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. 2018 Nov 15;2018:3752723. doi: 10.1155/2018/3752723

A Literature Review of Women's Sex Hormone Changes by Acupuncture Treatment: Analysis of Human and Animal Studies

Jade Heejae Ko 1, Seung-Nam Kim 1,✉
PMCID: PMC6276442  PMID: 30581481

Abstract

Background

It has been known that acupuncture treatment relieves gynecological disorders such as menopause, ovarian dysfunction, and dysmenorrhea. Sex hormones, including estrogen, progesterone, and gonadotropins, are related to the women disease. However, regulative effect of acupuncture on sex hormones has not been fully identified.

Methods

Acupuncture articles including analysis of sex hormones were searched in electronic databases from inception to June 2018. The methodological quality was assessed using modified CAMRADES tool. A total of 23 articles were selected and analyzed.

Results

In the results, overall studies showed that acupuncture increases estrogen, especially estradiol, progesterone, prolactin, and other hormones. Estradiol level was increased in most of studies except 3 studies which resulted in decreased level or not meaningful change. Two studies showed increase of FSH and LH whereas it was decreased in other studies. Other hormones were mostly increased by acupuncture.

Conclusion

This study possibly indicates that acupuncture changes sex hormone in various gynecological conditions in women.

1. Background

Female reproductive health is closely related to menstrual cycle and menstrual health. The causes of gynecological disorders, reproductive dysfunctions, and menopausal syndromes such as polycystic ovarian syndrome (PCOS), dysmenorrhea, and hot flush were suggested in numerous studies. The cause of the gynecological issues is mainly imbalance of sex hormones [1–4] in addition to extrinsic factors [5]. Along with the scientific findings in terms of the dysfunctions and symptoms, various treatment methods have been used in patients. Hormonal contraceptives have been used most widely and frequently for gynecological disorders and reproductive dysfunctions [6]. For instance, oral contraceptives pills (OCPs), which are known to regulate hyperandrogenism, have been used to treat patients with PCOS and menstrual dysfunctions [7]. The efficacy and safety of the OCPs were proven via numerous experiments and clinical trials. Nevertheless, a considerable proportion of women who have ever taken OCPs discontinued taking OCPs due to side effects such as weight gain, headache, and nausea [8].

For gynecological issues of women, acupuncture has become one of the popular complementary treatment methods and use of acupuncture has been steadily increasing [9]. It has been well understood that acupuncture is effective in analgesia and blood flow regulation [10]. According to research, women are more likely to use acupuncture as an adjunct treatment compared to men [11, 12]. With increased recognition of effect of acupuncture in many field of studies, its effects on gynecological and reproductive issues were raised among people. Therefore, in present review, we explored how acupuncture affects and changes different sex hormone levels in animal model and human.

2. Methods

2.1. Eligibility Criteria

All eligible studies examined changes in follicle stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH, progesterone, estrogen, prolactin, or oxytocin level. Acupuncture treatment involving hormone studies were retrieved. Studies that only used either electroacupuncture or manual acupuncture were enrolled, while studies which used other acupoint stimulation method or moxibustion were excluded.

2.2. Study Selection

The following Pubmed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception until June 2018. The search terms included the following: ([acupuncture OR electroacupuncture] AND [follicle stimulating hormone OR luteinizing hormone OR progesterone OR estrogen OR prolactin OR oxytocin OR reproductive hormone]). The searching of the electronic databases led us to identify 124 potentially relevant manuscripts. The titles and abstracts that met the criteria of our study were independently read by two reviewers and only complete manuscripts published in English were retrieved. A total of 101 articles were excluded and the exclusion criteria were as follows: (1) full texts not accessible, (2) review article, (3) use of other acupoint stimulation or moxibustion, (4) case report, (5) letter, (6) irrelevance in terms of hormone study, and (7) irrelevance in terms of acupuncture study. 23 studies were included ultimately.

2.3. Quality Assessment

The methodological quality of each included study was assessed by two authors (Kim and Ko) by using 8-item checklist modified from CAMARADES checklist [13, 14]: (1) peer-reviewed manuscript, (2) explanation of acupuncture procedure, (3) detailed description of condition, (4) detailed statement of sample, (5) detailed explanation of sampling method, (6) statement of screened hormone type, (7) compliance with experiment subject welfare regulation, and (8) statement of potential conflict of interests. A sum of quality score was recorded for each article and possible total score was 8 points.

