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41 questions

Q:  My wife has been seeing an acupuncturist for fertility issues. The acupuncturist still has not used needles on my wife after four visits. She has been using a handheld electronic device with a pointed end that doesn't break the skin (like a TENS machine). Is this treatment likely to be effective, we have our concerns as we have not heard of acupuncturists using this type of equipment in a clinic. My wife has no problem with needles and if these are more likely to be effective we would rather that these be used.

 

A:The use of electro-acupuncture machines, of which we assume this is one, is quite common, and there are a number of BAcC members who like to use them on a regular basis. The reason most often given by those who do so it that the EA machine can often deliver a gentle stimulation of the acupuncture point over a long period of time, and for some kinds of treatment this can be very beneficial. The majority of EA machines are wired up to needles which have been inserted as normal, although there are a few hand-held machines which can deliver the pulse waves which stimulate the energy.
 
There is no evidence suggesting that EA devices are any more or any less effective than traditional needling, and we assume that the practitioner would have trained with the use of needles and used this technique after deliberation and on the basis that it actually works. Most practitioners often experiment with all sorts of sizes of needle and styles of treatment until they find a system that works best for them, and we assume that this practitioner has decided on the basis of her experience of working in this field that this is her preferred and most effective option.
 
If your wife would prefer traditional needling, and for many people this is part of the authentic experience of acupuncture which they seek, we are sure that the practitioner will be happy to accede to this request, or at very least explain her own rationale for using the EA device instead.
 

 

 

Q. i suffer from pcos on both ovaries, i also suffer from weight issues due to this but have been told by nhs that they cannot help until my bmi is below 30. I know that i need to help myself but can accupuncture help whilst trying to concieve. Have been trying for 5 years.

 

A. The evidence for the treatment of fertility problems with acupuncture is a little thin, as our factsheet here shows. There are a number of studies which appear to indicate that acupuncture may help PCOS and the attendant fertility problems which it can cause, but not enough and not enough of consistently high quality for us to make any claims.

 

 

However, traditional Chinese medicine has a very long history of treating exactly the same issues which trouble people today, and although its conceptual basis is entirely different from conventional western medicine, the symptoms which people have and the way in which they describe them haven't changed, and have been diagnosed and treated in Chinese medicine terms for centuries. There are a number of patterns or syndromes in Chinese medicine which reflect quite closely the sorts of problems which PCOS sufferers have and their problems with fertility, and a practitioner may be able to use these as the basis of a worthwhile strategy.

 

We have to be realistic, though, PCOS makes pregnancy difficult, whatever system of medicine you use to diagnose it. Our main concern is that you are not led into unnecessary time and expense for something which cannot help, and not diverted from conventional treatment which may ultimately be of benefit. Our members are responsible and safe practitioners, and if you visit one local to you, we hope that they are happy to see you for a short consultation, hopefully without charge, to determine whether the unique case which you represent in Chinese medicine terms is one for which they feel that treatment may offer some hope.

From a western perspective the evidence for treating fibroids is not that good. In a major review undertaken two years ago

 

 

http://www.thecochranelibrary.com/userfiles/ccoch/file/Acupuncture_ancient_traditions/CD007221.pdf

 

the authors concluded that while acupuncture was heavily used in China to treat fibroids, there was not enough research conducted according to the best practice in the West to be able to draw firm conclusions. The same applies to acupuncture for the treatment of (in)fertility. As our own factsheet acknowledges such evidence as there is does not really provide a strong enough foundation to make sustainable claims.

 

However, one of the great strengths of Chinese medicine is that it operates with an entirely different understanding of pathology and physiology. There are ways in which conditions which are given western labels like 'fibroids' are understood which do not overlap or translate exactly with the western label. Fibroids, for example, are sometimes described as 'Blood stasis' or as manifestations of 'Dampness', and the treatment protocols are aimed at these as systemic problems which manifest in the local disturbance. If the diagnosis is one of 'blood stasis' or 'dampness' there may well be other symptoms and diagnostic signs which confirm this pattern.

 

As far as fertility is concerned, much the same reasoning applies. The Chinese took the simplistic, but effective, view that if everything was in balance, then natural processes should happen without problem. If a natural process like conception did not function, then it was simply a matter of correcting the overall balance and letting nature take its course. Even if there are specific symptoms which are implicated in the failure to conceive, these may still be best understood as part of an overall pattern and treated accordingly.

 

Our one word of caution is that the acupuncture treatment of fertility issues, especially related to assisted reproduction such as IVF and ICSI, has become a growth industry over the last few years, and alongside BAcC members many other individuals and clinics have set up which often charge extremely high fees for treatment which is no better than that offered by any BAcC member. While we do not recognise specialisms, there are many BAcC members who focus their work on fertility and pregnancy issues, and often have a wealth of additional background knowledge in these areas. For women undergoing IVF and ICSI this understanding can be a valuable addition to the work that a BAcC member does. The acupuncture treatment itself, however, is based on principles over 2000 years old which underpin the work of all BAcC members.

 

Q. Can acupuncture help if you are trying to conceive?

 

A. Just as every magazine and sunday newspaper runs regular articles on how best to prepare yourself for conception and childbirth it won't come as a surprise to know that Chinese medicine has equivalent ideas about what counts as the best possible health and what might remove some of the impediments to conception. Most of these are independent of specific cultures and just straightforward common sense - eat well, sleep well, don't work to hard, don't try to make the process happen when you don't actually feel like, and so on.
 
Chinese medicine is founded on notions of balance and harmony in good health, however, rather more than the absence of disease. This is not unique to Chinese medicine; an increasing amount of NHS resource is now directed towards healthy living. In the Chinese medical model, though, the practitioner can do a great deal to achieve states of better balance which they believe will make the person as a whole - body, mind and spirit - function much better. BAcC members are trained in depth in how to use Chinese medicine in this way, and any normal process in life should, in theory, be improved by being in better balance.
 
There are obviously no guarantees, and no-one will claim to be able to influence the process of conception to that extent. However, it appears that a growing number of women seem to have found that having acupuncture treatment while they were trying to conceive has been beneficial if only for the relaxation which treatment seems to encourage.

 

Q. Can acupuncture help with male infertility and where would the needles go?

 

A. Although there is no conclusive evidence that male infertility can be helped by acupuncture a number of studies, such as this one undertaken in 2002 http://www.ncbi.nlm.nih.gov/pubmed/12658811, suggest that there may be measurable changes in important aspects of sperm motility and quality. Traditional Chinese medicine clearly did not have access to such sophisticated methods of analysis but infertility was recognised as just as much a problem in both sexes over a thousand years ago, and its diagnosis was understood in terms of the patterns of energy with which infertile couples presented for treatment.
 
As we say frequently on the website, chinese medicine primarily treats the person, not simply the condition, and most treatments use points on the limbs below the elbow and knee, and powerful points on the trunk and back. As we constantly remind patients, though, they are in charge of the treatment. If any needling is suggested for areas outside their comfort zones, they can and should say 'no.' A well-trained practitioner will always be able to find suitable alternative ways to achieve the same results.

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