Research: Gynaecological disorders

• Miscarriage
• PCOS
• Endometriosis
• Anovulation
• Painful Periods / Dysmenorrhoea
• Heavy Bleeding / Menorrhagia
• Dysfunctional Uterine Bleeding
• Uterine Fibroids
• Premenstrual Syndrome / PMS
• Menopause
• Ovarian Cysts or Polyps
• Absent or Excess Vaginal Discharge

Miscarriage (Acupuncture)

Acupuncture for Miscarriage Acupuncture aims to rebalance the hormones after a miscarriage and gently rebuild the body and provides emotional support. Rest is encouraged and if another pregnancy is planned, acupuncture can help with preconception. Acupuncture can increase blood flow to the reproductive organs so that eggs and sperm are bathed in nutrient-rich blood while they are maturing. Better quality eggs, endometrial lining and sperm lead to better quality embryos and healthy implantation.

Miscarriage (Herbs)

Recurrent miscarriage and Chinese herbal medicine The effect of Chinese herbal medicine in threatened miscarriage was observed in a study at Shanghai Gynaecology & Obstetrics Department of Shanghai Medical University. In 40 women with threatened abortion and a history of miscarriage, blood test showed threatened abortion (TA), compared to the blood test of normal pregnant women (The plasma beta-EP level in TA was significantly higher than that in normal pregnant women, P < 0.01. On the contrary, plasma GnRH, HCG and P4 were obviously lower in TA as compared with those of the normal cases, P < 0.01.) After treatment with Chinese herbal medicine that supported reproduction and blood circulation and protected the foetus, 36 of the 40 patients continued their pregnancy without symptoms of TA, and the above-mentioned four criteria measured at 10-12th week of gestation were similar to those of normal cases, P > 0.05. The authors concluded that Chinese herbal Medicine can regulate plasma beta-EP and placental endocrine function in threatened abortion in women with a history of recurrent miscarriage. Sun F, Yu J. [Effect of TCM on plasma beta-endorphin and placental endocrine in threatened abortion] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Feb; 19 (2):87-9. Recurrent miscarriage with immulogial basis and Chinese herbal medicine A study in Japan showed that recurrent miscarriages with an immunological component (rejection of the foetus as foreign) benefit positively to the treatment with Chinese herbal medicine. Twelve patients with recurrent abortion who had shown positive anti-phospholipid antibodies were treated through the administration of a Japanese modified traditional Chinese herbal medicine Sairei-To (Cai ling Tang). The patients had experienced a total of 27 spontaneous abortions in their previous pregnancies and had no other pregnancy history except for one patient. The patients were treated with 9.0 g of Sairei-To per day before their next pregnancy. The positive value of antiphospholipid antibodies returned to negative in 9 patients out of 12 patients through the treatment. Out of 12 patients, 10 patients continued their new pregnancy uneventfully, and they delivered an offspring (Success rate: 83.3%). Thus, the current treatment was considered to be an effective therapy for patients with recurrent abortion whose miscarriage is immune related (positive anti-phospholipid antibodies). Takakuwa K, Yasuda M, Hataya I, Sekizuka N, Tamura M, Arakawa M, Higashino M, Hasegawa I, Tanaka K. Treatment for patients with recurrent abortion with positive antiphospholipid antibodies using a traditional Chinese herbal medicine. J Med. 1996; 24(5):489-94.

PCOS (Acupuncture)

Electro acupuncture treatments induce regular ovulations in women with PCOS In a study of twenty-four women (age 24-40) with PCOS and oligo-/amenorrhea research shows that repeated electro-acupuncture treatments induced regular ovulations in 9 women (38%), more than one third of the women with PCOS. Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO: Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2000, 79:180-188.

PCOS (Herbs)

