Acupuncture Archives

Acupuncture for PCOS – YES!

Screen Shot 2013-10-07 at 5.30.08 PMI often say that Chinese Medicine is one of the best modalities to treat chronic gynecological issues such as infertility, PCOS, dysmenorrhea and amenorrhea. There have been several studies recently that showed the benefit of acupuncture for Polycystic Ovarian Syndrome (PCOS).

This past spring a Swedish study compared using acupuncture to meeting with a therapist for 10-13 weeks. The author’s conclusions also showed that acupuncture can be an effective treatment for PCOS. A fantastic review article on acupuncture and PCOS was recently released. You can download the article here or get it here.

For those that are not interested in reading a research article the conclusion is that there is a lot of evidence on the benefit of acupuncture and PCOS. Given that there is also a lot of good research on diet and PCOS improvement I believe the best approach is not just using acupuncture but to incorporate diet and lifestyle changes to improve PCOS outcomes. As a dietitian I do have post graduate training in PCOS nutritional counseling and am very happy to help you improve your GYN symptoms.


Yours In Health,

George Mandler LDN LicAc



Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome



Women with polycystic ovary syndrome (PCOS) have symptoms of depression and anxiety and impaired health related quality of life (HRQoL). Here we test the post-hoc hypothesis that acupuncture and exercise improve depression and anxiety symptoms and HRQoL in PCOS women.


Seventy-two PCOS women were randomly assigned to 16 weeks of 1) acupuncture (n = 28); 2) exercise (n = 29); or 3) no intervention (control) (n = 15). Outcome measures included: change in Montgomery Åsberg Depression Rating Scale (MADRS-S), Brief Scale for Anxiety (BSA-S), Swedish Short-Form 36 (SF-36), and PCOS Questionnaire (PCOSQ) scores from baseline to after 16-week intervention, and to 16-week post-intervention follow-up.


A reduction in MADRS-S and BSA-S from baseline to 16-weeks post-intervention follow-up was observed for the acupuncture group. The SF-36 domains role physical, energy/vitality, general health perception and the mental component of summary scores improved in the acupuncture group after intervention and at follow-up. Within the exercise group the role physical decreased after treatment, while physical functioning and general health perception scores increased at follow-up. The emotion domain in the PCOSQ improved after 16-weeks of intervention within all three groups, and at follow-up in acupuncture and exercise groups. At follow-up, improvement in the infertility domain was observed within the exercise group.


There was a modest improvement in depression and anxiety scores in women treated with acupuncture, and improved HRQoL scores were noted in both intervention groups. While not a primary focus of the trial, these data suggest continued investigation of mental health outcomes in women treated for PCOS.

This is a meta-analysis which means that gather many different research papers and focus on combining and contrasting different studies to draw a conclusion. In this paper they showed the via functional MRI (fMRI) the brain response for needling is different than other stimulation at the same point.


Acupuncture is a therapeutic treatment that is defined as the insertion of needles into the body at specific points (ie, acupoints). Advances in functional neuroimaging have made it possible to study brain responses to acupuncture; however, previous studies have mainly concentrated on acupoint specificity. We wanted to focus on the functional brain responses that occur because of needle insertion into the body. An activation likelihood estimation meta-analysis was carried out to investigate common characteristics of brain responses to acupuncture needle stimulation compared to tactile stimulation. A total of 28 functional magnetic resonance imaging studies, which consisted of 51 acupuncture and 10 tactile stimulation experiments, were selected for the meta-analysis. Following acupuncture needle stimulation, activation in the sensorimotor cortical network, including the insula, thalamus, anterior cingulate cortex, and primary and secondary somatosensory cortices, and deactivation in the limbic-paralimbic neocortical network, including the medial prefrontal cortex, caudate, amygdala, posterior cingulate cortex, and parahippocampus, were detected and assessed. Following control tactile stimulation, weaker patterns of brain responses were detected in areas similar to those stated above. The activation and deactivation patterns following acupuncture stimulation suggest that the hemodynamic responses in the brain simultaneously reflect the sensory, cognitive, and affective dimensions of pain.


This article facilitates a better understanding of acupuncture needle stimulation and its effects on specific activity changes in different brain regions as well as its relationship to the multiple dimensions of pain. Future studies can build on this meta-analysis and will help to elucidate the clinically relevant therapeutic effects of acupuncture.


Tapping in acupuncture needleThe lack of acupuncture coverage by insurance companies in Massachusetts at best disappointing. Very few companies actually cover acupuncture treatments. I know I save insurance companies tens of thousands each year. I have little doubt that my acupuncture colleagues in Massachusetts in total save insurance companies many millions. We would save insurance companies more money if we weren’t a last resort.

How could I be so sure we are saving so much? One metric is simply based on people telling me they need surgery. Back, knee, intestinal, hip etc. Many times after a series of acupuncture treatments people feel remarkably better. If they underwent surgery those procedure are often at minimum $15,000 per procedure. ( typically much more). If people came to us before getting an expensive MRI the cost effectiveness would be even further realized.

