Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial
Elizabeth Jedel1, Fernand Labrie2, Anders Odén3, Göran Holm4, Lars Nilsson5, Per Olof Janson5, Anna-Karin Lind5, Claes Ohlsson6, and Elisabet Stener-Victorin7,8
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1Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;
2Laval University Research Center in Molecular Endocrinology, Oncology and Human Genomics, CHUL Research Center, Quebec, Canada;
3Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg;
4Institute of Medicine, Department of Metabolism and Cardiovascular Disease,
5Institute of Clinical Science, Department of Obstetrics and Gynecology,
6Institute of Medicine, Center for Bone and Arthritis Research, and
7Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Göteborg, Gothenburg, Sweden; and
8Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
Address for reprint requests and other correspondence: E. Stener-Victorin, Inst. of Neuroscience and Physiology, Dept. of Physiology, Sahlgrenska Academy, Göteborg University, Box 434, SE-405 30 Gothenburg, Sweden (e-mail: email@example.com).
Submitted 20 August 2010. accepted in final form 6 October 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 electro-acupuncture (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 ?25%, androsterone glucuronide by ?30%, and androstane-3?,17?-diol-3-glucuronide by ?28% in the EA group (P = 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 = 0.018 vs. exercise). After the 16-wk follow-up, the acne score decreased by ?32% in the EA group (P = 0.006 vs. exercise). Both E Acupuncture 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 E Acupuncture and physical exercise improved hyperandrogenism and menstrual frequency more effectively than no intervention in women with PCOS. Low-frequency E Acupuncture was superior to physical exercise and may be useful for treating hyperandrogenism and oligomenorrhea/amenorrhea.