is degenerative which is caused by losing brain cells in the cerebral cortex and some other regions of the brain. This loss leads to shrink of the affected regions causing the symptoms mentioned above. Mild cognitive impairment (MCI) is the most important at risk state of AD which is a transition stage of normal aging and dementia. It has a high probability of degenerating into AD at a rate of 10-15% per year. Unfortunately there is no effective treatment for AD and MCI.

Acupuncture is used in treating AD and MCI in China. Recently Wang Z et al studied the effect of acupuncture on brain functional activity throughout the entire brain in patients with AD and MCI and compared with normal controls. Participants were 14 patients with AD, 8 patients with MCI and 14 healthy controls. At the resting state, in patients with MCI, there were increased activities in the brain regions of the temporal lobe, frontal lobe and left lentiform nuleus, while there were decreased activities in the regions of right cingulated gyrus and left fusiform gyrus compared with normal controls. In patients with AD, there were decreased activities in left temporal lobe and left middle frontal gyrus. Then data was taken during the process of acupuncture at points LI4 and LR3 bilaterally and 10 min after acupuncture treatments. They found that brain activities related to memory were altered during the acupuncture process and after the acupuncture treatment in patients with AD or MCI compared with the resting state. They found that acupuncture regulates brain activity bilaterally in patients with MCI which is it activates the regions with decreased activities in the resting state, while it deactivates the regions with increased activities in the resting state. In patients with AD it also showed increased or decreased regions of activities. They confirmed that the two points used for acupuncture can contribute to activate certain memory-related regions in patients with AD and MCI.

Zhou J and Jin J also showed that acupuncture at points HT7, ST36, ST40 and KI3 acupoints stimulated right main hemisphere activations (temporal lobe, such as hippocampal gyrus, insula, and some area of parietal lobe) and left activated regions (temporal lobe, parietal lobule, some regions of cerebellum). These activations by the acupuncture on these points were on the impaired regions in patients with AD, which closely associated with cognitive function such as memory, language etc. These researches provided strong evidence for the effect of acupuncture on dementia.

A ten-minute memory test operated by a computer programme is available. This test is aimed to recognize early stage of dementia, which could tell the differences between normal forgetfulness and memory loss of dementia. Early diagnosis of dementia could spot patients before their brain were damaged and help them to get early treatment which could delay the progress of the disease. For dementia care information you can find at Alzheimers society website http://alzheimers.org.uk/caring_for_someone_with_dementia and at department of health website http://www.dh.gov.uk/health/category/policy-areas/social-care/dementia.

Vascular dementia is a second main cause of dementia. There were many case studies that reported the effectiveness of acupuncture on vascular dementia. Shi GX et al studied the effect of acupuncture on vascular dementia in 16 patients with vascular dementia. They found that acupuncture improved cognitive function and quality of life in patients with vascular dementia and acupuncture reduced oxidative damage in patients with vascular dementia. Zhang H et al conducted a randomized control trial to study effect of acupuncture for treatment of vascular dementia. 270 patients with vascular dementia were recruited and received 6 weeks acupuncture treatment. The acupuncture points used Sishencong EX-HN1, Baihui GV20, Shenting GV24 and Fengchi GB20. They found acupuncture improve cognitive function and quality life in patients with vascular dementia. The effect was better than that for Nimodipine on its own, but acupuncture together with Nimodipine had better effect than acupuncture alone. Huang Y et al found that stimulating acupoints improves various brain area functions and this contributes to the improvement of cognition function, memory and daily life quality etc.

Acupuncture help sleep in patients with dementia

Elderly with dementia often have sleep problems. Recently there was a study investigating the effectiveness of acupuncture on sleep quality of elderly with dementia. There were 19 patients with dementia participated the study. These patients were followed through a control period for 6 weeks and an acupuncture treatment for 6 weeks. Sleep quality and congnitive function were measured and compared before and after the treatments period. The results showed that resting time and total sleep time in acupuncture treatment period significantly more than those in the control period. Improvement in congnitive function was not significantly different between the two periods. This study suggests that acupuncture was effective in improving some domain of sleep quality of patients with dementia and acupuncture was an acceptable intervention for these patients.

Acupuncture reduces oxidative stress of the cells

Oxidative stress is a sign of the imbalance between the production of reactive oxygen species and detoxification of the antioxidant system. As a result, this causes cell function damage and diseases. Oxidative stress is a critical feature in the pathological process of various diseases such as vascular dementia, Alzheimer’s disease and Parkinson’s disease. Recent research from last 5 years has shown that acupuncture treatment could decrease oxidative stress of the body and increase antioxidant system ability. Because of this acupuncture could improve memory impairment in vascular dementia and Alzerimer’s disease and reduce brain damage. Increased oxidative stress and depletion of the antioxidant are important mechanisms of the onset and progression of Parkinson’s disease. Acupuncture could reduce oxidative stress, inhibit cell death in the neurons and protect neurons improving motor function.

References

Wang Z et al PloS One (2012) 7:e42730

Zhou J and Jin J Acupunct Electrother Res (2008) 33:9-17

Shi GX et al J Tradit Chin Med (2012) 32:199-202

Zhang H et al Zhongguo Zhen Jiu (2008) 28:783-7

Huang Y et al Chin J Integr Med (2007) 13:103-8

Kwok T et al Clin Interv Aging (2013) 8:923-9

Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294

Saturday, 29 September 2012

Menopause, perimenopausal syndrome and acupuncture

Menopause is women’s period stopped permanently. At this time ovaries stopped working. Perimenopause means the time around the start of menopause. As ovaries stopped working, the hormone produced by ovaries (estrogen and progesterone) reduced. In many women this could cause many symptoms; hot flash is a well known symptom. Other symptoms include mood change, fatigue, insomnia and memory problem etc. Recently research showed that acupuncture is very effective in treating perimenopausal syndrome.

