Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab 300: E37-E45, 2011. First published October 13, 2010; doi:10.1152/ajpendo.00495.2010.-Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by hyperandrogenism, oligo/amenorrhea, and polycystic ovaries. We aimed to determine whether low-frequency electroacupuncture (EA) would decrease hyperandrogenism and improve oligo/amenorrhea more effectively than physical exercise or no intervention. We randomized 84 women with PCOS, aged 18 -37 yr, to 16 wk of low-frequency EA, physical exercise, or no intervention. The primary outcome measure changes in the concentration of total testosterone (T) at week 16 determined by gas and liquid chromatography-mass spectrometry was analyzed by intention to treat. Secondary outcome measures were changes in menstrual frequency; concentrations of androgens, estrogens, androgen precursors, and glucuronidated androgen metabolites; and acne and hirsutism. Outcomes were assessed at baseline, after 16 wk of intervention, and after a 16-wk follow-up. After 16 wk of intervention, circulating T decreased by Ϫ25%, androsterone glucuronide by Ϫ30%, and androstane-3␣,17-diol-3-glucuronide by Ϫ28% in the EA group (P ϭ 0.038, 0.030, and 0.047, respectively vs. exercise); menstrual frequency increased to 0.69/month from 0.28 at baseline in the EA group (P ϭ 0.018 vs. exercise). After the 16-wk follow-up, the acne score decreased by Ϫ32% in the EA group (P ϭ 0.006 vs. exercise). Both EA and exercise improved menstrual frequency and decreased the levels of several sex steroids at week 16 and at the 16-wk follow-up compared with no intervention. Low-frequency EA and physical exercise improved hyperandrogenism and menstrual frequency more effectively than no intervention in women with PCOS. Low-frequency EA was superior to physical exercise and may be useful for treating hyperandrogenism and oligo/amenorrhea. acupuncture; androgens; estrogens; exercise; glucuronidated androgen metabolites; oligomenorrhea; sex steroid precursors POLYCYSTIC OVARY SYNDROME (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by clinical or biochemical hyperandrogenism, oligo/amenorrhea, and polycystic ovaries with or without increased ovarian volume (4). The most constant and prominent feature is hyperandrogenism, manifested by hirsutism, persistent acne, and biochemical abnormalities (4), including elevated levels of androgens, sex steroid precursors, and glucuronidated androgen metabolites as well as estrogens (22).There is no gold standard for the long-term treatment of women with PCOS who do not attempt to conceive (1). Treatments for hyperandrogenism and menstrual disturbances include oral contraceptives, insulin sensitizers, and lifestyle interventions. Combined low-dose oral contraceptives are recommended as the primary treat...
Stener-Victorin E, Jedel E, Janson PO, Sverrisdottir YB. Lowfrequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. Am J Physiol Regul Integr Comp Physiol 297: R387-R395, 2009. First published June 3, 2009 doi:10.1152/ajpregu.00197.2009We have recently shown that polycystic ovary syndrome (PCOS) is associated with high muscle sympathetic nerve activity (MSNA). Animal studies support the concept that low-frequency electroacupuncture (EA) and physical exercise, via stimulation of ergoreceptors and somatic afferents in the muscles, may modulate the activity of the sympathetic nervous system. The aim of the present study was to investigate the effect of these interventions on sympathetic nerve activity in women with PCOS. In a randomized controlled trial, 20 women with PCOS were randomly allocated to one of three groups: low-frequency EA (n ϭ 9), physical exercise (n ϭ 5), or untreated control (n ϭ 6) during 16 wk. Direct recordings of multiunit efferent postganglionic MSNA in a muscle fascicle of the peroneal nerve before and following 16 wk of treatment. Biometric, hemodynamic, endocrine, and metabolic parameters were measured. Low-frequency EA (P ϭ 0.036) and physical exercise (P ϭ 0.030) decreased MSNA burst frequency compared with the untreated control group. The low-frequency EA group reduced sagittal diameter (P ϭ 0.001), while the physical exercise group reduced body weight (P ϭ 0.004) and body mass index (P ϭ 0.004) compared with the untreated control group. Sagittal diameter was related to MSNA burst frequency (Rs ϭ 0.58, P Ͻ 0.005) in the EA group. No correlation was found for body mass index and MSNA in the exercise group. There were no differences between the groups in hemodynamic, endocrine, and metabolic variables. For the first time we demonstrate that low-frequency EA and physical exercise lowers high sympathetic nerve activity in women with PCOS. Thus, treatment with low-frequency EA or physical exercise with the aim to reduce MSNA may be of importance for women with PCOS. polycystic ovary syndrome; sympathetic nerve activity; testosterone; insulin resistance; metabolic syndrome; cardiovascular disease POLYCYSTIC OVARY SYNDROME (PCOS) is one of the most common female endocrine disorders affecting ϳ10% of women of reproductive age, and is strongly associated with hyperandrogenism and ovulatory dysfunction (8,46). PCOS increases the risk of metabolic disturbances such as abdominal obesity, hyperinsulinaemia, and insulin resistance, which can lead to type 2 diabetes, and dyslipidemia (8, 46), as well as hypertension which may lead to the development of other cardiovascular diseases (35).Despite extensive research, the primary etiology remains unknown, although both environmental and genetic factors are implicated (17). Existing evidence suggests the ovarian theca cells, the major source of androgen production and secretion (22) to play a key role in the etiology. Also, the hypothalamicpituitary axis (50) and defective insulin a...
