Acupuncture for Pelvic Pain

Acupuncture, a traditional Chinese medicine technique involving the insertion of thin needles into specific points on the body, has been explored as a potential treatment for pelvic pain. Numerous clinical trials and randomized controlled trials (RCTs) have investigated its efficacy in alleviating this often debilitating condition. Understanding the findings of these studies is crucial for assessing the role of acupuncture as a therapeutic option within a comprehensive approach to pelvic pain management.

Protocols Studied in Research

[1] Acupuncture for endometriosis-associated pain. (Cited by: 12) (pmid: 36716811)

• Protocol: A multicenter, randomized, single-blind, placebo-controlled trial compared acupuncture to sham acupuncture in 106 women with endometriosis-associated pain. Treatment involved 12 weeks of acupuncture/sham acupuncture, 3 times a week, with daily treatment during menstruation.
• Outcome: Acupuncture significantly reduced dysmenorrhea and pain duration, and improved well-being at 12 weeks, but these effects were not sustained at 24 weeks. No significant differences were found for non-menstrual pelvic pain or dyspareunia.

[2] Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 41) (pmid: 34399062)

• Protocol: A multicenter, randomized, sham-controlled trial in 440 men with moderate to severe CP/CPPS. Participants received 20 acupuncture or sham acupuncture sessions over 8 weeks, followed by 24-week follow-up.
• Outcome: Acupuncture demonstrated significantly greater and sustained improvement in CP/CPPS symptoms compared to sham acupuncture at both 8 and 32 weeks post-treatment. The effects were durable, lasting 24 weeks after treatment completion.

[3] Verum ear acupuncture for pregnancy-related lower back and posterior pelvic girdle pain (LBPGP). (Cited by: 12) (pmid: 31034580)

• Protocol: A four-group, multicenter, randomized controlled trial comparing verum, nonspecific, and placebo ear acupuncture plus standard obstetric care to standard obstetric care alone in 205 pregnant women (24-36 weeks gestation) with LBPGP. Midwives administered acupuncture.
• Outcome: Verum ear acupuncture significantly reduced pain intensity, improved quality of life, and decreased functional disability compared to standard obstetric care alone at 2 weeks and 3 months postpartum.

[4] Electro-acupuncture (EA) for postpartum diastasis recti abdominis (DRA). (Cited by: 4) (pmid: 36483239)

• Protocol: A randomized controlled trial comparing EA plus physical exercise versus physical exercise alone in 110 postpartum women (20-45 years) with DRA. Participants received 10 EA sessions (or sham) over 2 weeks, followed by 26 weeks of follow-up.
• Outcome: EA showed improvements in inter recti distance (IRD), pelvic floor muscle function, BMI, linea alba elasticity, and DRA symptoms compared to the control group, with effects lasting 26 weeks. The difference in IRD was statistically significant at 26 weeks in specific body positions.

[5] Acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 0) (pmid: 37313559)

• Protocol: A randomized controlled trial comparing acupuncture versus sham acupuncture in 42 CP/CPPS patients. Treatment involved 20 sessions over 8 weeks. Specific acupuncture points were used in the treatment group, while sham acupuncture used non-acupoints.
• Outcome: Acupuncture significantly reduced CP/CPPS symptoms (NIH-CPSI scores) and improved urinary flow rate compared to sham acupuncture, with effects sustained at 24-week follow-up. Acupuncture was safe and well-tolerated.

[6] Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 0) (pmid: 38431530)

• Protocol: A secondary analysis of a randomized controlled trial involving 206 men with CP/CPPS receiving acupuncture for 32 weeks. Response was defined as a ≥6-point decrease in NIH-CPSI score.
• Outcome: Patients who were physically active, non-smokers, without comorbidities, and had initially severe symptoms showed a significantly greater response to acupuncture treatment.

