Abstract
The use of acupuncture to treat reproductive dysfunction has not been well investigated.
Only a few clinical studies have been reported, most of which are flawed by poor design
and a lack of valid outcome measures and diagnostic criteria, making the results difficult
to interpret. Experimental studies, however, show that acupuncture has substantial
effects on reproductive function. Here we review the possible mechanisms of action
of acupuncture on the reproductive system and its effects on reproductive dysfunction,
focusing in particular on polycystic ovary syndrome, the most common endocrine and
metabolic disorder in women. Clinical and experimental evidence demonstrates that
acupuncture is a suitable alternative or complement to pharmacological induction of
ovulation, without adverse side effects. Clearly, acupuncture modulates endogenous
regulatory systems, including the sympathetic nervous system, the endocrine system,
and the neuroendocrine system. Randomized clinical trials are warranted to further
evaluate the clinical effects of acupuncture in reproductive disorders.
Keywords
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References
- Developmental origin of polycystic ovary syndrome — a hypothesis.J. Endocrinol. 2002; 174: 1-5
- Naltrexone treatment in clomiphene resistant women with polycystic ovary syndrome.Hum. Reprod. 2008; 23: 2564-2569
- Acupuncture — from empiricism to science: functional background to acupuncture effects in pain and disease.Med. Hypotheses. 1995; 45: 271-281
- Surgical treatment of polycystic ovary syndrome.Best Pract. Res. Clin. Endocrinol. Metab. 2006; 20: 271-280
- Obesity and polycystic ovary syndrome.Clin. Endocrinol. (Oxf). 2006; 65: 137-145
- Ovarian steroidal response to gonadotropins and beta-adrenergic stimulation is enhanced in polycystic ovary syndrome: role of sympathetic innervation.Endocrinology. 1993; 133: 2696-2703
- Endogenous pain control systems: brain-stem spinal pathways and endorphin circuitry.Ann. Rev. Neurosci. 1984; : 309-338
- Neuroendocrine effects of androgens in adult polycystic ovary syndrome and female puberty.Semin Reprod. Med. 2007; 25: 352-359
- The Management of Pain.2 ed. Lea & Febiger, Philadelphia, London1990 (2107)
- beta-Endorphin in the human pancreas.J. Clin. Endocrinol. Metab. 1979; 49: 649-651
- Substitution of acupuncture for HCG in ovulation induction.J. Tradit. Chin. Med. 1997; 17: 119-121
- Increased circulating levels of immunoreactive beta-endorphin in polycystic ovary syndrome is not caused by increased pituitary secretion.Am. J. Obstet. Gynecol. 1992; 167: 1819-1824
- Corticotropin releasing factor (CRF): effects on the release of pro-opiomelanocortin (POMC)-related peptides by human anterior pituitary cells in vitro.Endocrinology. 1982; 111: 1388-1390
- Relationship between blood radioimmunoreactive beta-endorphin and hand skin temperature during the electro-acupuncture induction of ovulation.Acupunct. Electrother. Res. 1991; 16: 1-5
- Opioid blockade effect on insulin beta-cells secretory patterns in polycystic ovary syndrome Oral glucose load versus intravenous glucagon bolus.Horm. Res. 1998; 49: 263-268
- Biosynthesis of beta-endorphin from beta-lipotropin and a larger molecular weight precursor in rat pars intermedia.Proc. Natl Acad. Sci. U.S.A. 1978; 75: 4719-4723
- The influence of acupuncture on salivary flow rates in healthy subjects.J. Oral Rehabil. 1997; 24: 204-208
- Role of neurotrophic factors in early ovarian development.Semin Reprod. Med. 2009; 27: 24-31
- Excessive ovarian production of nerve growth factor facilitates development of cystic ovarian morphology in mice and is a feature of polycystic ovarian syndrome (PCOS) in humans.Endocrinology. 2009; 150: 2906-2914
- Current concepts in the polycystic ovary syndrome.Annu. Rev. Med. 2001; 52: 401-419
- The role of the endogenous opioid system in polycystic ovary syndrome.Fertil. Steril. 2009; 92: 1-12
- Sympathetic nerve activity in metabolic control—some basic concepts.Acta Physiol. Scand. 2003; 177: 337-343
