Effects of acupuncture for the treatment of endometriosis-related pain

Role of Acupuncture in the reduction of pain in women with endometriosis

Key Points

Highlights:

• Acupuncture may be implicated in pain relief for some women with endometriosis due to multiple effects including analgesia and anti-inflammatory changes.

Key Results:

• Analysis from six trials that evaluated the change in pain level after acupuncture therapy revealed a positive effect compared to the control group.
• Peripheral blood CA-125 level analysis was highly variable among the studies used but yielded a slight mean positive effect, while one study had opposing results. 
• Seven trials compared the clinical effectiveness rate of acupuncture revealed that women who used acupuncture were twice as likely to feel some form of relief compared to the control group.

What’s done here?

• This meta-analysis used data from ten randomized controlled trials of women with endometriosis-related pain to evaluate the utility of acupuncture on pain reduction.

Limitations:

• It is important to note that acupuncture is not a form of definitive treatment for endometriosis.
• There are variations in the quantitative measurement of pain reduction pre and post-intervention among the included studies.
• Authors did not perform a subgroup analysis; it is not possible to understand the utility of the other control therapies compared to actual “acupuncture therapy.”
• A clear description of the method of acupuncture and the duration of treatment was not described by the authors.
• Additionally, authors acknowledged that the studies used in their analysis were few and had variations in the implementation of the blinding method.

Lay Summary

Acupuncture has been seen to offer chronic pain relief most likely due to multiple effects including analgesia and anti-inflammatory changes. Current therapy for endometriosis includes pharmacological and surgical methods. Symptom relief using other supplementary therapies such as acupuncture has been implicated in chronic pain relief, but its effectiveness is still uncertain. The meta-analysis published in PLoS One by Xu et al. aims to summarize the current understanding of acupuncture’s role in the multi-disciplinary approach to treating endometriosis.

Using the Cochrane Menstrual Disorders and Subfertility Group (MDSG) search strategy, data from 10 randomized controlled trials were retrieved that had studied endometriosis in women with laparoscopically confirmed endometriosis. Women had either received acupuncture therapy (295 women) or were part of a control group that had either received sham acupuncture, western medicine, or traditional Chinese medicine (294 women). Researchers then sought to study the utility of acupuncture on the reduction of pain level, peripheral blood CA-125, and “clinical symptom relief” which was described as either being curative, markedly effective, effective or failing in the reduction of endometriotic symptoms among the 589 women included in the analysis.

Analysis of six trials that evaluated the change in pain level after acupuncture therapy revealed a positive effect compared to the control group. Highly variable data from four studies showed that peripheral blood CA-125 yielded a slight positive impact on acupuncture use (one study had opposing results). Seven trials that compared the clinical effectiveness rate of acupuncture resulted in an odds ratio of 2.07 (meaning that women who used acupuncture were twice as likely to feel some form of relief than the control group).

It is important to note that acupuncture is not a form of definitive treatment for endometriosis. Authors did not do a subgroup analysis; thus, we cannot understand the utility of the other control therapies compared to actual “acupuncture therapy.” Additionally, authors acknowledged that the studies used in their analysis were few and had variations in the implementation of the blinding method. A clear description of the practice of acupuncture and the duration of the treatment was not described by the authors.

Thus, further research is needed to elucidate what form of acupuncture and with what method can offer relief to some women with endometriosis.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29077705