Shang YJ et al reported effectiveness of acupuncture on perimenopausal syndrome. They compared effect different acupuncture points. 80 patients were allocated into two groups: The acupuncture points for the first group were KI3, LR3, SP3, SP6, BL23, BL18, BL20 and CV4. The acupuncture points for the second groups were GV20, CV4, BL23, KI3 and SP6. The Kepperman score (score to measure menopausal syndrome), blood estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured and compared before and after acupuncture treatment for both groups. Total effect rate was 92.5% for the first group and 80% for the second group. Mean Kupperman score after treatment was 24.85 for the first group which was significantly lower than that (35.38) for the second group. E2, FSH and LH levels after treatment were significantly improved for both groups, but first group had better improvement. From their study, we can see acupuncture is effective in treating perimenopausal syndrome. Effects are different between different acupuncture points chosen.

Xia XH et al studied the effect of electroacupuncture at acupoint SP6 on perimenopausal syndrome. 81 patients were in acupuncture group and 76 patients were in medication group. Electroacupuncture at SP6 were applied three times a week for 3 months. The effect was assessed by symptom score, E2, FSH and LH values. After treatment, symptoms reduced significantly; FSH and LH level decreased significantly; E2 level increased compared with before treatment. The effect of acupuncture was similar to the medication.

Qin ZY et al studied the effect of acupuncture point SP6 on perimenopausal syndrome and compared the effect with that of nilestriol together with medrysone. There were 81 patients in acupuncture group and 76 patients in medication group. Acupuncture group received electroacupuncture at SP6 bilaterally for 30 min, three times a week for 3 months. Medication group received nilestriol treatment for 3 months and medrysone on the third month. E2, FSH and LH were measured before and after treatments. After treatments, FSH and LH decreased and E2 increased significantly for both group. And acupuncture had better effect than nilestriol and medrysone.

Jin H et al also observed the effect of acupuncture at acupuncture five-zangshu points on perimenopausal syndrome. Their cases include 20 patients in each group. Effect rate for acupuncture group was 90%.

From the results of these researches, we can see the effectiveness of acupuncture on perimenopausal syndrome. The effect rate depended on the acupuncture points.

References
Shang YJ et al Zhongguo Zhen Jiu (2009) 29: 444-8
Xia XH et al Zhen Ci Yan Jiu (2008) 33:262-6
Qin ZY et al Zhongguo Zhen Jiu (2007) 32: 255-9
Jin H et al Zhongguo Zhen Jiu (2007) 27: 572-4

Friday, 28 September 2012

Effect of acupuncture on premenstrual syndrome

Premenstrual syndrome is believed to affect many women. Suffer from PMS, acupuncture can help

Premenstrual syndrome is a serial of symptoms occurred before woman’s monthly period. These include physical and emotional symptoms such as bloating, breast tenderness, insomnia, headache fatigue, mood swing, irritability, tension, stress and anxiety etc. 90% of women have experienced premenstrual symptoms (PMS). It occurs in the second half of the menstrual cycle and disappears when your periods arrive. PMS can range in severity from mild discomfort to severe form dysphoric disorder. It can cause significant disruption to your daily activities. Women in their 40s tend to be affected most severely. The symptoms of PMS include two aspects: emotional and physical symptoms such as anxiety, mood swings, tiredness, irritability, anger, aggression, depression, difficulty sleeping, headache, feeling bloated, increase in appetite or food cravings, water retention, pain in your joints, tender breasts, abdominal (tummy) pain, backache, spots, acne, tiredness, constipation, dizzness. If you think you have PMS, keep a diary of your symptoms for two or three menstrual cycles. The symptoms of PMS are non specific and the most important thing is the timing of the symptoms and its repetitive pattern which is related to your menstrual cycle. What causes PMS is not clear yet. One reason is that the body’s sensitivity to hormone levels which varies during the menstrual cycle and these hormones interact with brain mood controlling chemicals.

About a decade ago there was a survey about premenstrual syndrome in US. There was 1052 of women aged 21-64 involved. The result showed that 41% women said that they suffered from premenstrual syndrome and 42% of them took prescription or over counter medicine to release the symptoms. Fewer people used acupuncture. Recent years with research advance, acupuncture was proven to be effective to treat premenstrual syndrome.

Habek D et al Observed the effect of acupuncture in patient with premenstrual syndrome. They found 9 patients received two acupuncture treatments and their symptoms are disappeared completely; 8 patients received three acupuncture treatments and symptoms had gone completely; 1 patient had 4 acupuncture treatments and symptoms had gone. The total effect rate was 77.8% in acupuncture group while the effect rate was 5.9% in placebo group.

Kim SY et al analysed data available in the research to study the effect of acupuncture on premenstrual syndrome. Ten randomly controlled trials throughout of 2009 were included their study. These studies performed sham acupuncture control, medication and no treatment control. They found that 8 trials showed that effect of acupuncture was better than for the control. The improvement of symptoms in acupuncture was better than sham acupuncture. No side effects were observed. They concluded that acupuncture is a promising approach in treating premenstrual syndrome.

Anil A et al studied the effect of acupuncture on premenstrual syndrome. There were 11 participants (aged 23-40) with premenstrual syndrome diagnosed. Acupuncture points used were Ren2, Ren6, Ren12, LI4, LI11, P6, Liv3, SP6, ST36 and Du20. The treatment period was three menstrual cycles. The results showed that the symptoms such as muscle pain, period pain and breast tenderness in all patients were reduced or disappeared completely.

