Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief.
Based at Kensington Central London.Qualified as a medical doctor in Western medicine over 20 years ago in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many 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 for women and men, facial rejuvenation, acne, various pain conditions, chronic fatigue and hormone regulation with acupuncture treatment.

Practice contact for appointments and addresses 

Kensington: for appointments (Mondays, Fridays, Saturdays, and Thursdays) at Anamaya center Kensington 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: (Wednesdays)
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 in Western medicine 20 years ago in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Also I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. I am dedicated to treat patients with acupuncture and am recognized 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 practicing, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, neck pain, headache, migraine, shoulder pain, back pain, fatigue and hot flushes etc to achieve best treatment results. My devotion and skills are highly praised by my patients. 


Friday, 29 June 2012

Effectiveness of acupuncture on luteal phase defect associated with infertility and miscarriage

Women’s period cycle is divided into two phases: follicular phases when follicles develop and mature. The time for eggs to mature and release may vary between different women and same woman in different period cycle. This is the reason why period cycles vary to a great extent. When one of the eggs becomes mature, it is released from the ovary. As soon as egg is released, luteal phase began. Dwon KA and Gibson M studied body basal temperatures (BBT) charts and the luteal phase defect from three menstrual cycles of 20 normal women and 20 women with luteal phase defect. They found that luteal phase length in the normal women was 13.4 days and that of the women with luteal phase defect was 11.8 days. 30% of the women with luteal phase defect had luteal phases with less than 11 days and 5 of these women had severely endometrial problems. None of the normal women had luteal phase less than 11 days. Luteal phase does not vary much with length of period. It is normally12-14 days. After ovulation, the remaining part of the follicle forms the corpus luteum which continues to grow and produces a hormone called progesterone. Progesterone is very important for making inner lining of womb suitable for fertilized egg to implant and supporting for early pregnancy. The inner lining of womb is like a comfortable bed for the egg. If the luteal phase is shorter than 12 days, the bed is not ready. This may be because the corpus luteum dies earlier than12 days, your body may not produce enough progestone to make a good bed for the embryo. Luteal phase defect affects 10% women with infertility and over 60% women with miscarriage. The symptoms of luteal phase defect include a short period cycle, spotting, low progesterone, disrupted BBT after ovulation, and other nonspecific symptoms such as low back pain, vagina dryness etc.

There are three causes that could lead to luteal phase defect. 1) Poor follicle production: After ovulation, remaining follicle becomes corpus luteum. If follicle development is poor, this would create poor quality of corpus luteum which does not produce enough progesterone, resulting in poor uterine inner lining. 2) Premature failure corpus luteum. Corpus luteum does not last as long as normal corpus luteum does. This can occur even if initial quality of follicle is good. Again this makes poor uterine lining. 3) Failed response from uterine lining. In this case, uterine inner lining does not respond well to normal progesterone level. As a result it is not well developed for implantation.

According to traditional Chinese medicine (TCM) theory, luteal phase defect is caused by kidney or spleen qi deficiency. Or it is caused by liver qi stagnation. Qi deficiency and stagnation cause blood stagnation and blockage of channels. As a result corpus luteum dies earlier. This is agreed with recent research. During corpus luteum formation, it becomes one of the most highly vascularised organs in the body. Blood flow in the corpus luteum is important for the development of the corpus luteum and maintenance of luteal function. It is important for progesterone synthesis and release. The corpus luteum blood flow in women with luteal phase defect is significantly lower than women with normal luteal function. Increasing corpus luteum blood flow improves its function.

Acupuncture improves ovarian and corpus luteum blood flow. It is very effective to regulate period cycle and restore normal luteal phase. There was a report in Chinese Journals showing effectiveness of acupuncture on luteal phase defect with infertility. 50 patients were diagnosed luteal phase defect. Their age range is from 26 to 42 and average age 32. The history of difficulty to conceive is from 6 months to 4 years. Patients were received acupuncture. Pregnancy rate was calculated. Blood eostrogen and progesterone level was tested; egg development, ovulation and inner lining of womb were checked to measure the effectiveness of acupuncture. Result showed that 40% women achieved pregnancy during 3-6 months. In remaining 53% women, dominant matured egg size was increased, womb inner lining was thicker, blood oestrogen and progesterone level was increased comparing to those before the treatment. Follow up study with those pregnant showed that there was no miscarriage occurred.

Another report from China was about effectiveness of acupuncture treatment on patient with recurrent miscarriage. There were 558 cases with recurrent miscarriage 4 times. 211 cases were treated with acupuncture between 1973-1976; success rate was 86%; 347 cases were treated with acupuncture between 1982-1984, success rate was 93.4%.

References
Takasaki A et al J Ovarian Res. (2009) 14:2:1
Hongwei Yang and Xueyan Huang Shanghai Journal of Acupuncture and Moxibustion (2010) 10:626-628
Downs KA and Gibson M Fertil (1983) 40:466-8

Wednesday, 27 June 2012

Hot flushes, acupuncture is a good choice of treatment

Hot flush, acupuncture is a good choice of treatment

Because women are so busy all the time, they may not notice that they are growing older. Wrinkles may be already on our face; skin may become loose. Hormone level in the body has changed. Because of this change, it declared the old age’s coming. Some women may have unpleasant symptoms, such as hot flush, night sweaty; these symptoms may exist a few years before menopause starts and may last a few years afterwards. For them, pleasant summer became unbearable hot; night became sleepless nights. What can you do about it? Hormone replacement therapy may relieve the symptoms, but the risk to take is very big which include having breast cancer, stroke and dementia etc. For this reason, alternative treatment is a good choice. Acupuncture was recognised as an effective way to reduce hot flush. Borud et al performed a randomised controlled trial to study effectiveness of acupuncture for hot flush. 10 sessions of acupuncture were given to acupuncture group and advice on self-care was for control group. The results showed that acupuncture group has significant improvements in hot flush, sleep and other symptoms. Borud also analysed 16 clinical trial studies. Some studies showed that acupuncture reduces about 50% in hot flush frequency comparing with no specific treatment; the effect of acupuncture on frequency is smaller than that oestrogen therapy. They concluded that acupuncture reduces hot flush. Sunay D et al carried out a sham controlled clinical trial to investigate effect of acupuncture on hot flush and hormone levels. They not only showed that acupuncture relieved hot flush, but also showed that acupuncture lowered LH levels, increased oestrogen levels.

