Acupuncture for polycystic ovarian syndrome

Lim DCE, Chen W, Cheng LNC, Xue CChangli, Wong FWS, O'Sullivan AJ, Liu JP

Published Online:

August 10, 2011

Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of infrequent or very light menstruation, failure to conceive, and excessive hair growth. The current standard western medical treatments for women with PCOS are prescription medications, surgery and lifestyle changes, whether or not they want to become pregnant. However, problems associated with current western therapies are the cost, increased risk of multiple pregnancies, undesirable side effects and inconsistency in their effectiveness. On the other hand, various non-randomised studies of acupuncture in PCOS have suggested low rates of associated adverse events, no increased risk of multiple pregnancy and that it is comparatively inexpensive to administer. However, it should be emphasised that these conclusions are made based on the findings of non-randomised controlled studies alone and therefore may not reliably support the effectiveness and use of acupuncture in this area.

Abstract (click to read)

Background:

Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of oligo-amenorrhoea (infrequent or very light menstruation), infertility (failure to conceive), and hirsutism (excessive hair growth). Whilst Aleem 1987 revealed the presence of beta-endorphin in the follicular fluid of both normal and polycystic ovaries, Petraglia 1987 demonstrated that the beta-endorphin levels in ovarian follicular fluid of otherwise healthy women who were undergoing ovulation were much higher than the levels measured in plasma. Given that acupuncture has an impact on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion, it is postulated that acupuncture may have a role in ovulation induction and fertility.

Objectives:

To assess the efficacy and safety of acupuncture treatment for women with polycystic ovarian syndrome (PCOS).

Search strategy:

Relevant studies were identified from the Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE® In-Process and other non-indexed citations, Ovid MEDLINE® Daily and Ovid MEDLINE(R), EMBASE, PsycINFO, AMED, Chinese National Knowledge Infrastructure (CNKI) (including the Chinese journal full-text database (CJFD)), Chinese BioMedical Literature Database (CBM), VIP database for Chinese Technical Periodicals, China's important Conference Papers Database, and the China dissertation database.

Selection criteria:

Truly randomised controlled trials (RCTs) that studied the efficacy of acupuncture treatment for infertility in women with PCOS. We excluded quasi- or pseudo-RCTs.

Data collection and analysis:

We aimed to extract data independently by three authors using a piloted data extraction form. Data on study characteristics including methods, participants, interventions, and outcomes would be extracted. Crossover trials were not included unless there were first-phase data provided. Non-randomised controlled studies have been excluded.

Main results:

No truly randomised controlled trials of acupuncture for PCOS were found .

Authors' conclusions:

The current conventional medical treatments for women with PCOS are prescription medications, surgery, and lifestyle changes. Associated problems with current western therapies are the cost, risk of multiple pregnancies, undesirable side effects, and inconsistent effectiveness. Non-randomised acupuncture studies in PCOS have suggested a low associated adverse events rate, no increased risk of multiple pregnancies, and that it is inexpensive. However, there no RCTs have been performed in this area thus far. Therefore, properly designed RCTs are required before a conclusive statement can be drawn to support the use of acupuncture in the management of PCOS.

This record should be cited as:

Lim DCE, Chen W, Cheng LNC, Xue CChangli, Wong FWS, O'Sullivan AJ, Liu JP. Acupuncture for polycystic ovarian syndrome. Cochrane Database of Systematic Reviews 2011, Issue 8. Art. No.: CD007689. DOI: 10.1002/14651858.CD007689.pub2

Assessed as up to date:

March 8, 2011

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Primary Review Group:

Menstrual Disorders and Subfertility Group

Health topics:

Complementary & alternative medicine > Gynaecology > Menstrual cycle disorders/oligo-amenorrhoea

Gynaecology > Menstrual cycle disorders/oligo-amenorrhoea > Polycystic ovary syndrome

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Acupuncture for polycystic ovarian syndrome

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