[7] Catgut-embedding acupuncture for functional anorectal pain (FAP). (Cited by: 0) (pmid: 37933076)

• Protocol: A randomized controlled trial comparing catgut-embedding acupuncture to sham acupuncture in 71 FAP patients. Treatment involved two sessions per month for two months. Outcomes measured included pain scores, anal incontinence, and quality of life.
• Outcome: Catgut-embedding acupuncture significantly improved anorectal pain, quality of life, and showed a much higher effective rate (85.71%) compared to the sham group (8.33%). No adverse effects were reported.

[8] Acupuncture therapy for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 17) (pmid: 25453515)

• Protocol: A randomized controlled trial comparing acupuncture versus sham acupuncture in 12 CP/CPPS patients. Blood samples were collected before and after 20 acupuncture sessions (10 weeks). Symptom and mood questionnaires were also administered.
• Outcome: While clinical response was similar between groups (67% responders), acupuncture was associated with a significant increase in natural killer cell levels compared to sham acupuncture (p=0.03). The study suggests a potential link between acupuncture, immune function, and CP/CPPS symptom improvement, but further research is needed.

[9] Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 26) (pmid: 29733836)

• Protocol: A 32-week randomized, sham-controlled trial with 68 men (18-50 years old) comparing real acupuncture to sham acupuncture; 8 weeks of treatment followed by 24 weeks of follow-up.
• Outcome: Acupuncture demonstrated statistically significant and clinically meaningful improvements in NIH-CPSI total scores compared to sham acupuncture at 8, 20, and 32 weeks. While some secondary outcomes showed no significant difference, acupuncture generally performed better than sham. Larger trials are warranted.

[10] Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 0) (pmid: 38621728)

• Protocol: A randomized controlled trial comparing true acupuncture to sham acupuncture in 70 CP/CPPS patients. Treatment involved 24 sessions over 8 weeks. Outcomes were assessed using SF-36, VAS, NIH-CPSI, and IPSS scores.
• Outcome: Acupuncture significantly improved quality of life, reduced pain, and alleviated prostate symptoms compared to sham acupuncture, with effects lasting up to 24 weeks post-treatment. No significant adverse effects were reported.

[11] Neurogenic acupoint dry cupping therapy for chronic pelvic pain (CPP) in women. (Cited by: 6) (pmid: 33657762)

• Protocol: A randomized controlled trial comparing 8 weeks of neurogenic acupoint dry cupping plus lifestyle modifications (study group, n=15) versus lifestyle modifications alone (control group, n=15) in 30 women with CPP. hs-CRP, pain perception (SF-MPQ), and pain impact (PPIQ) were assessed.
• Outcome: Neurogenic acupoint cupping significantly reduced hs-CRP levels, pain perception, and pain's impact on life in women with CPP compared to the control group. hs-CRP correlated positively with pain measures.

[12] Acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in drinkers. (Cited by: 0) (pmid: 39219163)

• Protocol: A randomized controlled trial (RCT) with 224 drinkers receiving either acupuncture or sham acupuncture. Outcomes were assessed at multiple time points using NIH-CPSI, GRA, IPSS, and IIEF-5.
• Outcome: Acupuncture significantly reduced pain (NIH-CPSI and GRA) and improved erectile function (IIEF-5) in drinkers with CP/CPPS compared to sham acupuncture, but showed no effect on urinary symptoms (IPSS).

[13] Acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 33) (pmid: 25939517)

• Protocol: A randomized, sham-controlled trial of 100 CP/CPPS patients (category III B) comparing acupuncture at seven bilateral acupoints versus sham acupuncture. NIH-CPSI scores were measured at baseline and at multiple time points.
• Outcome: Acupuncture resulted in significantly greater improvement in NIH-CPSI scores compared to sham acupuncture, with 92% of the acupuncture group showing >50% reduction in total score at 8 weeks post-treatment.