Chinese herbal medicine for PCOS In the treatment of Polycystic Ovary Syndrome (PCOS), 100 patients with high LH levels showed significant reduction in these levels, 50% in the PCOS group, and 60% in the non PCOS group. (Effects of unkei-to, an herbal medicine, on endocrine function and ovulation in women with high basal levels of luteinizing hormone secretion. J Reprod Med (2001) Vol 46 (5): 451-6.) Chinese herbal medicine for PCOS In 2006 two groups were given two Chinese herbal formulas formulas (dang gui chao yao san, and gui zhi fu ling wan). Only 10 of the 64 women ovulated on these formulas. But when they switched to another Chinese herbal formula Wen Jing Tang 59.3 % ovulated. (Effects of switching to wen jing tang (unkei-to) from preceding herbal preparations selected by eight-principle pattern identification on endocrinological status and ovulatory induction in women with polycystic ovary syndrome. American Journal of Chinese Medicine. (2006) Vol 34 (2):1 77-87.) Chinese herbal medicine has a higher efficacy in restoring ovulation and normal BBT measures in PCOS The effectiveness of a Chinese formula called ‘Tian gui fang’ in comparison with metformin was tested on patients with polycystic ovarian syndrome [PCOS]. The patients were divided into two groups and either Tian gui fang or metformin was administered for three months. After treatment, 4 out of the 8 patients on metformin had restoration of menstrual cyclicity, and two of them had a double phase BBT. The testosterone levels had decreased. No other measures changed. In the group that received the Chinese medicine, 6 patients out of 8 had a restored cycle as well as a double phase BBT. Testosterone and the body mass index (BMI) decreased significantly. The authors conclude that both therapies can induce ovulation but that Chinese herbal medicine has a higher efficacy in restoring ovulation and normal BBT measures. Hou J, Yu J, Wei M. ‘[Study on treatment of hyperandrogenism and hyperinsulinism in polycystic ovary syndrome with chinese herbal formula ‘tian gui fang]’. Zhongguo Zhong Xi Jie he Za Zhi. 2000; 20 (8):589. Chinese herbal medicine and PCOS The effectiveness of a Chinese herbal formulary was tested on patients with high LH levels due to polycystic ovary syndrome. Eight weeks of treatment with Chinese herbal medicine significantly reduced plasma LH. Ushiroyama T, Ikeda A, Sakai M, Hosotani T, Suzuki Y, Tsubokura S, Ueki M. ‘Effects of unkei-to, an herbal medicine, on endocrine function and ovulation in women with high basal levels of luteinizing hormone secretion.’ J Reprod Med. 2001 May; 46(5):451-6. Chinese herbal medicine and PCOS In Japan, a Chinese herbal formulary was tested on patients with polycystic ovarian disease [PCOD] to find an effective treatment without side effects that could be used instead of clomiphene citrate or gonadotropin therapy. After a course of treatment, the FSH/ LH ratio had significantly decreased, and the ovulatory rate was 70.6%. Serum testosterone did not change during treatment. The authors conclude that the Chinese formula may be useful for the treatment of anovulation in PCOS patients. Sakai A, Kondo Z, Kamei K, Izumi S, Sumi K. ‘Induction of ovulation by Sairei-to for polycystic ovary syndrome patients.’ Endocr J. 1999 Feb; 46(1):217-20.

Endometriosis (Acupuncture)

Acupuncture and Endometriosis In a study published in the December 2002 issue of The Journal of Traditional Chinese Medicine researchers selected 67 women diagnosed with dysmenorrhea (painful periods) due to endometriosis. It was reported that 81% of these women had less painful periods after receiving the acupuncture treatments. Research shows that acupuncture promotes blood circulation, regulates the endocrine system and suggests that acupuncture could act as an analgesic by elevating levels of endorphins in the blood. Less painful periods with acupuncture In a study published in the December 2002 issue of The Journal of Traditional Chinese Medicine researchers selected 67 women diagnosed with dysmenorrhea (painful periods) due to endometriosis. It was reported that 81% of these women had less painful periods after receiving the acupuncture treatments. Research shows that acupuncture promotes blood circulation, regulates the endocrine system and suggests that acupuncture could act as an analgesic by elevating levels of endorphins in the blood.

Endometriosis (Herbs)

