Endometriosis discussed in Parliament – Practitioner summary
On Tuesday 19 November, two members of Parliament, Alice MacDonald (MP) and Jim Shannon (MP), raised questions about the waiting times for treatment and diagnosis for conditions such as endometriosis. An update of the 2017 NICE guidelines [NG73] Endometriosis: diagnosis and management, was published on 11 November 2024.
Scientific evidence for acupuncture
Looking back through the documentation and evidence that supported the development of these guidelines, we can see some of the barriers that prevent acupuncture from being made more widely available within the NHS.
Firstly, acupuncture was not included in the scope for the 2024 update. So, the decision not to include acupuncture and Chinese herbal medicines dates back to 2017. Since 2017, systematic reviews on the benefits of acupuncture for those with endometriosis have been published. These include the following Open Access papers (free for anyone to read):
Acupuncture for endometriosis: A systematic review and meta-analysis (Giese et al, 2023)
Concluded: Acupuncture treatment for endometriosis demonstrated clinically relevant improvements in pelvic pain and should be considered as a potential treatment intervention.
Acupuncture and moxibustion for endometriosis: A systematic review and analysis (Yang et al, 2024)
Concluded: Low to moderate certainty evidence from single studies showed that manual acupuncture may improve pain-related symptoms and quality of life; however, there is insufficient evidence on the overall effectiveness of acupuncture and moxibustion for endometriosis.
Acupuncture for clinical improvement of endometriosis‑related pain: a systematic review and meta‑analysis (Chen et al 2024)
Concluded: Acupuncture is effective in alleviating dysmenorrhea and pelvic pain associated with endometriosis, reducing serum CA-125 levels, decreasing the size of nodules, improving patients’ quality of life, and lowering the recurrence rate.
UK research is needed
As you can see, Yang et al (2024) state that there is insufficient evidence on the overall effectiveness. It is important to note this is an issue of an insufficient number of high-quality clinical trials, which means a firm conclusion cannot be made. It does not mean that acupuncture is ineffective.
Chen et al (2024) raised the same issue stating:
‘…it should be noted that the current evidence is limited by the design and quality flaws of the original studies’
In 2017, the NICE committee also noted the lack of high-quality evidence. Although, the evidence base has improved since 2017, it is important to have evidence that is directly applicable to the UK population. The British Acupuncture Council believes that the current evidence is sufficient to justify the funding of high-quality clinical trials. High-quality research requires collaboration between universities, healthcare systems, and practitioners. The British Acupuncture Council has a long history of supporting research: for example, studies on safety; and depression.
Finding a competent acupuncturist
In 2017, the NICE committee noted that there were risks because of a lack of regulation. If a profession is not statutory regulated, it can be difficult for people to identify a qualified practitioner who adheres to professional codes. Endometriosis UK directs people to the British Acupuncture Council website.
Concerns about the lack of regulation has been in the news recently in relation to a sharp rise in complaints relating to poorly qualified and regulated counsellors and psychotherapists.
The British Acupuncture Council is an Accredited Register of the Professional Standards Authority (PSA). The PSA is an independent body reporting to the UK parliament to protect the public when seeking healthcare. Therefore, by choosing a BAcC Member you can be assured that your acupuncturist is a highly qualified professional with a three-year degree level training.
If the government do not wish to statutory regulate acupuncture, we believe it is important that there is much greater public awareness of the accredited register scheme.
