Insights & Discussion
Acupuncture may be considered in patients with persistent, idiopathic vulvar pruritus.
Vulvar pruritus is a complex symptom of multifactorial origin, frequently affecting the patient’s quality of life. The treatment of patients with chronic pruritus (>6 weeks) is particularly challenging and often requires a multimodal strategy with an interdisciplinary approach. Besides the elimination of potential triggers and continuous lipid-replenishing basic care, antifungal agents and glucocorticoids are paramount. Medical professionals not specialized in the field should refer patients with refractory and/or suspicious lesions to an experienced gynecologist. A specimen should be obtained by punch biopsy for histological evaluation to rule out (pre-) malignant lesions.
It is central to the management of vulvar pruritus to offer a detailed discussion of the condition and treat patients with empathy. Their complaints should be taken seriously and patients should be informed about what could cause their symptoms and which treatment options are available for them.
Discover Related Insights
Pomegranate can significantly enhance women's health during and after menopause by reducing hot flashes severity and other menopause symptoms.
2023 Phytotherapy Research Pomegranate effects on the health aspects of women during peri‐ and postmenopause: A systematic review and meta‐analysis Moeini R, Shirafkan H, Gorji N
Systematic Review Hot Flushes Menopause Pomegranate
The study aimed at understanding the impacts of pomegranate on women's health through and following menopause. To gather data, a rigorous search was conducted on various academic platforms, including PubMed, Web of Science, Cochrane, Scopus, and Google Scholar, up to the end of 2022. All forms of clinical research studies, from randomized clinical trials to case series, were considered for review. The material was evaluated using the Cochrane RoB 2.0 tool specifically for quality assessment of randomized clinical trials. To quantify the effects of the pomegranate intervention, standardized mean differences were calculated using a random effect model.
It was found that pomegranate significantly reduces the severity of hot flashes in menopausal women, improves their high-density lipoprotein levels, and reduces the Follicle-Stimulating Hormone (FSH). However, no significant improvement was noticed in the low-density lipoprotein, body mass index, and body weight. Despite these findings, the study recognized that the results' conclusiveness was hampered due to small sample sizes and the lack of study design elements such as blinding and randomization.
Si Wu Tang has improved menstrual symptoms by increasing estradiol content and antioxidative effects as a result of its herbs' synergistic relationships.
2022 Frontiers in Pharmacology Elucidation of the Effects of Si-Wu Tang on Menstrual Disorder Patterns through Activation of Aromatase and Antioxidation Guan-Cheng Huang, Yi-Zhe Tsai, Chia-Jung Lee, Heng-Yu Chang, Ching-Chiung Wang
Experimental Study Oestradiol Shao Yao Shu Di Huang
In the methodology of the study, a testosterone-treated MCF-7 cell model was employed to determine the effects of each herb in the SWT formula. Key metrics that were considered included the regulation of estradiol, antioxidative effects, and the total polyphenol and polysaccharide contents as quality markers. The study also explored the potential ability of certain elements within the formula to act as an aromatase promoter, notably catalpol and other elements.
In terms of results, certain herbs in SWT such as catalpol showed an ability to significantly increase estradiol content and boost upregulation in cell culture, indicating their role as potential aromatase promoters within the formula. Antioxidant activity was also strong in other compounds like pentagalloylglucose, gallic acid, and ferulic acid. These antioxidative effects were attributed to the presence of polyphenols in the herbs. Furthermore, the herb with the strongest antioxidant effects could possibly help ameliorate menstrual disorder patterns due to its ability to prevent ROS damage to the ovaries.
Current evidence shows that short-term honey supplementation following surgical or physiological menopause exerts an oestrogenic, antioxidant and anti-inflammatory effect on the female reproductive system.
2021 Molecules Augmentation of the Female Reproductive System Using Honey: A Mini Systematic Review Ismail NH, Ibrahim SF, Jaffar FHF, Mokhtar MH, Chin KY, Osman K
Systematic Review Female Reproductive System Honey Menopause
A systematic literature search using Scopus, MEDLINE via Ovid and Cochrane Library databases was conducted. Records were screened and identified for preclinical and clinical studies addressing the effects of HS on the FRS. Data on populations, interventions, outcomes and methodological quality were extracted. Studies were synthesised using tables and written summaries. Of the 198 identified records, six fulfilled the inclusion criteria. All six records were used for data extraction: two experimental studies using rats as the model organism and four human clinical studies of honey on female reproductive health. HS elevated the progesterone levels, restrained body weight increase, prevented uterine and vaginal atrophies in ovariectomised rats, attenuated symptoms of candidiasis and improved oxidative status in patients.
The present study indicated that acupuncture had an advantage over hormone replacement therapy in reducing serum FSH level and increasing serum E2 level in women with premature ovarian insufficiency.
2020 Journal of Acupuncture and Tuina Science Acupuncture for premature ovarian insufficiency: a systematic review and meta-analysis Yin, Yq., Xu, Hf., Fang, Yg. et al.
Systematic Review HRT Ovarian Function Ovarian Insufficiency
Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level and a remarkable elevation in the basal E2 level in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone and acupuncture plus HRT, while a remarkable elevation of E2 was only found in acupuncture plus HRT. There was no significant difference in the LH level between acupuncture and HRT, only one trial reported AMH, and no significant difference was found between acupuncture and HRT.
Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections.
2020 BJOG: An International Journal of Obstetrics & Gynaecology Acupuncture for recurrent urinary tract infection in women: a systematic review and meta‐analysis Qin X, Coyle ME, Yang L, Liang J, Wang K, Guo X, et al.
Systematic Review Bladder Conditions Urinary Tract Infection
Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics. The risk of UTI recurrence was lower with acupuncture than with no treatment and sham acupuncture.
Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture.
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