Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial

Peter M Wayne; Catherine E Kerr; Rosa N Schnyer; Anna T R Legedza; Jacqueline Savetsky-German; Monica H Shields; Julie E Buring; Roger B Davis; Lisa A Conboy; Ellen Highfield; Barbara Parton; Phaedra Thomas; Marc R Laufer

doi:10.1016/j.jpag.2007.07.008

Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial

Wayne PM, Kerr CE, Schnyer RN, Legedza AT, Savetsky-German J, Shields MH, Buring JE, Davis RB, Conboy LA, Highfield E, Parton B, Thomas P, Laufer MR

Published October 2008 Journal of pediatric and adolescent gynecology, 21(5), 247-57

DOI 10.1016/j.jpag.2007.07.008 PMID 18794019 PMC PMC2610346

RRM Academy Synopsis

Acupuncture lowered endometriosis pain in young women at 4 weeks

A small randomized trial of 18 girls and young women with endometriosis found that Japanese-style acupuncture lowered their non-menstrual pelvic pain more than sham at 4 weeks. At 8 weeks and 6 months, the groups did not differ significantly.

Key Findings

Of 18 young women, 10 received active acupuncture and 8 received sham. Nine active and 5 sham participants finished all 16 treatments, and analyses use those 14.
Pain unrelated to menses or sex fell 4.8 points (sd = 2.4) with acupuncture and 1.4 (sd = 2.1) with sham at 4 weeks, on an 11 point scale (P = 0.004).
At 8 weeks and 6 months, the active group kept a slightly larger drop in pain, yet group differences lacked statistical significance.
Pain-related activity limitation fell by 3.4 (sd = 2.2) points out of 10 with active acupuncture and 0.5 (sd = 1.5) with sham at 4 weeks (P = 0.02).
No serious harms were reported. Nine minor, expected events occurred over 232 treatments, including light-headedness, bruising and minor burns from moxibustion.

Interpretation

The study is a pilot randomized, sham-controlled trial with blinded participants and outcome assessors, built mainly to test feasibility. Its main outcome was pain at 8 weeks, where the groups did not differ significantly. The 4-week result is the significant one. Quality of life scores leaned toward the active group without reaching significance, and two blood markers of inflammation showed no significant differences. All participants had Stage I disease and used, or were candidates for, combination hormonal therapy. The authors call the sample very small.

RRM Context

Every participant had a surgical diagnosis. All used, or could use, hormonal pills, patches or rings that suppress the cycle. Restorative reproductive medicine treats the disease itself, with excision as the surgical standard. Teens with endometriosis have received far less treatment research than adults. The authors call a larger trial warranted.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To assess feasibility, and collect preliminary data for a subsequent randomized, sham-controlled trial to evaluate Japanese-style acupuncture for reducing chronic pelvic pain and improving health-related quality of life (HRQOL) in adolescents with endometriosis.

Design

Randomized, sham-controlled trial.

Setting

Tertiary-referral hospital.

Participants

Eighteen young women (13-22y) with laparoscopically-diagnosed endometriosis-related chronic pelvic pain.

Interventions

A Japanese style of acupuncture and a sham acupuncture control. Sixteen treatments were administered over 8 weeks.

Main Outcome Measures

Protocol feasibility, recruitment numbers, pain not associated with menses or intercourse, and multiple HRQOL instruments including Endometriosis Health Profile, Pediatric Quality of Life, Perceived Stress, and Activity Limitation.

Results

Fourteen participants (out of 18 randomized) completed the study per protocol. Participants in the active acupuncture group (n = 9) experienced an average 4.8 (SD = 2.4) point reduction on a 11 point scale (62%) in pain after 4 weeks, which differed significantly from the control group's (n = 5) average reduction of 1.4 (SD = 2.1) points (P = 0.004). Reduction in pain in the active group persisted through a 6-month assessment; however, after 4 weeks, differences between the active and control group decreased and were not statistically significant. All HRQOL measures indicated greater improvements in the active acupuncture group compared to the control; however, the majority of these trends were not statistically significant. No serious adverse events were reported.

Conclusion

Preliminary estimates indicate that Japanese-style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain in adolescents. A more definitive trial evaluating Japanese-style acupuncture in this population is both feasible and warranted.

Topics

General Gynecology

Pelvic Pain Chronic Pelvic Pain

General Gynecology › Pelvic Pain › Chronic Pelvic Pain

Peter M Wayne, Catherine E Kerr, Rosa N Schnyer, Anna T R Legedza, Jacqueline Savetsky-German, Monica H Shields, Julie E Buring, Roger B Davis, Lisa A Conboy, Ellen Highfield, Barbara Parton, Phaedra Thomas, Marc R Laufer

Pete Wayne, P Wayne, Cathy Kerr, Kate Kerr, C Kerr, R Schnyer, A Legedza, J Savetsky-German, M Shields, J Buring, R Davis, L Conboy, E Highfield, Barb Parton, B Parton, P Thomas, M Laufer

PMID 18794019 18794019 DOI 10.1016/j.jpag.2007.07.008 10.1016/j.jpag.2007.07.008 Wayne et al. 2008, Wayne 2008

Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial

Acupuncture lowered endometriosis pain in young women at 4 weeks

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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