There are other promising research data supporting the effectiveness of acupuncture in hot flushes in menopausal women. Recently Baccetti et al from Italy conducted a randomized trial to investigate the effect of acupuncture treatment for hot flushes. One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training. 6 weeks acupuncture treatments were offered for these women. They found that treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating. They also found that other symptoms including sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed were also significantly improved after acupuncture treatments. They suggested that Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

A study of acupuncture on hot flushes was performed by Borud EK et al from the National research Center in Complementary and Alternative Medicine University of Tromso Norway in 2006/2007. There were 267 participants with hot flashes. Mean age was 53.8 year old. 134 women were in acupuncture group receiving 10 sessions of acupuncture treatment over 12 weeks. The most frequently used 10 acupuncture points were SP6, HT6, KI7, KI6, CV4, LU7, LI4, LR3, ST36 and KI3. 133 women were in control group receiving self care only. In acupuncture group 67 women responded to the acupuncture treatment. 64 women did not respond to the treatment. There were no serious side effects found in acupuncture treatments.

From this report, we can see that acupuncture could be effective on hot flashes for some people, tough not everyone responded to the treatment. If you have hot flashes, it is worth trying acupuncture to see if it works for you.

Acupuncture is for hot flashes in patients with cancer

Acupuncture is suggested to treat hot flushes in women with breast cancer and men with prostate cancer. How long does the effect last after the end of the acupuncture treatment period? Recently researchers analysed existing data including 172 patients. The data has shown that the average reduction of hot flashes from the start of acupuncture to the end of acupuncture was 43.2%. The 153 of 172 patients were followed up. After 3-9 months (average 5.8 months) from the end of the treatment period 45.6% of the patients remain at the same level of reduction. From this existing data, it can be seen that acupuncture effect on the hot flashes could last at least 3 months.

References

Borud EK et al Acupunct Med (2009) 27:101-10

Borud EK et al Menopause (2009), 16: 484-93

Borud E et al Auton Neurosi (2010), 157: 57-62

Sunday D Acupunct Med (2011), 29: 27-31

Baccetti S et al J Altern Complement Med (2014) May 14

Frisk JW et al Support Care Cancer 2014 Jan 30



Tuesday, 26 June 2012

Differences between Chinese acupuncture, western medical acupuncture and dry needling

Differences between Chinese acupuncture and western medical acupuncture

Acupuncture is originated from China thousands years ago known as Chinese acupuncture or TCM acupuncture. It is a complementary medicine as a part of Chinese medicine. It is based on qi, meridian theory or Yin Yang theory. In this theory, there is qi which is energy force flowing through meridians or channels freely. There are 14 channels on our body with 361 acupoints. Apart from these acupoints there are many extra points developed or to be developed. If these channels are blocked, qi cannot run through, this will cause disharmony of the body and unbalanced Yin and Yan. Diseases may occur. Chinese acupuncture is involved insertion of needles to certain acupoints to unblock the channels and restore body harmony and Yin and Yan balance. As a consequence, it cures illness.

Chinese acupuncture was introduced into Western countries for some time and adapted into western medical acupuncture using current knowledge of anatomy, physiology, pathology and principles based on modern medicine. This term of western medical acupuncture is used to distinguish it from traditional Chinese acupuncture. Since 1970s the concept of traditional Chinese medicine such as qi, Yin and Yang is no longer used in western medical acupuncture. It is accepted as a part of conventional medicine instead of alternative medicine. Many doctors and nurses practice acupuncture. Patients are benefit from these needling. The effectiveness of these needles is explained by stimulating nervous system. It is mainly used in releasing pain. Classical acupuncture points are still applied because they are proved to be the optimal points to stimulate the nervous system.

There are fewer differences between traditional Chinese acupuncture and western medical acupuncture in terms of treatment techniques. Both use manual and electrical needles. The same acupoints are selected as mentioned above. Duration of the acupuncture sessions vary from very brief to up to 20 min or 30 min.

Dry needling and acupuncture

Dry needling is a technique using acupuncture needles for the treatment of muscle pain. It is similar to acupuncture. The points that dry needling used are so called trigger points which are comparable to the ashi points in acupuncture theory. Trigger points in skeletal muscles are the most painful points on deep palpation. They also can trigger referred pain and motor dysfunction. The difference of dry needling from acupuncture is that it is not based on meridian theory, neither needles are not on the acupuncture points. Dry needling are practiced by many physiotherapists and chiropractors in many countries.

Thursday, 21 June 2012

Knee pain, acupuncture can help

If you are over 40 year old female and you are overweight with knee disease history, you are at great risk of having knee osteoarthritis.You could have pain and swelling in your knee and the pain is accompanied with stiffness and restricted movement. You could have grinding feeling when you move the knee. Osteoarthritis (OA) of the knee is the most common disabling condition and major cause of chronic pain. Knee pain or osteoarthritis affects 25% of people older than 55 year old and one third of populations over 65’s. There is a clear link between knee osteoarthritis and obesity. This may be due to mechanical, hormonal and genetic factors involved. Weight loss has benefit for reducing knee pain associated with knee osteoarthritis in those overweight.

Painkillers are common drugs used to reduce pain. Pharmacological therapies have limited applications because of either gastrointestinal side effects or cardiovascular risks. Research showed that muscle weakness is associated with knee pain, physical dysfunction and progress of the disease. Strengthening muscle is an important aspect of the treatment. Muscle strengthening and aerobic exercises are beneficial for reducing pain and improving physical function in patients with mild to moderate knee osteoarthritis.