3. Results

3.1. Search Result

A total of 124 publications were initially identified in Pubmed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from their inception to June 2018. Among the initial 124 publications, 22 articles were excluded because their full-texts were unobtainable, and 5 duplicate records were also excluded. After title and abstract screening, total of 32 articles were excluded because they were reviews, case reports, letters, or other acupoint stimulation methods. 42 articles were excluded additionally after full-text screening and there were 28 nonhormone studies, 4 nonacupuncture, 3 low-quality studies, and 7 studies which had other reasons. Among the 7 studies, 2 studies used animals other than rat or mouse, 1 study used herb as treatment, 1 study was conducted with male patients, and the remaining three studies induced diseases by estrogen or progesterone. 23 articles which satisfied the criteria of our study were ultimately selected. Our screening process is summarized as flow diagram in Figure 1.

Figure 1.

Figure 1

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Flow diagram of the review.

13 articles used electroacupuncture (EA), 7 articles used manual acupuncture (MA), 2 articles used both EA and MA, and acupuncture method of one article was not able to identify. Of the 23 articles, 11 articles used human as subject and 12 articles used animal subject.

3.2. Quality Assessment

Table 1 shows quality assessment of included studies. The quality score of included studies ranged from 4 to 8 out of a total 8 points. The overall score for the studies were high. 9 studies scored 8 points [15–23], 10 studies scored 7 points [24–33], 2 studies scored 6 points [34, 35], and 2 studies scored 5 points [36, 37]. Of the 23 studies, 21 studies were peer-reviewed, 21 studies included explanation of acupuncture procedures, 22 studies described condition of experiment subject, and all 23 studies included detailed explanation of sample, sampling method, and screened hormone type. 22 studies mentioned compliance with experiment subject welfare regulations. 9 studies included potential conflicts of interest.

Table 1.

Quality assessment of studies included.

Author Year Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Score
Maliqueo et al. 2015 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Johansson et al. 2013 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Feng et al. 2012 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Pastore et al. 2011 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Stener-Victorin et al. 2000 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Ma et al. 2017 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Qin et al. 2013 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Yao et al. 2007 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Zhao et al. 2004 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Zhao et al. 2003 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Sunay et al. 2011 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Qu et al. 2007   ✓ ✓ ✓ ✓ ✓ ✓   6
Dong et al. 2001   ✓ ✓ ✓ ✓ ✓ ✓   6
Wang et al. 2016 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Xiong et al. 2015 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Zhou et al. 2013 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
Magarelli et al. 2009 ✓   ✓ ✓ ✓ ✓     5
Zhang et al. 2007 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Gaudernack et al. 2006 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Yang et al. 2006 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Yang et al. 2006 ✓ ✓ ✓ ✓ ✓ ✓ ✓   7
Uvnäs-Moberg et al. 1993 ✓     ✓ ✓ ✓ ✓   5
Zheng et al. 2013 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 8
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3.3. Effect of Acupuncture on Estrogen Level

We observed changes of estrogen level by acupuncture treatment of the 23 included studies (Table 2). Of the 23 studies, 14 studies investigated how acupuncture treatment affects changes in estrogen level solely or in addition to other female sex hormones. 3 articles measured estradiol (E2) level change in polycystic ovary syndrome (PCOS) models [15, 16, 24]. E2 level was decreased in 2 studies [15, 24] while there was no meaningful change in one study [16]. E2 level was increased in 5 ovariectomized rat model studies [17, 18, 27–29]. There were 3 articles which measured E2 level in human with menopausal syndrome [19, 34, 35]. There was no meaningful change in estrogen level in two of the studies [34, 35], while one study showed increment of E2 level [19].

Table 2.

Changes in estrogen by acupuncture treatment.