It is well accepted that pain sensation has changed in specific acupuncture points related to specific conditions. Chae Y et al analysed 46 participants to study acupuncture points sensation. These participants were divided into two groups: with premenstrual syndrome group, without premenstrual syndrome group (control group). Pressure pain threshold (PPT) was measured in acupuncture points in the leg and arm. The points chosen included three acupuncture points SP6, GB39, LR3 and one non acupuncture points in the leg and three acupuncture points P6, TE5 and LI4 and one non acupuncture point in the arm. And then the PPT was compared between the two groups. They found that PPT at SP6 for premenstrual syndrome group was significantly lower than for the control group and it was linked to the severity of the conditions. This finding provided a possible basis for the clinical diagnosis and acupuncture treatment.

Acupuncture for premenstrual dysphoric disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome. Symptoms start before the period and end shortly after period begins. It presents a cyclic pattern every month. Mood changes including anxiety and depression were dominant. Carvalho F et al studied the effects of acupuncture on the symptoms of anxiety and depression caused by PMDD. They compared the effect of acupuncture and sham acupuncture on these symptoms. 15 patients were in each group. Acupuncture was performed twice a week for two menstrual cycles. There were 16 sessions of treatments. There were no differences in the symptom assessment between the two groups before the treatments. After 16 sessions of treatments the symptoms of anxiety and depression were reduced in both groups, but the improvement was significantly better in acupuncture group compared with sham acupuncture group. They suggested that acupuncture could be treatment option for patients with PMDD.

A survey in US has shown that 80% of women preferred non-pharmacological interventions, such as vitamins and supplements or alternative methods of treatments.

Acupuncture is one of the preferred treatment options for patients with PMS. Recently Jang analysed existing data for the effectiveness of acupuncture on PMS. They found that acupuncture treatment improved physical symptoms including headache, cramps, backache, cold sweats, hot flashes, breast pain, skin disorders, swelling of hands and feet, sensitivity to cold, abdominal pain and bulging as much as 50%.

References

Anil A et al Clin Exp Obstet Dynecol (2012) 39:209-13

Kim SY et al BJOG (2011) 118:899-915

Chae Y et al J Physiol Sci (2007) 57:115-9

Habek D et al Arch Gynecol Obstet (2002) 267:23-6

Singh BB et al Altern Ther Health Med (1998) 4:75-9

Carvalho F et al Acupunct Med (2013) Sep 12 doi 10.1136

Jang SH et al BMC Complement Altern Med (2014) 10:14:11

Thursday, 27 September 2012

Effect of acupuncture in treating diabetes

Awareness of diabetes

14 November 2012 is World Diabetes Day which raises global awareness of diabetes. This day is started by the International Diabetes Federation (IDF) and World Health Organization (WHO). It is celebrated on 14 November to remember the birthday of Frederick Banting who together with Charles Best was involved in the discovery of insulin in 1922, a life-saving treatment for diabetes patients. WHO estimated that more than 346 million people worldwide have diabetes.

What is diabetes? Diabetes is a long term condition caused by high blood sugar (glucose) level which will damage the body. High blood glucose is caused by insulin deficiency, resistance or both. Glucose which comes from the food we eat is absorbed into blood. Glucose is then carried to different body cells. Insulin which is secreted by the pancreas is needed for glucose to be transported from blood into body cells. If insulin production is decreased or insulin does not work well, it affects glucose transportation. As a result, glucose remains in the blood causing high blood glucose. High blood glucose causes many symptoms. There are three classic symptoms which are increasing urination frequency, drinking more water because of thirsty and eating more than usual.

There are two main types of diabetes: type 1 and type 2. Type 1 is developed in younger age and is insulin dependent. In type 1 diabetes, the pancreas cannot produce any insulin which regulates blood sugar level. Type 2 is developed later in adult life. In type 2 diabetes, the pancreas does not produce enough insulin or the body’s cells do not react well to insulin. This is known as insulin resistance. The common symptoms of diabetes are feeling very thirsty, frequent urination particular at night, feeling very tired and weight loss. There is a survey suggesting that about 90% of parents are not aware of the symptoms of diabetes type 1 in children. Awareness of diabetes is very important to get the condition diagnosed and treated.

850,000 people are thought to have undiagnosed type 2 diabetes. Three million people in the UK have been diagnosed with diabetes. Most of the cases are type 2 diabetes which the body does not produce enough insulin or the body does not respond well to insulin known as insulin resistance. Obesity is one of the risk factor of type 2 diabetes. Weight loss is important in controlling the development of diabetes. To get help in early stage of the condition could improve quality of life.

Effect of acupuncture in treating diabetes

Diabetes is initially managed by a healthy diet, weight reduction and exercise. If these failed to control blood sugar, oral glucose lowering drugs are needed. These drugs may get good effect at first, but after a while their effects would reduce. Also they have many side effects, such as, weight gain, weakness, fatigue, lactic acidosis etc. Insulin is expected to added, if oral agents fail to control blood sugar level.

Acupuncture, one of the oldest healing practices, is one of the most rapidly growing complementary therapies which is recognised by both the National Institutes of Health and the World Health Organisation (WHO). Treating diabetes with acupuncture is a common approach in China. It has been used in the United States during the last tens of years. Recently research showed that acupuncture is effective in treating not only diabetes, but also in preventing and managing complications of the diabetes. Acupuncture helps reduce weight and improve quality of life in people with diabetes. The effects of acupuncture include improving insulin resistance, lipid metabolism and improving inflammation. Maintaining blood sugar level in normal range with essential health care methods could help people with diabetes control the progress of the condition without developing complications. Acupuncture combined with diet control and exercises could have beneficial short term and long term effects on preventing progressing of diabetes in early stage and preventing and treating complications in late stage.