Non pharmacological therapies for knee pain are increasingly popular. Complementary therapy is a major part for treatment of knee osteoarthritis. Acupuncture is one of the most commonly used applications and is very effective complementary treatment for knee osteoarthritis. Its use for relieving knee pain is supported by many research data. Lansdown H from the University of York UK performed a pilot study for a randomized control trial to compare effectiveness of acupuncture and usual care for knee osteoarthritis. 10 sessions of acupuncture was given to patients in acupuncture group on weekly basis. They found acupuncture has significantly better effect than usual care in patients with knee osteoarthritis. Corbett MS et al also from the University of York UK compared the effectiveness of acupuncture with other relevant physical treatments for reducing pain caused by knee osteoarthritis. They analysed 114 randomised controlled trials in patients with osteoarthritis of the knee pain. The trials covered 22 treatments and 9709 patients. Compared with standard care, there were eight interventions produced a significant reduction in pain. These interventions were interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise. Most good quality studies showed that both acupuncture and muscle-strengthening exercise were significantly better than standard care, with acupuncture being significantly better than muscle-strengthening exercise. They concluded that acupuncture can be considered as one of the more effective physical treatments for reducing osteoarthritis knee pain in the short term.

Recently there was more data showing the effectiveness of acupuncture on the treatment of knee osteoarthritis. This research compared the efficacy of different acupuncture methods at different stage of pain development. Patients in stage treatment group were received acupuncture at the tendon points of meridians and electric thermal needling method at the stagnation stage, small needling-knife therapy and bleeding method at the fascia cramp stage and electric thermal therapy with thick silver needles at the tendon lesion stage. Patients in electroacupuncture group received electroacupuncture at all three stages at specific acupoints. They found the total effective rate was 96.1% in the staging treatment group and was 91.1% in the electroacupuncture group. The controlled and remarkably effective rate was better in stage treatment group than that in electroacupuncture group which was also effective.

Cao L et al analysed 14 randomised control trials from July to October 2011, involving 3835 patients with knee osteoarthritis. They found that acupuncture has significantly better effects on reducing pain and restore joint function both in the short term and long term compared to sham acupuncture or standard care.

Acupuncture was shown to be effective in treating knee osteoarthritis, but there was still a debate if it is a specific effect or non specific effect. There is a research report about acupuncture in osteoarthritis of the knee. A new research was just published about acupuncture on knee osteoarthritis. This was a double-blinded randomised trial to identify specific and non specific effects of acupuncture on osteoarthritis of the knee by Karner et al from Heidelberg University Hospital Germany. Karner et al recruited 160 patients aged from 35-82 with knee osteoarthritis in three study centers. These patients were double-blindedly allocated into three groups: classic Chinese acupuncture group, modern acupuncture group and non specific needling. Knee flexibility and pain sensation were tested to measure the effectiveness of the treatment. Their result showed that improvement of knee flexibility was the highest for Chinese acupuncture among three groups, following by modern acupuncture. Pain relief for Chinese acupuncture was also the highest among these groups which was 73% for classic Chinese acupuncture, 64% for modern acupuncture and 48% for non-specific needling. They suggested that there was a specific effect of acupuncture in knee mobility and both non-specific and specific effects of needling in pain relief.

The question is that how many acupuncture treatments are enough to reduce knee pain? How frequent do you need to receive acupuncture treatment? The effects of acupuncture will depend on the stimulation intensity, frequency and repetition, and neurological level at which it is given. The precise location of the needles may less important. How much acupuncture treatment for knee pain is adequate? White A et al reviewed 13 studies. They defined that adequate acupuncture treatment consisted of at least 6 treatments, at least one per week, with at least four points needled for each painful knee for at least 20 minutes; needle sensation achieved in either in manual acupuncture, or electrical stimulation of sufficient intensity to produce more than minimal sensation. They found evidence that acupuncture that meets the adequate criteria is superior to sham placebo for treating chronic knee pain, in both the short term and long term. The results are reliable because the conclusions were drawn from high quality studies of reasonable size from different research groups.

Both manual and electroacupuncture helps knee osteoarthritis

There are a few types of acupunctures, are they all effective for knee pain or some types of acupuncture have better effects than others?

Electroacupuncutre and manual acupuncture are commonly used. Electroacupuncutre is a type of acupuncture which a small electric current is conducted between a pair of acupuncture needles inserted into the skin, while manual acupuncture is that only needles are inserted into the skin without using electric current. Many people think that effect of elecroacupuncture was better than manual acupuncture on knee osteoarthritis, is there any evidence for that? The answer is no. A recent study compared immediate effects of electroacupuncture and manual acupuncture on pain mobility and muscle strength in patients with knee osteoarthritis. They found that both electroacupuncture and manual acupuncture showed a significant reduction in pain intensity and time to run the TUG test after the acupuncture treatment. There were no differences between the groups regarding pain intensity, TUG test, maximum voluntary isometric contraction or pressure pain threshold. They concluded that this study found no difference between the immediate effects of a single session of manual acupuncture and electroacupuncture on pain, muscle strength and mobility in patients with knee osteoarthritis.

There was another study about evaluation on knee osteoarthritis treated with acupuncture. In this study there was 193 patients with knee osteoarthritis involved. After4 weeks of acupuncture treatment joint pain was reduced significantly and joint function was improved significantly as well. The effect was evaluated 4 week after termination of the treatment. This effect last at least 4 week after the termination of treatment. The acupuncture points used in this study include The acupoints in the two groups were Liangqiu (ST 34), Dubi (ST 35), Zusanli (ST 36), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Xiyan (EX-LE 4), Xiyangguan (GB 33).

Case report, knee pain with acupuncture treatment

Though long term effect of acupuncture in treating osteoarthritis is to be confirmed, there are many cases in which long term benefit can be seen clinically. For example Mary was 51, she had knee pain for a few years and she was diagnosed osteoarthritis. Her knee pain was getting worse in winter and getting better in summer. She had difficulty to climb stairs. In last winter, her knees were extremely painful and she hardly walked without pain. She decided to seek help from acupuncture. After first session of acupuncture, she felt less pain. With continuing a few sessions of acupuncture her knee pain was completely gone. A year on another winter arrived, she still did not have any pain on her knees.