          Changes in hormone level  
Author Year Subject Condition Number Disease Acupuncture Acupuncture method
of sample (exp/con) compared to
disease
Maliqueo et al. 2015 Animal (rat) PCOS 10/12 ▲ E2 ▽ E2 EA
Johansson et al. 2013 Human PCOS 11/14 ▽ E1, E1-S, E2 EA+MA
Feng et al. 2012 Animal (rat) PCOS 40/44 ▲ E2 EA+MA
Ma et al. 2017 Animal (rat) Ovariectomized 8/8 ▽ E2 ▲ E2 EA
Qin et al. 2013 Animal (rat) Ovariectomized 8/8 ▲ E2 EA
Yao et al. 2007 Animal (rat) Ovariectomized 8/8 ▲ E2 EA
Zhao et al. 2004 Animal (rat) Ovariectomized 10/12 ▲ E2 EA
Zhao et al. 2003 Animal (rat) Ovariectomized 10/12 ▲ E2 EA
Sunay et al. 2011 Human Menopausal syndrome 27/26 ▽ E2 ▲ E2 MA
Qu et al. 2007 Human Menopausal syndrome 36/31 ≒ Estrogen MA
Dong et al. 2001 Human Menopausal syndrome 11 ≒ E2 MA
Wang et al. 2016 Human Diminished ovarian reserve 21 ▽ E2 ▲ E2 EA
Zhou et al. 2013 Human Primary ovarian insufficiency 11 ▽ E2 ▲ E2 EA
Zhang et al. 2007 Animal (rat) Pubertal development 5/4 ▽ E2 ▲E2 EA
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▲ Increased, ▽ decreased, and ≒ not significant

Wang et al. and Zhou et al. investigated effect of acupuncture on E2 level in human with diminished ovarian reserve and primary ovarian insufficiency, respectively [20, 22]. E2 level was increased in compliance with acupuncture treatment in the both studies.

3.4. Effect of Acupuncture on FSH and LH Level

Table 3 shows 14 studies that examined effect of acupuncture and reported on the outcomes of FSH and LH level changes. Among the 14 studies, 6 studies measured FSH level, LH level, or FSH/LH level in PCOS models [15, 16, 23–26]. Maliqueo et al. suggested that acupuncture rendered FSH level increase, whereas LH level and FSH/LH level were decreased [23, 24]. Pastore et al. also found that FSH/LH level was upregulated with acupuncture treatment although there was no notable change in FSH level and LH level [16]. Changes in LH level in most of the studies were found to be decreased or not significant.

Table 3.

Changes in FSH and LH by acupuncture treatment.

          Changes in hormone level  
Author Year Subject Condition Number of sample (exp/con) Disease Acupuncture Acupuncture method
Compared to
disease
Maliqueo et al. 2015 Animal (rat) PCOS 10/12 ▽ FSH, ▲ LH ▲ FSH, ▽ LH, 
▽ FSH/LH		 EA
Johansson et al. 2013 Human PCOS 11/14 ≒ FSH, ≒ LH,  
≒ FSH/LH		 EA+MA
Feng et al. 2012 Animal (rat) PCOS 8/8 ≒ LH EA+MA
Pastore et al. 2011 Human PCOS 40/44 ≒ FSH, LH,  
▲ FSH/LH		 MA
Stener-Victorin et al. 2000 Human PCOS 24 ≒ FSH, LH,  
▽ FSH/LH		 EA
Zheng et al. 2013 Human PCOS 43 ▽ FSH, ▽ LH,  
▽ FSH/LH		 MA
Ma et al. 2017 Animal (rat) Ovariectomized 8/8 ▲ LH ▽ LH EA
Sunay et al. 2011 Human Menopausal syndrome 27/26 ▲ FSH, ▲ LH ≒ FSH (p = 0.053), ▽ LH, MA
Qu et al. 2007 Human Menopausal syndrome 36/31 ▽ FSH, ≒ LH MA
Dong et al. 2001 Human Menopausal syndrome 11 ≒ FSH (p = 0.04),  
≒ LH		 MA
Wang et al. 2016 Human Diminished ovarian reserve 21 ▲ FSH, ▲ LH ▽ FSH, ▽ LH, ▲FSH/LH EA
Zhou et al. 2013 Human Primary ovarian insufficiency 11 ▲ FSH, ▲ LH ▽ FSH, ▽ LH EA
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▲ Increased, ▽ decreased, and ≒ not significant

3.5. Effect of Acupuncture on Other Hormones

In Table 4, 10 studies suggested effect of acupuncture on hormonal changes by measuring several other sex hormones: progesterone [21, 25, 35], prolactin [21, 26, 35, 36], human chorionic gonadotropin (hCG) [16, 36], gonadotropin releasing hormone (GnRH) [29], oxytocin [31, 37], and prolactin releasing protein (PrRP) [27]. Each hormone was examined solely or along with FSH, LH, or estrogen. 3 studies investigated progesterone level in different pathological conditions and there was increment of progesterone level in the three studies [21, 25, 35]. Furthermore, other studies which examined prolactin, hCG, GnRH, oxytocin, and brain PrRP also suggested increased hormone level in compliance with acupuncture treatment.