The mechanism is not completely clear, but there are a few possible mechanisms for the effectiveness of acupuncture on diabetes: acupuncture can activate glucose-6-phosphate and affect hypothalamus; acupuncture can act on the pancreas to increase insulin synthesis; it can also increase the numbers of insulin receptors on target cells; in addition, it can accelerate the utilization of glucose. As a result, blood sugar decreases. Recent study showed that acupuncture reduces insulin resistance and improves obesity which may contribute to the effectiveness of acupuncture on diabetes. Meng H studied effect of electoracupuncture on impaired glucose tolerance. There were 60 patients were involved. The patients were divided into two groups: 30 cases in acupuncture group, 30 cases in control group. The acupuncture points applied included Shenshu (BL23), Pishu (BL20), Zusali (ST36) and Sanyinjiao (SP6). 6 sessions was carried out. There was no intervention in control group. Fasting blood-glucose (FBG) and 2 hour postprandial blood glucose (2h PBG) were measured before and after treatment and compared between the two groups. 2h PBG was significantly lower in acupuncture group compared with the control group. They concluded that acupuncture is a promising treatment for impaired glucose tolerance.

References
Meng H et al Zhongguo Zhen Jiu (2011) 31:971-3
Http://www.bbc.co.uk/news/health-21630812

Monday, 24 September 2012

Forbidden acupuncture points do not exist?

It was in acupuncture literature suggested that some acupuncture points have risks for pregnancy. Acupuncture has been widely used in many obstetric complaints such as nausea and vomiting, insomnia and low backpain etc. Also acupuncture was suggested to be beneficial for threatened miscarriage. Are there scientific bases for the suggestion of forbidden points? Recently some articles argue that these points do not exist. Cummings in Royal London Hospital, London, UK did research and examined the proposed risks. He did not find any possible physiological mechanism for supporting the exist of forbidden points. Da Silva AV et al did a research on these and they found that current available some publications though limited do not support that the forbidden points exist. Guerreiro da Silva AV et al did an animal research to investigate 4 acupuncture points LI4, SP6, BL27 and BL28 to see if these points cause harm for pregnancy. They found that these points did not cause embryonic loss after implantation or fetal death or abortion or resorption. They concluded that these acupuncture points has no harm to pregnancy.

References
Cummings M Acupunc Med (2011) 29:140-2
Da Silva AV et al Acupunc Med (2011) 29:135-6
Guerreiro da Silva AV et al Forsch Komplementmed 2011:10-4

Tuesday, 18 September 2012

Case report: acupuncture increased sperm count

A 31 year old man was diagnosed azoospermia (no measurable level of sperm in his semen). His testis and vasa deferentia were normal. The tests showed that his sperm production was impaired which was difficult to cure. The couple failed one cycle of percutaneous sperm aspiration and intracytosplasmic sperm injection. He was referred for acupuncture treatment. He received a course of 20 session acupuncture treatment. After a course of acupuncture treatment, his sperm count was 10 millions/ml with 10% good motility and 60% normal shape of sperms. With continuing another course, his sperm count increased to 18 millions/ml with 30% good motility and 60% normal shape of sperms.

References
Bidouee F et al J Kidney Dis Transpl (2011) 22:1039

40 patients have low sperm count or abnormal sperm shapes. 28 of them received acupuncture treatment twice a week for 5 weeks while other 12 patients did not receive treatment as control. At the end of the treatment, sperm counts were significantly increased and sperm shapes were significantly improved in acupuncture group compared to control group.

References
Pei J et al Fertil Steril (2005) 84:141-7

3 weeks of acupuncture increased sperm quality

A study about effect of acupuncture on male infertility was published in 1984 in German. There were 28 males with infertility. They received 10 treatments for 3 weeks. Sperm count, concentration and motility were evaluated before and after acupuncture treatment. Result showed that in all cases sperm quality was improved.

References

Fischl F et al Geburtshilfe Frauenheilkd (1984) 44:510-2

Effects of acupuncture and moxa treatment on semen abnormalities

19 patients with semen abnormalities were aged 24-42. They were randomly divided into two groups: acupuncture group and control group. Acupuncture group received 10 weeks of acupuncture and moxa treatment while control group receive sham acupuncture. Semen analysis was performed before and after the treatment. At the end of the treatment, total sperm numbers and normal shaped sperms increased in acupuncture group compared to control group.

References
Gurfinkel E Asian J Androl (2003) 5:345-8

Acupuncture helps fertilisation of ICSI in male infertility

There was a case report that acupuncture improves sperm quality and the outcome of intracytoplasmic sperm injection (ICSI). 22 male patients with infertility who failed ICSI participated the study. They received acupuncture treatment twice a week for 8 weeks followed by ICSI. At the end of the treatment, sperm motility and normality was improved. The fertilisation rates after acupuncture treatment were 66.2% significantly higher than that before the treatment (40.2%). Embryo quality was also improved. Acupuncture has a positive prospect for men with infertility undergoing ICSI treatment.

References
Zhang M et al J Huazhong Uni Sci Technology Med Sci (2002) 22:228-30

Case report: effect of acupuncture and herbs on male immune infertility.

