Acupuncture + Endometriosis: What research says + why it works!

Endometriosis is one of the most common, and often misunderstood, causes of pelvic pain. Many people living with endometriosis seek complementary treatments alongside medical care, especially when symptoms persist despite conventional options. Acupuncture has gained growing attention as a supportive therapy, but what does the research actually say?

Let’s explore the science, clinical rationale, and how acupuncture may help people living with endometriosis.

But first, what Is Endometriosis?

Endometriosis is a chronic inflammatory condition where tissue, similar to the uterine lining, grows outside the uterus. These lesions may occur on the ovaries, pelvic peritoneum, bowel, bladder, or other pelvic structures.

Because this tissue responds to hormonal changes, it can cause inflammation, scarring, and sensitization of nerves, contributing to complex, persistent pain patterns.

Endometriosis affects about 10% of reproductive-age individuals and significantly impacts quality of life.

Common Signs and Symptoms

While each person’s experience is different, common symptoms include:

• Pelvic pain (cyclical or constant)

• Severe menstrual cramps (dysmenorrhea)

• Pain with intercourse (dyspareunia)

• Painful bowel movements or urination

• Low back or hip pain

• Fatigue

• Bloating (“endo belly”)

• Infertility or difficulty conceiving

Why Consider Acupuncture for Endometriosis?

Acupuncture is increasingly used as part of integrative pelvic health care because it targets multiple systems involved in endometriosis:

• Pain modulation

• Menstrual regulation

• Nervous system balance

• Inflammation

• Hormonal signaling

• Blood flow and tissue oxygenation

What Does the Research Say?

1. Evidence Supports Pain Reduction

A recent systematic review and meta-analysis evaluating randomized controlled trials found that acupuncture significantly reduced pain severity in individuals with endometriosis compared to control treatments. Researchers reported improvements in dysmenorrhea, pelvic pain, and overall clinical response rates.

Another meta-analysis including nine randomized trials showed acupuncture significantly reduced pain intensity scores and improved symptom response rates compared with non-acupuncture treatments.

These findings suggest acupuncture may be an effective adjunct therapy, particularly for pain management.

2. Possible Effects on Inflammation and Disease Markers

Some research suggests acupuncture may influence biological markers associated with endometriosis.

• Reductions in serum CA-125 (a biomarker sometimes elevated in endometriosis) were reported in pooled analyses.

• Improvements in quality of life and lower recurrence rates have also been suggested, although further high-quality studies are needed.

How Acupuncture Works for Endometriosis

Modern research offers several explanations for why acupuncture may benefit people with endometriosis.

Pain Modulation

Acupuncture stimulates peripheral nerves, triggering the release of endogenous opioids and neurotransmitters such as endorphins and serotonin. These changes:

• Reduce pain signaling

• Modulate central sensitization

• Improve pain tolerance

Since endometriosis often involves both inflammatory and neuropathic pain mechanisms, this multimodal effect may be particularly helpful.

Nervous System Regulation

Endometriosis is associated with altered autonomic nervous system activity and increased stress reactivity.

Acupuncture can:

• Enhance parasympathetic activity

• Reduce sympathetic overactivation

• Improve stress resilience

These effects may help calm chronic pelvic pain pathways and reduce flare frequency.

Anti-Inflammatory Effects

Chronic inflammation plays a central role in endometriosis.

Research suggests acupuncture may:

• Modulate cytokine activity

• Influence immune signaling

• Reduce inflammatory mediators

This may help explain improvements in pain and symptom severity seen in clinical trials.

Improved Pelvic Blood Flow

Traditional East Asian medicine concepts often emphasize circulation. From a biomedical perspective, acupuncture may improve microcirculation and tissue oxygenation, potentially reducing ischemia-related pain.

Who Might Benefit Most?

Clinical experience and emerging research suggest acupuncture may be helpful for individuals who:

• Experience chronic low back, abdominal, hip, pelvic pain or dysmenorrhea

• Want non-pharmaceutical pain management options

• Have nervous system dysregulation or high stress

• Are seeking complementary support alongside medical treatment

If you’re struggling with endometriosis, we’d love to support you! At Pure Balance Holistic Healing, in Portsmouth NH, our acupuncturists specialize in women’s health conditions like endometriosis. Click Here to book your initial consult.

References:

Fan, Y., Zhang, H., Liu, J., & Wang, X. (2024). Acupuncture monotherapy for endometriosis-related pain: A systematic review and meta-analysis. Journal of Pain Research. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/40859475/

Yang, F., Li, Y., Chen, L., & Zhao, J. (2024). Acupuncture for clinical improvement of endometriosis-related pain: A systematic review and meta-analysis. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-024-07675-z

Zhu, X., Hamilton, K. D., & McNicol, E. D. (2011). Acupuncture for pain in endometriosis. Cochrane Database of Systematic Reviews, (9), CD007864. https://doi.org/10.1002/14651858.CD007864.pub2

Zhang, Y., Liu, Z., & Chen, S. (2025). Network meta-analysis of acupuncture-related therapies for symptomatic endometriosis. Complementary Therapies in Medicine. https://pubmed.ncbi.nlm.nih.gov/40019501/