Table 4.

Changes in other hormones by acupuncture treatment.

          Changes in hormone level  
Author Year Subject Condition Number of sample (exp/con) Disease Acupuncture compared to Acupuncture method
disease
Feng et al. 2012 Animal (rat) PCOS 8/8 ▽ Progesterone ▲ Progesterone EA+MA
Pastore et al. 2011 Human PCOS 40/44 ▲ Testosterone ≒ Testosterone MA
Stener-Victorin et al. 2000 Human PCOS 24 ▽ Prolactin ▲ Prolactin EA
Yao et al. 2007 Animal (rat) Ovariectomized 8/8 ▽ PrRP ▲ Brain PrRP EA
Zhao et al. 2003 Animal (rat) Ovariectomized 10/12 ▽ GnRH ▲GnRH EA
Dong et al. 2001 Human Menopausal syndrome 11 ▽ Progesterone,
▽ Prolactin		 ≒ Progesterone,
≒ Prolactin		 MA
Xiong et al. 2015 Animal (rat) Embryo implantation dysfunction 6/6 ▽ Progesterone,  
▽ Prolactin		 ▲ Progesterone,  
▲ Prolactin		 MA
Magarelli et al. 2009 Human in vitro fertilization 34/33 ▽ hCG,  
▽ Prolactin		 ▲ hCG, ▲ Prolactin N/A
Gaudernack et al. 2006 Human Labour 48/52 N/A ▽ need of oxytocin MA
Uvnäs-Moberg et al. 1993 Animal (rat) Normal 6/6 N/A ▲ oxytocin EA
Yang et al. 2006 Animal (rat) Analgesia 6/7 ▽ oxytocin ≒ oxytocin EA
Yang et al. 2006 Animal (rat) Analgesia 9/9 ▽ oxytocin ≒ oxytocin EA
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▲ Increased, ▽ decreased, ≒ not significant, and N/A; not applicable.

4. Discussion

This review found that acupuncture potentially alters different sex hormone levels in animal model and patients with gynecological or reproductive issues. It is evident that acupuncture has been increasingly used in many diseases and its effects are examined through studies in various fields. Knowing that female population is high in number among acupuncture users, aim of understanding clinical significance and effect of acupuncture on women's sex hormone has been raised. We examined change in women's sex hormones: estrogen, progesterone, oxytocin, and gonadotropin hormones and searched evidence of hormones being regulated by acupuncture. A total of 23 studies were included for the review and hormone level change was investigated for each included study.

Based on what we have found, estrogen (estradiol) level was a mainly measured hormone in the articles and the increased estrogen was detected in most of the studies, while estrogen was decreased in the study of Maliqueo et al. [23, 24] and Johansson et al. [15]. As these two articles studied PCOS disease whereas other articles studied ovarian dysfunction, it is possible that increased estrogen level in ovarian dysfunction and decreased estrogen level in PCOS are presumably influenced by disease characteristics.

Gonadotropin hormone level was also investigated in most of the studies to see whether acupuncture affected hormone levels in animal model and patients. In an early hormonal study, Patel et al. suggested that GnRH-stimulated, oversecretion of LH best elucidates cause of PCOS in women [38]. Results were inconsistent among the studies; therefore further studies are expected for better understanding of effect of acupuncture in terms of gonadotropins.

Although there were comparatively less studies which examined other sex hormones, progesterone, oxytocin, hCG, PrRP, prolactin, and GnRH, hormone level was increased as a result of acupuncture. Among the studies, prolactin level was found to be increased by acupuncture. In several other studies, prolactin is increased as a result of acupuncture treatment [39, 40]. It seems that acupuncture potentially increases prolactin level, yet more mechanism studies are needed in order to verify exact effect of acupuncture on sex hormones.

