Evidence for acupuncture PMS relief is shaky
Earlier studies plagued by bias and unclear results on symptoms effectively treated by acupuncture.
Fri, Jun 10, 2011 at 12:23 PM
NEW YORK — While studies have suggested that acupuncture may ease the symptoms of women with premenstrual syndrome, or PMS, a new review concludes that most of those studies may be biased and their findings questionable.
"I'm sure that there are good responders to acupuncture," review author Hyangsook Lee, of the College of Korean Medicine in Seoul, told Reuters Health in an email.
"The current evidence, however, is not strong enough to recommend acupuncture as a part of standard care," Lee added.
Women who suffer from PMS often have abdominal pain and bloating, muscle pain and feel tired and irritable in the days leading up to their menstrual period.
Most women have mild PMS, but up to 30 percent may have symptoms bothersome enough to warrant treatment, the authors of the new review write in BJOG: An International Journal of Obstetrics and Gynaecology.
Lee said that most doctors first recommend lifestyle changes, exercise, or behavioral therapy for women with bothersome PMS. Women that don't respond can then be treated with contraceptive pills to regulate their hormone levels or anti-depressants — but those, too, don't always work.
Acupuncture has been noted as a potential treatment for PMS, Lee said, because previous studies have suggested it can help people with depression, "abdominal discomforts" and bloating.
Trying to provide patients with a clearer answer about the effectiveness of acupuncture, the authors reviewed 10 studies that had tested acupuncture techniques in women with PMS. Those studies compared acupuncture with hormonal medications including progestin, fake acupuncture treatment, herbal medicines or no treatment at all.
When the researchers pooled data from those studies, acupuncture was about 50 percent better at improving PMS symptoms than all other treatments combined. The pattern was the same when they looked just at studies that compared acupuncture to contraceptive pills and just at those that tested acupuncture against fake acupuncture.
However, the authors write, the studies looked at a range of acupuncture techniques on different body parts — including the hand, back, and scalp — and in at least some of the studies, the "placebo effect" might have come into play if women or their doctors knew they were getting acupuncture treatment and believed it would work.
And, they noted, the original study authors didn't always make it clear which specific symptoms had improved, and by how much, in women given acupuncture.
Finally, the researchers point out that the available results might be biased if researchers are more likely to choose to publish studies that find an effect with acupuncture, versus those that find no effect.
Jongbae Park, from the University of North Carolina School of Medicine's Acupuncture Clinic, said the findings don't cause him to question the effectiveness of treating PMS with acupuncture — instead they highlight that the treatment is safe when done by a licensed professional.
"I have no hesitation to recommend (acupuncture) for PMS when the cost is affordable," said Park, who performs acupuncture at the clinic himself.
He said a typical session of acupuncture costs between $60 and $100, and that he recommends an initial six weekly sessions for women trying acupuncture for PMS.
Park, who was not involved in the current study, told Reuters Health that acupuncture lessens the pain and anxiety associated with PMS by improving circulation in blood vessels around the uterus.
But Lee and colleagues conclude bigger studies that do a better job of eliminating bias are necessary to determine if acupuncture is really better than other methods of treating PMS symptoms.
On the Web: An International Journal of Obstetrics and Gynaecology, online May 24, 2011
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