Good news, acupuncture fans: It really does help relieve stress. And now, a new study is giving a closer look at why.

The new study explores the biological mechanisms involved in acupuncture’s stress-relieving abilities, something science has yet to fully understand.

The researchers discovered that stress hormones were lower in rats that had received electronic acupuncture. Results were published in the Journal of Endocrinology.

“Many practitioners of acupuncture have observed that this ancient practice can reduce stress in their patients, but there is a lack of biological proof of how or why this happens. We’re starting to understand what’s going on at the molecular level that helps explain acupuncture’s benefit,” study researcher Dr. Ladan Eshkevari, an associate professor of nursing at Georgetown University School of Nursing and Health Studies, said in a statement.

For the study, Eshkevari and colleagues designed a series of tests with electronic acupuncture to ensure that each rat received the exact same dose of pressure. Eshkevari targeted the spot below the knee, or the “Zusanli” point, with the needle. This area is the same in rats and humans and it is reported that stimulating it can alleviate stress and other conditions.

For the 10-day experiment, researchers split the rats into four groups. One group was a control group with no added stress and no acupuncture; one group was made to be stressed out for an hour each day but didn’t receive acupuncture; one group was made to feel stressed for an hour each day but received “sham” acupuncture by their tails; and one group was made to feel stressed and received the genuine acupuncture treatment at the Zusanli area.

The body secretes an assortment of hormones into the bloodstream as a reaction to stress, which the researchers were then able to measure in the rats. They assessed blood hormone levels secreted by the hypothalamus, the pituitary gland and the adrenal gland — together these are known as the hypothalamus pituitary adrenal (HPA) axis. They also measured a peptide involved in creatures’ “fight or flight” responses, called NPY.

Researchers discovered that the “…electronic acupuncture blocks the chronic, stress-induced elevations of the HPA axis hormones and the sympathetic NPY pathway,” Eshkevari said in the statement.

Since stress has been linked with detrimental health effects includingheart disease and even brain shrinkage it’s important to study any measures to combat its detrimental nature.

Never gotten acupuncture, but interested in trying it? Click through the slideshow for some pointers on what to expect at your first appointment:


Perimenopause is the transition that women go through on their way to menopause – the cessation of menstruation and fertility.   This transition can be a multi-year or even decade or longer process with the average being 4 years.  Some women will experience minimal symptoms and others can have years of problematic symptoms.  These symptoms are related to the lowering of estrogen levels as the ovaries reduce production throughout this process.  Symptoms run the gamut from mildly irregular cycles, occasional hot flashes and fatigue to more significant issues such as frequent spotting, very short and/or heavy cycles, increased PMS, changes in mood and/or libido and more.

One of the more common western treatments for perimenopause is birth control pills, but this can be problematic for some women and obviously problematic for those still interested in conceiving.  Other aspects of western treatment may be antidepressants, but obviously those are not dealing with the causes of the issues and only potentially help with a sub-set of issues

A common form of western medical treatment in the 1960’s and 70’s was hormone replacement therapy (HRT), which is still used today.  In recent years, however, thesmoxibustion_roll_arme treatments are used far more sparingly and cautiously after seeing increases in cancer rates and other health issues arise from treatment.  The issues potentially related to HRT are breast cancer, uterine cancer, bowel cancer, blood clots and/or stroke.  While bioidentical hormones are arguably an improved mechanism for hormonal treatment, there are no long term studies indicating any greater safety than standard treatments.  Either way, none of these treatments deal with your bodies ability to balance itself, which is the most positive outcome of treatment.

Acupuncture and Chinese Herbal Medicine have long been used to help treat a broad range of menstrual, hormonal and fertility issues.

Example Chinese Medicine diagnoses and treatment protocols related to menopause can be seen on our acupuncture for menopause page.  What you will see there is the range of more subtle diagnoses used to explore these symptoms vs. the western way of simply naming symptoms and doing baseline treatments that don’t always respect the true dynamic nature of each individual woman.  These more specific diagnoses are the crucial base of Chinese Medicine treatment.