In terms of acupuncture method, there was insufficient number of correlation identified between acupuncture method and hormone changes. For instance, estrogen level was increased by use of MA in the study of Sunay et al. [19] and there was also increased estrogen level in the study of Wang et al. [20] by using EA. By contrast, LH level was decreased in the study of Ma et al. [17]. However, the studies included in this review not only have broad range of acupuncture method, but also have different acupuncture forms (manual or electroacupuncture), durations of treatment, acupuncture points, and intensities (see in Supplementary Table 1). Such diversity of acupuncture method made drawing definite conclusion hardly possible. Thus, further study is required to understand the relationship between sex hormones and acupuncture method. Meanwhile, effect of homeostasis regulating effect of acupuncture may elucidate mechanism in hormone changes. It was studied how acupoint specificity affects hypothalamic-pituitary-adrenal cortex axis (HPAA) regulation. In addition, it was suggested that acupuncture altered stress reaction neurons in paraventricular nucleus [41]. One of the key factors in brain activity and homeostasis regulation, Neuropeptide Y (NPY), which is highly concentrated in hypothalamus, is involved in the regulation of various physiological functions such as energy homeostasis and stress-related behavior process. Several studies investigated effect of acupuncture on critical physiological processes. In diabetic rats, acupuncture suppressed NPY and it led to controlling hyperphagia [42]. Anxiogenic-like behaviors in maternally separated rats were also recovered to normal state and decreased NPY expression was upregulated by acupuncture [43]. Acupuncture prevented elevation of NPY expression which was induced by cold stress [44]. The hormonal changes were inconsistent among same disease models. The inconsistency is considered to be due to different reasons of disease and used acupoints. It is suggested to focus more on the fact that acupuncture may restore the balance among the hormones rather than solely focusing on increase and decrease of hormone level. To suggest clinical implications of acupuncture in various diseases, it is important to recognize that acupuncture may have bidirectional effect depending on diseases. It also should be considered what physiological context a disease potentially has in order to properly account for effect of acupuncture.

5. Conclusion

Our study has shown that acupuncture altered some of the sex hormone levels in both animal model and human. It is difficult to conclude that this review provided strong evidence to elucidate regulative effect of acupuncture on sex hormones. Still, we believed that result of this review and holistic approach to effect of acupuncture on sex hormones will contribute to the field of hormonal study and acupuncture study as further guidance and reference.

Acknowledgments

This work was supported by the National Research Foundation of Korea funded by the Korean government (MSIT) (NRF-2017R1C1B5018061).

Data Availability

The data sets supporting the conclusions of this article are included within the article.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Authors' Contributions

Jade Heejae Ko and Seung-Nam Kim conceived and designed this study, extracted and analyzed the data, and wrote the paper. All authors read and approved the final manuscript.

Supplementary Materials

Supplementary Materials

Supplementary Table 1. Detailed description of acupuncture treatment in the studies.

Click here for additional data file. (172.5KB, pdf)

