There's no doubt that polycystic ovary syndrome (PCOS) plays havoc with female hormones, often disrupting ovulation. But a handful of studies has found acupuncture can help - and recent Swedish research determined that it improves ovulation in women with the syndrome, boosting their chances of pregnancy.
If acupuncture proves effective, it has the potential to help a lot of women. In Australia, 12 to 18 per cent of women of reproductive age are thought to have PCOS.
Its cause is a mystery but likely to involve genes and lifestyle. A family history of Type-2 diabetes also increases the risk.
So how can tiny needles inserted under the skin have an impact on a woman's ovaries?
"We don't know for sure how it works, but one theory is the needles act on the sympathetic nervous system, which, in turn, affects the hormones that control ovulation," says Jane Lyttleton, a traditional Chinese medicine practitioner specialising in infertility, who uses acupuncture in her Sydney clinic.
"It's still early days, but we have evidence that acupuncture and, in particular, electro acupuncture, has good success.
"Electro acupuncture involves passing a low-frequency electric pulse through fine wires attached to acupuncture needles."
Underlying the symptoms of polycystic ovary syndrome, which include excess hair and acne as well as disrupted ovulation, is a rise in levels of male hormones produced by the ovaries. This is caused by insulin resistance, common in women with the syndrome, which often increases testosterone production.
Although acupuncture shows promise in improving ovulation, there's little research on its effects on other symptoms - although, anecdotally, Lyttleton says that acne often improves.
Although some branches of complementary medicine arouse scepticism among conventional medical practitioners, attitudes towards acupuncture in female infertility are more open, says Dr Caroline Smith, associate professor in complementary medicine at the University of Western Sydney.
She is working on a study of more than 1000 women undergoing IVF, some with polycystic ovary syndrome, to see if acupuncture increases their chances of a live birth.
"There's already some evidence that when acupuncture is used around the time of embryo transfer it improves the chances of pregnancy," she says.
"It may be that acupuncture increases the blood supply to the uterus, which may improve the odds of the embryo implanting itself successfully."
Twelve IVF centres are taking part, which shows the level of interest in establishing an evidence base, she says.
Acupuncture may also help cool hot flushes at menopause, Melbourne GP DrCaroline Ee says.
She is involved in a study of the effects of acupuncture on hot flushes at a number of research centres, including the University of Melbourne, Jean Hailes for Women's Health, RMIT University, Southern Cross University and Monash University.
"Most studies so far have been small and inconclusive, but two have shown that acupuncture can make a difference," Dr Ee says.
"I've seen a lot of women with hot flushes in my practice, and when I go through the treatment options with them they're very resistant to using drugs, so I've tried acupuncture. It has helped some of them."
Hot flushes happen when the body's thermostat goes haywire. Antidepressants often help, she says, because they raise levels of the brain's "feel-good" hormone, serotonin, which helps regulate body temperature.
"Acupuncture also raises serotonin levels so it may work in a similar way," Dr Ee says.
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