Can acupuncture treat endometriosis?

A team of researchers from NICM, Western Sydney University and UNSW are investigating if acupuncture is effective in treating the symptoms of endometriosis, a gynaecological disease that causes pain and/or infertility and affects an estimated 176 million women worldwide.[i]

Endometriosis is diagnosed when tissue similar to the lining of the uterus is found at other sites in the pelvis,[ii] primarily the ovaries, fallopian tubes, bladder, and bowel, causing an inflammatory reaction.

NICM Postdoctoral Research Fellow and Chief Investigator of the clinical trial, Dr Mike Armour says endometriosis is the most common cause of persistent pelvic pain worldwide.

"The disease significantly affects the lives of women worldwide, with around 10 per cent of women having endometriosis,[iii] it is as common as lower back pain," said Dr Armour.

"In Australia at least 15 per cent of women show some pain symptoms suggestive of endometriosis,[iv] and we know women with endometriosis suffer from a variety of painful symptoms including persistent pelvic pain, period pain, pain when having sex and pain when using the bathroom. The persistent pain and its impact on these women often makes them tired, anxious and depressed."

There is no cure for endometriosis and current pharmaceutical treatments provide limited relief and effectiveness, with between 20-50 per cent of women either not receiving satisfactory relief or finding the side effects too severe.[v]

Dr Armour says preliminary overseas trials have shown acupuncture to be a promising treatment for the disease with few side effects.[vi]

"Acupuncture shows promise in treating endometriosis related chronic pelvic pain, however no studies have examined the feasibility of undertaking a fully powered trial in Australia or the effect of acupuncture on a number of objective biomarkers that are altered in women with endometriosis, such as IL-6, an inflammatory marker, or changes in functional connectivity in the brain," said Dr Armour.

"Our randomised clinical trial will assess the feasibility and acceptability of acupuncture and investigate any changes in neurological or biomarkers when using acupuncture to treat endometriosis-related chronic pelvic pain.

This pilot study will inform a larger clinical trial and the wider international research community by helping researchers understand better what parts of the pain processing mechanisms in the brain might not be functioning correctly in women with endometriosis.

Understanding the complex mechanisms underlying endometriosis pain will help direct future research and guide potential new therapies for this condition says Dr Armour.

Recruitment of the trial is now underway with sites currently located in Campbelltown, Westmead, Maroubra, Bella Vista, and Camden.

People interested in participating in the trial can contact Dr Mike Armour.

The study has been approved by Western Sydney University Human Research Ethics Committee (Approval Number H11984). The researchers acknowledge the support of Western Sydney University for this study and funding received from an Early Career Fellowship Development Grant.

This project supports the Government's National Women's Health Policy 2010 (opens in a new window).

Trial registration: Australian New Zealand Clinical Trials Registry (opens in a new window)

Study Participant Information Sheet

Study Participant Criteria:

  • Women aged 18-45
  • Laparoscopic diagnosis of endometriosis in the last five years 
  • Regular menstruation
  • The presence of at least one of the following: dysmenorrhea (period pain), dyspareunia (pain during sexual intercourse), dyschezia (pain on bowel motions)  or dysuria (pain on urination) rated >= 4/10 on a numeric rating scale
  • Haven't undergone endometriosis surgery within the last six months
  • Haven't started oral or injectable contraceptive pill, GnRH-a or danazol within the last six months

[i] Adamson, G. D. et al. (2010). Creating solutions in endometriosis: global collaboration through the World Endometriosis Research Foundation. J Endometriosis, 2(1), 3-6.
[ii] (2010). endometriosis. In Concise Medical Dictionary. : Oxford University Press. Retrieved 15 Mar. 2017, from http://www.oxfordreference.com/view/10.1093/acref/9780199557141.001.0001/acref-9780199557141-e-3153.
[iii] Eskenazi, B., & Warner, M. L. (1997). Epidemiology of endometriosis. Obstetrics and gynecology clinics of North America, 24(2), 235-258.
[iv] Pitts, M. K., et al. (2008). Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women. Med J Aust, 189(3), 138-43.
[v] Sinaii, N., et al. (2007). Treatment utilization for endometriosis symptoms: a cross-sectional survey study of lifetime experience. Fertility and sterility, 87(6), 1277-1286.
[vi] Rubi-Klein, K., et al. (2010). Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis?: A randomised controlled cross-over trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 153(1), 90-93.