There are techniques within Chinese Medicine that can be utilized with minimal education for certain conditions without a deep understanding of the clinical underpinnings of TCM that is required for acupuncture and proper Chinese herbal medicine treatment.  One of these techniques is acupressure, for example HT 6 for hot flashes.  Overall however, acupressure is somewhat limited in what you can accomplish for these range of symptoms.  Another commonly used technique is moxibustion (or “moxa”) – see “What Is Moxibustion?” for the basics.  Moxibustion is the technique utilized in the study I will present below.

Researchers from Shanghai Jiangwan Hospital and the Shanghai University of Traditional Chinese Medicine recently conducted a study evaluating the clinical effects of moxibustion on the range of chemical and hormonal underpinnings of perimenopause.  Utilizing 3 groups of perimenopausal rats, a control, a moxibustion treatment group, and a estrogen treatment group they began their exploration of the changes spawned on by the process of moxibustion.

The moxa treatment group received moxibustion at the following acupuncture points – 20 minutes daily for 6 days with 1 rest day.

  • CV 4 –  found in the lower abdomen a couple body inches (“2 cun“) up from the pubic symphysis, it is one of the more tonifying points for the kidney system  which is functionally the foundation of the hormonal and fertility systems in western terms.  It is used for nearly all kidney system diagnoses in Chinese Medicine including kidney yin deficiency anub_meridian_18-26kidney yang deficiency as well as generally tonifying blood (xue) and qi.  Can be used for a range of symptoms including most fertility issues, amenorrhea, fatigue, nightsweats, hot flashes and more.

  • UB 23
     – found 1.5 cun lateral to the 2nd lumbar vertebrae (or GV 4), it is what is known as the kidney shu point (generally important points for their named systems).  Similar in broad function to CV 4, bladder 23 is used for a range of “kidney” system imbalances.  This includes such symptoms dysmenorrhea, amenorrhea, fertility issues, leukorrhea, overall systemic fatigue, etc.


The researchers found that moxibustion raised estrogen levels at similar levels to those with standard hormonal treatment.

The moxa group also had lower follicle stimulating hormone (FSH) levels, similar to the hormonal treatment group but with results seen in early stages of the study.  They also found that at 8 weeks in the moxibustion group there was a significant upregulating of estrogen receptors in the uterus.  Finally, they found that there were significant decreases in ovarian tissue death (apoptosis).

In essence the researchers found that moxibustion can stimulate the body to increase estrogen levels and protect itself from cell death.

Of importance here is that this effect is largely modulated by your bodies response to moxibustion, not by chemical interactions that happen with herbal medicine or other ways of treating these issues.  Clinically, in general, moxibustion has limited side effects when used properly as it is largely improving circulation and stimulating functions via certain acupuncture points.  The only potential downside of moxibustion is that in some over stimulated people (lots of heat signs, palpitations, anxiety – i.e. kidney yin deficiency) it may overheat and/or further stimulate them.  However, compared to what will happen with improperly prescribed Chinese herbal formulas (for example, stronger tonics such as you gui wan for kidney yin deficiency) the side effects would be minimal in most cases.

All in all, these responses are very interesting and help to deeply explain some of the beneficial effects of acupuncture and associated techniques such as moxibustion.  Further studies should be done to evaluate the clinical effects of needling those points vs. moxibustion, perhaps even acupressure.  All things considered, this is a simple technique to help your body restore its own hormonal levels without strong external intervention.  Along with proper acupuncture and/or herbal medicine treatment, moxibustion is a crucial part of easing perimenopausal issues, particularly in women who are still interested in becoming pregnant.



Article From: YinYangHouse


For men comes one of the more directly named syndromes in western medicine, PADAM (or partial androgen deficiency of the aging male). Also known as “male menopause”, PADAM is an indicator for an important set of issues which may arise as men age.