[14] Electroacupuncture (EA) with different waveforms (4 Hz continuous, 20 Hz continuous, 4/20 Hz extended) for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 3) (pmid: 35935300)

• Protocol: A randomized controlled trial (RCT) with 108 CP/CPPS patients randomly assigned to one of three EA waveform groups. Treatment involved 20-minute EA sessions twice weekly for 4 weeks.
• Outcome: The 4/20 Hz extended waveform EA group showed significantly higher CP/CPPS response rates and improved erectile function compared to the 4 Hz and 20 Hz continuous waveform groups. Pain reduction was also superior in the 4/20 Hz group. All groups showed improvements in symptoms, but the extended waveform was most effective.

[15] Acupuncture combined with tamsulosin hydrochloride for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 4) (pmid: 32195959)

• Protocol: A randomized controlled trial (RCT) will assign 166 CP/CPPS patients to either acupuncture plus tamsulosin or tamsulosin alone. The acupuncture group receives ten 30-minute sessions. The NIH-CPSI score at week 4 is the primary outcome.
• Outcome: The abstract does not present findings; it only describes the planned study protocol to evaluate the effectiveness, safety, and cost-effectiveness of adding acupuncture to standard drug treatment for CP/CPPS.

[16] Acupuncture versus standard care for pelvic girdle and low back pain (PGLBP) during pregnancy. (Cited by: 11) (pmid: 31009470)

• Protocol: A pragmatic, open-label, randomized controlled trial comparing standard care to standard care plus acupuncture (5 sessions) in pregnant women with PGLBP across five maternity hospitals.
• Outcome: Acupuncture was a dominant strategy, resulting in a greater proportion of pain-free days and lower disability scores, despite slightly higher healthcare costs. Including indirect costs (absenteeism/presenteeism), acupuncture was more cost-effective.

[17] CO₂ laser moxibustion for endometriosis-related pelvic pain (cold coagulation and blood stasis). (Cited by: 1) (pmid: 35403398)

• Protocol: A randomized controlled trial (RCT) comparing CO₂ laser moxibustion to sham laser moxibustion in 76 patients. Treatment involved 30-minute sessions, three times a week for four weeks.
• Outcome: CO₂ laser moxibustion significantly reduced pain (GBS and VAS scores) and analgesic drug use compared to sham treatment and baseline measurements.

[18] Acupuncture for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 4) (pmid: 27821109)

• Protocol: A randomized, sham-controlled trial comparing acupuncture vs. sham acupuncture in 68 men with CP/CPPS. Treatment involved 30-minute sessions, three times weekly for 8 weeks.
• Outcome: The abstract describes the study protocol; no results or conclusions regarding the intervention's effect are presented.

[19] Acupuncture versus antibiotics/NSAIDs for Category IIIB Chronic Prostatitis-Chronic Pelvic Pain Syndrome (CP-CPPS). (Cited by: 23) (pmid: 25582816)

• Protocol: A non-blinded randomized controlled trial comparing acupuncture (electrical stimulation of BL32 and BL33) to levofloxacin and ibuprofen in 54 men with CP-CPPS. Treatments lasted 6-7 weeks.
• Outcome: Acupuncture resulted in significantly greater improvements in pain, urinary symptoms, quality of life, and NIH-CPSI scores compared to medical treatment. The study concludes acupuncture is a safe and effective treatment option.

[20] Low-level laser biostimulation at sensitized acupoints for chronic pelvic pain (CPP) in women with pelvic inflammatory disease (PID). (Cited by: 0) (pmid: 40005470)

• Protocol: A randomized controlled trial (RCT) of 36 women with PID-related CPP. One group received NSAIDs and laser therapy at sensitized acupoints for 6 weeks; the other received NSAIDs only. Pain, quality of life, and pressure pain thresholds were assessed.
• Outcome: Laser biostimulation significantly reduced pain intensity and improved quality of life and pressure pain thresholds compared to NSAIDs alone in women with PID-related CPP. It's suggested as a potential component of rehabilitation programs.

[21] Acupuncture versus sham acupuncture for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 1) (pmid: 30335011)

• Protocol: A randomized controlled trial (RCT) will assign 60 CP/CPPS patients to either acupuncture or sham acupuncture. Treatment involves three sessions per week for four weeks. Three assessment modes of the NIH-CPSI will be compared.
• Outcome: This is a study protocol; therefore, no outcomes are presented. The study aims to determine the efficacy of acupuncture for CP/CPPS and compare different assessment methods for measuring treatment effects.