References

  • 1.Alpízar-Rodríguez D., Pluchino N., Canny G., Gabay C., Finckh A. The role of female hormonal factors in the development of rheumatoid arthritis. Rheumatology. 2017;56(8):1254–1263. doi: 10.1093/rheumatology/kew318. [DOI] [PubMed] [Google Scholar]
  • 2.Berrih-Aknin S., Panse R. L., Dragin N. AIRE: A missing link to explain female susceptibility to autoimmune diseases. Annals of the New York Academy of Sciences. 2018 doi: 10.1111/nyas.13529. [DOI] [PubMed] [Google Scholar]
  • 3.Saito S., Suzuki K., Yoshimoto K., et al. A new bioassay for measuring the strength of IL-6/STAT3 signal inhibition by tocilizumab in patients with rheumatoid arthritis. Arthritis Research & Therapy. 2017;19(1) doi: 10.1186/s13075-017-1434-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Ahmed S. B., Ramesh S. Sex hormones in women with kidney disease. Nephrology Dialysis Transplantation . 2016;31(11):1787–1795. doi: 10.1093/ndt/gfw084. [DOI] [PubMed] [Google Scholar]
  • 5.Sharma R., Biedenharn K. R., Fedor J. M., Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reproductive Biology and Endocrinology. 2013;11(1):p. 66. doi: 10.1186/1477-7827-11-66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.HOLINKA C. F. Hormonal Contraception: Current Status and Future Perspectives. Annals of the New York Academy of Sciences. 1994;734(1):257–262. doi: 10.1111/j.1749-6632.1994.tb21755.x. [DOI] [PubMed] [Google Scholar]
  • 7.Badawy A., Elnashar A. Treatment options for polycystic ovary syndrome. International Journal of Women's Health. 2011;3(1):25–35. doi: 10.2147/IJWH.S11304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Westhoff C. L., Heartwell S., Edwards S., et al. Oral contraceptive discontinuation: do side effects matter? American Journal of Obstetrics & Gynecology. 2007;196(4):412–e7. doi: 10.1016/j.ajog.2006.12.015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Han J.-S., Ho Y.-S. Global trends and performances of acupuncture research. Neuroscience & Biobehavioral Reviews. 2011;35(3):680–687. doi: 10.1016/j.neubiorev.2010.08.006. [DOI] [PubMed] [Google Scholar]
  • 10.Cochrane S., Smith C. A., Possamai-Inesedy A., Bensoussan A. Acupuncture and women's health: an overview of the role of acupuncture and its clinical management in women's reproductive health. International Journal of Women's Health. 2014;6(1):313–325. doi: 10.2147/ijwh.s38969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Upchurch D. M., Chyu L., Greendale G. A., et al. Complementary and alternative medicine use among American women: findings from the National Health Interview Survey, 2002. Journal of Women's Health. 2007;16(1):102–113. doi: 10.1089/jwh.2006.m074. [DOI] [PubMed] [Google Scholar]
  • 12.Burke A., Upchurch D. M., Dye C., Chyu L. Acupuncture use in the United States: findings from the National Health Interview Survey. The Journal of Alternative and Complementary Medicine. 2006;12(7):639–648. doi: 10.1089/acm.2006.12.639. [DOI] [PubMed] [Google Scholar]
  • 13.Lu L., Zhang X. G., Zhong L. L., et al. Acupuncture for neurogenesis in experimental ischemic stroke: a systematic review and meta-analysis. Scientific Reports. 2016;6(1) doi: 10.1038/srep19521.19521 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Macleod M. R., O'Collins T., Howells D. W., Donnan G. A. Pooling of animal experimental data reveals influence of study design and publication bias. Stroke. 2004;35(5):1203–1208. doi: 10.1161/01.STR.0000125719.25853.20. [DOI] [PubMed] [Google Scholar]
  • 15.Johansson J., Redman L., Veldhuis P. P., et al. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. American Journal of Physiology-Endocrinology and Metabolism. 2013;304(9):E934–E943. doi: 10.1152/ajpendo.00039.2013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Pastore L. M., Williams C. D., Jenkins J., Patrie J. T. True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2011;96(10):3143–3150. doi: 10.1210/jc.2011-1126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Ma S., Li D., Jiang J., Shen B. Role of the medial preoptic area in electroacupuncture treatment of reproductive dysfunction in ovariectomised rats. Acupuncture in Medicine. 2017;35(1):52–58. doi: 10.1136/acupmed-2015-010839. [DOI] [PubMed] [Google Scholar]
