I remember sitting in my acupuncturist’s office seeking help for period pain when she asked, “And did you allow yourself to have it?” I sat there slightly stunned. I had just finished describing the food cravings I was having, which are familiar to many who suffer from endometriosis, as I do.
I paused and thought, what an unexpected response—‘did I allow myself to have it?’ It was the first time a health professional had asked me if I listened to my body. Immediately I felt safe, nurtured, and calm. This one question alone made me start to see my health and endometriosis treatment differently.
I became curious about what my endo symptoms meant, rather than feeling judgmental towards them. I initially came to acupuncture searching for relief from endometriosis and period pain, and walked away with an entire perspective shift.
You might be thinking, “What does this new perspective about listening to one’s body have to do with period pain?” According to Traditional Chinese Medicine, a form of Eastern medicine, symptoms like food cravings may indicate an imbalance in a particular organ system that could be a root cause for pain. But before we dive into Eastern medicine and how one of its key components, acupuncture, may relieve your endometriosis-related period pain, let’s first explain what acupuncture is.
What is acupuncture? Perspectives in Eastern and Western medicine
Acupuncture is a component of Eastern medicine that has been practiced for over 3,000 years [1]. According to Harvard Health, acupuncture “involves the insertion of extremely fine needles into the skin at specific ‘acupoints’” [2]. There are 361 acupoints found along meridians (also called energy pathways), and there are 12 of these meridians in the body that correspond to the body’s organ systems, including ones not recognized by Western medicine [3]. To help us understand acupuncture more fully, let’s break it down through the lenses of both Eastern and Western medicine.
Eastern medicine
Through the Eastern medicine lens, acupuncture works by encouraging the flow of resources to certain parts of the body. More specifically, acupuncture improves “Qi” (pronounced “chee”) and blood circulation. Qi refers to all forms of energy, in the earth and in your body.
In Eastern medicine, when Qi is “stuck,” meaning not flowing easily, pain is generated [4]. By inserting needles into specific acupoints, the thinking goes, both Qi and blood are encouraged to flow more smoothly throughout the body, thus relieving pain.
Western medicine
The Western view of acupuncture says that it works to relieve pain and inflammation by increasing circulation, supporting the immune system, and increasing endorphins (the body’s natural pain-relieving hormones) [2].
How might acupuncture reduce period pain?
Evidence surrounding the efficacy of acupuncture is mixed, but it may be more effective for some individuals than others, and some studies indicate that it may be more effective at relieving certain types of pain, such as period pain caused by endometriosis.
For example, in one small study of 18 women with endometriosis, on average those who underwent acupuncture experienced a 62% reduction in their pain after four weeks of treatments [5]. Those who received acupuncture continued to experience greater pain reduction after an eight-week and six-month follow-up.
Why might acupuncture be particularly helpful for period pain? According to one review of literature, it may be due to acupuncture’s ability to increase circulation, regulate and support the immune system, activate neurotransmitters, and regulate prostaglandins and other inflammatory substances [1].
Decreasing inflammation
Studies have shown that acupuncture reduces CA-125 levels, an inflammatory marker [6]. This marker is often elevated in those with endometriosis and other chronic inflammatory diseases.
Why does relieving inflammation relieve pain? Because pain and inflammation go hand and hand. Think about the last time you stubbed your toe or bumped your elbow—the area may have become red and swollen, and the tissue became sore. That is because inflammation contributes to pain. Think of it as your body’s gentle request for rest!
Menstruation itself is an inflammatory process. For your period to begin, some level of inflammation is needed. However, we want the inflammation in the right amount—too much is not a good thing. It leads to pain! So, the logic goes, if we can reduce inflammation, we can reduce period pain.
Elevating the pain threshold and activating neurotransmitters
There is also evidence that acupuncture affects our “feel-good” neurotransmitters, serotonin and dopamine, which can improve mood and reduce pain [7,8]. According to one study, “acupuncture seems to alleviate pain by increasing pain thresholds in human subjects, and it would appear to activate analgesic brain mechanisms through the release of neurohumoral factors, including adenosine, γ-aminobutyric acid, opioid peptide, acetylcholine, nitric oxide, noradrenaline, dopamine) and others” [9].