Many people are not interested in taking medications with side effects. It seems more and more people are waking up to the fact that mediation for chronic conditions only treats symptoms and does little to help the underlying issue. Acupuncture is one of many great modalities that can help correct chronic conditions that Western medicine where western medicine has little answers except medication or surgery. Those answers can be very costly.

The review just released below demonstrates the cost effectiveness of acupuncture to back up my claim.

Acupunct Med. 2012 Dec;30(4):273-85.
A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture.
Kim SY, Lee H, Chae Y, Park HJ, Lee H.
OBJECTIVE: To summarise the evidence on the cost-effectiveness of acupuncture.

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Natural Solutions for Pregnancy Complications

Pregnancy is a critical time for smart dietary choices and proper nutritional support to improve the health of a baby. But pregnancy and childbirth in the opinion of many has become has become a pathology and medical procedure with excessive interventions that can negatively influence a mother and babies’ health.

Of course a small percentage of pregnancies require modern medical intervention in the forms of medications and potential surgeries. Modern medicine has saved countless pregnant women and newborn lives. But I don’t agree with the unnecessary overuse of strong medicines or procedures that have little clinical evidence of safety and potential deleterious side effects when safer options are available. Read the rest of this entry

Acupuncture For Sleep Issues is not overrated! Sleep is how our body restores itself. Lack of sleep leads to inflammation and there is good data tying lack of sleep to many undesirable health consequences.

There can be many reasons why someone is not sleeping well. The typical patterns I see when someone complains of a not sleeping well or ‘insomnia’ is either:

  • A person cannot fall asleep. Either their head is spinning with thoughts (“monkey mind” 心猿) or they just feel wired and jittery.
  • A person wakes up after a few hours of sleep. Often around 2 am for about 1-2 hours.
  • A person wakes up early in the morning feeling they haven’t had enough sleep, but cannot fall back asleep. (even though it is 4:00am).

Some sleep issues can stem from endocrine system and blood sugar dysregulation. Some can be caused by anemia. Some may stem from circumstantial life situations one is currently experiencing and causing a ‘Heart’ disturbance. Certainly the sleep disorder is not from an Ambien deficiency.

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acupuncture relieves pain A recent Archives of Internal Medicine systematic review article of acupuncture randomized control trials (RCTs) found that acupuncture was more effective than what customary care for chronic pain. The meta analysis examined 29 studies involving almost 18,000 adults. The researchers concluded that acupuncture was more effective than customary medical treatments and slightly better than ‘sham’ acupuncture.

So we now have a meta analysis that looked at raw data from over 2 dozen studies and it showed that acupuncture is an effective treatment for back pain. However the anti-alternative medicine folks are quick to pounce on the fact that real acupuncture over sham acupuncture only had about a 10% improvement in chronic pain scores. In other words it wasn’t statistically significant. The 5 senses only folks then claim acupuncture is just a placebo effect, which is a ridiculous argument in of itself for a few reasons:

  1. The sham group in this case is not ‘sham’, as in receiving no treatment. “Sham” absolutely can trigger a physiological response. As any acupuncturists will tell you the mere puncturing of the skin in needles at random points can bring about positive change in some. Yes you don’t need to hit exact points in some people as they may respond to almost anything.
  2. Of course there is a ‘placebo’ effect in acupuncture treatments. How can there not be? The patient/practitioner relationship plays a significant role as shown by Ted Kaptchuk. But what is the ‘placebo effect’? It is the mind bringing about a healing response. If the goal is to make people feel better than that is a treatment! Who cares how one gets there as long as they feel better.
  3. If it is just a placebo effect then how does one explain the numerous reports of improvement of health for animals?

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Acupuncture For Pain Management During Labor

A review study was recently published that evaluated 13 trials which included 1,986 women and found that acupuncture during labor was associated with:

  1. Less intense pain reported
  2. More satisfaction with pain relief compared to no treatment
  3. A reduced use of pharmacological analgesia
  4. Fewer instrumental deliveries

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Acupuncture for Migraine Prevention

Acupuncture studies using the standard “Evidence Based Medicine” are difficult to conduct as there are limitation to how an effective placebo can be carried out. Even studies that use so called “sham” acupuncture may not necessary be a placebo as the sham can have physiological effects beyond just the mind. I know from a clinical perspective that acupuncture works, but showing it within the confines of the current research model is difficult. Anyone that says acupuncture is only a placebo effect I suggest they talk to someone that brought their animal (dog, cat, horse) to someone that does animal acupuncture. The results are often outstanding so if it is a placebo effect these creatures are experiencing then they are a lot smarter than we think.

An interesting study was just released that looked at acupuncture’s efficacy for preventing migraines. Read the rest of this entry

Polycystic ovary syndrome (PCOS) is a metabolic imbalance of a woman’s hormones. This imbalance can cause changes in the menstrual cycle (amenorrhea, irregular periods, dysmenorrhea), skin changes, small cysts in the ovaries, infertility, hair growth and other problems. In a woman’s normal menstrual cycle one (or more) eggs are released from the follicles in the ovaries. In PCOS the eggs do not mature and instead form small cysts in the ovaries. This can lead to infertility. Read the rest of this entry

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