pain

Acupuncture found to be effective adjunctive treatment for endometriosis-related pain

Acupuncture found to be effective adjunctive treatment for endometriosis-related pain

By I.Soussis MD, Fertility Specialist

Endometriosis, Pain Management Meta-analysis of 3 studies of acupuncture for relief of endometriosis-related pain found positive results for reduction in pain intensity, according to research published in the Journal of Pain Research. This alternative and complementary therapy has been proven to be safe, with a low side-effect profile.

Swedish researchers performed a literature search for clinical trials, case reports, and observational studies with abstracts written in English using the keywords “acupuncture and endometriosis.” 

They retrieved 3 articles involving a total of 99 women with diagnosed endometriosis (stages I-IV) aged 13 to 40. All of the studies entailed acupuncture sessions during which 7 to 12 needles were inserted per subject and left in for 15 to 25 minutes. 

The needles were placed in the lower back,/pelvic area, lower abdominal area, feet, and/or hands. Depth of stimulation with the needles ranged from intracutaneous to subcutaneous to intramuscular, and the stimulation was primarily manual in nature. 

The number of treatments varied from 9 to 16 and occurred once or twice a week, and treatments were given in a hospital, acupuncturist’s office, or patient’s home. All of the studies reported a decrease in rated pain intensity, but differed in terms of research design, needle stimulation techniques, and the instruments used to evaluate the outcomes.

Two of the studies were prospective, randomized, single-blind, placebo/sham trials and the other was a retrospective observational case series study (n=2). The Visual Analog Scale, Numeric Rating Scale, and Verbal Rating Scale were used to measure patient-rated pain intensity. Subjects were permitted to continue using their standard analgesic in 2 studies.

The results indicated that no matter the specific technique used, acupuncture effectively and safely reduced pain intensity compared to baseline. One study found that acupuncture also reduced pain-related disability, and 2 studies found reduced analgesic intake and perceived stress. Likewise, 2 studies found that the therapy improved health-related quality of life, and social activity and attendance in school were increased after acupuncture treatment in the observational study.

 

Although acupuncture has been used for many years to relieve pain and has been noted to have few serious side effects, its use remains controversial due to a lack of understanding of its mechanism of action. 

The authors reported that “the pain-alleviating effects induced by acupuncture have been attributed to different physiological and psychological processes such as activation of endogenous descending pain inhibitory systems, deactivation of brain areas transmitting sensations of pain-related unpleasantness, interaction between nocioceptive impulses and somato-visceral reflexes, and as a method that induces the expectation of symptom relief.” 

They noted that currently available therapies for pain management in endometriosis patients are often ineffective or accompanied by adverse effects, and there is need for nonpharmacological interventions such as acupuncture. 

Source: http://www.contemporaryobgyn.net/endometriosis/acupuncture-found-be-effective-adjunctive-treatment-endometriosis-related-pain?rememberme=1&elq_mid=2570&elq_cid=607376

 

Fatigue is a common symptom of endometriosis

Fatigue is a common symptom of endometriosis

By I.Soussis MD,MSc,FRCOG, Fertility Specialist

Women with endometriosis experience debilitating fatigue more than twice as often as those who don’t have the condition, yet fatigue isn’t discussed or researched widely enough in these patients, a recent study concluded.

The international study found that high levels of fatigue experienced by women with endometriosis are independent of other factors, such as insomnia, pain, depression, occupational stress, weight, and motherhood.

The study “Fatigue – a symptom in endometriosis,” was published in the journal Human Reproduction.

Fatigue is a known symptom of endometriosis that affects the daily activities and quality of life of women living with the condition. But scientists and physicians lack large population studies investigating the frequency of fatigue in women with the disease.

Researchers designed a multicenter study that recruited 1,120 women (560 with endometriosis and 560 without it), at hospitals and private practices in Switzerland, Germany, and Austria between 2010 and 2016.

Participants responded to a questionnaire focused on several factors associating quality of life with endometriosis, as well as family and medical histories, mental disorders, and lifestyle. Fatigue and insomnia were classified at five different levels, with 1 being “never” and 5 being “very often.”

Responses showed that frequent fatigue was experienced by more than half of the women with endometriosis (50.7 percent) but by only a minority of women who didn’t have endometriosis (22.4 percent).

The study also found a link between fatigue in endometriosis and insomnia (women with endometriosis had a seven-fold increase in insomnia compared with healthy women), depression (a four-fold increase), pain (a two-fold increase), and occupational stress (nearly a 1.5-fold increase). However, no correlation was seen between the above symptoms and age, disease stage, and time since diagnosis.

Endometriosis leads to inflammation and an activation of the immune system, which may help to explain the link between endometriosis and fatigue, researchers said.

Proteins that are produced when the immune system is activated are known to be involved in fatigue symptoms. Also, chronic exposure to high stress can lead to fatigue, and researchers said this could be an additional explanation.

“These findings suggest that endometriosis has an effect on fatigue that is independent of other factors and that cannot be attributed to symptoms of the disease,” Brigitte Leeners, the study’s lead researcher and deputy head of the Department of Reproductive Endocrinology at the University Hospital Zurich, in Switzerland, said.

“We believe that in order to improve the quality of life for women with this condition, investigating and addressing fatigue should become a routine part of medical care, and doctors should investigate and address this problem when they are discussing with their patients the best ways to manage and treat the disease”. It would also help these women if steps were taken to reduce insomnia, pain, depression and occupational stress,” she added.

 

Read more: https://academic.oup.com/humrep/advance-article/doi/10.1093/humrep/dey115/5040620

Image credit: https://endometriosisnews.com/2018/03/16/endometriosis-causes-chronic-fatigue-more-than-feeling-tired/

Visit Us On FacebookVisit Us On Google PlusVisit Us On Linkedin