[22] Inferior hypogastric plexus blockade (IHPB) and acupuncture for idiopathic chronic pelvic pain (CPP). (Cited by: 7) (pmid: 25673173)

• Protocol: A randomized clinical trial comparing IHPB (n=62) and acupuncture (n=55) in 117 patients with CPP. Pain was assessed using a visual analogue scale (VAS) at multiple time points.
• Outcome: IHPB demonstrated significantly greater pain reduction and a higher success rate (72.6% vs 54.5%) compared to acupuncture in the short-term management of CPP. Fewer patients in the IHPB group did not benefit from the treatment.

[23] Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 15) (pmid: 21245238)

• Protocol: A randomized, double-blind clinical trial compared true acupuncture to sham acupuncture (needles 0.5cm from true points) in CP/CPPS patients over 10 weeks. Blood samples were analyzed for certain hormones in a subset of participants.
• Outcome: Sham acupuncture was a valid control. True acupuncture showed a significantly greater clinical response rate and higher post-treatment beta-endorphin and leucine-enkephalin levels compared to sham.

[24] Manual acupuncture plus usual care versus usual care alone for endometriosis-related chronic pelvic pain. (Cited by: 10) (pmid: 34161143)

• Protocol: A randomized controlled feasibility study of 19 women (aged 18-45) with endometriosis and chronic pelvic pain. The acupuncture group received 16 treatments over 8 weeks; the control group received usual care.
• Outcome: Acupuncture was well-tolerated and potentially effective in reducing pelvic pain and improving quality of life in women with endometriosis. High dropout rate in the usual care group suggests it was not an adequate control.

[25] Auricular acupuncture for low back pain and pelvic girdle pain (LBPGP) during pregnancy. (Cited by: 7) (pmid: 25027493)

• Protocol: A four-arm, multicenter, randomized, placebo-controlled trial of 212 pregnant women (24-36 weeks gestation) comparing verum, non-specific, and placebo auricular acupuncture plus standard obstetric care to standard obstetric care alone. Treatment involved weekly acupuncture sessions for two weeks.
• Outcome: The abstract describes the study protocol; no outcomes are presented as the study is ongoing (as indicated by the inclusion of "Trial Registration").

[26] Acupuncture combined with ibuprofen vs. ibuprofen alone for chronic pelvic pain (CPP) after pelvic inflammatory disease (PID). (Cited by: 4) (pmid: 33559439)

• Protocol: A multi-center randomized controlled trial (RCT) compared acupuncture plus ibuprofen to ibuprofen alone in 144 women with CPP post-PID. Treatment lasted 3 menstrual cycles; acupuncture targeted specific points.
• Outcome: Acupuncture plus ibuprofen significantly improved pain scores (VAS), local signs, and quality of life (WHOQOL-BREF) compared to ibuprofen alone in women with CPP after PID.

[27] Psychotherapy with somatosensory stimulation (acupuncture point stimulation) for endometriosis-associated pain and quality of life. (Cited by: 27) (pmid: 27741200)

• Protocol: A randomized controlled trial (RCT) with 67 women with endometriosis and chronic pelvic pain. Participants were randomized to either the intervention group (psychotherapy with somatosensory stimulation) or a waitlist control group for 3 months, followed by treatment for all.
• Outcome: Psychotherapy with somatosensory stimulation significantly reduced pain (global, pelvic, dyschezia) and improved quality of life (physical and mental) in endometriosis patients compared to the control group at 3 months. Improvements were maintained at 6 and 24 months.

[28] Japanese-style acupuncture for endometriosis-related chronic pelvic pain in adolescents and young women. (Cited by: 37) (pmid: 18794019)

• Protocol: A randomized, sham-controlled trial involving 18 young women (13-22 years) with laparoscopically diagnosed endometriosis. Participants received 16 acupuncture treatments (real or sham) over 8 weeks.
• Outcome: Japanese-style acupuncture showed a statistically significant reduction in pain at 4 weeks compared to sham acupuncture. While the effect lessened over time, preliminary results suggest it may be an effective, safe, and well-tolerated adjunct therapy.