A case report was published that acupuncture and herb treatment is effective for male immune infertility. 100 patients with infertility and positive AsAb were divided into two groups: acupuncture group and prednisone control group. Acupuncture group was treated with acupuncture and herb medicine was also given. The control group was treated with prednisone (a immune suppressive agent which is seldom used because of side effects). The result showed that AsAb decreased in both group with bigger effect in acupuncture group. This indicates that acupuncture is a promising treatment for male infertility caused by immune problem.

References

Fu B et al J Tradit Chin Med (2005) 25:186-189

Monday, 20 August 2012

Acupuncture is effective for treating antisperm antibodies associated male infertility

Antisperm antibodies can affect fertility in men. 10% of male infertility is caused by antisperm antibodies. Immune system can respond to produce antisperm antibodies in some circumstances such as infection. These antibodies tend to destroy sperms causing infertility. The antibodies can be present in tail of sperm which may cause mobility problems; they can be found in the head of the sperm as well which may prevent sperm binding to eggs resulting in fertilisation problems. It is easy to diagnosis by directly analysing sperms to see if there is antibody present. Once this condition is diagnosed, it is difficult to be treated. High dose of corticosteroids can reduce the number of antibodies; however it produces serious side effects at the same time. Fu B et al have reported that effectiveness of acupuncture and herbal medicines on male immune infertility. This study was involved 100 male with positive antisperm antibody associated infertility. These cases were divided into two groups: 50 cases in acupuncture and herbal group and another 50 cases in control group treated with prednisone. Antisperm antibodies were monitored in the two groups for measuring the effect. They found that antibodies were decreased in both groups but acupuncture group had significantly better effect than that for prednisone group.

References
Fu B et al J Tradit Chin Med (2005) 25:186-9

Thursday, 16 August 2012

How obesity affects fertility and how acupuncture can help?

Obesity increasingly affects people’s health. It is well studied and extensively agreed that obesity has negative impact on fertility. Women with obesity are three times more likely to suffer from infertility than women with body normal weight. The impaired fertility has been seen in obese women naturally and obese women with assisted conception. Obesity reduced fertility by affecting ovulation, egg development, embryo development, endometrial development implantation and pregnancy loss.

Obesity affects ovulation and period cycles. Obesity has effect on hypothalamus-pituitary-ovarian axis which is important in regulation of sexual hormone production. If this axis is disturbed, normal hormone production is impaired leading to abnormal period cycle and anovulation. This causes infertility. Women with obesity respond poorly to ovulation induction. Weight loss only could restore normal period cycle and ovulation; it increased response to ovulation induction.

Obesity affects egg quality and egg quality is likely to be poor in women with obesity
Obesity has great impact on reproductive health. Women with obesity are nearly three times more likely than women without obesity to have difficulty to conceive and may take longer to conceive. Women with obesity also have an increased risk of miscarriage, pregnancy complications and congenital defects in offspring, if they do get pregnant. Obesity may affect egg competence and maturation caused by alterations in steroid hormone balance, particularly those hormones that trigger follicle maturation. This is because fat tissue is an important site for steroid hormone production and metabolism and excessive fat in obesity may alter steroid hormone levels. Also metabolic alterations in obesity occur in the serum which is reflected in the follicular fluid and some changes in this micro environment may affect egg quality. For example, serum insulin concentrations and resistance to insulin action in cells are increased in obesity. In women with obesity has increased C-reactive protein which is an inflammatory marker in follicular fluid. When undergoing IVF, women with obesity have less quality eggs collected. This is caused by reduced human chorionic gonadotrophin (hCG) concentration impairing egg maturation. Many studies showed that obese women undergoing IVF have lower fertilization rate than women with normal weight. Impaired egg development could lead to impaired embryo development and following impaired implantation.

Obesity reduces uterine receptivity
How obesity affects women’s fertility? Recent research suggested that obesity reduces uterine receptivity in overweight women. Bellver J et al analysed the reproductive outcome of recipients of donated ova according to their body mass index (BMI). These data were from 9587 first cycles of ovum donation from normal weight donors. Recipients received in vitro fertilization (IVF) were divided into four groups according to their BMI: group A lean BMI<20 kg/m2, group B normoweight BMI 20-24.9 kg/m2, group C overweight BMI 25-29.9 kg/m2 and group D obese BMI ≥30 kg/m2. There was no difference among the groups in IVF parameter. However, implantation, biochemical pregnancy, clinical pregnancy, twin pregnancy, and live-birth rates were significantly decreased as BMI increased. In the lean, normoweight, overweight and obese groups, the implantation rate was 40.4%, 39.9%, 38.5% and 30.9%. Clinical pregnancy rate was 56.9%, 55.9%, 54.3% and 45.3% and live-birth rate was 38.6%, 37.9%, 34.9% and 27.7% respectively. Clinical miscarriage rates were similar in all groups. They suggested that female obesity impairs the reproductive outcome of donated ovum because of reduced uterine receptivity. To make uterus more acceptable for pregnancy, it is time to lose weight for those overweight women.

Women with obesity are more likely to have early pregnancy loss once they are pregnant. Increased miscarriage rates were observed in pregnancy from natural conception, ovulation induction and assisted conception. This suggests that endometrium may play a part in early pregnancy loss.

Obesity affects assisted conception treatments. Many studies have shown that obese women undergoing assisted conception such as IVF have lower live birth rates. This is accumulated effect of lower implantation and pregnancy rate, higher miscarriage rates and increased pregnancy complications.

Weight loss improves fertility greatly no matter what weight loss methods were used. The first method used should be life style changes including diet and exercises. Many evidences showed improvement of ovulation frequency and pregnancy rates after good weight loss.

