Acupuncture for PCOS no better than fake treatment

In a new study of women with polycystic ovary syndrome, or PCOS, there was no difference in ovulation or hormone levels in those who got real versus sham acupuncture treatments.

Women in both groups saw an improvement in hormones related to pregnancy and ovulation, and tended to have more periods after going to the study sessions than before.

That’s a confusing finding, researchers said, because it’s not clear why women getting fake acupuncture treatments would improve.

“Whether there’s actually some physiological benefit from a sham acupuncture treatment, I don’t know,” said study author Lisa Pastore, from the University of Virginia in Charlottesville.

It could be that the hope of getting better with acupuncture makes a difference, she told Reuters Health, or that the benefit of “simply slowing down, lying down in a quiet room” during either treatment was behind hormone and ovulation changes.

PCOS is a hormone disorder characterized by infrequent ovulation, weight gain, and acne. About one in 15 women of reproductive age has the condition, according to estimates.

While medications such as Metformin can increase ovulation in PCOS, the disease is chronic and many women don’t want to be taking prescription drugs for long periods of time, said Courtney Lynch, the head of reproductive epidemiology at The Ohio State University in Columbus, who was not involved in the new study.

That’s why researchers are looking into alternative treatment options to restore periods and increase fertility in this group, she said.

Some initial research had suggested that acupuncture in particular may be beneficial for women with PCOS. To better explore that, Pastore and her colleagues randomly assigned 84 women diagnosed with PCOS to get 12 real or fake acupuncture treatment sessions over an eight-week period.

Acupuncturists stimulated points on the skin above the bladder and spleen in women getting real acupuncture treatment, while a phony device was used on the arms and legs in women in the sham group.

During the eight-week study and for three months afterwards, there was no difference in the number of women in each group who ovulated every month. On average, 37 percent of women in the real acupuncture group ovulated in a given month, compared to 40 percent in the fake group.

In general, women tended to have more frequent periods during those five months than before, and the difference was more pronounced in the sham group.

Both groups saw some improvement related to the balance of pregnancy and ovulation hormones in their blood compared to before they started treatment, the researchers reported in the Journal of Clinical Endocrinology and Metabolism.

That might suggest that the “placebo effect” - when patients get better because they think a treatment will help them - could be behind the responses in both groups, Lynch said.

It’s clear that acupuncture can be useful for some patients, such as those who are suffering from pain or who are very stressed, she added.

But, “I personally think that the use of acupuncture in relation to PCOS is a little bit of a reach, because these women actually have hormonal reasons why they cannot ovulate appropriately,” she told Reuters Health.

For women with PCOS who are trying to get pregnant, usually medication or in-vitro fertilization works pretty well, she said. The women in the current study weren’t necessarily trying to have a baby.

Pastore pointed out that the acupuncture treatment was standardized for all women, and that in the real world practitioners would work with patients to develop the best treatment for their needs. That could be why the sessions didn’t seem to help women more than fake acupuncture, she said.

“My advice is, if you want to try a non-drug treatment and if you can afford the acupuncture treatment, why not try it?” she said. “If you try it for two, three months, you’re going to know if you start having regular periods or not.”

Although the cost of acupuncture varies greatly, a typical session runs for about $60 to $100.

“At least, as a good thing we can say that it does no harm,” said Elisabet Stener-Victorin, a PCOS researcher from the University of Gothenburg in Sweden whose own studies have suggested a benefit from acupuncture.

However, the current study “leaves a lot of unanswered questions,” she concluded.

SOURCE:  Journal of Clinical Endocrinology and Metabolism, online August 3, 2011.

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