Generally involving low testosterone (also mentioned as “Low T” in popular media), PADAM is actually broader than just testosterone and can have effects on an array of systems in the body. For men, most of the androgens in their body are produced by the testicles, primarily testosterone. These decline naturally as men age, some faster, some slower. The steroid hormones, “androgens”, have effects on muscle growth, skin and hair growth, involved in fat metabolism and various brain functions. As men age and these androgens decline they can experience a range of symptoms including depression, fatigue, muscle weakness, insomnia, among many others.

Besides testosterone, other androgens are DHEA, DHEAS and DHT which are produced by the skin, liver, and adrenals. Androgen deficiency may occur in younger males as well but will come from testicular damage and/or genetic issues. Most of what I write about here would also apply to those cases, but this study and the information within is largely written for the “aging male”.

I’ve written previously about the meaning of and treatment for “Low T” within Chinese Medicine.  The study I’m going to write about today goes deeper into the internal hormonal changes which are initiated from both acupuncture and moxibustion (see “What is Moxibustion?“) and serves to explain some of the beneficial effects of treatment.

In this study, researchers from Chongqing Medical University, utilized a PADAM induced rat model to explore the effects of both electroacupuncture (EA) and moxibustion (“moxa”) at particular points.  They induce androgen deficiency with cyclophosphamide injections given over week.  Then they divided the 40 induced androgen deficiency rats into 4 groups of 10 – an untreated control, an EA group, a moxa group and a western medicine treatment, “androlin/testosterone”, group.

From the Chinese Medicine side both the EA and the Moxa utilized the same points:

  • UB 23
    • The kidney back “shu” point – shu points are empirical points on the back of the body for certain organ systems in the body.  UB 23 is often helpful for a very wide range of “kidney” imbalances – see “My Kidneys are What?” for more on those.  This point is particularly useful foub_meridian_18-26r a wide range of hormonal/sexual/fertility related issues in both men and women.




  • CV 4
    • cv_meridian_2-11The small intestine front “mu” point – mu points are empirical points on the front of the body for certain organ systems in the body.  CV 4 is also quite helpful for a very wide range of “kidney” imbalances, a variety of fertility/hormonal issues and deeper weaknesses in the body.


Researchers treated over 8 weeks and then analysis was performed on all of the rats in the study.  They found that both the EA and the moxa groups had significantly increased serum levels of total testosterone and free testosterone with moxibustion showing the highest results.  Similar results were shown for other important markers with moxibustion consistently showing better results than electroacupuncture.

Now in general, these are not surprising results to practitioners.  Particularly that moxibustion brought about more strengthening changes is of little surprise.  Moxibustion is most often used for tonification (i.e. strengthening) of deficiencies in the body.  In fact, it needs to be used sparingly if at all on more excess conditions.  For example, digestive problems from weakness, may improve with moxibustion at CV 12 and ST 36 for instance, but it could potentially worsen digestive problems from liver fire, for example.  But even though we understand these mechanisms from a Chinese Medicine theory perspective, it does help to see it play out in direct research.

The researchers concluded that both electroacupuncture and moxibustion “appear to be effective treatments for PADAM”.

This should be good news for men who are struggling with a wide range of moderate to severe issues that they often think are just “part of getting older”.  While we do age, and our strength and vitality will change – this can be slowed within reason.  In fact, large parts of Chinese Medicine were largely established to enable sensible uses of medicine and lifestyle/diet change to foster less illness and longer life spans with stronger vitality.  The value of the medicine was (and is) largely in preserving health and limiting illness, not in emergency care and symptomatic management.  These issues should be taken seriously and treated as there is great possibilities for improvement within Chinese Medicine.



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Acupuncture Points used in IVF Clinical TrialsTim H. Tanaka, Ph.D. April 20, 2013

Note: Acupuncture protocols used in clinical studies are generally simplified, short, and standardized procedures, because the protocols are developed not only with consideration of its potential efficacy but also by considering its experimental design, budgets, time constraint, and other methodological factors.