Acupuncture helps reduce appetite in women with obesity. Acupuncture helps increase ovarian and uterine blood flow to improve egg quality and uterine lining for conceiving and implantation and supporting pregnancy.

References
Bellver J et al Fertil Steril (2013) Jul 3
Yao H et al Zhen Ci Yan Jiu (2012) 37:497-501

Friday, 10 August 2012

Keep fit for pregnancy, acupuncture can help

How long it takes to conceive when you start trying?

How long it takes for you to get pregnant. This is difficult to say. There is an average time for a couple to conceive. Within one month, 30% couples get pregnant; within three months, 60% get pregnant, within 6 month, 80% get pregnant, within one year 85% get pregnant. Within two years 92% get pregnant. This is only a guide. Many factors affect the figures. For example age is obviously an important factor and it takes longer to conceive, if you have age disadvantage, but it is not impossible.

When do you need to get your fertility tested?

You need to get your fertility tested, if you have tried to get pregnant for a year without success or if you are over 35 year old and you have tried for 6 months without success. Basic fertility tests are to check your egg quantity and quality, your ovulation and your tubes and uterus. These include day 3 FSH (follicle stimulating hormone) and E2 (estradiol) test, AMH (anti-mullerian hormone) test which could be done at any day of a woman’s cycle, antral follicle count to measure and count small follicles. Your ovulation could be tested by ovulation prediction kit, BBT (basal body temperature) chart, ultrasound scan and day 21 progesterone tests. HSG (Hysterosalpinggogram) is used to test your tube and uterine cavity.

There are a few things you can do to improve your fertility.

Keep a healthy weight

Obesity is associated with a number of health problems, such as cardiovascular diseases and diabetes. Obesity which causes hormone imbalances and ovulation problem associated with infertility is extensively agreed. A healthy weight is important for women who want to conceive. Obesity is associated with reduced female fertility. Women with obesity are more likely to suffer dysfunction of hypothalamic-pituitary-ovarian axis, irregular period cycle and anovulation. Hormone balance to regulate follicular development and egg maturation is disturbed. Endometrial development and implantation are also affected by obesity. Weight loss will restore normal period cycle and ovulation and improve the chance of conception.

Obesity is also associated with reduced male fertility. It reduces semen quality, changes sperm proteomes, contributes to erectile and induces other physical problems related to obesity including increased scrotal temperatures. Obesity affects hormone balance. Weight loss may restore fertility in male.

Low body weight is also linked to infertility. Keep normal body weight can optimise your fertility. Body mass index (BMI kg/m2) which is body weight over height is used to measure healthy weight. Normal BMI is 20-25. High or low BMI is abnormal. BMI higher than 30 is obese. Numerous studies showed that it takes longer time for women with high or low body weight to conceive. For example, a study involved in 87 obese women with infertility showed the impact of obesity on ovulation. 80% of women before weight loss were anovulating; after 6 months of a weight loss programme, average weight loss of the women was 10.2 kg/m2 and 90% of them were ovulating spontaneously. 77.6% of those women became pregnant and 67% achieved a live birth. Abnormal body weight in men is associated with reduction of sperm count which causes male infertility. Many studies showed that IVF success rate for women with obesity is 50% less than that for women with normal BMI. Increased risk of early pregnancy loss results in lower live birth rate in women with obesity compared to women with normal BMI.

Keep a balanced diet. A balanced diet should provide about 2000 kilocalories each day. About 200 kilocalories more would be requested during pregnancy.

What is well balanced diet? When it comes to a healthy diet, balance is the key, which means eating a wide range of foods in the right proportions to achieve and maintain a healthy body weight. If you are overweight or obese which means you eat more than you need and should eat less; and vice versa. Healthy eating does not have to be complicated; it can be really straightforward. All the food we eat can be allocated into five groups. They are

1, Fruit and vegetables: They are main source of vitamins and minerals for the body. They also contain fibers. Five portions of a variety of fruit and vegetables a day will provide enough vitamins and minerals for body needs. How much is one portion? Just one apple, banana, pear a slice of pineapple or melon or one similar-sized fruits is one portion. Three heaped tablespoons of vegetables is another portion. This is not hard to achieve.

2, Starchy foods, such as rice, pasta, bread and potatoes, cereals: They are main source of energy and calories which are fuels of the body. They also contain some vitamins, minerals and fibers. This group of foods should make up around one third of everything we eat. Or meals are based on these foods.

3, Meat fish, eggs and beans: This group of foods is good source of protein, which are fundamental for growth and repair of the body. They also have a variety of vitamins and minerals. Meat provides vitamin B12. At least two portions of fish per week are very healthy.

4, Milk and dairy foods: These are a good source of protein and calcium. These four groups of foods are healthy foods from which a range of foods should be chosen.

5, Foods containing fat and sugar: Fat and sugar provide energy for the body. If there is too much sugar and fat, it will lead to overweight. Fat can be divided into saturated fat and unsaturated fat. Saturated fat can raise blood cholesterol and increase risk of heart disease. However unsaturated fat can help lower cholesterol and provides body with essential fatty acids which help body stay healthy. Oily fish, nuts, seeds, vegetable oils and olive oils are main sources of unsaturated fat.

Try to control fat and sugar intake and eat foods contain unsaturated fat.

Do you need to take vitamin and mineral supplements?

