• Auricle acupuncture significantly reduces pain in cases of severe dysmenorrhea. In this Australian review, 24 studies were reviewed to determine the effectiveness and safety of acupuncture for pain in endometriosis. While it was found that more studies are warranted, the review concluded that acupuncture ‘cured’, was ‘significantly effective’ or ‘effective’ 91.9% of the time, for the treatment of pain associated with endometriosis. Chinese herbal medicine had a success rate of 60% of the time. To note, there was insignificant difference in the effectiveness between acupuncture and Chinese herbal medicine for the treatment of mild to moderate dysmenorrhoea, whereas auricular acupuncture did significantly reduce pain in cases of severe dysmenorrhoea. 31

• Acupuncture appears to be an effective pain treatment for endometriosis. The aim of this study was to examine whether acupuncture is an effective additional pain treatment for endometriosis. One hundred and one women aged 20-40 years participated and were randomised into two groups, each receiving two units of 10 acupuncture treatments, twice a week over a period of five weeks. Group 1 (n = 47) received verum-acupuncture during the first series, and group 2 (n = 54) received non-specific acupuncture. Group 1 showed a significant reduction of pain intensity after the first 10 treatments.32

• The aim of this study was to review the effectiveness and safety of Chinese Herbal Medicine (CHM) in alleviating endometriosis-related pain and infertility. In China, treatment of endometriosis using Chinese herbal medicine (CHM) is routine and considerable research into the role of CHM in alleviating pain, promoting fertility, and preventing relapse has taken place. Randomised controlled trials (RCTs) involving CHM and 158 women were included in this review. The researchers concluded that post-surgical administration of CHM may have comparable benefits to gestrinone but with fewer side effects. Oral CHM may have a better overall treatment effect than danazol; it may be more effective in relieving dysmenorrhoea and shrinking adnexal masses when used in conjunction with a CHM enema.47

• Reserachers in this study compared the difference in the clinical efficacy on endometriosis (EM) between electroacupuncture (EA) and western medication. EM patients were divided into an EA group and a western medication group. The EA was given once every two days. In the western medication group, mifepristone tablets were prescribed for oral administration, 12. 5 mg per treatment, once a day, for 6 months. The pain degree was observed before and after treatment and the clinical efficacy and recurrence rate were evaluated in the two groups. EA achieved a significant clinical efficacy, and the reoccurrence rate in 1 year in the EA group was clearly lower than that of the western medication group. Acupuncture therapy may be promoted as a potential treatment for EM in clinical practice. 80

• In this study, researchers sough to evaluate the efficacy and safety of acupuncture for the treatment of endometriosis-associated pain. Subjects were assigned randomly to receive either acupuncture or sham acupuncture (the control) treatment for 12 weeks, starting one week before each expected menstruation and administered as a 30-minute session once per day, 3 times a week. During the menstruation period, acupuncture was administered daily when pelvic pain associated with endometriosis occurred. After acupuncture or sham acupuncture treatment, the subjects were followed for another 12 weeks. In the acupuncture group, the reduction in the dysmenorrhea VAS score was significantly greater after treatment compared to the sham group. The duration of pain was significantly shorter in the acupuncture group. Researcher were confident to conclude Acupuncture is an effective and safe method of relieving dysmenorrhea, shortening the pain duration, and improving wellbeing and quality of life in women with endometriosis-associated pain, although its efficacy fades after treatment is discontinued.88