They are compromised acupuncture protocols, and often far from those commonly used in clinical practice.

Study by Paulus, WE et al.
One hundred sixty patients who were undergoing IVF and who had good quality embryos were randomly divided into the following two groups: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). Each patient in the experimental group received an acupuncture treatment 25 minutes before and after embryo transfer.

The needles were left in position for 25 minutes and then removed. Before embryo transfer, the following Acupoints were used: PC6 (Neiguan), SP8 (Diji), LR3 (Taichong), GV20 (Baihui), and ST29 (Guilai). After embryo transfer, the following Acupoints were used: ST36 (Zusanli), SP6 (Sanyinjiao), SP10 (Xuehai), and LI4 (Hegu).

Additional AcuPoints: Additional AcuPoints: Auricular acupuncture at the following points, without rotation: ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi), and ear point 34 (Naodian). Two needles were inserted in the right ear, the other two needles in the left ear. The four needles remained in the ears for 25 minutes. The side of the auricular acupuncture was changed after embryo transfer.

The locations of acupuncture points used in this study are shown in Figures 1 and 2.

German Protocol Before Embryo Transfer

Figure 1: German Acupuncture Protocol Points before Embryo TransferPaulus WE, et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and sterility 2002; 77(4): 721-4.

Figure 2: German Acupuncture Protocol Points after Embryo Transfer

German Protocol after Embryo Transfer

Paulus WE, et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and sterility 2002; 77(4): 721-4.

Their results showed that clinical pregnancies were documented in 34 out of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group. Since this preliminary study, a number of studies e.g. 2-7 have attempted to replicate their findings using the same or similar acupuncture around embryo transfer protocols (German Acupuncture Protocol), however, the results were equivocal.

A systematic review published in 2008,8 reported a non-significant impact of German acupuncture protocol, based on the meta-analysis of 8 trials on acupuncture during IVF. An updated meta-analysis of 9 trials by the same research group further confirmed their original finding.9 (about Systematic Review and Meta-Analysis)

Despite the less than impressive follow-up data since the highly publicized initial study by Paulus, et al.,1 the German protocol has been widely used among acupuncturists. In fact, it quickly became a “gold standard” acupuncture protocol during IVF cycle.

In my view however, the German acupuncture protocol is a typical example of the standardized, compromised acupuncture used in many acupuncture trials, which does not reflect the practice of classical acupuncture and traditional Chinese medicine.

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Acupressure is often used for a wide range of mild to moderate conditions. One point that is often recommended is on the wrist and is often used for nausea – PC 6. Another point on the leg is used for digestive issues, strength and stamina and more – ST 36. Both of these points have been discussed in many studies before and have hundreds of years of clinical use backing them up.

A recent study from Taiwan published in the Complementary Therapies in Medicine journal, looked specifically at these two points and the effect on post-operative pain for gastric cancer patients.

Following gastric surgery pain, nausea and vomiting is common. The researchers here recruited 60 patients from a surgery center in Taiwan and randomnly assigned them to a control group and an acupressure group. Treatment was offered 3 days in a row, so this was only looking at immediate results in a post-operative setting.

They found significant results from the acupressure group in pain and nausea/vomiting scores and concluded that “acupressure is a simple, noninvasive, safe, and economical procedure for improving the comfort of patients who undergo surgery for gastric cancer. Acupressure at the P6 and ST36 acupoints can improve postoperative comfort by alleviating pain and decreasing the time until first flatus.”

Longer term studies should be done with more follow-up treatment to see if there are differences in healing speed and bowel function at the 3 month, 6 month and 1 year marks.