Most people can get all the vitamins and minerals they need by eating a balanced, varied diet. You don’t have to take supplements if you don’t have symptoms of deficiency. If you choose to take supplements, be careful not to take too much otherwise it would be harmful. There are two types of vitamins: water-soluble or fat- soluble. There are 9 water-soluble vitamins: 8 vitamin Bs and vitamin C. For water-soluble vitamins your body will choose what is needed and the rest will be excreted. But for fat-soluble vitamin, thing is different. There are 4 types of fat-soluble vitamins A, D, E, and K. They are ready to store in the body. If intake is more than need, the excessive amount of vitamin will not be excreted from the body, and they will stay in the body for a long time and will be toxic to the organs.

Be careful with what you drink if you want to get pregnant

Stop drinking alcohol.

Do you drink alcohol? Drinking alcohol, especially large amount of alcohol is associated with reduced fertility and spontaneous abortion. This was agreed by many researches. One drink per week might be associated with reduced fertility. The mechanism that alcohol affects fertility is not clear, but it may alter hormone levels causing follicle development, ovulation, and implantation problems. Both men and women drinking alcohol affects success rate of assist reproductive treatment. Women drinking alcohol increased miscarriage in early pregnancy.Excessive consumption of alcohol disturbs hypothalamic-pituitary function leading to ovulation disorder. Too much alcohol can damage sperm quality. Infertility improved with stop of alcohol consumption. Drinking alcohol during early pregnancy can cause severe developmental abnormalities in the baby, such as retardation and physical malformation.

You might say that I don’t drink alcohol at all; what else could affect my fertility. Do you drink a lot of coffee, tea or soft drinks? Do you know what the component of them? In this drinks, caffeine is one of the important components. Caffeine is a stimulant of the brain. It has been reported to prolong the time to pregnancy, but the mechanism for this is not clear. It may affect female reproduction by changing hormone levels. This results in ovulatory problem and corpus luteal dysfunction. There was a study of 104 women on links between pregnancy and caffeine consumption. They found that women who drank less than a cup of coffee a day were two times as likely to get pregnant compared with the moderate coffee drinkers. A reduced chance of conception was found with increased coffee consumption. Large amount of caffeine consumption is associated with delayed conception. Also it causes higher spontaneous abortion in early pregnancy. For women undergoing assist reproductive treatment, caffeine might decrease live birth rate.

Stop smoking. The metabolites of cigarette smoking are toxic to eggs (causing oxidative damage to mitochondrial), sperm and embryos (causing miscarriage). Smoking decreases the chances of conceiving. Increasing numbers of cigarettes consumption per day significantly decreased fertility. If smoking during pregnancy, miscarriage risk is doubled and premature labour is increased 50%. Low birth weight baby and interurine retardation and perinatal mortality are also increased. Stopping smoking is another step to take to be ready for pregnancy.

Sleep well. Good sleep is important to get your mind and body rested to keep healthy. Sleep loss may affect your hormones levels.

Do regular exercises to improve eggs and sperm quantity and quality

Reduce stress. Stress can alter hormones causing fertility problems. Keeping stress free is very important. Severe stress may affect ovulation and sperm production. Prolonged stress makes some part of your body not function properly including reproductive system. Try to relax. Try to eat regularly and get good sleep which could help your body relaxed and healthy. This is very important. If your body healthier and stress free, your fertility improves and you may get pregnant naturally or it may improve your chance of IVF success, if you decide to go through the IVF treatment.

Fertility acupuncture

Getting pregnant seems so easy for most of women; however wanting to have a baby seems unreachable for those who suffer from infertility for years. It is hard to imagine what they have been going through, physically and emotionally. Many people don’t realise that infertility is a disorder that occurs in women’s reproductive systems. There are many underlying causes such as polycystic ovarian syndrome (PCOS), endometriosis and premature ovarian failure etc that could explain why infertility happens. Even if it is unexplained infertility, there may be a reason. The reason cannot be explained, only because science is not advanced enough to know why it happens. It is still unclear how pregnancy happens in many ways physiologically and biochemically.

Do you know acupuncture boosts your fertility?

It does not help if only asking why me? One has to do something to solve the problem. Many women recognize that acupuncture could help their fertility treatment and this is their chance. Bovey et al (2010) performed a survey of acupuncture practitioners to study acceptance of acupuncture for infertility treatment in the UK. They found that 15% of 861 practitioners responded support fertility issues; patients with infertility comprise a large part of their cases. 60% of these practitioners had specialist training. They stated that the benefit of acupuncture treatment for infertility included stress reduction, relaxation, regulation of menstrual cycle and of course, emotional support. Hopton et al (2012) conducted a survey in surrey, UK. They showed that women seeking infertility treatment with acupuncture increased 5% from 2.5% in 2002 to 13% in 2009. Most commonly these were treated by independent acupuncturists. There was a survey in the US about women with infertility seeking complementary and alternative treatment. They showed that during 18 months 22% had tried acupuncture, 17% herbal therapy, 5% a form of body work and 1% medication.

Acupuncture is originated from ancient China. Not only because of its history, but also because of evidence from current scientific research, acupuncture becomes very popular. Acupuncture can boost your fertility and help you conceive naturally by stimulating nerve endings and regulating reproductive system physiological function. Needles inserted into particular acupoints stimulate nervous system. Acupuncture decreases sympathetic nerve activity, as a result, it helps improve blood flow of the ovaries and uterus to develop high quality eggs to be fertillized and better uterine lining to get ready for implantation. It also helps relax fallopian tubes and uterus to provide an uninterrupted passageway and a fertile environment for egg and embryo. It also helps regulate hormone balance to improve ovulation and support pregnancy. Acupuncture can also reduce fertility related stress to help you conceive.