  • 18.Qin Y., He J., Xia L., Guo H., He C. Effects of electro-acupuncture on oestrogen levels, body weight, articular cartilage histology and MMP-13 expression in ovariectomised rabbits. Acupuncture in Medicine. 2013;31(2):214–221. doi: 10.1136/acupmed-2012-010289. [DOI] [PubMed] [Google Scholar]
  • 19.Sunay D., Ozdiken M., Arslan H., Seven A., Aral Y. The effect of acupuncture on postmenopausal symptoms and reproductive hormones: a sham controlled clinical trial. Acupuncture in Medicine. 2011;29(1):27–31. doi: 10.1136/aim.2010.003285. [DOI] [PubMed] [Google Scholar]
  • 20.Wang Y., Li Y., Chen R., Cui X., Yu J., Liu Z. Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: A prospective observational study. Acupuncture in Medicine. 2016;34(5):386–391. doi: 10.1136/acupmed-2015-011014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Xiong F., Gui J., Yang W., Li J., Huang G.-Y. Effects of acupuncture on progesterone and prolactin in rats of embryo implantation dysfunction. Chinese Journal of Integrative Medicine. 2015;21(1):58–66. doi: 10.1007/s11655-014-1755-0. [DOI] [PubMed] [Google Scholar]
  • 22.Zhou Kehua, Jiang Jingxi, Wu Jiani, Liu Zhishun. Electroacupuncture Modulates Reproductive Hormone Levels in Patients with Primary Ovarian Insufficiency: Results from a Prospective Observational Study. Evidence-Based Complementary and Alternative Medicine. 2013;2013:7. doi: 10.1155/2013/657234.657234 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Zheng Y.-H., Wang X.-H., Lai M.-H., Yao H., Liu H., Ma H.-X. Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: A randomized controlled trial. The Journal of Alternative and Complementary Medicine. 2013;19(9):740–745. doi: 10.1089/acm.2012.0429. [DOI] [PubMed] [Google Scholar]
  • 24.Maliqueo M., Benrick A., Alvi A., et al. Circulating gonadotropins and ovarian adiponectin system are modulated by acupuncture independently of sex steroid or β-adrenergic action in a female hyperandrogenic rat model of polycystic ovary syndrome. Molecular and Cellular Endocrinology. 2015;412:159–169. doi: 10.1016/j.mce.2015.04.026. [DOI] [PubMed] [Google Scholar]
  • 25.Feng Y., Johansson J., Shao R., Holm L. M., Billig H., Stener-Victorin E. Electrical and manual acupuncture stimulation affect oestrous cyclicity and neuroendocrine function in an 5α-dihydrotestosterone-induced rat polycystic ovary syndrome model. Experimental Physiology. 2012;97(5):651–662. doi: 10.1113/expphysiol.2011.063131. [DOI] [PubMed] [Google Scholar]
  • 26.Stener-Victorin E., Waldenström U., Tägnfors U., Lundeberg T., Lindstedt G., Janson P. O. Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstetricia et Gynecologica Scandinavica. 2000;79(3):180–188. doi: 10.1034/j.1600-0412.2000.079003180.x. [DOI] [PubMed] [Google Scholar]
  • 27.Yao X., Wang X.-Q., Ma S.-L., Chen B.-Y. Electroacupuncture stimulates the expression of prolactin-releasing peptide (PrRP) in the medulla oblongata of ovariectomized rats. Neuroscience Letters. 2007;411(3):243–248. doi: 10.1016/j.neulet.2006.10.017. [DOI] [PubMed] [Google Scholar]
  • 28.Zhao H., Tian Z., Cheng L., Chen B. Electroacupuncture enhances extragonadal aromatization in ovariectomized rats. Reproductive Biology and Endocrinology. 2004;2, article no. 18 doi: 10.1186/1477-7827-2-18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Zhao H., Tian Z.-Z., Chen B.-Y. An important role of corticotropin-releasing hormone in electroacupuncture normalizing the subnormal function of hypothalamus-pituitary-ovary axis in ovariectomized rats. Neuroscience Letters. 2003;349(1):25–28. doi: 10.1016/S0304-3940(03)00676-1. [DOI] [PubMed] [Google Scholar]
  • 30.Zhaohui Z., Yugui C., Yuanming Z., et al. Effect of acupuncture on pubertal development of rats and rabbits at different developmental stages. Neuropeptides. 2007;41(4):249–261. doi: 10.1016/j.npep.2007.02.003. [DOI] [PubMed] [Google Scholar]
  • 31.Gaudernack L. C., Forbord S., Hole E. Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica. 2006;85(11):1348–1353. doi: 10.1080/00016340600935839. [DOI] [PubMed] [Google Scholar]