[29] Ashi acupuncture and local anesthetic injections for chronic pelvic pain secondary to abdominal myofascial pain syndrome (AMPS). (Cited by: 8) (pmid: 32967393)

• Protocol: A randomized controlled trial comparing ashi acupuncture (n=16) and local anesthetic injections (n=19) in women with AMPS-related CPP. Pain was assessed using VAS, NCS, and the McGill Questionnaire at multiple time points.
• Outcome: Both ashi acupuncture and local anesthetic injections effectively reduced pain in women with AMPS-related CPP, with no significant difference between the groups.

[30] Acupuncture for pelvic pain in late pregnancy. (Cited by: 17) (pmid: 16521674)

• Protocol: A randomized, single-blind, controlled trial compared superficial vs. deep acupuncture (n=47 pregnant women with pelvic pain) over 10 sessions. Pain intensity and emotional impact were assessed.
• Outcome: Both superficial and deep acupuncture significantly reduced pain intensity, emotional reactions, and energy loss in pregnant women with pelvic pain; no difference was found between the two acupuncture techniques.

[31] Acupuncture and stabilizing exercises as adjuncts to standard treatment for pelvic girdle pain during pregnancy. (Cited by: 54) (pmid: 15778231)

• Protocol: A randomized, single-blind controlled trial compared standard treatment alone versus standard treatment plus acupuncture versus standard treatment plus stabilizing exercises in 386 pregnant women with pelvic girdle pain. Interventions lasted six weeks.
• Outcome: Acupuncture and stabilizing exercises both significantly reduced pain compared to standard treatment alone. Acupuncture showed greater pain reduction than stabilizing exercises.

[32] Acupuncture for pelvic and low-back pain in late pregnancy. (Cited by: 28) (pmid: 14995919)

• Protocol: A randomized controlled trial of 72 pregnant women (weeks 24-37) with pelvic or low-back pain. The acupuncture group received traditional and local acupuncture (once or twice weekly), while the control group received no intervention. Pain was assessed weekly using a visual analog scale.
• Outcome: Acupuncture significantly reduced pain intensity and improved functional limitations compared to the control group, with no serious adverse effects on mothers or infants.

[33] Acupuncture and physiotherapy for low-back and pelvic pain during pregnancy. (Cited by: 29) (pmid: 10830757)

• Protocol: A prospective randomized controlled trial comparing acupuncture and physiotherapy in 60 pregnant women with low-back and pelvic pain. Pain and disability were assessed using visual analog scales (VAS) and disability rating indices (DRI).
• Outcome: Acupuncture provided significantly greater pain relief and disability reduction compared to physiotherapy for low-back and pelvic pain in pregnant women. The improvement was statistically significant for both morning and evening pain scores and across most daily activities.

[34] Acupuncture combined with Western medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). (Cited by: 6) (pmid: 29231360)

• Protocol: A randomized controlled trial comparing acupuncture combined with Western medicine, acupuncture alone, and Western medicine alone in 90 CP/CPPS patients. Treatment consisted of 2 twelve-day sessions.
• Outcome: Combined acupuncture and Western medicine showed superior efficacy compared to either treatment alone in improving CP/CPPS symptoms, NIH-CPSI scores, and anxiety/depression levels.

[35] Transcutaneous Electrical Nerve Stimulation (TENS) for chronic pelvic pain and deep dyspareunia in women with deep endometriosis. (Cited by: 12) (pmid: 26319650)

• Protocol: A randomized controlled trial compared two TENS applications (acupuncture-like and self-applied) in 22 women with deep endometriosis and persistent pain despite hormone therapy. Treatment lasted 8 weeks.
• Outcome: Both acupuncture-like and self-applied TENS significantly improved chronic pelvic pain, deep dyspareunia, and quality of life in participants. Both methods proved effective.

