Acupuncture is effective for premature ovarian insufficiency (POI)

Premature ovarian insufficiency (POI) is a condition characterized by a decline in ovarian function before the age of 40, which is a significant contributor to female infertility. This condition is marked by elevated levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), along with low levels of estradiol (E2). Common symptoms of POI include menstrual disturbances, as well as menopausal symptoms like hot flashes, night sweats, and insomnia. Additionally, POI increases the risk of decreased bone mineral density and cardiovascular disease. The incidence of POI is estimated to be around 1%–5%.

The European Society of Human Reproduction and Embryology (ESHRE) has established guidelines for the diagnosis of POI. According to these guidelines, the diagnostic criteria include age younger than 40, oligo/amenorrhea for at least 4 months, and FSH levels higher than 25 mIU/ml on two occasions separated by at least 4 weeks. While the exact causes of POI remain unclear, they may be associated with genetic factors, iatrogenic causes, autoimmunity, unhealthy lifestyle, and psychological stress.

In Western medicine, hormone replacement therapy (HRT) is the primary treatment option for POI. However, acupuncture has emerged as a potential alternative for improving ovarian function in Chinese women with POI who desire to conceive. Clinical research has demonstrated the effectiveness of acupuncture in treating POI, as it has been shown to alleviate clinical symptoms, slow down female genital atrophy, regulate hormone levels, and improve pregnancy rates.

For instance, a research study analyzing eight randomized controlled trials (RCTs) conducted before 2014 found that acupuncture significantly reduced serum FSH levels, and more women receiving acupuncture reported a resumption of menstrual cycles. Another study investigated the effect of acupuncture on POI in a total of 66 randomly assigned patients, divided into an observation group and a control group. Both groups underwent treatment for three menstrual cycles. The study observed a decrease in FSH and LH levels, along with an increase in E2 levels after treatment. Furthermore, the observation group exhibited increased serum levels of anti-Müllerian hormone (AMH) and antral follicle count (AFC), surpassing those in the control group. Additionally, a separate study demonstrated that after three menstrual cycles, FSH levels significantly decreased, E2 levels increased, the endometrium thickened, and menstrual symptoms improved. These findings suggest that acupuncture therapy effectively improves ovarian function and alleviates low estrogen symptoms in patients with POI.

In conclusion, POI is a condition characterized by a decline in ovarian function before the age of 40, leading to female infertility. Current treatment options primarily revolve around hormone replacement therapy in Western medicine. However, acupuncture has shown promise in improving ovarian function and addressing the symptoms associated with POI. Clinical research has demonstrated the effectiveness of acupuncture in regulating hormone levels, reducing FSH levels, and improving menstrual cycles. Acupuncture may serve as a valuable adjunct or alternative therapy for women with POI who desire to conceive.

Yang Fu et al Evid Based Complement Alternat Med. 2022; 2022: 9053930.
Junyoung Jo et al Evid Based Complement Alternat Med. 2015; 2015: 842180.
Lin-Lin Wang et al Zhongguo Zhen Jiu 2021 Jul 12;41(7):742-6.

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