Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence

Conclusion: Despite the lack of a large body of evidence, we should not ignore the fact that many women with PCOS use acupuncture. This alone is a compelling reason to investigate the method. In the hands of competent  egistered health-practitioners, acupuncture is safe (96). Clinical and experimental evidence shows that  cupuncture can be a suitable alternative or complement to pharmacological induction of ovulation in women with PCOS and may also relieve other symptoms, without adverse side-effects. Clearly, acupuncture  odulates endogenous regulatory systems, including the sympathetic nervous system, the endocrine system and the neuroendocrine system. However, randomised controlled trials are needed to evaluate the effect of acupuncture in women with PCOS. 

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.

Effects on metabolic pattern
Low-frequency EA with repetitive muscle contractions activate physiological processes similar to those  esulting from physical exercise. Daily low-frequency EA treatment induces weight loss and increases insulin  ensitivity, reducing blood glucose and lipid levels (71, 72). Repeated low-frequency EA reduces food intake  nd body weight, possibly by increasing leptin levels in both rats (71) and humans (72–75). Low-frequency EA also stimulates glucose transport in skeletal muscle independently of insulin and increase the insulin sensitivity of glucose transport in rats (76–78). In female rats with PCOS, induced by continuous prepubertal  dministration of DHT (51), we found that both repeated low-frequency EA treatment and 4–5 weeks of  voluntary exercise reduced insulin resistance (unpublished data). Exercise also reduced body fat and body  eight an  increased lean body mass. Thus, repeated low-frequency EA may reduce insulin resistance, a  central feature of PCOS.

Journal of Neuroendocrinology

E. Stener-Victorin,* E. Jedel and L. Mannera°s*
*Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Go¨teborg University, Go¨teborg, Sweden.

Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.