Acupuncture in Obstetrics and Gynecology

Abstract

Importance Acupuncture is a key component of therapy in traditional Chinese medicine. Only in the last few decades has acupuncture become popular in the United States. The mechanism behind acupuncture's effects on the body and brain has not been completely elucidated, but there is evidence that acupuncture has effects on the endocrine, immune, and sympathetic and parasympathetic nervous systems. It may also act through electrical and mechanical signaling through the connective tissue and fascia. Despite this uncertainty, the positive effects of acupuncture have been well established. Objective In this review, we discuss the basic concepts of traditional Chinese medicine and acupuncture and examine the evidence regarding the use of acupuncture in obstetrics and gynecology. Evidence Acquisition We conducted a literature review of acupuncture in obstetrics and gynecology using PubMed. Results The available data demonstrate that acupuncture is beneficial in the treatment of labor pain, back pain in pregnancy, and dysmenorrhea. It is unclear if acupuncture is effective for hyperemesis, chemotherapy-induced nausea and vomiting, and menopausal hot flushes, or if moxibustion is effective in correcting breech presentation. There are limited but positive data regarding menopause-related sleep disturbances, depression in pregnancy, and overactive bladder. Acupuncture is not beneficial for improving outcomes in in vitro fertilization. Conclusions and Relevance Acupuncture is an increasingly popular therapy with many potential applications in obstetrics and gynecology. A general understanding of the basic principles of acupuncture and the safety and efficacy of its practice is necessary for the general obstetrician and gynecologist to make informed recommendations to patients. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to identify the basic concepts of traditional Chinese medicine and how it differs from Western medicine; describe common obstetrical and gynecologic issues that can be successfully treated with acupuncture; and distinguish the main issues in designing acupuncture studies regarding blinding, choosing a control group, and identifying areas of potential bias.