Acupuncture reduced pain in patients with osteoarthritis by altering brain cortical thickness and brain activity

Osteoarthritis (OA) is a major health problem among the elderly and is associated with considerable disability. Recent research data have suggested that knee OA patients can benefit from acupuncture treatment. Some studies have shown that acupuncture may produce an analgesic effect through the endogenous descending pain modulatory system. Brain imaging studies have also shown that acupuncture needle stimulation can evoke widespread brain activity changes and modulate the functional connectivity of the pain processing network. A recent research has studied the effect of acupuncture on patients with knee osteoarthritis. Each patient received a total of 6 acupuncture treatment sessions in one month (twice per week for the first two weeks, once per week for the last two weeks). Result has shown that pain reduction in acupuncture group was significantly higher than that for control group. Daily living and quality of life showed significant improvement in acupuncture group compared to control group. Cortical thickness remained static in acupuncture group and decreased in control group. There was significantly stronger brain connectivity in acupuncture group compared to control group. This study has shown that acupuncture treatment can significantly modulate cortical thickness, functional connectivity, and clinical pain rating in OA patients. These results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by preventing cortical thinning and decreases in functional connectivity in major pain related areas, therefore modulating pain in the descending pain modulatory pathway.

References
Sridhar MS, et al J Bone Joint Surg Br. (2012) 94:433-40.
Iwamoto, Jun et al World J Orthop (2011) 2: 37-42
Lansdown H et al BMC Musculoskelet Disord. (2009) 24;10:130.
Cao L, et al Saudi Med J. ( 2012) 33:526-32.
Corbett MS et al Osteoarthritis Cartilage (2013) 21:1290-8
Cheng Y et al Zhongguo Zhen Jiu (2013) 33 :508-12
Karner M et al Evid Based Complemennt Alternat Med (2013): 2013:427265
White A et al Rheumatology (2007) 46:384-390
Plaster R et al Acupunct Med (2014) Feb 24. doi: 10.1136/acupmed-2013-010489
Chen X et al Sci Rep (2014) 4:6482

Monday, 18 June 2012

heart burn, acupuncture can help

Do you know anything about stomach? Stomach is food storage in our body. All food we eat from mouth will go into stomach which is located inside of upper abdomen. The food will then be stored there for up to a few hours. Meanwhile, the stomach produces acid and some enzymes, mixes them with the food which is ground to smaller pieces by the movement of stomach. This mixture will be sent to the duodenum and small intestine for absorption providing energy for our body.

Your stomach need to be well looked after; otherwise it would get sick. Not eating properly will upset your stomach. Stress, anxiety and depression may upset your stomach too. Many drugs you take orally could upset your stomach such as painkillers. There is no doubt that drinking too much alcohol and smoking can upset your stomach. The common benign disorders of stomach are stomach ulcers and gastritis which are caused by Helicobacter pylori infection. Stomach cancer is also caused by Helicobacter pylori infection. The lining of the stomach is damaged or inflamed. Stomach-ache is a common symptom of stomach diseases. The feature of the pain could be cramping, burning or dull; it may extend to the back. The pain is chronic and recurring. Other symptoms may be associated with it such as poor appetite, bloating, nausea and vomiting.

If stomach acid goes back up to oesophagus, this can cause gastro-oesophageal reflux disease (GORD); the lining of oesophagus is eroded by the acid. Heartburn is a common symptom of GORD. Heartburn is a burning chest pain and discomfort occurring after eating. Sore taste in the mouth is often accompanied, which is caused by the acid going back up to the mouth. Difficulty of swallowing is also common.

Sick stomach will affect your food digestion; as a result, it would affect your overall health. How to look after your stomach? Life style change can help you. Eat healthily and regularly avoiding food which could upset your stomach. Stop drinking too much and stop smoking. Don’t take painkillers which can upset your stomach. Acupuncture can help to look after your stomach. Takahashi T summarised the mechanisms of acupuncture effect on stomach problems. Acupuncture could reduce stomach pain and alter acid secretion and stomach movement. Also acupuncture has anti nausea and anti vomiting effects which will beneficial for the patients with stomach problems.

Reference
Takahashi T J Gastroenterol (2006) 41: 408-17

Monday, 11 June 2012

Acupuncture is effective for diabetic and idiopathic peripheral neuropathy

Acupuncture is effective for diabetic peripheral neuropathy

Diabetic neuropathy is that the nerves in the patients with diabetes were damaged which is caused by high blood sugar levels and decreased blood flow. In a high blood sugar environment nerve cells as well as repair mechanisms are more likely to be damaged. About 50% of patients with diabetes will develop nerve damage many years later after they have been diagnosed diabetes. Many nerves could be affected including cranial nerves (nerves in the skull), autonomic nerves (nerves for internal organs such as heart, stomach etc) and of course peripheral nerves (for instance, nerves for arms and legs). Symptoms may vary depending on which nerves are injured

If peripheral nerves (nerves for the arms and legs) are damaged, this is called peripheral neuropathy which occurs in 50% of the diabetes 2 patients. The early sign of peripheral nerve damage is abnormal sensation such as pain and numbness often started in the toes and feet. The symptoms tingling and burning pain and numbness could be present in the arms and legs. Some pain could be very severe. The nerve conduction became slow. Foot ulcer may occur because of poor blood supply to the skin. The symptoms are worsening with times and age.

The treatment for diabetic peripheral neuropathy included two aspects: first is to keep blood sugar controlled in a normal level to prevent further nerve damage; second is to reduce symptoms. Many medicines are available to relive pain symptoms. Long term use of these medicines could cause kidney damage. Recently there are many studies supporting using acupuncture for the treatment of peripheral neuropathy.

Recent research by Chinese clinicians showed that acupuncture helps improving symptoms of peripheral neuropathy. Chen etc (2009) and Ji XQ (2010) used randomized controlled trials to study effect of acupuncture on nerve conduction velocity in patients with diabetic peripheral neuropathy. They found that acupuncture significantly increased nerve conduction speed. Tong Y (2010) etc compared the effect of acupuncture in patients with diabetic peripheral neuropathy with that of sham acupuncture using randomised trials. After 15 sessions of acupuncture treatment, acupuncture significantly improved nerve conduction speed; acupuncture also significantly improved numbness, pain and rigidity in the arms and legs; vibration and temperature sensations were improved after acupuncture treatment. As we already know that acupuncture has analgesic effect and also acupuncture improves local blood flow, these could contribute to the effectiveness of the treatment.

