Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence

E. Stener-Victorin,* E. Jedel† and L. Manneras*
*Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Goteborg University, Go¨teborg, Sweden.
Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity.

PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity.

Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.

Key words: acupuncture, insulin resistance, metabolic syndrome, obesity, opioids, ovulation, physical exercise, polycystic ovary syndrome, sympathetic nerve activity.

Learn more about PCOS and treatment options (Full Study)

Acupuncture Can Provide Long-lasting Beneficial Effects for Women with Polycystic Ovary Syndrome

PCOS is the most common female endocrine disorder.  It is said to affect up to ten percent of women of reproductive age, and up to ninety percent of woman with irregular menstrual cycles.

Clinically, a patient usually presents with menstrual irregularities, infertility, and hirsutism. PCOS is associated with hyperandrogenism, ovulatory dysfunction and obesity.  If not treated properly, a patient is at risk for type 2 diabetes, cardiovascular disease, and hyperestrogen-related cancers. The hallmark endocrine disorders of this syndrome are hyperandrogenism and hyperinsulinemia. There also appears to be a defect in the hypothalamic-pituitary-adrenal (HPA) axis in patients presenting with polycystic ovary syndrome. The syndrome is also associated with dyslipidemia and acanthosis nigricans, During the reproductive years, PCOS is associated with significant reproductive morbidity, including infertility, abnormal uterine bleeding, miscarriage, and other complications of pregnancy.

Women diagnosed with polycystic ovarian syndrome historically do not respond positively to Western assisted reproductive techniques including in-vitro procedures; nor do they respond well to clomid alone, or any hormonal manipulation which does not address the state of the ovary’s endocrine milleau over the previous three or more months of development. If they do become pregnant, they are at higher risk of miscarriage, again presumably because of the health of the egg and therefore the developing embryo.
SIGNS & SYMPTOMS of PCOS
  • Abnormal menstruation
  • Anovulatory infertility
  • Hirsutism (facial hair) and/or acne
  • Central obesity
  • Elevated androgen levels (testosterone)
  • Elevated lutenizing hormone (LH) concentration
  • Normal to mildly elevated follicular stimulating hormone (FSH) level
  • Insulin resistance with hyperinsulinemia
  • Multiple subcortical follicular cystsIncreased ovarian
  • Stromal density and/or volume

There is little known about the causes of PCOS.  It is associated with factors that influence the sympathetic nervous system.  Many women with PCOS require prolonged treatment.  Pharmaceutical drugs can be effective but have adverse side effects.

Experimental observations and clinical data from studies in women with PCOS suggest that acupuncture can exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.

Clinical Studies
Studies done in Europe in the 1990s on anovulatory women with PCOS showed that electro-acupuncture restored ovulation in one-third of the test subjects. Acupuncture also reduced the endocrine indicators of PCOS, including LH/FSH ratios, mean testosterone concentrations and beta-endorphin concentrations. Researchers theorized that this improvement was due to an inhibition of hyperactivity in the sympathetic nervous system. For more information, see Chapter 11 of The Infertility Cure.

A Swedish/Italian study in 2000 described in the Biology of Reproduction Journal validated this theory. This study involved using injections of estradiol valerate, a kind of estrogen, to induce a state of polycystic ovaries in rats. Increased activity of the sympathetic nervous system resulted, followed by increased concentrations of nerve growth factor in the rats’ ovaries and the adrenal glands. Within sixty days, the rats developed polycystic ovaries. The rodent subjects were separated into two groups. The control group received no therapy and maintained features of PCOS. In contrast, those treated with acupuncture showed a reduction in the hyperactivity of the ovarian sympathetic nerve fibers, reduction of the increased nerve growth factor concentrations within the ovaries to normal and reduction the weight of the polycystic ovaries. These are all indicators of a reduction in the “stress” reaction within the nerve and blood supply of polycystic ovaries. Acupuncture treatments were effective at resolving this condition because they reduced the level of hypersympathetic nervous system response, relaxing the whole neuroendocrine system.

Learn more about PCOS and treatment options