Regulating and supporting the immune system
Studies have shown that acupuncture supports the immune system by increasing our immune response. Our immune system is made up of white blood cells (WBC) that fight infections and diseases. Acupuncture has been found to increase a particular type of WBC, called natural killer (NK) cells, that attack abnormal cells [6].
Researchers report that, “acupuncture stimulation increases the cytotoxicity of NK cells by promoting cross-talk between the neurotransmitter network and the immune system” [6]. Essentially, acupuncture makes NK cells more potent so they can get their job done! When we consider endometriosis, where abnormal cells are present as well as immune dysfunction, this effect could be very useful.
In summary, there are many different ways acupuncture could help reduce period pain, depending on the cause. Listening to your body may help you and your acupuncturist identify the root cause of your pain.
Finding an Acupuncturist
Complementary and alternative medicine (CAM) therapies like acupuncture, massage, and herbal medicine can be an important component of one’s reproductive health journey. Acupuncture may or may not help to relieve your period pain, but it could be worth a try. The risks of acupuncture are low if you find a licensed/certified provider who only uses sterilized, single-use needles, and if you are a good candidate for this kind of therapy. You may want to discuss your choice to incorporate acupuncture into your health journey with your primary care provider.
If you would like to try acupuncture to reduce period pain (or for any other reason), the Mayo Clinic recommends that you “take the same steps you would to choose a doctor,” i.e., by asking people you trust for their recommendations, and by checking your practitioner’s training and credentials. Also note that as an “alternative” therapy, acupuncture may not be covered by your insurance. Try looking here at the American Academy of Medical Acupuncture or here at the American Society of Acupuncturists, to locate an acupuncturist near you.
References
1.Guo Y, Liu FY, Shen Y, et al. Complementary and Alternative Medicine for Dysmenorrhea Caused by Endometriosis: A Review of Utilization and Mechanism. Smaoui S, ed. Evidence-Based Complementary and Alternative Medicine. (2021) pp. 1-14. doi:10.1155/2021/6663602
2. Relieving pain with acupuncture. Harvard Health. Published June 15, 2016. https://www.health.harvard.edu/healthbeat/relieving-pain-with-acupuncture#:~:text=Traditional%20Chinese%20acupuncture%20involves%20the
3. Hafner C. What Is Acupuncture? Taking Charge of Your Health & Wellbeing. Accessed April 25, 2022. https://www.takingcharge.csh.umn.edu/what-is-acupuncture
4. Liang R, Li P, Peng X, et al. Efficacy of acupuncture on pelvic pain in patients with endometriosis: study protocol for a randomized, single-blind, multi-center, placebo-controlled trial. Trials, vol. 19, no. 1 (2018). doi:10.1186/s13063-018-2684-6
5. Wayne PM, Kerr CE, Schnyer RN, et al. Japanese-Style Acupuncture for Endometriosis-Related Pelvic Pain in Adolescents and Young Women: Results of a Randomized Sham-Controlled Trial. Journal of Pediatric and Adolescent Gynecology, vol. 21, no. 5(2008)pp: 247-257. doi:10.1016/j.jpag.2007.07.008
6. Xu Y, Zhao W, Li T, Zhao Y, Bu H, Song S. Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis. Zhang Q, ed. PLOS ONE, vol. 12, no. 10 (2017):e0186616. doi:10.1371/journal.pone.0186616
7. Lee MJ, Ryu JS, Won SK, et al. Effects of Acupuncture on Chronic Stress-Induced Depression-Like Behavior and Its Central Neural Mechanism. Frontiers in Psychology, vol. 10 (2019). doi:10.3389/fpsyg.2019.01353
8. Cheng KJ. Neurobiological Mechanisms of Acupuncture for Some Common Illnesses: A Clinician’s Perspective. Journal of Acupuncture and Meridian Studies, vol. 7, no. 3 (2014): pp.105-114. doi:10.1016/j.jams.2013.07.008
9. Staud R, Price DD. Mechanisms of acupuncture analgesia for clinical and experimental pain. Expert Review of Neurotherapeutics, vol. 6, no. 5 (2006): pp. 661-667, DOI: 10.1586/14737175.6.5.661
Additional Reading:
Complementary and alternative medicine for better reproductive health
Managing endometriosis pain with fertility awareness
How to solve period issues without the pill
How to get an endometriosis diagnosis and find truly restorative treatment
“What causes endometriosis?” and other questions: a Natural Womanhood Endo FAQ