[36] Electrical pudendal nerve stimulation (EPNS) and intravesical instillation (II) for urethral pain syndrome (UPS). (Cited by: 2) (pmid: 33934208)

• Protocol: A double-blind, randomized controlled trial comparing EPNS (3 sessions/week for 6 weeks) to II (1 session/week for 6 weeks) in 80 patients with UPS. Baseline characteristics were balanced between groups.
• Outcome: EPNS resulted in significantly greater improvement in pelvic pain, urgency/frequency, and other UPS symptoms compared to II at 6 weeks. EPNS demonstrated superior pain control and lower urinary tract symptom relief.

[37] Japanese acupuncture (JA) for endometriosis-related chronic pelvic pain in adolescents and young women. (Cited by: 23) (pmid: 18537469)

• Protocol: A randomized sham-controlled pilot trial was conducted using a manualized protocol to standardize JA treatment. A modified Streitberger device and sham moxibustion were used for sham acupuncture. The study took place at the Japanese Acupuncture Department at the New England School of Acupuncture.
• Outcome: The developed protocols showed good compliance, were well-tolerated, maintained patient blinding, and minimized differences in outcome expectations. The modified Streitberger needle and sham moxibustion showed promise as a sham control, but require further validation.

[38] Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 52) (pmid: 18187077)

• Protocol: A randomized controlled trial comparing acupuncture to sham acupuncture in 89 men with CP/CPPS. Participants received twice-weekly 30-minute sessions for 10 weeks. Sham acupuncture involved needles without stimulation.
• Outcome: Acupuncture was significantly more effective than sham acupuncture in improving CP/CPPS symptoms at 10 weeks and showed a greater likelihood of long-term benefit.

[39] Long-needle acupuncture (LA) at acupoints BL30 and BL35 for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). (Cited by: 11) (pmid: 28499367)

• Protocol: A randomized, single-blind, controlled trial compared LA to traditional acupuncture (TA) in 77 CP/CPPS patients. Participants received six acupuncture sessions over two weeks, with a 24-week follow-up.
• Outcome: Long-needle acupuncture demonstrated significantly greater improvement in NIH-CPSI scores and all four symptom domains (urination, pain, symptom effects, quality of life) at both 2 and 24 weeks compared to traditional acupuncture.

[40] Acupuncture (real vs. sham) for pelvic girdle pain (PGP) in pregnant women. (Cited by: 23) (pmid: 18947338)

• Protocol: A randomized, double-blinded controlled trial comparing acupuncture and sham acupuncture, added to standard treatment, in 115 pregnant women with PGP. Treatment lasted 8 weeks.
• Outcome: Acupuncture showed no significant effect on pain or sick leave compared to sham acupuncture. However, it showed a small, statistically significant improvement in performing daily activities. Needle penetration appears to contribute minimally to any benefit.

Research Interpretation: Summary and Conclusion

Several randomized controlled trials (RCTs) investigated acupuncture's efficacy for pelvic pain, employing diverse protocols including various acupuncture techniques (e.g., ear, catgut-embedding, electroacupuncture), sham controls (placebo needles, non-acupoints), and durations. While many studies demonstrated statistically significant improvements in pain intensity, quality of life, and specific symptoms (e.g., dysmenorrhea, urinary flow) compared to sham acupuncture or control groups, the magnitude of effects and duration of benefit varied considerably. Consistent positive findings were more prevalent in studies focusing on chronic pelvic pain (CPP) in men, particularly CP/CPPS, whereas results for endometriosis-associated pain were less consistently positive and often not sustained long-term. Some studies showed synergistic benefits when combined with other therapies. Importantly, methodological variations across studies (e.g., acupuncture type, patient populations, outcome measures) limit definitive conclusions, necessitating larger, well-designed, standardized trials to confirm the efficacy and identify optimal parameters for acupuncture treatment of pelvic pain. The role of patient factors (e.g., physical activity, comorbidities) also appears influential in treatment response.