Endometriosis and Chinese herbal medicine A study from Beijing compared three treatment methods to find the most effective treatment for endometrial ovarian cysts. 152 patients with endometrial ovarian cysts were divided into three groups: an integrated laparoscopy and Chinese herbal medicine (combination group), a Chinese herbal medicine group, and a Danazol group. The clinical efficacy, side-effects and reproductive hormones were compared. The shrinking rate and disappearance rate of the cysts were highest in the combination group as was the pregnancy rate. Few side effects were noticed in the combination and Chinese herbal medicine group. The authors conclude that combining laparoscopy with Chinese herbal medicine is an effective treatment for endometrial ovarian cysts with minimal side effects and a maximal preservation of the reproductive function. Wu Y, Hua L, Jin Y [Clinical study on endometrial ovarian cyst treated by integrated laparoscopy and Chinese herbal medicine] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Mar; 20 (3):183-6. Chinese herbal medicine better than danazol A study was carried out in Shanghai to explore the mechanism of treating endometriosis by tonifying Kidney and removing blood stasis with Neiyixiao Recipe (NYXR). METHODS: One hundred and three patients with endometriosis were divided randomly into the NYXR group (58 cases, treated with NYXR) and the control group (45 cases, treated with danazol) and were reviewed for the improvement of clinical symptoms, serum level of FSH, LH, PRL, E2, P and T, humoral and cellular immunity (C3, C4, CD3, CD4, CD8), and plasma prostaglandin after treatment. RESULTS: There was no significant difference in effect between the NYXR group and the control group in relief of dysmenorrhea and degradation of elevated plasma prostaglandin (chi 2 = 0.71, P > 0.05). But there was significant difference between the two groups in curing infertility (chi 2 = 14.77, P < 0.01), and the effect of NYXR in regulating endocrine and immunity was significantly better than that of danazol. The authors conclude that by tonifying Kidney and removing blood stasis, Chinese herbal medicine is an effective method for the treatment of endometriosis, simultaneously maintaining and improving fertility. Liu J, Li X, Hu X. [Clinical observations on treatment of endometriosis by tonifying kidney and removing blood stasis] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1998 Mar;18 (3):145-7. Chinese herbal medicine could modulate the immunologic disturbance in women with endometriosis A study in Shanghai tested the therapeutic mechanism of endometriosis by the treatment of Yiqi Huoxue Huayu Tongfu Principle (YQHXHYTFP, tonifying Qi and promoting blood circulation to remove stasis and purgation therapy) with Neiyi 1+ pill. Methods: Forty-five cases with endometriosis were divided randomly into TCM group (30 cases, treated with Neiyi 1+ pill) and the control group (15 cases, treated with tamoxifen). The activity of natural killer cell of peripheral blood, T lymphocyte subsets, secreting interleukin-II and the EmAb were determined. Results: Endometriosis is associated with immunologic disturbance. After treatment, the activity of NK cells and the count of T-suppressor cells were significantly increased (P < 0.01), the count of T-helper cells, the secretion of interleukin-II and TH/TS ratio were significantly reduced (P < 0.01). Over 50% of the cases whose EmAb was positive eventually turned to negative. The effective rate of this therapy was 90%. There was no significant difference between TCM group and the control group. Conclusion: Chinese herbal medicine could modulate the immunologic disturbance in women with endometriosis, and could clearly improve clinical symptoms and signs. Li J, Zheng J, Wang D. [Clinical observation on treatment of endometriosis by tonifying qi and promoting blood circulation to remove stasis and purgation principle] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Sep; 19 (9):533-5. Chinese herbal prescription is as effective as danazol for the treatment of endometriosis, without observed side effects A study in Kunmin aimed to find a medicine that treats endometriosis effectively with less side-effects. Methods: A Chinese herbal prescription [Dan'e mixture] (DEM, consists of Radix Salviae Miltiorrhizae and Rhizoma Zedoariae) was used to treat 189 cases of endometriosis and the change of symptom and sign, the B ultrasonograph, the anti-endometrium antibody and endometriosis quantitative diagnostic index were observed. Another 160 cases were treated with Danazol as control. Results: One hundred and eighty-nine cases were treated for 9 months. According to National Standards, 39 cases (20.6%) were cured, 67 cases (35.4%) were markedly effective, 67 cases (35.4%) were effective, and 16 cases (8.4%) were ineffective. Compared with 160 cases treated with Danazol for 9 months, the total effective rates were 95% and 91.5% respectively, the difference between them was insignificant. Animal experiments showed similar results to the clinical ones. Conclusion: The authors conclude that the Chinese herbal prescription is as effective as Danazol for the treatment of endometriosis, without observed side effects. It is particularly helpful for diagnosis, treatment and prevention of endometriosis in the early stage. Cai L, Shu Y, Xie H. [Clinical and experimental study on the treatment of endometriosis with dan'e mixture] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Mar;19 (3):159-61.

Anovulation (Acupuncture)

Electro acupuncture helps restore regular ovulation In absent periods, evidence suggests that the hypothalamic dysfunction is sensitive to emotional and physical stresses, diet, body weight, exercise, environmental factors etc. Acupuncture is used clinically for the treatment of amenorrhea. In one study, electrical acupuncture helped restore regular ovulation to more than a third of women with polycystic ovary syndrome. Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO: Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2000, 79:180-188. Acupuncture can normalize the hypothalamic-pituitary-ovarian axis, improve ovulation and enhance pelvic blood flow, which may help with implantation A review of acupuncture and female infertility, by physicians from New York Weill Cornell Medical Center, identified that acupuncture can normalize the hypothalamic-pituitary-ovarian axis, improve ovulation, and enhance pelvic blood flow, which may help with implantation. Chang R, Chung P, Rosenwaks Z. Role of acupuncture in the treatment of female infertility. Fertility and Sterility. December 2002; 78:1149-53.