Success rate is what many people concern about. I would say that it is difficult to calculate success rate for infertility with acupuncture treatment though there is some research showing over 60% success rate. Human body is a living biological body. Our body does not work like computer which run the same programme if you give it the same command. Everyone is different which is responding differently to the treatments. This is why no treatments for any diseases have 100% success rate. Acupuncture is different from IVF which has clear cycles. It is easy to see whether it is successful or not. Acupuncture has accumulating effects. Some people may need three month treatments, while others may need six months and some need 1 year. If you give it a cut off time, like research does, this does not reflex actual success rate. Women with infertility may have other symptoms, such as chronic backache or abdominal pains; their chosen acupuncture points must be different. How can you compare success rate between them? Some people see acupuncturist for treating other diseases such as chronic pelvic pain, as a result, they end up getting pregnant. Acupuncture can also treat underlying causes of infertility and improve overall health to benefit fertility.

Acupuncture supports IVF as well. If you do want to go ahead for IVF, acupuncture also can help. There is no conflict between IVF and acupuncture. Manheimer E studied effects of acupuncture on pregnancy rates and live birth among women undergoing IVF by analysing seven trails involved in 1366 women. They suggested that acupuncture given with embryo transfer improves pregnancy rates and live birth among women undergoing IVF. Recently, there is a randomized controlled trial of study conducted in Western Sydney. They examined the effectiveness of acupuncture for reducing infertility-related stress. The effect of acupuncture group was compared with a waiting-list control group. The patients involved were 32 women aged 20-45 years, with a diagnosis of infertility or a history of unsuccessfully trying to conceive for over 12 months. Six sessions of acupuncture over 8 weeks were given. The result showed that women in acupuncture group have significantly reduction of infertility stress compared with those in the waiting-list control. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and intervention with few negative side effects. A research conducted by Balk et al studied 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. They found that women who received this acupuncture achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. Those who received acupuncture had a low stress scores before and after ET. They concluded that lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.

References
Smith CA J Altern omplement Med (2011) 17:923-30
Balk J et al Complement Ther Clin Pract. (2010) 16:154-7
Manheimer E et al BMJ (2008) 336:545-9
Homan GF et al Human Reproduction Update (2007) 13:209-223

Thursday, 9 August 2012

Smoking affects fertility and IVF success rate, acupuncture can help

Smoking affects on many aspects on health. Fertility is one side. There is strong evidence showing the negative effects of smoking on fertility both in male and female. In female, smoking affects follicular microenvironment and changes hormone levels in the luteal phase. Many studies showed strong association between female smoke and compromised fertility. Menopause occurs 1-4 year earlier in women who smoke compared to those who don’t smoke. A study involved in 14893 women in pregnancy showed delayed pregnancy more than 12 months in women who smoke compared to women who don’t. In male, smoking reduces sperm production, sperm motility and changes sperm morphology. Smoking also increases risk of DNA damage. In adult men smoking leads to hypoxia in testis this is because smoking causes small blood vessel contraction and reduces blood and oxygen supply to the testis. Compromised oxygen supply to testis would impair sperm production. Mother in pregnancy smoked heavily could affect her son’s sperm production when he grew up. Men’s sperm production could decrease about 40% by maternal smoking in pregnancy.

Both male and female smoking decrease IVF success rate. A study with 301 couples undergoing IVF or ICSI revealed that men smoking significantly decreased the success rate. There are many studies of association between women who smoke or passively smoke and IVF success rate. The findings are very similar: women who smoke have reduced IVF pregnancy rate and live birth rate compared to women who don’t smoke.

How can physicians help stop smoking?

Stop smoking can hard to some people who smoke. Many methods are considered to help patients stop smoking such as individual counselling, pharmacotherapy, and group therapy etc. There is a survey from Swiss to assess how physicians help patients stop smoking. 84% prescribed nicotine replacement therapy; 65% prescribed bupropion, or 70% provided counselling. 26% recommended acupuncture, 8% recommended hypnosis, 7% recommended relaxation and 24% recommended self-help material.

How can acupuncture help giving up smoking?

Some complementary and alternative medicine (CAM) was used to help adult smokers to give up smoking. There was a National Health Interview Survey (NHIS) in the United State survey to analyse CAM usage in adult smokers. A total 54437 aged over 18 smokers were participated the survey from 2002 and 2007. 10 type of CAM therapies were analysed including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energytherapy, folk medicine, hypnosis, massage and naturopathy. The percentage of recent users of CAM therapies increased from 12.5% to 15.4% between 2002 and 2007. The largest increases were seen in massage, chiropractic, and acupuncture. Despite a decrease in the national average smokers, proportions of smokers within specific CAM remained consistent. CAM practitioners in particular those in chiropractic, acupuncture and massage, represent new groups in the health care community to promote giving up smoking.

Acupuncture can help giving up smoking. A research paper has recently been just published. Kang OS et al studied that acupuncture reduces the desire for smoking using fMRI- a brain scan through which brain activity can be measured. There were 25 male smokers involved in the study in two groups real acupuncture group and sham acupuncture group. After 36 hour of smoking ban for them, their brain activity was measured using fMRI scan and then treatments of real acupuncture and sham acupuncture were given. They found that the desire for smoking scored lower in real acupuncture group compared with sham acupuncture group. Brain activities in a few regions were significantly different including prefrontal cortex, the premotor cortex, the amygdale, the hippocampus and the thalamus. These regions were involved in attention, motivation and reward. Acupuncture helps reduce desires of smoking through altering particular part of brain activity in smokers after stop smoking.

References
Kang OS et al. Psychopharmacology (Berl) 2013 Feb 28 [Epub ahead of print]
Homan GF et al Human Reproduction Update (2007) 13:209-223
Hamm E et al Am J Health Promot 2013 Dec 20.