Several anxiety symptoms distinguished women with PCOS from a control group matched on BMI. A better understanding of the symptoms is needed to identify and alleviate anxiety symptoms in this vulnerable group.
Polycystic ovary syndrome (PCOS), the most common female endocrinopathy, is associated with hyperandrogenism, ovulatory dysfunction and obesity (1). PCOS increases the risk of hyperinsulinaemia, insulin resistance and type 2 diabetes. Type 2 diabetes results primarily from insulin resistance and is correlated with both hyperandrogenaemia and obesity (1). Women with PCOS often develop hypertension and have an increased likelihood of developing cardiovascular risk factors (2). They also appear to have impaired mental health (3,4). Common features of PCOS can be highly distressing to patients and body image appears to be strongly associated with depression (5), and there are also indications that anorexia nervosa coexists with PCOS (6). Taken together, PCOS-related symptoms lead to higher levels of depression, psychological and psychosexual morbidity, and increased exposure to stressful stimuli.Data on the dietary history of women with PCOS are limited but there are indications that women with PCOS consume: (i) more saturated fat and less dietary fibre than age-matched control women (7) and (ii) larger quantities of specific foods with a high glycaemic index compared to matched controls (8).This review aims to describe the aetiology and pathogenesis of PCOS and to evaluate the use of acupuncture to prevent and reduce symptoms related with PCOS. Polycystic ovary syndrome aetiologyThe aetiology of PCOS is incompletely understood, despite high prevalence of the syndrome, morbidity from its metabolic, reproductive and hyperandrogenic features, and the associated cardiovascular risk. The most consistent endocrine feature is hyperandrogenaemia from a predominantly ovarian source, which likely plays a key aetiological role (9, 10). Insulin sensitivity is decreased by 30-40% in women with PCOS, predominantly in overweight women, and the compensatory hyperinsulinaemia This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervou...
CHQ-CF87 could be used for measuring health and to evaluate the efficacy of treatment in child patients with TMD pain.
The aim of this systematic review was to assess the efficacy of acupuncture in the management of xerostomia. Assessing quality of studies aim to efficiently integrate valid information and provide a basis for sound decision making based on the best available evidence. Articles of controlled clinical trials evaluating the efficacy of acupuncture in the management of xerostomia were obtained by searching through the databases MEDLINE and Cochrane Central Register of Controlled Trials to September 2003. Three articles met the criteria for inclusion and a criteria list was used to assess the quality of these studies. The studies were considered to be of high quality or low quality in accordance with the criteria list utilized. The results of the trials were considered positive, negative or indifferent based on statistically significant between group differences. The criteria list utilized indicate that one of the three studies was of high quality and it presents indifferent results. One of the two studies of low quality presents positive results and one presents indifferent results. An analysis of the results degree of evidence resulted in no evidence for the efficacy of acupuncture in the management of xerostomia. This systematic review shows that there is no evidence for the efficacy of acupuncture in the management of xerostomia. There is a need for future high quality randomized controlled trials.
The Swedish version of PCOSQ is reliable and can be used to measure HRQL in PCOS. Researchers and clinicians should be aware of the benefits of PCOSQ.
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