Publications

[1] Li PS; Peng XM; Niu XX; Xu L; Hung Yu Ng E; Wang CC; Dai JF; Lu J; Liang RN (2023). Efficacy of acupuncture for endometriosis-associated pain: a multicenter randomized single-blind placebo-controlled trial Fertility and sterility 119 (5) :815-823.

[2] Sun Y; Liu Y; Liu B; Zhou K; Yue Z; Zhang W; Fu W; Yang J; Li N; He L; Zang Z; Su T; Fang J; Ding Y; Qin Z; Song H; Hu H; Zhao H; Mo Q; Zhou J; Wu J; Liu X; Wang W; Pang R; Chen H; Wang X; Liu Z (2021). Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome : A Randomized Trial Annals of internal medicine 174 (10) :1357-1366.

[3] Vas J; Cintado MC; Aranda-Regules JM; Aguilar I; Rivas Ruiz F (2019). Effect of ear acupuncture on pregnancy-related pain in the lower back and posterior pelvic girdle: A multicenter randomized clinical trial Acta obstetricia et gynecologica Scandinavica 98 (10) :1307-1317.

[4] Liu Y; Zhu Y; Jiang L; Lu C; Xiao L; Wang T; Chen J; Sun L; Deng L; Gu M; Zheng T; Feng M; Shi Y (2022). Efficacy of electro-acupuncture in postpartum with diastasis recti abdominis: A randomized controlled clinical trial Frontiers in public health 10 :1003361.

[5] Li B; Wang DD; Qiao XD; Yuan AH; Jiang P; Xu JP; Yang J; Zhang QP (2023). [Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial] Zhongguo zhen jiu = Chinese acupuncture & moxibustion 43 (6) :654-8.

[6] Wang X; Zhu L; Yang M; Chen Y; Liu Z (2024). Factors related to acupuncture response in patients with chronic prostatitis/chronic pelvic pain syndrome: secondary analysis of a randomized controlled trial World journal of urology 42 (1) :112.

[7] Li J; Sun Y; Zhang C; Thomas K; Lin W; Cheng C; Li H; Zhu Q; Ma S; Hua Q; Shi Q; Zheng X (2023). A randomized, controlled clinical trial of acupoint catgut embedding as an effective control of functional anorectal pain Medicine 102 (44) :e35462.

[8] Lee SW; Liong ML; Yuen KH; Krieger JN (2014). Acupuncture and immune function in chronic prostatitis/chronic pelvic pain syndrome: a randomized, controlled study Complementary therapies in medicine 22 (6) :965-9.

[9] Qin Z; Zang Z; Zhou K; Wu J; Zhou J; Kwong JSW; Liu Z (2018). Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Sham Acupuncture Controlled Trial The Journal of urology 200 (4) :815-822.

[10] Wang H; Ji Y; Zhang S; Yuan P; Zhao H; Guo Y; Xie X; Ding Y (2024). Effect of acupuncture on quality of life in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial Zhongguo zhen jiu = Chinese acupuncture & moxibustion 44 (4) :411-417.

[11] Abdulaziz KS; Tareq Mohamad R; Saad El-Din Mahmoud L; Abdel Azim Ramzy T; Osman DA (2021). Effect of neurogenic acupoint cupping on high sensitive C-reactive protein and pain perception in female chronic pelvic pain: A randomized controlled trial Journal of musculoskeletal & neuronal interactions 21 (1) :121-129.

[12] Zhu L; Sun Y; Yan S; Liu X; Wang X; Liu Z (2024). Efficacy of acupuncture on drinkers with chronic prostatitis / chronic pelvic pain syndrome: secondary analysis of a randomized clinical trial Acupuncture in medicine : journal of the British Medical Acupuncture Society 42 (5) :243-250.

[13] Sahin S; Bicer M; Eren GA; Tas S; Tugcu V; Tasci AI; Cek M (2015). Acupuncture relieves symptoms in chronic prostatitis/chronic pelvic pain syndrome: a randomized, sham-controlled trial Prostate cancer and prostatic diseases 18 (3) :249-54.