Anovulation (Herbs)

Chinese herbal medicine with chlomidphene (clomid) for anovulation This study combined a Chinese herbal formula (wen Jing Tang) with clomiphene (Clomid). When the treatment was given to patients who previously had not responded to clomiphene only, 43.8% ovulated. There was no occurrence of ovarian hyper stimulation syndrome or pregnancy. (Ovulation following combined therapy with wen jing tang and clomiphene citrate therapy in anovulatory women. American Journal of Chinese Medicine (1989) Vol XVII (3-4): 243-244.)

Painful Periods / Dysmenorrhoea (Acupuncture)

Acupuncture for Painful Periods Acupuncture can treat painful periods and provide symptom management. In a randomised control trial of 43 women with primary dysmenorrhoea found that acupuncture significantly increased the proportion of women with reduced pain compared with other treatment (10/11 [91%] with acupuncture v 4/11 [36%] with placebo acupuncture v 1/10 [10%] with monthly medical visits v 2/11 [18%] with no medical treatment. [1] [1] Helms JM. Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol 1987;69:51–56. Acupuncture treatment of dysmenorrhoea resistant to conventional medical treatment We evaluated the effect of acupuncture on NSAID resistant dysmenorrhoea related pain [measured according to Visual Analogue Scale (VAS)] in 15 consecutive patients. Pain was measured at baseline (T1), mid treatment (T2), end of treatment (T3) and 3 (T4) and 6 months (T5) after the end of treatment. Substantial reduction of pain and NSAID assumption was observed in 13 of 15 patients (87%). Pain intensity was significantly reduced with respect to baseline (average VAS = 8.5), by 64, 72, 60 or 53% at T2, T3, T4 or T5. Greater reduction of pain was observed for primary as compared with secondary dysmenorrhoea. Average pain duration at baseline (2.6 days) was significantly reduced by 62, 69, 54 or 54% at T2, T3, T4 or T5. Average NSAID use was significantly reduced by 63, 74, 58 or 58% at T2, T3, T4 or T5, respectively, and ceased totally in 7 patients, still asymptomatic 6 months after treatment. Our findings suggest that acupuncture may be indicated to treat dysmenorrhoea related pain, in particular in those subjects in whom NSAID or oral contraceptives are contraindicated or refused. V. Iorno1, R. Burani2, B. Bianchini1, E. Minelli3, F. Martinelli4 and S. Ciatto4 1Centro di Medicina del Dolore ‘Mario Tiengo’ Osp Maggiore Policlinico Mangiagalli Regina Elena, Milano, 2Dipartimento di Prevenzione ASL Provincia Milano 1, 3Centro collaborante OMS per la Medicina Tradizionale – Università degli Studi Milano and 4Centro per lo Studio e la Prevenzione Oncologica, Firenze, Italia. eCAM Advance Access originally published online on June 28, 2007. eCAM 2008 5(2):133-143; doi:10.1093/ecam/nem050. Acupuncture helps treat painful periods and provide symptom management In a randomised control trial of 43 women with primary dysmenorrhoea found that acupuncture significantly increased the proportion of women with reduced pain compared with other treatment (10/11 [91%] with acupuncture v 4/11 [36%] with placebo acupuncture v 1/10 [10%] with monthly medical visits v 2/11 [18%] with no medical treatment. Helms JM. Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol 1987;69:51–56. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. The clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhoea Study Design In a randomized controlled trial plus non-randomized cohort, patients with dysmenorrhea were randomized to acupuncture (15 sessions over three months) or to a control group (no acupuncture). Patients who declined randomization received acupuncture treatment. All subjects were allowed to receive usual medical care. Conclusion Additional acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost-effective within usual thresholds. Claudia M. Witt Thomas, Reinhold,Benno Brinkhaus,Stephanie Roll Susanne Jena and Stefan N. Willich Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.