- Hypothalamic neuroendocrine functions in rats with dihydrotestosterone-induced polycystic ovary syndrome: effects of low-frequency electro-acupuncture.PLoS ONE. 2009; 4: e6638
- The hypothalamic control of the menstrual cycle and the role of endogenous opioid peptides.Recent Prog. Horm. Res. 1984; 40: 441-485
- Effect of long-term naltrexone treatment on endocrine profile, clinical features, and insulin sensitivity in obese women with polycystic ovary syndrome.Fertil. Steril. 2002; 77: 936-944
- Role of opioid tone in the pathophysiology of hyperinsulinemia and insulin resistance in polycystic ovarian disease.Metabolism. 1998; 47: 158-162
- Opioid control of gonadotrophin secretion in humans.Hum. Reprod. 1993; 8: 151-153
- Auricular acupuncture in the treatment of female infertility.Gynecol. Endocrinol. 1992; 6: 171-181
- Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome.Clin. Endocrinol. (Oxf). 1997; 47: 93-99
- Role of stress and sympathetic innervation in the development of polycystic ovary syndrome.Endocr. 2005; 28: 319-324
- Normalization of hyperinsulinemia by chronic opioid receptor blockade in hyperandrogenemic women.Fertil. Steril. 2006; 86: 651-657
- Minimal immunoreactive plasma beta-endorphin and decrease of cortisol at standard analgesia or different acupuncture techniques.Eur. J. Anaesthesiol. 2007; 24: 370-376
- Increase in nerve fibers and loss of mast cells in polycystic and postmenopausal ovaries.Fertil. Steril. 2001; 75: 1141-1147
- Electro-acupuncture improves responsiveness to insulin via excitation of somatic afferent fibers in diabetic rats.Auton Neurosci. 2009; 150: 100-103
- Acupuncture and sensory neuropeptides increase cutaneous blood flow in rats.Neurosci. Lett. 1989; 97: 305-309
- The control of the gonadotrophin releasing hormone pulse generator in relation to opioid and nutritional cues.Hum. Reprod. 1993; 8: 154-161
- Increased oocyte production after acupuncture treatment during superovulation process ni mice.J. of Reprod. & Conception. 2009; 20: 35-44
- Manual acupuncture needle stimulation of the rat hindlimb activates groups I, II, III and IV single afferent nerve fibers in the dorsal spinal roots.Jpn. J. Physiol. 2005; 55: 149-155
- Effects of static and rythmic twitch contractions on the discharge of group III and IV muscle afferents.Cardiovasc. Rec. 1984; 18: 663-668
- Evidence of a distinct derangement of opioid tone in hyperinsulinemic patients with polycystic ovarian syndrome: relationship with insulin and luteinizing hormone secretion.J. Clin. Endocrinol. Metab. 1995; 80: 3501-3506
- Psychological stress and increases in urinary norepinephrine metabolites, platelet serotonin, and adrenal androgens in women with polycystic ovary syndrome.Am. J. Obstet. Gynecol. 1983; 145: 496-503
- Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS.Am. J. Physiol. Regul. Integr. Comp. Physiol. 2009; 296: R1124-R1131
- A new rat model exhibiting both ovarian and metabolic characteristics of polycystic ovary syndrome.Endocrinology. 2007; 148: 3781-3791
- Effect of exercise on ovarian morphology and expression of nerve growth factor and alpha(1)- and beta(2)-adrenergic receptors in rats with steroid-induced polycystic ovaries.J. Neuroendocrinol. 2005; 17: 846-858
- Effect of electro-acupuncture on ovarian expression of alpha (1)- and beta (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries.Reprod. Biol. Endocrinol. 2005; 3: 21
- Role of the sympathetic nervous system in the regulation of ovarian function.Springer-Verlag, Berlin1989 (26–33)
- A systematic evaluation of the impact of STRICTA and CONSORT recommendations on quality of reporting for acupuncture trials.PLoS ONE. 2008; 3: e1577
- Hypertension and associated metabolic abnormalities—the role of insulin resistance and the sympathoadrenal system.N. Engl. J. Med. 1996; 334: 374-381
- Effects of stress on the activity of hypothalamic–pituitary–gonadal axis: peripheral and central mechanisms.Biol. Reprod. 1991; 45: 523-532
- Springer-Verlag, Heidelberg1997: 325 The Impact of Somatosensory Input on Autonomic Functions.