Positive result of acupuncture in the treatment of diabetic painful neuropathy from Manchester

Role of acupuncture in the management of diabetic painful neuropathy (DPN) was studied by Garrow AP et al in Tameside Hospital NHS foundation Trust, Diabetes Center in greater Manchester UK. In this study, there were 45 patients involved and allocated to two groups real acupuncture group and sham acupuncture group which is a control group. A 10 week course acupuncture was offered to these patients and five standardised acupuncture points on the lower limb of each leg were used in the study: LR3, KI3, SP6, SP10 and ST36. Assessment was done before and after acupuncture treatments. Over the 10-week treatment period, small improvements were seen in Visual Analogue Scale which was used to assess lower limb pain, Measure Yourself Medical Outcome Profile and resting diastolic blood pressure in the true acupuncture group and little changes were in sham acupuncture group. They demonstrated the potential practicality and feasibility of acupuncture as an additional treatment for people with DPN. Acupuncture treatment was well tolerated with little side effects.

Peripheral nerve injury with acupuncture treatment

Peripheral nerve injury can occur through various traumas and it became increasingly common condition. Injury to motor nerves may produce symptoms including muscle weakness, atrophy, twitching and paralysis. Injury to sensory nerve may produce symptoms including continuous burning pain, sensitivity, numbness, tingling or pricking and problems with positional awareness. A first degree injury or neuraplaxia will recover quickly within a few months. The recovery will be completed with no lasting muscle or sensory problem. More severe injuries may take longer to recover completely or may not be fully recovered. The recovery depends on the severity of the injury and the time to get the treatment. Nerve injuries should be treated as early as possible. Apart from surgical treatment, nonsurgical treatments for nerve injuries include medication, massage therapy, orthotics, physical therapy and acupuncture. Studies showed that acupuncture has significantly better effect for nerve injuries than those without acupuncture treatment. Acupuncture provided immediate symptom relief for patients with peripheral nerve injuries. Acupuncture has effect to reduce pain sensation. Acupuncture also improves motor nerve recovery. In addition acupuncture improves nerve conduction over the period of treatment and has been shown effective for nerve repair. This indicates that acupuncture may help nerves regeneration. Acupuncture is a promising approach for nonsurgical treatment of peripheral nerve injuries.

Acupuncture helps with peripheral neuropathy

Peripheral neuropathy is a condition affecting nerves causing impaired sensation, movement, or other organ dysfunction. There are many factors causing the condition, such as diabetes, vitamin deficiency, medication, injury or infection etc. If the cause is unknown, this is called idiopathic neuropathy. The symptoms depend on which nerves are affected. For example, if motor nerves are affected, it could present painful cramps, muscle twitching, muscle weekness, muscle loss, bone degeneration, impaired balance and coordination. If sensory nerves are affected, it may present numbness, loss of sensation, poor balance and coordination, tingling, burning pain etc. If autonomic nerves are affected, it may present poor bladder control, abnormal blood pressure and heart rate, sweat changes abnormally.

Acupuncture can help with peripheral neuropathy, by improving blood supply to the nerves, reducing inflammation and increasing nerve conductivity.

Acupuncture helps motor nerve injury recovering

Recent research from China reported the effectiveness of acupuncture for peripheral nerve injury. Xiao GR et al did a control trial study which investigated and compared the effects of acupuncture on peripheral nerve injury with that of function training and no treatment. They recruited 90 patients and allocated them into three groups: acupuncture group, function training group and control group with each group of 30 patients. After three months of treatments basic function, practical function, EMG, nerve conduction velocity were compared among the 3 groups. They found that the acupuncture group achieved the best recovery; the function training group is the second. They suggested that acupuncture plus function training can accelerate nerve repair, promote functional recovery of the muscles.

Another case report was from Millea PJ in Medical College of Wisconsin USA. A 41-year old female with a 1 week history of inability to write or extend the right wrist received 1 session of acupuncture treatment. Wrist motion returned strait away after the treatment. After acupuncture treatment wrist splint was then used. On the same day, the patient reported increasing strength in wrist and finger extension. On the next day, the patient cancelled the second session of acupuncture treatment, because of her hand recovered. 4 month followup found all wrist and finger extension, sensation and return of the brachioradialis reflex were normal. 1 year followup showed fully recovery to normal. Acupuncture potentially facilitates recovery and may accelerate peripheral motor nerve injury recovery. Although evidence that acupuncture is effective for any type of motor nerve injury is limited to case reports and case series, these findings are beneficial.

Common peroneal nerve palsy, acupuncture can help.

Common peroneal nerve palsy is damage to the peroneal nerve which is a branch of the sciatic nerve and supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve palsy is a type of peripheral neuropathy. This condition can affect people of any age. The peroneal nerve palsy leads to loss of movement or sensation in the foot and leg. There is a loss of feeling, muscle control, muscle tone, and eventual loss of muscle mass because the nerves aren't stimulating the muscles.

The causes include Trauma or injury to the knee, fracture of the fibula (a bone of the lower leg), use of a tight plaster cast (or other long-term constriction) of the lower leg, crossing the legs regularly, regularly wearing high boots, pressure to the knee from positions during deep sleep injury during knee surgery or from being placed in an awkward position during anesthesia, or unknown reasons. People who have diabetes or exposed certain toxins are in high risk.

The symptoms include decreased sensation, numbness, or tingling in the top of the foot or outer part of the upper or lower leg, foot drops, walking problems including slapping gait and toes drag while walking, weakness of the ankles or feet. Examination shows Loss of muscle control in the lower legs and feet, atrophy of the foot or leg muscles, difficulty lifting up the foot and toes and making toe out movements. Nerve conduction tests show reduced conduction velocity.

Treatments including surgery, physiotherapy etc are aimed for improving mobility and independence. Acupuncture helps improve recovery of peroneal nerve function and increase nerve conductivity. Acupuncture can also reduce pain caused to nerve injury.