  • 32.Yang J., Liu W.-Y., Song C.-Y., Lin B.-C. Through central arginine vasopressin, not oxytocin and endogenous opiate peptides, glutamate sodium induces hypothalamic paraventricular nucleus enhancing acupuncture analgesia in the rat. Neuroscience Research. 2006;54(1):49–56. doi: 10.1016/j.neures.2005.10.006. [DOI] [PubMed] [Google Scholar]
  • 33.Yang J., Liu W.-Y., Song C.-Y., Lin B.-C. Only arginine vasopressin, not oxytocin and endogenous opiate peptides, in hypothalamic paraventricular nucleus play a role in acupuncture analgesia in the rat. Brain Research Bulletin. 2006;68(6):453–458. doi: 10.1016/j.brainresbull.2005.10.002. [DOI] [PubMed] [Google Scholar]
  • 34.Qu F., Zhou J., Nan R. Acupuncture for Perimenopausal Symptoms in Women who Underwent Oophorectomy – a Comparative Study. Complementary Medicine Research. 2007;14(1):25–32. doi: 10.1159/000098799. [DOI] [PubMed] [Google Scholar]
  • 35.Dong H., Lüdicke F., Comte I., Campana A., Graff P., Bischof P. An exploratory pilot study of acupuncture on the quality of life and reproductive hormone secretion in menopausal women. The Journal of Alternative and Complementary Medicine. 2001;7(6):651–658. doi: 10.1089/10755530152755207. [DOI] [PubMed] [Google Scholar]
  • 36.Magarelli P. C., Cridennda D. K., Cohen M. Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertility and Sterility. 2009;92(6):1870–1879. doi: 10.1016/j.fertnstert.2008.10.067. [DOI] [PubMed] [Google Scholar]
  • 37.Uvnas-Moberg K., Bruzelius G., Alster P., Lundeberg T. The antinociceptive effect of non-noxious sensory stimulation is mediated partly through oxytocinergic mechanisms. Acta Physiologica Scandinavica. 1993;149(2):199–204. doi: 10.1111/j.1748-1716.1993.tb09612.x. [DOI] [PubMed] [Google Scholar]
  • 38.Patel K., Coffler M. S., Dahan M. H., Malcom P. J., Deutsch R., Chang R. J. Relationship of GnRH-stimulated LH release to episodic LH secretion and baseline endocrine-metabolic measures in women with polycystic ovary syndrome. Clinical Endocrinology. 2004;60(1):67–74. doi: 10.1111/j.1365-2265.2004.01945.x. [DOI] [PubMed] [Google Scholar]
  • 39.Xie Q. W., Liu J. Effect of acupuncture on prolactin secretion of lactating rats. Zhongguo Yi Xue Ke Xue Yuan Yi Xue Qing Bao Yan Jiu Suo Bian Ji. 1986;11(4):303–307. [PubMed] [Google Scholar]
  • 40.Kho H. G., Egmond J. V., Zhuang C. F., Zhang G. L., Lin G. F. The patterns of stress response in patients undergoing thyroid surgery under acupuncture anaesthesia in China. Acta Anaesthesiologica Scandinavica. 1990;34(7):563–571. doi: 10.1111/j.1399-6576.1990.tb03146.x. [DOI] [PubMed] [Google Scholar]
  • 41.Wang S., Zhang J., Yang H., Wang F., Li S. Acupoint specificity on acupuncture regulation of hypothalamic- pituitary-adrenal cortex axis function. BMC Complementary and Alternative Medicine. 2015;15(1) doi: 10.1186/s12906-015-0625-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Lee J., Jang M., Kim E., Kim C. Acupuncture decreases neuropeptide Y expression in the hypothalamus of rats with Streptozotocin-induced diabetes. Acupuncture & Electro-Therapeutics Research. 2004;29(1):73–82. doi: 10.3727/036012904815901533. [DOI] [PubMed] [Google Scholar]
  • 43.Park H.-J., Chae Y., Jang J., Shim I., Lee H., Lim S. The effect of acupuncture on anxiety and neuropeptide Y expression in the basolateral amygdala of maternally separated rats. Neuroscience Letters. 2005;377(3):179–184. doi: 10.1016/j.neulet.2004.11.097. [DOI] [PubMed] [Google Scholar]
  • 44.Eshkevari L., Permaul E., Mulroney S. E. Acupuncture blocks cold stress-induced increases in the hypothalamus-pituitary-adrenal axis in the rat. Journal of Endocrinology. 2013;217(1):95–104. doi: 10.1530/joe-12-0404. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Materials

Supplementary Table 1. Detailed description of acupuncture treatment in the studies.

Click here for additional data file. (172.5KB, pdf)

Data Availability Statement

The data sets supporting the conclusions of this article are included within the article.

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