Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis
Junyoung Jo, Yoon Jae Lee, and Hyangsook Lee, 2015
This systematic review and meta-analysis suggests that current evidence showing that acupuncture for restoration of menstruation as well as improvement in hormone levels in patients with POI is insufficient to make a firm conclusion due to a lack of studies with a low risk of bias. Further rigorously designed studies are needed to confirm the effectiveness and safety of acupuncture in patients with POI.
This systematic review included a total of eight RCTs that evaluated acupuncture in the treatment of POI. We found that acupuncture significantly restored the menstruation as well as improvement in hormone levels.
The pooled data on serum FSH and E2 suggest that acupuncture could be effective to patients with POI. It showed that acupuncture treatment increased serum E2 (MD 31.51, 95% CI: 6.06–56.95, ) levels and reduced serum FSH (MD −9.26, 95% CI: −13.11–−5.41, ) levels. These results are similar with Wu et al.’s  study: they reported that CHM might relieve symptoms of POI partly through increasing E2 levels (MD 22.00, 95% CI: 2.90–41.10, ) and thereby decreasing serum FSH levels (MD −6.59, 95% CI: −9.06 to–−4.12, ) in patients with POI. There were no significant differences in LH levels in both studies.
We also found that acupuncture could help resumption of menstruation in women with POI. Significantly more women receiving acupuncture treatment resumed menstruation compared with those in the control groups (RR 1.25, 95% CI: 1.12–1.39, %, ). This finding needs to be confirmed in future trials with ovulation detection. Acupuncture treatments also relieved perimenopausal symptoms in all included studies.
While this finding seems promising, it should be interpreted with caution because of the small number of included studies and participants. In the 8 included studies, participants ranged only from 23 to 168 in each trial (13 to 84 patients in the acupuncture group versus 10 to 84 patients in the control group). In addition, no trial reported a formal sample size calculation, which is essential for ensuring adequate statistical power.