References
Chen YL Journal of Chinese integrative medicine (2009), 7:273
Ji XQ Zhen ci yan jiu (2010), 35; 443-7
Tong Y J Acupunct Meridian Stud. (2010) 3:95-103.
Millea PJ J Altern Complement Med (2005) 11: 167-9
King JC. Peroneal neuropathy. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal disorders, pain and rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 66.
Yao ZH et al J Tradit Chin Med (1984) 4:97-100
Xiao GR et al Zhongguo Zhen Jiu (2007) 27:329-32
Garrow AP et al Acupunct Med (2014) Mar 21. doi: 10.1136/acupmed-2013-010495

Sunday, 10 June 2012

Allergic rhinitis with acupuncture treatment

Allergic rhinitis is a very common condition in UK affecting over 30% populations. It is caused by allergy. House dust mites and pet skin flakes are common allergic antigens, which make the inside of the nose inflamed. The symptoms of allergic rhinitis are like common cold, such as sneezing, running or blocked nose, headache, disturbance of sleep etc. These symptoms could be irritating and affecting people’s quality of life. Nasal sprays and antiallergic medicines such as antihistamine drugs and steroids are useful, but not suitable for long term use. Patients turned to complementary and alternative medicine treatment to reduce symptoms and improve quality of life. Recent research study suggested that acupuncture is effective to improve patient symptoms and overall health.

A randomized trial study by Brinkhaus B. etc (2008) provided evidence for effectiveness of acupuncture treatment for allergic rhinitis by assessing patient quality of life. They compared acupuncture and routine care for patients with allergic rhinitis. 5237 patients average aged 40 year old were included in this study. The patients were allocated in to two groups: acupuncture group and control group. 15 acupuncture sessions during a period of 3 months were given to the patients in acupuncture group and no acupuncture received for those in control group. Quality of life survey was evaluated after 3 and 6 months. Results showed that quality of life was improved better in acupuncture group both at 3 and 6 months. They concluded that acupuncture played a part in treatment for allergic rhinitis and patient benefit.

Shiue HS etc was the first group using cDNA microarray analysis to study effect of acupuncture on blood gene expression for inducing immune and inflammatory response in patients with allergic rhinitis. They compared the gene expression in blood before and after acupuncture treatment. They studied 18 patients with allergic rhinitis. 8 sessions of acupuncture was given over 4 weeks and the blood was taken at each visit for gene expression analysis. Quality of life was also assessed using quality of life questionnaire. They found that gene expression in these patients was significantly decreased at 2 hours, 24 hours and 4 weeks after acupuncture treatment. This means acupuncture altered immune system function. The allergic rhinitis symptoms were also improved. They suggested that acupuncture is effective in treating allergic rhinitis by improving patient immune defence system.

Hay fever known as seasonal allergic rhinitis is a seasonal allergic reaction to pollen from grasses, weeds or trees. It usually occurs during the spring and summer when the pollen is carried in the air. Hay fever, asthma, food allergies and eczema are related allergic conditions. About one in five people in the UK have an allergy such as hay fever and these allergies are becoming more common. They can run in a family. Symptoms of hay fever include sneezing, a blocked or runny nose, itchy eyes, nose, throat and roof of the mouth, headaches. This could disturb your sleep and make you not concentrating.

Treatments of hay fever include

Self help: try to stay indoor and keep windows closed on the days when the pollen count is high.

Medicines: Antihistamine tablets usually reduce sneezing and a runny nose, but may not improve a blocked nose. Some of antihistamines can cause drowsiness. A steroid nasal spray can help prevent symptoms such as blocked nose. A decongestant nasal spray can improve a runny nose or blocked nose. Eye drops can help with itchy or sore eyes. Immunotherapy is also available to severe cases.

Research has shown that acupuncture treatment is effective for hay fever. It improves quality of life in patients with hay fever though it is not most cost effective treatment.

As stated above acupuncture can help with hay fever.

References
Yu L etc. Zhongguo Zhen Jiu. (2010) 30:787-92.
Tan C etc. Zhen Ci Yan Jiu. (2011) 36:302-6.
Yang QY etc Clin Rev Allergy Immunol. 2012 Jun 3.Brinkhaus B etc Ann Allergy Asthma Immunol. (2008)101:535-43.
Shiue HS eetc J Altern Complement Med. (2008) 14:689-98.
Reinhold T et al Ann Allergy Asthma Immunol. (2013) 111:56-63

Saturday, 9 June 2012

What gynaecological diseases are suitable for acupuncture treatment

Acupuncture is very effective for some common gynaecological disorders.

Endometriosis: Endometriosis is a condition in which endometrial cells grow outside of uterus. These misplaced tissues are mostly found on the ovaries and fallopian tubes and in the pelvic cavity etc. These cells respond to the ovaries hormonal cycles each month, but are inseparable from the tissues, which cause scarring and adhesions. Endometriosis does not always produce symptoms. When it does, it mainly causes pain, irregular menstrual bleeding and infertility. Many women experience period pain, intercourse pain and pelvic pain which is unrelated to menstruation and intercourse. Irregular menstruation, excessive bleeding and clot are common. About 50% infertile women suffer from endometriosis. There are different treatments available, such as pain relief, hormonal treatments and surgery etc. Some women may benefit from alternative medical treatments. Acupuncture reduces pain by producing endorphins. Acupuncture is proven an effective complementary management for endometriosis in patients with infertility. Acupuncture improves local circulation, balances hormonal levels, reduces inflammation and improves immune function. Recent studies showed that the ectopic tissues were reduced and the invasion of ectopic tissue to extracellular matrix was inhibited. The symptoms such as period pain, irregular menstruation and chronic pelvic pain in endometriosis were significantly improved.

Polycystic ovary syndrome (PCOS): PCOS is a common endocrine disease in women. There are many small fluid-filled cysts in ovaries which referred to polycystic ovaries. The symptoms include absent or irregular period, infertility (About 20% women with infertility have PCOS) because of anovulation, excess hair on the body and acne. Acne could be treated with benzoyl peroxide and oral contraceptive pills. Metformin and clomifene are used to induce ovulation. Surgery may be necessary for the treatment. Assisted conception would be needed for women with infertility. Acupuncture may improve endocrine system function, regulate blood hormone levels and improve ovary ovulation. Acupuncture may also reduce the cyst size and numbers

Infertility: Acupuncture is a valuable therapy for female infertility.

Hormones required for fertility. There are three organs involved in hormone production in women: hypothalamus, pituitary gland and ovaries. We call them hypothalamus pituitary ovarian axis. Hypothalamus releases Gonadotrophine-releasing hormone (GnRH), which acts on the anterior pituitary gland to release follicle-stimulating hormone (FSH) and Luteinising hormone (LH). FSH stimulates oestrogen release from ovary, whereas LH stimulates progesterone secretion from the corpus luteum in ovary. Ostrogen has a negative feedback effect on pituitary gland reducing gonadotrophine secretion; Progesterone has a negative feedback effect on hypothalamus and pituitary gland, reducing LH releasing.