Painful Periods / Dysmenorrhoea (Herbs)

Chinese herbal medicine better than drugs for dysmenorrhoea (painful periods) The evidence supporting the use of Chinese herbal medicine (CHM) for primary dysmenorrhoea is promising, but better quality research on the subject is still required. These are the conclusions of a systematic review by Australian researchers, which included 39 RCTs involving a total of 3475 women. CHM was found to result in significant improvements in pain relief, overall symptoms and use of additional medication when compared with use of pharmaceutical drugs. CHM also resulted in better pain relief than either acupuncture or heat compression in the studies analysed. There were no indications that CHM caused any adverse events. (Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005288). Chinese herbal medicine treats painful periods Chinese herbal formula Wen Jing Tang has been found useful for the treatment of dysmenorrhoea. In one study, a 50% alcoholic solution was used to extract active ingredients and create a freeze-dried product. At first, Wen-Jing Tang was used to suppress spontaneous contractions and prostaglandins F2alpha-induced contractions of rat uterine smooth muscle in vitro (that produce pain). The results showed that antagonism of both PGF2alpha and ACh are the major mechanisms for treating dysmenorrhoea by Wen-Jing Tang. Furthermore, the antagonistic effect of KCl-depolarization contractions may be an auxiliary mechanism of the curative effect. (Effect of dysmenorrhoea Chinese medicinal prescription on uterus contractibility in vitro (2003). Phytother research Vol 17 (7): 778-83.

Heavy Bleeding / Menorrhagia (Acupuncture)

Acupuncture and Heavy Periods Acupuncture and Traditional Chinese Medicine (TCM) offer a natural alternative to medical intervention in the treatment of heavy periods. They often refer to heavy periods as 'heat in the blood', usually deriving from liver qi stagnation. Using a selection of acupuncture points, we aim to restore a normal blood flow during the period, free from clots and menstrual pain. The combined oral contraceptive pill, progestogen-releasing IUCD (Mirena coil), Tranexamic acid (Cyklokapron) are sometimes prescribed by the medical profession to reduce heavy bleeding or Mefenamic acid (eg Ponstan) as a painkiller.

Heavy Bleeding / Menorrhagia (Herbs)

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Dysfunctional Uterine Bleeding (Acupuncture)

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Dysfunctional Uterine Bleeding (Herbs)

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Uterine Fibroids (Acupuncture)

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Uterine fibroids (Herbs)

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Premenstrual Syndrome / PMS (Acupuncture)

Acupuncture and PMT In a recent acupuncture and PMS study, the success rate of acupuncture in treating PMS symptoms was 77.8%, whereas it was 5.9% in the placebo group. The positive influence of acupuncture in treating PMS symptoms was ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. [1]

Premenstrual syndrome / PMS (Herbs)

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Menopause (Acupuncture)

US study finds acupuncture effective for hot flashes and insomnia From 1997 to 1999, in one of the first studies in the US to explore the effectiveness of acupuncture in alleviating hot flashes, insomnia and nervousness, conducted by Dr. Susan Cohen, D.S.N., APRN, it was found that during the course of acupuncture treatments, hot flashes decreased by 35% and insomnia decreased by 50%. A follow-up study revealed hot flashes significantly decreased in those receiving acupuncture, compared to those receiving routine care.

Menopause (Herbs)

Chinese herbal medicine for menopausal depression in HRT taking women When Chinese herbal medicine formula wen jing tang was given to menopausal women taking HRT experiencing depressive symptoms, symptoms significantly improved after 3 months (Efficacy of the herbal medicine unkei-to as an adjunctive treatment to hormone replacement therapy for postmenopausal women with depressive symptoms. Clin Neuropharmacol (2004) Vol 27 (4):157-62.) Relief of hot and cold symptoms in peri menopausal women after treatment with Chinese herbal medicine In a large study of 160 peri-menopausal women with a chilly sensation in the lower extremities, taking the Chinese herbal formula wen jing tang increased blood flow in the lower extremities, and suppressed excessive blood flow throughout the upper half of the body. It was found to successfully restore the distribution of blood flow throughout the entire body, reducing etremes of hot and cold sensations. (Comparison of effects of vitamin E and wen jing tang (unkei-to), an herbal medicine, on peripheral blood flow in post menopausal women with chilly sensation in the lower extremities: A randomised prospective study. (2006)Am J Chin Med Vol 34 (6): 969-79.) Chinese herbal medicine formula Wen Jing Tang may help prevent development of bone loss in menopausal women Researchers found that this formula was as effective as 17beta-estradiol in preventing the development of bone loss induced by ovariectomy in rats. (Preventive effects of traditional Chinese (Kampo) medicines on experimental osteoporosis induced by ovariectomy in rats) (1997) Calcif Tissue Int Vol 61 (3): 239-46.)

Ovarian Cysts or Polyps (Acupuncture)

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Ovarian Cysts or Polyps (Herbs)

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Absent or Excess Vaginal Discharge (Acupuncture)

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Absent or Excess Vaginal Discharge (Herbs)

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