Acupuncture and Endometriosis

Endometriosis is a major cause of painful menstrual cycles and female infertility in about 1.5 million women in the UK.

It is caused by endometrial cells that line the womb (endometrium) migrating outside the womb to areas where they become ‘trapped’ - often around the ovaries and fallopian tubes. These cells build up, bleed and then shed as part of the normal menstrual cycle but because they cannot leave the body easily they can cause localised inflammation, pain and scarring.

From the perspective of Chinese Medicine, this build up is viewed as stagnation of blood in the uterus. In a normal cycle when pregnancy doesn’t happen the lining of the womb should break down and be shed fully as the period. If this doesn’t happen fully each time then blood and cells begins to build up in the womb (stagnate) leading to painful periods, clotting and mid-cycle bleeding or spotting, increasing the likelihood of endometriosis developing.

Treatment with acupuncture and herbal medicine aims to re-establish this normal cycle of shedding the lining of the womb fully to resolve the endometriosis.

Support, guidance and information for endometriosis sufferers is offered by a number of UK charities including Endometriosis UK and She Trust. 

These charities also offer guidance on the use of alternative and complementary medicines for women with endometriosis.

Period Pain: Why the drugs don't work & finding what does

acupuncture-for-period pain

Somewhere between 80-90% of women experience mild to severe physical or psychological discomfort in the days before their period.

Yet despite PMT (pre-menstrual tension) being a medical condition for which 20% of women seek treatment, its causes are poorly understood and effective drug treatments remain elusive. Here we  detail why drug treatments prove ineffective and examine some alternative treatment options for women with PMT.

What is PMT and what causes it?

A diagnosis of PMT covers any pre-menstrual symptoms that affect a woman’s ‘quality of life, social engagements and/or work performance’. Symptoms vary in their severity and duration but common ones include:

  • Emotional symptoms     
  • Depressed, sad, down, low mood
  • Anxious, tense, on edge, wound up
  • Angry or irritable
  • Physical symptoms
  • Breast tenderness
  •  Muscle or joint aches
  •  Stomach bloating or diarrhoea
  •  Carbohydrate craving or increased appetite

These symptoms affect women across continents and cultures, yet despite over 40 years of research into the potential origins of PMT an exact cause has yet to be identified.

For most women, it is likely that their PMT symptoms occur due to a complex interplay of different factors – emotional, physical and environmental.

Unfortunately, the existing medicine cabinet available to treat PMT is concentrated on individual factors – antidepressants which affect serotonin levels (SSRIs like Prozac and Seroxat) to regulate mood, hormones via contraceptive pills, NSAIDs – anti-inflammatories to combat the immune response and spironolactone which regulates adrenal function.

Of all of these options, a recent study has shown that to date the only drugs clinically effective for PMT are anti-depressants (SSRIs) and the side-effects of taking anti-depressants far outweigh the limited benefits. Taking daily anti-depressants to treat low mood which may occur for only 3-4 days a month is the medical equivalent of using a sledge hammer to crack a nut.

This high side-effect / low benefit risk ratio is what makes drug therapy a poor first choice treatment for all but the most severe cases of PMT.

The drugs don’t work. So what does?

If we understand the cause of PMT to be a combination of physical, emotional and environmental factors, then an integrative approach to treatment – taking into consideration a woman’s individual symptoms and preferences – is a great starting point for treatment as it offers potential benefits with low risk of side effects.

An integrative treatment strategy might combine exercise, meditation, active relaxation (such as yoga or tai chi) with external factors like improved diet, acupuncture, massage, herbal medicine, nutrition, supplements and/or pharmaceuticals.

This integrative approach to gynaecology is practiced by James Thirlwall where an evidence-based integrative medicine provides  patients with highly individualized treatment plans to treat symptoms of PMT and other gynaecological conditions.

Fertility Acupuncture: When should you try it?

I’m often asked by patients why they might consider using acupuncture to support fertility rather than go to their doctor.

The answer is very simple – do both. Going to your GP or consultant is the starting point for trying to understand why you are yet to get pregnant or having other pregnancy related problems. Your doctor knows your medical history and can perform all relevant tests and scans to help reach a clear diagnosis.

So you have a diagnosis – what next?

And especially, what next if the diagnosis is that nothing’s ‘wrong’?

What’s next is to consult your acupuncturist about your diagnosis and see what can be done to naturally improve your reproductive health.

One of the great strengths of acupuncture is that it helps to return the body to a state of equilibrium using the body’s own resources. In other words, unlike, say taking medication, acupuncture puts nothing ‘into’ the body – it works with the resources already inside the body to bring about change naturally. You might ask – why is this better than taking medication? The answer again is simple – it’s not. Sometimes you need medication to heal and sometimes with the support of acupuncture your body will heal itself. Let me explain with a simple scenario courtesy of Jane Lyttleton’s Treatment of Infertility with Chinese Medicine

Imagine that you are a round table and in a state of disease you have developed square corners.

You go to see a specialist in corners and he says, “That’s no problem – we can have those off in no time” and true enough you have an operation the next day where he removes the corners with a saw. The operation is a little painful, you have rather rough edges and one of your legs is a bit shorter but you are more or less round again. Job done.

Now imagine that you went to see another specialist in corners who said “I see…how has this come about?” He asks a lot of questions and takes time to examine all aspects of your corners. After a while he says, “I can help to make you round again” and brings out a small file which he uses to gently round down the square edges. It takes some time, effort and patience but when he has finished you have perfectly smooth, round corners – like your old self again.

The side effects of Western medicine – the rough edges and shortened leg – can be a high price to pay for treatment with an immediate effect.

Yet this is often the choice we make when we opt for surgery or medication without considering other options. Clearly when ‘having corners’ means being in a life-threatening emergency then fast, effective intervention is exactly what we want – we can worry about side effects later.

But when ‘corners’ only affect the quality of life rather than threaten life itself, it can be better to use a slower, subtler and more gradual approach to restore health i.e. working slowly and deliberately to create change without side effects. This is the approach that fertility acupuncture takes to move you towards a state of health that can support conception and pregnancy.

And it is the knowledge and experience to know when to use each approach that should be the hallmark of any acupuncturist – or doctor – that you consult.


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