Acupuncture for Endometriosis Pain in Denver

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Design

Systematic review and meta-analysis of trials using penetrating acupuncture, with pain and quality of life as outcomes. Six databases were searched on 20 March 2023.

Result

Compared with non-specific acupuncture, acupuncture improved overall pelvic pain (g = 1.54, 95% CI 0.92 to 2.16, 3 trials, 231 people, low certainty) and menstrual pain (g = 1.67, 95% CI 1.23 to 2.12, one trial of 106 people, moderate certainty). Compared with usual care, menstrual pain also improved (one trial of 19 people, very low certainty). Most studies reported low rates of adverse events.

Limit

Several findings rest on one small trial, and the comparison with usual care included only 19 people with very low certainty.

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Design

Meta-analysis of randomized trials of acupuncture for endometriosis-related pain. Eight databases were searched to December 2022. Controls included placebo, traditional Chinese medicine and Western medicine.

Result

Acupuncture reduced pain severity (SMD -1.10, 95% CI -1.45 to -0.75) and improved the response rate (RR 1.25, 95% CI 1.09 to 1.44) compared with controls.

Limit

The authors note design and quality flaws in the original studies and a lack of research on specific types of acupuncture, and advise caution. Results for electroacupuncture were inconsistent between analyses.

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Design

Multicenter randomized single-blind trial in four hospitals. Women aged 20 to 40 with endometriosis-associated pain received acupuncture or imitation acupuncture for 12 weeks, then were followed for another 12 weeks. Sessions lasted 30 minutes, three times a week, starting one week before each expected period, with daily sessions when pain occurred.

Result

After treatment, the drop in period pain scores was greater with acupuncture, and pain lasted a shorter time. Pain, mood and quality of life scores all improved more at week 12. No severe adverse events were recorded.

Limit

Most benefits were gone by week 24, so the effect faded after treatment stopped. Pelvic pain between periods and pain with intercourse did not differ between groups.

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Design

Network meta-analysis of randomized trials of acupuncture-related therapies for endometriosis, comparing six interventions at once. Eight databases were searched to 21 April 2024, and the main outcome was pain on the visual analog scale.

Result

For pain scores, acupuncture was superior to western medicine (SMD -2.33, 95% CI -4.37 to -0.29). Acupoint catgut embedding ranked best for lowering pain scores, and auricular therapy ranked first for response rate. Combination therapy was more effective than western medicine or Chinese herbal medicine for pain, CA125 level and response rate.

Limit

The confidence interval for acupuncture is wide, the comparison is against western medicine rather than imitation acupuncture, and several of the treatments ranked best (catgut embedding, acupoint application) are not ordinary needling. The authors call for higher-quality trials and optimal regimens.

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Design

Systematic review and meta-analysis of randomized trials comparing acupuncture alone with non-acupuncture treatments for endometriosis-related pain. Six databases were searched to March 1, 2025, and 9 trials with 535 patients were included.

Result

Acupuncture reduced pain intensity on the visual analog scale (mean difference -1.67, 95% CI -2.85 to -0.49, p = 0.006) and improved clinical response rates (odds ratio 2.61, 95% CI 1.38 to 4.95). Serum CA125 levels and the overall effective rate (odds ratio 2.18, 95% CI 0.99 to 4.80, p = 0.05) did not differ significantly.

Limit

The authors cite heterogeneity and methodological limits in the included studies and call for larger, high-quality trials to confirm the findings and establish long-term effect.

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Design

Systematic review of randomized trials of acupuncture and moxibustion, used alone or added to guideline-recommended drug treatment, for symptoms and quality of life in endometriosis. Nine databases were searched to April 2022. Diversity in comparisons and outcome measures prevented a full meta-analysis.

Result

Compared with imitation acupuncture, manual acupuncture lowered dysmenorrhea pain scores (mean difference -2.40, 95% CI -2.80 to -2.00, moderate certainty) and pelvic pain scores (mean difference -2.65, 95% CI -3.40 to -1.90, high certainty), and improved quality of life. Manual acupuncture plus conventional therapy, and warm needle alone, improved quality of life more than conventional therapy. Among the six studies that reported safety, fewer adverse events occurred with acupuncture or moxibustion.

Limit

These findings came from single studies with low to moderate certainty, and the authors concluded there is insufficient evidence on the overall effectiveness of acupuncture and moxibustion for endometriosis.

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Design

Cochrane review of randomized trials in women with laparoscopically confirmed endometriosis. Twenty-four studies were found, but only one met all criteria.

Result

In that single trial, period pain scores were lower with ear acupuncture than with Chinese herbal medicine, and the total effective rate was 91.9% versus 60%.

Limit

The authors called the evidence limited because it rested on one study, and asked for well-designed randomized trials.

The evidence is limited but encouraging. A 2024 review of 14 trials (793 people) found acupuncture reduced endometriosis-related pain more than control treatments, and a 2023 trial of 106 women found period pain fell more with acupuncture after 12 weeks. The benefit faded by week 24 once treatment stopped, and the authors advise caution. I treat acupuncture as supportive pain care next to your doctor's plan.

The 2023 trial gave 30-minute sessions three times a week for 12 weeks, beginning one week before each expected period, with daily sessions when pelvic pain occurred. Two small trials gave 16 treatments over 8 weeks. At your first visit I will estimate what is realistic for your cycle, and we check progress together after the first five visits.

No. Endometriosis needs a medical diagnosis and ongoing care from a doctor. The trials I rely on measured pain and quality of life, not the disease itself. Some reviews also report blood markers or cyst size, but the authors point to quality flaws, and a 2025 review found no significant difference in the blood marker CA125. I offer acupuncture for pain support only.

Yes. Acupuncture is meant to sit alongside your gynecologist's plan, not replace it. A 2023 review of 15 trials found that manual acupuncture plus conventional therapy gave greater quality of life improvements than conventional therapy alone. Keep taking your medication and keep your appointments, and tell your doctor you are trying acupuncture so everyone is working from the same picture.

See your doctor first for severe pelvic pain that has never been diagnosed, pain with intercourse, heavy bleeding, blood in your stool or urine during your period, fever with pelvic pain, trying to conceive, or a possible pregnancy. Endometriosis needs a medical diagnosis and ongoing care from a doctor. If you have any of these symptoms and have not already told your doctor, please let them know.

At The Subtle Point a 90-minute first visit is $150 and follow-ups are $60 for 30 minutes of acupuncture, $95 for 60 minutes of acupuncture with Tuina massage, or $130 for 90 minutes of acupuncture with Tuina massage and cupping. HSA and FSA cards work, and you receive a superbill for your insurer.

Rarely, and never the way an injection does. Acupuncture needles are about the width of a human hair. Most people feel a brief tap, then a dull, heavy or warm sensation that fades in a few seconds. If any point feels sharp, tell me and I will adjust or remove it.