Uterine Fibroids • Traditional Chinese Medicine • Acupuncture
Uterine Fibroids and Acupuncture: A Traditional Chinese Medicine Perspective
An overview of epidemiology, conventional treatment limitations, and how acupuncture may support women with uterine fibroids.
Epidemiology and Risk Factors
Uterine fibroids (also known as uterine smooth muscle tumors, fibroids, or uterine fibroma) (1) are the most common type of benign tumor in the female reproductive system (2). Several factors can contribute to their development, including race, increasing age, family history, obesity, parity, smoking, and lifestyle habits (2–5). Although fibroids can occur at various ages, they are most prevalent among women aged 30–50 in China, with the highest incidence between ages 40 and 50. Approximately 66% of women are affected by the age of 50 (6). Statistically, the cumulative incidence of uterine fibroids by age 50 is as high as 80% in African-American women and about 50% in white women (7). In contrast, fibroids are uncommon in women under 30 and extremely rare in women under 20. The incidence continues to rise as lifestyle factors change.
Clinical Presentation and Diagnosis
Most patients with uterine fibroids do not present with clinical symptoms (8). Diagnosis often requires pelvic examinations or ultrasound to determine the presence, location, and size of the fibroids (9). However, some patients experience symptoms such as abnormal uterine bleeding, pelvic pressure, bowel dysfunction, or genitourinary disturbances (10–12), which may significantly impact quality of life and daily activities.
Conventional Treatments and Limitations
Current treatments primarily include surgical and pharmacological approaches. Surgical methods include myomectomy, laparoscopic removal, uterine artery embolization, and magnetic resonance–guided focused ultrasound surgery (13–15). These procedures, however, often carry unavoidable side effects such as pain, fever, fertility complications, and high recurrence rates (16,17).
Pharmacological treatments—such as high-dose progesterone injections, oral contraceptives, and mifepristone (18)—may result in estrogen deficiency with long-term use. Both surgical and medical therapies consume substantial healthcare resources, placing a significant burden on individuals and the medical system.
Traditional Chinese Medicine and Acupuncture for Uterine Fibroids
Traditional Chinese Medicine (TCM) is increasingly used worldwide as a complementary and alternative therapy for uterine fibroids. Acupuncture treats fibroids by stimulating specific acupoints (19), and various techniques—such as manual acupuncture, electroacupuncture, warming needles, transcutaneous electrical nerve stimulation (TENS), acupoint injections, and moxibustion—can be applied. Acupuncture helps regulate pelvic nerves, balance female sex hormone levels, and improve blood circulation (20).
Numerous clinical and animal studies have shown that acupuncture can reduce symptoms such as heavy menstrual bleeding (21), abdominal pain, and lower back pain, and can even decrease the size of uterine leiomyomas (22). High-frequency TENS has also been shown to reduce ovarian blood flow in rats (23). Other studies suggest that using TCM or Western medicine alone may have limited effectiveness due to the complexity of the condition and associated complications (24). Therefore, acupuncture serves as a reasonable alternative therapeutic option for fibroids.
Summary
Uterine fibroids are common and often silent, but in some women they can severely affect daily life through heavy bleeding, pelvic pressure, and pain. While surgery and medication are the mainstays of conventional care, they can be associated with side effects, recurrence, and significant resource use. From a TCM perspective, acupuncture offers a gentle, regulatory approach that may help improve symptoms and modulate underlying physiological processes.
Note: Reference numbers (1–24) are preserved from the original article for academic discussion. This article is for information only and does not replace personal medical advice. Patients should consult their physician and qualified practitioners before making treatment decisions.
Reference: Chen T., et al. “Acupuncture combined with Chinese herbs versus Chinese herbs alone to improve the clinical efficacy of uterine fibroids: a systematic review and meta-analysis.” PMCID: PMC11617359
子宮肌瘤 • 中醫 • 針灸
子宮肌瘤與針灸：從傳統中醫觀點看女性照護
概述流行病學、常規治療的限制，以及針灸在子宮肌瘤中的可能輔助角色。
流行病學與危險因子
子宮肌瘤（又稱子宮平滑肌瘤、子宮纖維瘤）(1) 是女性生殖系統中最常見的良性腫瘤 (2)。 多種因素可能促使肌瘤形成，主要包括：種族、年齡增加、家族史、肥胖、生育次數、吸菸與生活習慣 (2–5)。 子宮肌瘤可發生於不同年齡層，但在中國最常見於 30 至 50 歲女性，其中 40–50 歲為高峰期。 約 66% 的女性在 50 歲時會受到影響 (6)。統計顯示，50 歲前累積發病率：非裔美國女性可高達 80%， 白人女性約為 50% (7)。然而，30 歲以下的女性較少見，20 歲以下則極為罕見。隨著生活型態的變化， 子宮肌瘤的發生率仍持續上升。
臨床表現與診斷
大部分子宮肌瘤患者沒有明顯臨床症狀 (8)，因此需要透過骨盆腔檢查或超聲波檢查進行診斷， 並評估肌瘤的位置與大小 (9)。然而，也有部分患者會出現異常子宮出血、骨盆壓迫感、 腸道功能異常或泌尿生殖系統症狀 (10–12)，嚴重時會影響生活品質與日常活動。
現代常規治療與其限制
目前最常見的治療方式包括手術與藥物。手術選項有肌瘤切除術、腹腔鏡手術、 子宮動脈栓塞術、磁振導引聚焦超音波手術等 (13–15)。然而，這些手術往往伴隨無法避免的副作用， 包括疼痛、發燒、生育影響及高復發率 (16,17)。
藥物治療包括高劑量黃體素注射、口服避孕藥、米非司酮 (18)，但長期使用可能造成雌激素缺乏。 手術與藥物治療皆會消耗大量醫療與社會成本，對個人及醫療系統造成沉重負擔。
傳統中醫與針灸在子宮肌瘤的應用
傳統中醫作為子宮肌瘤的補充與替代療法正受到全球關注，其中針灸透過刺激特定穴位以調理機體 (19)。 常見刺激方式包括：傳統針刺、電針、溫針、經皮電神經刺激（TENS）、穴位注射與艾灸。 針灸可調節骨盆神經、平衡女性性激素水平並改善血液循環 (20)。
許多臨床與動物實驗顯示，針灸可改善月經過多 (21)、腹痛、腰痛等症狀，並可減小子宮肌瘤大小 (22)。 此外，高頻 TENS 在大鼠研究中也被證實可降低卵巢血流量 (23)。其他研究則指出， 單獨使用中藥或西藥治療子宮肌瘤，常因併發症多、病情複雜而療效有限 (24)。 因此，針灸被視為一種合理且具潛力的替代或輔助治療方式。
小結
子宮肌瘤相當常見，許多患者沒有症狀，但對部分女性而言，可能因經血過多、骨盆壓迫與疼痛， 嚴重影響日常生活。現代醫學的手術與藥物治療雖是主要選擇，卻可能伴隨副作用、復發與資源消耗。 從中醫觀點來看，針灸強調調整整體氣血與臟腑平衡，以較溫和的方式協助改善症狀， 並作為現代治療的有益補充。
註：文中 (1–24) 為原文獻中的編號，於此保留以供學術參考。本文章僅作為一般性資訊分享， 不構成醫療建議。實際治療請與您的醫師及合格醫療人員討論。
參考文獻：Chen T. 等人，2024。 PMCID: PMC11617359
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