Key steps for fertility in women. Many ovarian follicles in ovaries in reproductive age women grow stimulated by FSH, but normally only one of them become mature and are released from the ovary each period cycle (we call it ovulation) triggered by LH. The egg released travels through a fallopian tube where fertilisation occurs when a sperm penetrating into the egg and then the fertilised egg will travel to the uterus and implant in inner lining of uterus where the fetus may grow. Thus pregnancy begins. If for any reasons, any of these factors are interrupted, it will result in infertility.

Women's infertility could be caused by many diseases, though some of it is without underlying causes or the underlying causes could not be found.

Causes of female infertility:

Ovulation disorders:

First of all, hormonal problem will cause anovulation. As we already know, hormones mentioned above are very important for fertility. Ovulation depends on the balance of these hormones; any disruption of the hormone balance can cause anovulation. These could be results of three levels: 1, Ovaries fail to produce mature eggs. In this case ovaries do not produce normal follicles causing immature eggs which cannot be ovulated. Polycystic ovary syndrome is the common condition of this category. 2, Hypothalamus does not function well. Hypothalamus is the start of hypothalamus-pituitary-ovarian axis. If hypothalamus fails to produce or release GnRH, the hormonal system will lose the balance, immature eggs will be produced. 3, Pituitary gland is not normal. FSH and LH produced by pituitary gland are very important hormones for egg development and maturation. Pituitary gland disorders will result in abnormal FSH and LH level causing ovulation problem.

Secondly, Scarred ovaries could lead to anovulation. For instance, surgery, endometriosis and pelvic infection might cause ovary scars in which case ovaries may fail to ovulate.

At last, other ovarian problems are responsible for anovulation, for example, premature ovarian failure.

Fallopian tube problems:

Fallopian tubes can become constant spasm, mild adhesions and complete blockage. One of the common causes for this is pelvic or abdominal infection that affects fallopian tubes. Other one is pelvic or abdominal surgery causing adhesions. The eggs cannot pass through the blocked tubes causing infertility.

Endometriosis:

Endometriosis causes infertility, because the overgrowth causes adhesion and it could scar ovaries, block fallopian tubes or disrupt egg implant in uterus, depending on where it grows.

Uterus disorders:

Some uterus problems could result in infertility, such as fibroids, polyps probably because of obstruction of the uterus or fallopian tubes.

Cervical mucus problem:

Hormone imbalance, for instance, too little estrogen or too much progesterone causes abnormal cervical mucus which makes it harder to conceive.

Other risk factors:

Obesity is a growing issue in many countries. Body mass index (BMI) (kg/m2) is used for definition. According to world Health Organization (WHO) standard, a BMI of 18.5-24.9 is within a normal range; 25-29.9 is overweight and ≥30 is obese. Obesity has negative effects on many aspects of women’s health. Fertility is one of them. Obese women are more likely to experience infertility, they are more likely not to response to fertility treatment and there is high risk of miscarriage and low live birth rates. Obesity associates with infertility from the impact on many aspects. Previous studies have shown lower number of oocytes retrieved; poorer egg quality due to impaired oocyte maturation and fertilization; poorer embryo quality. The reasons for these are: obesity is related to alterations in various hormones, such as LH. In addition, obesity increases insulin, glucose, or free fatty acids and changes in some proteins. Obesity is also linked with polycystic ovary syndrome (PCOS). Systemic inflammation may contribute to the causes of infertility in obesity.

Obese women respond poorly to ovulation induction resulting in fewer oocytes harvested, they required higher doses of gonadotrophins and took longer to ovulate. They have lower pregnancy rates and increased risk of early pregnancy loss. Obesity is associated with a significant rise in failure in assisted reproduction. Weight loss makes menstrual cycles regular and increases the chance of spontaneous ovulation.

Drugs, such as chemotherapy drugs and anti-depressants may cause infertility.

Environmental factor: such as exposure to lead could compromise fertility.

Smoking, alcohol and stress are recognised as risk factors.

Age, Women's fertility is linked to age. After 35 year old, the fertility is declining significantly.

Dysmenorrhea: Dysmenorrhea or period pain is the most common gynaecological complaint among adolescent females. Lower abdominal chronic pain is the most common symptom accompanied with or without other symptoms such as headaches, nausea and vomiting. Typically symptoms occur at around the start of menstrual flow and last for the first 24-48 hours. Smoking may prolong the duration of the pain due to nicotine-induced vascular vessel constriction. The majority of the period pain is primary or functional, associated with normal ovulatory cycles without pelvic pathological changes and has a clear physiological etiology. The pain for primary period pain is caused by over-production of prostaglandins (PGs) and leukotrenes (LTs) within the endometrium after ovulation. PGs and LTs are inflammation modulators which cause myometrial contractions and vasoconstriction resulting in local tissue ischemia, which is involved in cramp pain.

Treatment for primary period pain is divided into two categoies: traditional (ie, medical and surgical) and alternative. Traditional approach includes nonsteroidal anti-inflammatory drugs, which inhibit PG synthesis, combined oral contraceptives and long-acting hormonal therapies. Alternative approach is as follows: vitamins including vitamin E and B1, previous research suggested that vitamin E and B1 significantly reduce period pain through inhibition of PG synthesis; minerals such as magnesium; diet containing omega-3 fatty acids (such as fish) which lead to the uterine production of less potent PGs; transcutaneous electrical nerve stimulator; and last but not least, acupuncture. Acupuncture has analgesic effect. There was one study which investigated the effect of acupuncture in the treatment of primary period pain. The result showed significant difference of pain relief between acupuncture group and control group (without acupuncture). Acupuncture is very effective on primary period pain probably by regulating prostaglandin F2α (PGF2α) level in menstrual fluid and also regulating hormones related receptors.



