"But does acupuncture actually 'do' anything??"

If you are browsing through my blog, you maybe one of the people that is intrigued by my opinions, interested in my knowledge and perspective, but not convinced that acupuncture is a valid intervention as you can't see how it can help.

Firstly, when it comes to acupuncture for fertility in women, it is usually very easy to see the impact that treatment is having. I expect to see your menstrual cycle change.

And I don't mean that it will change in a subtle way, you won't have to convince yourself that it is different. It should be different.

• If you come to me with a painful cycle, you should see a significant drop in pain symptoms (I'm talking about taking a 8/10 pain level down to a 2-3/10 pain level within 2-3 cycles).

• If you have a period flow that floods uncontrollably, it should become more moderate.

• If your cycle is erratic and irregular, or too long or too short - we should see it move towards that ideal range of 28-32 days.

• If your period flow is dark and clotty, you should see it change to a fresh, red flow.

• If you come with a plethora of symptoms of poor methylation, we should see those issues improve.

And in my opinion, that last one is the big one.

Acupuncture and Methylation.

Methylation is the process through which cells take in substances and attach them to genes in the DNA to activate or deactivate particular genes which in turn controls how the cell behaves. Methylation influences gene activation, the metabolic function of the cell and the detoxification pathways. When methylation is not working well, our bodies are not working well all the way down to cell level. If you can improve the way our cells methylate, you can improve hormone regulation, blood sugar balance, energy, immunity and a whole host of other aspects of health.

There are various symptoms that suggest issues with methylation:

• symptoms such as irregular menstrual cycles

• symptoms indicating trouble processing hormones (hormone related breast tenderness, hormone related headaches, bloating etc)

• sleep issues (poor quality and quantity of sleep)

• fatigue, chronic tiredness

• mood issues - anxiety, depression, mood swings, PMT

• brain fog, lack of ability to focus

• digestive issues - bloating, IBS symptoms

• skin issues such as eczema, psoriasis, hormone related rashes

• increased susceptibility to infections (are you one of those who is constantly catching bugs and germs?)

That is not an exhaustive list, but it gives you a good idea of the far reaching impact of poor methylation. If you talk to any acupuncturist, they would look at the list above and think to themselves that they can improve all of those things with acupuncture. We see that happening all the time with our clients. Improving all of those issues is what we do and what acupuncture has been used for for thousands of years. But there is a growing body of research that shows acupuncture is actually having an impact on methylation - and as an acupuncturist, that is very exciting.

It is early days though. I have not yet found any studies looking at whether the impact we are having on menstrual health and fertility is due to changes to methylation BUT there are studies showing acupuncture has an impact on mental health, on pain and on fatigue through the impact it has on methylation. So if that is the mechanism that creates the change in these studies, it suggests that is the mechanism through which we create changes to hormone regulation and to the menstrual cycle.

For example, in one study on the impact of acupuncture on depression, the study was comprised of two groups - one taking paroxetine, and one taking paroxetine and having regular acupuncture. They concluded that the acupuncture group showed significant changes in methylation of a key gene implicated in depression, and concluded that acupuncture alongside medication produced a stronger and faster response than medication alone [Abulikemu et al, 2024].

If we are having an impact at cell level, through affecting methylation, that could explain how we are able to have such wide ranging impact from such a simple intervention. It could also explain why it is so crucial for us to resolve digestive issues in order to get the response that we are looking for - in order to methylate efficiently, we need to have access to the appropriate nutrients. The functional nutritionists that I often work alongside are so happy when an acupuncturist is on the team - the response they get to their work is usually faster and stronger when their client is also having acupuncture. I don't always work with a nutritionist on the team (for simple cases we don't need to), but it is so helpful when we are working on complex cases. These difficult cases are often more complex because there are underlying gene mutations involved and a bespoke diet and supplement plan is needed in order to provide the necessary nutrients to support methylation - which in turn will enable us to get the response that we are looking for.

CONCLUSION

Acupuncture changes the way our bodies function, and this is rarely more obvious than the changes that acupuncture can bring to the menstrual cycle. There should be no need to ask "Is acupuncture doing anything for me?", because it should be obvious to you from changes to your menstrual pattern, to your hormone-related symptoms, to your mood, sleep and immune system.

My current thoughts are that the underlying mechanism through which we are bringing about these changes, is that acupuncture is having an impact on methylation, however the research into the impact of acupuncture on methylation is relatively new, and I have not yet found any research specifically tying acupuncture treatment, methylation changes and fertility. As an acupuncturist, I will be watching this space with interest as it will be fascinating to get some scientific validation for the work that we do and the changes that we make.

Dilinuer Abulikemu, Wang Y, Zeng FC, Huang YW, Zhang AJ, Hu ZH. Study on the mechanisms of acupuncture combined with paroxetine in the treatment of mild to moderate depression based on DNA methylation analysis. Zhen Ci Yan Jiu. 2024 Jul 25;49(7):751-759. English, Chinese. doi: 10.13702/j.1000-0607.20230243. PMID: 39020494.

Wang L, Yu CC, Li J, Tian Q, Du YJ. Mechanism of Action of Acupuncture in Obesity: A Perspective From the Hypothalamus. Front Endocrinol (Lausanne). 2021 Apr 2;12:632324. doi: 10.3389/fendo.2021.632324. PMID: 33868169; PMCID: PMC8050351.

Jang JH, Song EM, Do YH, Ahn S, Oh JY, Hwang TY, Ryu Y, Jeon S, Song MY, Park HJ. Acupuncture alleviates chronic pain and comorbid conditions in a mouse model of neuropathic pain: the involvement of DNA methylation in the prefrontal cortex. Pain. 2021 Feb 1;162(2):514-530. doi: 10.1097/j.pain.0000000000002031. PMID: 32796318; PMCID: PMC7808350.