Endometriosis is a chronic condition characterised by growth of endometrial tissue in sites other than the uterus, most commonly in the pelvic cavity, but also in other parts of the body (RCOG 2006).
This ectopic tissue responds to the hormonal changes of the menstrual cycle, with subsequent bleeding, inflammation, and pain. If the ovaries are affected, endometriotic ovarian cysts may develop (Bulun 009). Although the condition may be asymptomatic, common symptoms include dysmenorrhoea, dyspareunia, non-cyclical pelvic and abdominal pain, and subfertility (RCOG 2006). When endometriosis remains untreated, the disease progresses in around a third of women, but seems either to resolve or does not progress in the rest (DTB 1999). The prevalence is estimated to vary from 2-22% of women and, in women with dysmenorrhoea, the incidence of endometriosis is 40-60% (Johnson 2007).
It has been shown that acupuncture treatment may specifically be of benefit in people with endometriosis by:
providing pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Zhao 2008, Han 2004, Zijlstra 2003, Pomeranz 1987).
reducing inflammation – by promoting release of vascular and immunomodulatory factors Kavoussi 2007, Zijlstra 2003).
regulating levels of prostaglandins (Jin 2009)
combining acupuncture with Chinese herbal medicine for endometriosis has been shown in animal studies to down-regulate the abnormal increase of matrix metalloproteinase-2 (MMP-2) levels that is associated with ectopic activity of endometrial cells. The treated rats had reduced areas of ectopic tissue (Chen 2008). MMP-2 is required for the anchoring of the placenta to the uterine wall in pregnancy but over-production can lead to endometriosis.