The birth of integrative reproductive medicine: finally, a randomized controlled trial for endometriosis treated with acupuncture!

Paul C. Magarelli, M.D., Ph.D.a
Michael Berkley, L.Ac.b
Diane Cridennda, L.Acc

https://pubmed.ncbi.nlm.nih.gov/36921836/

Reflections: Acupuncture for Endometriosis – A Breakthrough Study

A recent study by Li et al., published in the “Fertility and Sterility Journal,” examined whether acupuncture can effectively reduce pain associated with endometriosis and how long the pain relief lasts. The study found that acupuncture can indeed reduce pain, although the relief does not last permanently. This finding is similar to many Western treatments, like nonsteroidal anti-inflammatory drugs, which work only while being used.

The study is important for two reasons. First, it shows that acupuncture, a non-drug treatment, can effectively reduce endometriosis pain. Second, it provides a critical analysis of Traditional Chinese Medicine (TCM) methods, which is crucial for integrating these approaches into mainstream medical practice. As the medical community aims to reduce opioid use, finding effective, low-risk alternatives like acupuncture is beneficial.

The study included different acupuncture methods used in TCM, showing no single standard protocol. However, the researchers used a specific acupuncture protocol known as the CMAP protocol to ensure consistent results. This approach reduced variables and allowed for a more reliable comparison, leading to significant findings.

Publishing this study in “Fertility and Sterility” highlights the growing acceptance of integrative reproductive medicine. The study design and results align with National Institutes of Health (NIH) recommendations, adding high-quality evidence to the use of acupuncture for pain relief.

The NIH acknowledges acupuncture’s effectiveness for various pain conditions, including postoperative pain, chemotherapy-induced nausea, and possibly menstrual cramps. While some studies show mixed results, this study found that acupuncture not only relieved pain but also reduced the need for pain medications, such as nonsteroidal anti-inflammatory drugs. Additionally, a significant reduction in the inflammatory marker CA-125 was observed, indicating acupuncture’s impact on inflammation.

The NIH also explains that acupuncture may work by releasing opioid-like peptides in the body, activating certain brain areas, and altering neurotransmitter and hormone levels. These biological changes support acupuncture’s pain-relieving effects. The study also noted that placebo or “sham” acupuncture sometimes shows similar effects, suggesting the importance of well-designed control groups.

Interestingly, even the sham acupuncture in this study reduced inflammation, highlighting a debate within the TCM community about whether any acupuncture points are truly inactive. This debate underscores the complexity of studying acupuncture’s effects scientifically.

In conclusion, this study demonstrates that acupuncture can effectively reduce endometriosis pain, providing a valuable addition to integrative reproductive medicine. By using a standardized protocol, the researchers bridged traditional and modern medical approaches, paving the way for further collaborative research and improved patient outcomes.