Uterine fibroids (UFs), or uterine leiomyomas, are monoclonal tumors in the myometrium compartment of the uterus with extensive extracellular matrix containing collagen, fibronectin, and proteoglycan.1 UFs are a common condition that affects women in their reproductive and postreproductive years with an estimated lifetime incidence of up to 77% of all women, including 50% in Caucasian women and 80% in women of African descent.2–5 Development of UFs is still unknown. But genetic mutations and environmental factors such as obesity have been implicated in the development of UFs.6
The growth of UFs is regulated by complex feedback loops between sex steroid hormones and growth factors. UFs may also be estrogen and progesterone dependent, resulting in more fibroid prevalence in women who suffer from elevated levels of these hormones.7,8 Although many UF patients are asymptomatic, some others do have various symptoms including emotional imbalance, painful menses, heavy menses, spotting between menses, abdominal pain, pelvic pain, low-back pain, pain with intercourse, bloating, nausea, frequent urination, urine leakage, bowel difficulty, bowel pain, pregnancy complications, and prolonged bleeding leading to anemia, among many other symptoms.3,5,9
Common treatments available to women suffering from UFs, ranging from the most conservative to the most invasive approaches, are symptomatic treatment with oral contraceptive pills, levonorgestrel-releasing intrauterine devices, ulipristal acetate treatment, high-intensity focused ultrasound treatment, myoma embolization, surgical myomectomy, and hysterectomy. Depending upon tumor size, surgical removal is still the primary approach used to treat UFs.3,8 It is estimated that almost half of the 600,000 hysterectomies performed in the United States each year are performed to treat symptomatic UFs.8,10
A variety of factors affect the patients' choice of treatment protocol, including, but not limited to, personal preference, age, desire to bear children, future fertility, individual symptoms, and the patients' access to alternative protocols. Although there are considerable management options varying in methodology, patients are often disconcerted with the ramifications and side-effects of available contemporary treatments for UFs. Thus, safer and effective alternatives are needed for the management of UFs.
In China, acupuncture is a common treatment for UFs. Chinese Medicine categorizes UFs as Zhen Jia, defined as masses in the uterus with a feeling of pain, swelling, or fullness, and with bleeding in severe cases. The etiology of this condition is related to Qi deficiency and disharmony between Qi and Blood, and in most cases, agglomeration occurs due to Qi stagnation and Blood Stasis with Dampness and Phlegm accumulation in the Interior.11 According to Chinese Medicine, acupuncture can stimulate Qi of the meridians and activate the body's regulating functions to restore the disharmony of the organs and systems. But the exact benefit of acupuncture remains unknown.5
Acupuncture may deliver a mechanical signal to the body through breaking the skin and connective tissue.12 It is also been suggested that acupuncture results in the release of neurochemicals such as β endorphins or serotonin and has regulative effect on the endocrine and central nervous system.13,14 As we know that the growth of UFs is regulated by the feedback loop between sex steroid hormones and growth factors, it may be legitimate to consider acupuncture as a potential therapy for UFs.
Various schools of acupuncture have been used to treat UFs worldwide. Tung's acupuncture, once a closely guarded oral family tradition, is a complete system that includes its own channels, points, and needling techniques.15 According to Wei Chieh Young, this system predates the classical 14-channel system and is based on a unique Five-Element and Zang-Fu theory to treat disease. There are 740 Tung's acupuncture points, numbered by location in 10 segments of the body, including hand, arm, foot, leg, ear, and head. Although some Tung's points overlap with the points on the 14-channel system, their indications and curative effects are different.16 Tung's acupuncture has also been researched for the treatment of female diseases such as polycystic ovary syndrome17 and irregular menstruation.18 However, the effectiveness of acupuncture for the management of UFs remains uncertain.5
During the course of a 6 week and 12 week study, Dr. Jennifer Cruz, Linda Carrington and Harry Hong did a study which seeked to evaluate the feasibility to conduct clinical studies on the treatment of uterine fibroids (UFs) and related symptoms with a 7-point Tung's acupuncture protocol. Read the full study here.
Eastern Acupuncture And Wellness Plantation:
Eastern Acupuncture And Wellness Wilton Manors:
Jennifer Cruz, Linda Carrington, and Harry Hong.Medical Acupuncture.Dec 2019.384-391.http://doi.org/10.1089/acu.2019.1385
Published in Volume: 31 Issue 6: December 13, 2019
Online Ahead of Print:October 31, 2019