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The beneficial effects of acupuncture on improving outcomes during western chemo cancer treatments have been well established in both clinical outcomes and in research studies.  The reductions in nausea and/or vomiting from chemo are very beneficial not just from an obvious viewpoint, but many times proper treatment will allow the patient to continue taking western treatments where otherwise they would become too weak to do so.

While practitioners and researchers can accept the clinical outcomes as evidence of the benefits of acupuncture for chemo, it is still nice to know how in more exact terms that it is helping.  Many of the studies that help illustrate how acupuncture works are done on animal models as it is easier to see deeper effects than in human populations.  While animal studies have their own downsides, they do have some value in helping us to explore the “how” of acupuncture.


We know that many of the effects of acupuncture are modulated by the brain first and foremost and then very physical/chemical/hormonal changes happen – some points will make the similar change every time (i.e. lower stomach acid or release markers that tell certain muscle groups to relax); but other points are more modulating depending on the needs of the individual (for example, raise testosterone in someone with low testosterone and lower it in someone with high testosterone).

The study I am writing about today explored the effects of electroacupuncture for chemo induced nausea.  The study utilized an animal model where they were given the cancer drug cisplatin which may be used in ovarian cancertesticular cancerbladder cancer, and others where appropriate.  Among other more common side effects such as joint pain, tinnitus, and lower body edema, cisplatin commonly induces moderate to severe nausea and/or vomiting.

Publishing in the “Acupuncture in Medicine” journal, researchers from the Beijing Hospital of Traditional Chinese Medicine utilized 48 rats to conduct apc_meridian_6-9study trying to understand the mechanisms which acupuncture aids chemo induced nausea.  12 rats were given a saline solution as a control and 36 were given the cancer drug cisplatin.  Of the 36 – 12 were given electro acupuncture at CV 12, 12 were given electro acupuncture at
PC 6 and 12 were given sham acupuncture.  Treatment was offered 3 days before cisplatin and 1-2 days after cisplatin – with multiple rounds.

Without treatment the researchers observed reduced food intake and increased kaolin intake (eating clay – a common response in animals when they are nauseous, “pica response”).  They found that the CV 12 treatment group has “significantly reversed” kaolin intakcv_meridian_12-16e (on days 1 and 2 following treatment) and increase eating and bodyweight (on day 1).

The researchers also found that acupuncture treatment atCV 12 reduced the normally increased 5-HT level (serotonin signalling – ~95% is in the gut) in the duodenum (commonly increased with cisplatin and a known marker for gastrointestinal motility).  When 5-HT is increased there may be gastrointestinal upset, when it is lower there can beconstipation.

They also found that CV 12 suppressed c-Fos expression (an oncogene, which is normally raised with the existence of many types of cancer).  Treatment at PC 6 also appeared to influence c-Fos expression and kaolin intake, but didn’t seem to have similar effects with increasing food intake, improving body weight or modifying 5-HT expression.

The researchers concluded that there are clear beneficial effects of electroacupuncture at certain points for chemotherapy induced nausea and vomiting.  They postulate that this effect, particularly at CV 12, is from inhibiting the secretion of 5-HT in the duodenum and the suppression of the expression of c-Fos.

As an aside this effect on the altered mucosal serotonin (5-HT) signalling would in theory provide beneficial effects for a range of digestive issues as well (as we know from the clinical uses of CV 12).  These would include irritable bowel syndrome (IBS) and Crohn’s diseaseamong others.

Now as with most studies, particularly those that look at the low-level operations of acupuncture, the actual clinical applications would not be to simply apply electroacupuncture at CV 12 for someone undergoing chemo and leave it at that.  There are a multitude of points and appropriate protocols (many of which utilize CV 12) that would be far more helpful than a single point treatment.  These general concepts are explored in two articles – “What Does Acupuncture Treat?” which explores treating the causes rather than following symptoms and “General Point Selection Rules” which explores in basic terms how to design a treatment protocol.  Nonetheless, these types of studies are extremely valuable to illustrate the underlying mechanisms within which acupuncture offers clinical benefits.


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