Uterine fibroids: Uterine fibroids are most common benign tumours in uterine, occurring predominantly in middle or late reproductive ages in women. They may be asymptomatic or may cause series of symptoms, such as, irregular vaginal bleeding, heavy menstruation, severe period pain, intercourse pain, lower abdominal discomfort, lower back pain and urinary frequency and retention. They may also be a cause of infertility. They may interfere with embryo implantation and may cause miscarriage or premature labor during pregnancy.

The location of the tumour is an important factor of causing symptoms. Intramural fibroids are a most common type: they are located within the uterine smooth muscle wall either asymptomatic or causing symptoms, if they grow bigger. Submucosal fibroids are situated in the smooth muscle wall just underneath endometrial layer (inner layer) of the uterus, easily causing irregular vaginal bleeding. There are also two other types of fibroids: One type is subserosal fibroids growing under mucosal layer (outer layer) of the uterus, which can be very large without symptoms. The other uncommon type is cervical fibroids, found in the cervical wall. Transvaginal ultrasound, a non-invasive procedure is usually performed to diagnose the presence of uterine fibroids, which can be located and measured. Uterine fibroids could be single or multiple. Their growth is strongly stimulated by estrogen and prosgesterone. After menopause, the tumours shrink. Asymptomatic fibroids do not need treatments, however, intolerable symptoms do need to be treated. Medications are employed to control the symptoms and shrink the tumours, such as, danazol. Surgeries such as myomectomy and hysterectomy are applied to remove the fibroids. Apart from these methods of treatments, acupuncture is an effective method to reduce symptoms, such as vaginal bleeding, lower abdominal pain and lower back pain and it also makes the tumours shrink or vanish. Acupuncture is effective in treatment of uterine fibroids by regulating the pituitary gland, the thyroid gland system and the central nervous system.

Primary ovarian insufficiency (Premature ovarian failure): The ovary is unique in the female endocrine system in which follicle is developed every month and matured egg is released. Ovary produces sex steroids, which are necessary for development of reproductive organs and maintaining bone density and general health. Regular monthly menstruation after ovulation is an indication of healthy ovarian function. Menopause, permanent cessation of menses occurs at age of around 50. If menopause occurs before age 40, this is considered to be premature, called primary ovarian insufficiency which is a subclass of ovarian dysfunction. The main symptoms of this disorder are amenorrhoea for at least 4 months, sex steroid hormone deficiency and high follicle stimulating hormone (FSH). It is worth mentioning that about 50% of women with primary ovarian insufficiency have intermittent ovarian function causing irregular menses, instead of complete amenorrhea. Symptoms of estrogen deficiency are at present in many, but not all patients, which include vasomotor symptoms (hot flashes and night sweats), sleep disturbance, and intercourse pain due to vaginal dryness. Many causes lead to secondary amenorrhea, of which the polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia are three main causes. Hormone-replacement is first line therapy which physiologic estrogen and progestin are given to patients until the age when menopause usually occurs. Patients should take a pregnancy test if a menstrual period is late and therapy should be stopped, if the pregnancy test is positive. Oral contraceptive is another option. Calcium and vitamin D are recommended for maintaining healthy bone. Acupuncture help restoring body hormone balance by acting through meridian.

Dysfunctional irregular uterine bleeding or heavy period: This is a common condition in women's clinic which is caused by six hormonal level changes. The symptoms include heavy bleeding, prolonged bleeding days (more than 7 day), irregular cycles (shorted than 21 days or longer than 35 days. Anemia may occur because of losing too much blood. Underlying pathological conditions must be excluded before the diagnosis has been made. Acupuncture is effective to normalise uterine bleeding and improve full blood court.

Chronic pelvic inflammation: Pelvic inflammatory disease is the infection and inflammation of the female upper genital tract, one of the most common diseases in reproductive age women, which associates with infertility, ectopic pregnancy and chronic pelvic pain. A broad spectrum antibiotic should be first considered. Acupuncture is very effective for treatment of chronic pelvic inflammation by relieving the pain, anti inflammation and improvement of local circulation.

Menopausal syndrome: Menopause is caused by falling levels of estrogen and progesterone in women at the end of reproductive age, which produces a series of symptoms including hot flushes, night sweats, vaginal dryness, mood swings, insomnia, fatigue, irritability, anxiety, depression, heart palpitations, joint pain and osteoporosis. Hormone replacement therapy (HRP) is one option of treatments to reduce physical symptoms associated with menopause and avoid the conditions from estrogen-deficiency. But many researchers reported that long-term use of HRP causes serious adverse effects such as thrombosis, stroke and breast cancer etc. which limited HRP application. There indeed has been increased interest in alternative and complementary medicine such as acupuncture which has far less side effects. A number of studies showed the effects of acupuncture in the treatment of premenstrual syndrome, for example for hot flushes. One study published in the journal Acupuncture in Medicine by Turkish’s researchers showed that acupuncture group with acupuncture twice a week for ten weeks significantly improved the hot flushes and mood swings symptoms compared to the control group. Another study by Norway researchers reported improvement in frequency and intensity of hot flushes both by night and by day with acupuncture for 12 weeks.

Acupuncture is used for treating women’s reproductive health conditions as mentioned above. In Australia and New Zealand, three areas of women's reproductive health were commonly treated with acupuncture: treating gynaecological health, treating pregnancy conditions, and fertility conditions. The most commonly treated gynaecological conditions were premenstrual syndrome, menopause and primary dysmenorrhea. Other applications include treating general fertility not related to assisted reproduction, treatment for a diagnosed fertility related conditions, and to decrease infertility related stress. The most common pregnancy related conditions treated with acupuncture were nausea, back or pelvic pain, and prebirthlabour preparation.

References

Zhou and Qu. Afr.J.Trad. CAM (2009) 6: 494-517

Balen AH and Jacobs HS (2003). Infertility in Practice

Sanfilippo J and Erb T Clinical Obstetrics and Gynecology (2008), 51:257-267

Lawrence M. Nelson (2009), N Engl J Med, 360:606-614

Lim CE and Wong WS.Gynecol Endocrinol. 2010, 26:473-8.

Pandey S, etc J Hum Reprod Sci. (2010)3:62-7.

Scott H. etc J Assist Reprod Genet (2011) 28:517–524

http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/Causefem.htm

Smith CA et al Complement Ther Med (2014) 22:710-8