Can acupuncture treat women's health issues? Studies find mixed results
Whether acupuncture can really help treat certain health conditions is controversial, and now two new studies on the ancient practice have reached mixed conclusions.
One study found that women with stress urinary incontinence — who involuntarily urinate when they cough, sneeze, laugh or exercise — could benefit from acupuncture.
But the other study, which looked at acupuncture among women with a certain type of infertility, suggested that acupuncture did not increase these women's chances of having a baby.
Both studies were conducted in China, and were published today (June 27) in the journal JAMA.
"These studies shed new light on when and when not to consider using acupuncture," Dr. Josephine Briggs and David Shurtleff, of the U.S. National Center for Complementary and Integrative Health, wrote in an editorial accompany the studies.
The research done to date on acupuncture has shown that, generally, its benefits are limited to outcomes that are subjective, such as pain, Briggs and Shurtleff wrote. People's positive expectations and the reassurance they feel from the procedure likely contribute to the benefits. "Clearly these ancient practices are helping reveal the complexity of the links between the mind and the body ," the editorial said.
In both of the new studies, researchers applied rigorous scientific methods to test the effects of acupuncture.
In the first study, the researchers randomly assigned 504 women with stress urinary incontinence to receive either "electroacupuncture," which is acupuncture combined with electrical stimulation, or "sham electroacupuncture," which is a version of the procedure that is not expected to have benefits.
In the women receiving the electroacupuncture, the researchers, from the China Academy of Chinese Medical Sciences in Beijing, applied a weak electric current (not strong enough to cause pain) to the acupuncture needles. With sham electroacupuncture, the researchers placed needles on points in the body that are not traditional acupuncture points, and they didn't apply an electric current. The women underwent the procedure three times a week for six weeks.
At the end of the study, the participants in the electroacupuncture group had much less urine leakage during a one-hour stress test (about 10 grams less of urine) compared with their leakage at the start of the study, while those in the sham group showed a reduction in urine leakage of only 2.6 grams, compared with the start of the study.
The findings suggest that, for women with stress urinary incontinence, acupuncture "may be a reasonable option to explore" along with other behavior treatments before considering a more invasive treatment such as surgery, the editorial said. However, more research is needed to examine whether the treatment's effects last over the long term, and exactly how the treatment may be working to reduce urinary incontinence, the researchers said.
The placebo effect — or an effect that results from people's feeling that a treatment works, rather than from any physiological effect of the treatment — likely contributes to the benefits of acupuncture seen in this and other studies, the editorial said. But there may also be physiological effects of undergoing acupuncture. For instance, electroacupuncture might cause muscle contractions and simulate the pelvic floor muscles, which helps strengthen muscles of the uterus, bladder and bowel, the researchers said.
In the second study, researchers at Heilongjiang University of Chinese Medicine in Harbin, China, looked at whether acupuncture could help women with polycystic ovary syndrome (PCOS) , a common cause of infertility, to have a baby. In women with PCOS, the ovaries do not release an egg during the menstrual cycle.
The researchers randomly assigned 1,000 women with PCOS to one of four groups: One group received acupuncture along with the fertility drug clomiphene citrate; one group received sham acupuncture along with clomiphene citrate; the third received acupuncture plus a placebo drug, and the last group received sham acupuncture plus a placebo drug.
During the study, which took place from 2012 to 2015, about 200 of the women gave birth. As expected, women who received the fertility drug had a higher birth rate than those who received the placebo drug. (About 29 percent of those who received clomiphene citrate gave birth versus 15 percent of those who received the placebo). But acupuncture was not linked with an increase in the birth rate compared with sham acupuncture, regardless of whether it was given with or without clomiphene. About 22 percent of women in both the acupuncture and sham acupuncture groups gave birth during the study.
"This finding does not support acupuncture as an infertility treatment," for women with PCOS, the researchers said. Thus, acupuncture should not be considered a substitute for clomiphene treatment in women with this condition, according to the editorial.