- Calcitonin gene-related peptide produces skeletal muscle vasodilation following antidromic stimulation of unmyelinated afferents in the dorsal root in rats.Neurosci. Lett. 2000; 283: 137-140
- Adrenergic innervation of the ovaries in Stein–Leventhal syndrome.Vestn. Akad. Med. Nauk. SSSR. 1969; 24 ([Abstract in english]): 58-62
- Maternal serum androgens in pregnant women with polycystic ovarian syndrome: possible implications in prenatal androgenization.Hum. Reprod. 2002; 17: 2573-2579
- Immunity and beta-endorphin concentrations in hypothalamus and plasma in rats with steroid-induced polycystic ovaries: effect of low-frequency electroacupuncture.Biol. Reprod. 2004; 70: 329-333
- Effects of electro-acupuncture on nerve growth factor and ovarian morphology in rats with experimentally induced polycystic ovaries.Biol. Reprod. 2000; 63: 1497-1503
- Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.Acta Obstet. Gynecol. Scand. 2000; 79: 180-188
- Effects of electro-acupuncture on corticotropin-releasing factor in rats with experimentally-induced polycystic ovaries.Neuropeptides. 2001; 35: 227-231
- Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats.Auton. Neurosci.: Basic and Clin. 2003; 108: 50-56
- Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system.Reprod. Biol. Endocrinol. 2003; 1: 33
- Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetised rats with steroid-induced polycystic ovaries.Reprod. Biol. Endocrinol. 2004; 2: 16
- Ovarian blood flow responses to electroacupuncture stimulation depend on estrous cycle and on site and frequency of stimulation in anesthetized rats.J. Appl. Physiol. 2006; 101: 84-91
- Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.J. Neuroendocrinol. 2008; 20: 290-298
- Low-frequency electro-acupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome.Am. J. Physiol. Regul. Integr. Comp. Physiol. 2009; 297: R387-R395
- Is polycystic ovary syndrome associated with high sympathetic nerve activity and size at birth?.Am. J. Physiol. Endocrinol. Metab. 2008; 294: E576-E581
- Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain.Acta Anaesthesiol. Scand. 1994; 38: 63-69
- Does acupuncture work?.Pain clin. Updates. 1996; 4: 1-4
- Defining an adequate dose of acupuncture using a neurophysiological approach—a narrative review of the literature.Acupunct. Med. 2008; 26: 111-120
- Elevated levels of plasma beta-endorphin and gamma 3-melanocyte stimulating hormone in the polycystic ovary syndrome.Obstet. Gynecol. 1984; 63: 630-634
- Clinical studies on the mechanism for acupuncture stimulation of ovulation.J. Tradit. Chin. Med. 1993; 13: 115-119
- Long-lasting cardiovascular depression induced by acupuncture-like stimulation of the sciatic nerve in unanaesthetized spontaneously hypertensive rats.Brain Res. 1982; 240: 77-85
- An important role of corticotropin-releasing hormone in electroacupuncture normalizing the subnormal function of hypothalamus–pituitary–ovary axis in ovariectomized rats.Neurosci. Lett. 2003; 349: 25-28
- Increased corticortropin-releasing hormone release in ovariectomized rats' paraventricular nucleus: effects of electroacupuncture.Neurosci. Lett. 2003; 353: 37-40
- Electroacupuncture enhances extragonadal aromatization in ovariectomized rats.Reprod. Biol. Endocrinol. 2004; 2: 18
- Circulating estradiol and hypothalamic corticotrophin releasing hormone enhances along with time after ovariectomy in rats: effects of electroacupuncture.Neuropeptides. 2005; 39: 433-438
- Effect of acupuncture on pubertal development of rats and rabbits at different developmental stages.Neuropeptides. 2007; 41: 249-261
Article info
Publication history
Accepted:
March 8,
2010
Received:
December 17,
2009
Identification
Copyright
© 2010 Elsevier B.V. Published by Elsevier Inc. All rights reserved.