[14] Li Z; Liu J; Liu P; Zhang Y; Han W (2022). Effects of Electroacupuncture with Different Waveforms on Chronic Prostatitis/Chronic Pelvic Pain Syndromes: A Randomized Controlled Trial Contrast media & molecular imaging 2022 :6866000.

[15] Wang JS; Yang J; Deng S; Yu XD; Bao BH; Liu RJ; Li HS (2020). Acupuncture combined with tamsulosin hydrochloride sustained-release capsule in the treatment of chronic prostatitis/chronic pelvic pain syndrome: A study protocol for a randomized controlled trial Medicine 99 (12) :e19540.

[16] Nicolian S; Butel T; Gambotti L; Durand M; Filipovic-Pierucci A; Mallet A; Kone M; Durand-Zaleski I; Dommergues M (2019). Cost-effectiveness of acupuncture versus standard care for pelvic and low back pain in pregnancy: A randomized controlled trial PloS one 14 (4) :e0214195.

[17] Li T; Wang SY; Huang ZQ; Cai QH; Zhang S; Wang S; Tian T (2022). [CO(2) laser moxibustion for endometriosis related pelvic pain of cold coagulation and blood stasis: a randomized controlled trial] Zhongguo zhen jiu = Chinese acupuncture & moxibustion 42 (4) :397-401.

[18] Qin Z; Zang Z; Wu J; Zhou J; Liu Z (2016). Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndromes: study protocol for a randomized, sham acupuncture-controlled trial BMC complementary and alternative medicine 16 (1) :440.

[19] Kucuk EV; Suceken FY; Bindayi A; Boylu U; Onol FF; Gumus E (2015). Effectiveness of acupuncture on chronic prostatitis-chronic pelvic pain syndrome category IIIB patients: a prospective, randomized, nonblinded, clinical trial Urology 85 (3) :636-40.

[20] Hasanin ME; Aly SM; Taha MM; Mahmoud LSE; Aldhahi MI (2025). The Effect of Laser Biostimulation at Sensitized Acupoints on Chronic Pelvic Pain and Quality of Life in Women with Pelvic Inflammatory Disease: A Randomized Controlled Trial Medicina (Kaunas, Lithuania) 61 (2).

[21] Zhou J; Liu Y; Li C; Liu Z (2018). Comparison of 3 assessment modes of acupuncture effect on patients with chronic prostatitis/chronic pelvic pain syndrome: A study protocol for a randomized controlled trial Medicine 97 (42) :e12887.

[22] Amin MM; Ait-Allah AS; Ali Ael-S; Salem RA; Ahmed SR; Alsammani MA (2015). Inferior hypogastric plexus blockade versus acupuncture for the management of idiopathic chronic pelvic pain: A randomized clinical trial Biomedical journal 38 (4) :317-22.

[23] Lee SW; Liong ML; Yuen KH; Leong WS; Khan NK; Krieger JN (2011). Validation of a sham acupuncture procedure in a randomised, controlled clinical trial of chronic pelvic pain treatment Acupuncture in medicine : journal of the British Medical Acupuncture Society 29 (1) :40-6.

[24] Armour M; Cave AE; Schabrun SM; Steiner GZ; Zhu X; Song J; Abbott J; Smith CA (2021). Manual Acupuncture Plus Usual Care Versus Usual Care Alone in the Treatment of Endometriosis-Related Chronic Pelvic Pain: A Randomized Controlled Feasibility Study Journal of alternative and complementary medicine (New York, N.Y.) 27 (10) :841-849.

[25] Vas J; Aranda-Regules JM; Modesto M; Aguilar I; Baron-Crespo M; Ramos-Monserrat M; Quevedo-Carrasco M; Rivas-Ruiz F (2014). Auricular acupuncture for primary care treatment of low back pain and posterior pelvic pain in pregnancy: study protocol for a multicentre randomised placebo-controlled trial Trials 15 :288.

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