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Interviews with Experts

Acupuncturist Dorota Kowal

"I have found acupuncture to be particularly helpfull in medically unexplained cases, that is where nothing abnormal has been diagnosed from the western medical point of view. Yet, no medical diagnosis leaves couples hopeless as to where to look for help.
According to Isaksson (2004) research on infertility 10-20% of infertility cases in the UK are unexplained medically. The chinese medicine looking at the person in its entirety can give an explanation for those conditions."
(DK, Dec 2012) 

  • Interview with Dorota

    Can you explain the essence of acupuncture?
    Yes. Acupuncture is known as an ancient Chinese Medicine therapy that in its essence works on life’s vital energy. The vital energy is that which keeps us alive and animated. When life finishes, our vital energy dissipates completely and then stops existing. The vital energy in a human being is a joint whole of different kinds of energies that are organised within the body into channels, the body organs, the body parts, bodily animations and the emotions. Those channels, known as meridians, form a net of invisible lines throughout the body, which inter-connects the rest into dependable relationships. It is at the critical points along the meridian lines that acupuncture points lie and where the natural flow can get obstructed, requiring treatment.

    What type of acupuncture do you offer?
    I offer Classical Acupuncture, principly based on Five Element Acupuncture. Classical in the name refers to the theory and practice rooted in ancient classical texts of Chinese Medicine. The Five Elements refer to five principal energy types: Fire, Earth, Metal, Water and Wood.

    What is your philosophy based on?
    It is to: create health and maximise the potential of each human life according to the rules of nature, which are simple and harmonious.
    The dis-ease and the symptoms point to what and where in the patient’s vital energy has caused the interruption of the flow. By treating the meridians we enable the recovery of the vital flow of energy and thus re-create health in the entire system. It’s like repairing the functional system into becoming whole again.

    The other side of the dis-ease spectrum is the potentiality of each human being. There may be no medically diagnosed disease but the person may not feel at his/her best. For example, low energy level, low motivation, inability to deal with demands of life or life changes, recovery after an operation or after having suffered a loss, a separation or an accident. Such cases if treated by a practitioner who follows the natural laws of Five Elements can be positively assisted.

    Where did you obtain your qualifications?
    My first acupuncture degree was obtained at the School of Five Element Acupuncture (SOFEA) in London, England (accredited by the British Acupuncture Accreditation Board). This was followed by post-graduate studies at SOFEA, London Institute of Five Element Acupuncture and with the Worsley Institute. Then followed by, among other, Centro Studi Xin Shu Roma.

    How does acupuncture work?
    The first appointment will be a detailed oriental diagnosis. The mode of treatment is very personal with some patients needing more frequent treatments, sometimes daily and some starting with weekly sessions. Once the patient feels the benefits hold between the sessions, we extend the frequency until the patient comes only for maintenance. The more acute the problem the quicker it takes to treat it and respectively, the older the problem the longer it will take to heal it.

    Acupuncture is a completely different paradigm to the western way of thinking about health, nonetheless a very logical one. Good health is an ability to function in life to our maximum potential, more than being pain-free or disease-free. One of the ancient chinese medicine text says that it is much easier and quicker to make a healthy body stay healthy than to return to health once the defence from pathogens has broken down. It seems obvious and logical but we are not yet thinking that way.

    How do you think the practice of acupuncture in Italy compares to other countries?
    Practically, I am familiar with the practice in the UK and Italy only. I have found that people in the UK are generally more informed about acupuncture. Most who came to acupuncture had a broad idea of what to expect from acupuncture treatment process. In the UK, there are regular newspaper, magazine and TV programmes featuring the subject of acupuncture, as well as simple guide books published and very extensive public information avaiable on the British Acupuncture Council’s web site. It has becomes a part of people’s daily lives.

    In Italy acupuncture is generally something a doctor understands and the few articles found in public publishing are more generic than informative. That reflects the general culture of the more paternalistic society. From what I have seen in Italy, the majority of acupuncture is approached from the western medical point of view rather than the wholistic one, that is looking at the illness instead of the person. In such context, acupuncture is practiced to ‘fight’ the disease, rather than creating health. It is also rare to find a practitioner in Italy who would work on maximising patient’s life potential.

    For what kind of problems would someone benefit from undergoing a series of acupuncture sessions?
    I would start with the reference to the World Health Organisation’s (WHO) list of ailments that acupuncture typically treats. The list of all ailments is rather long and I would refer the readers to follow a link for the full list: http://apps.who.int/medicinedocs/en/d/Js4926e/5.html
    I would highlight those that may be of interest for fertility and pregnancy issues. They are grouped into two categories:
    1. ”Conditions proved, through controlled trials, to be effective: induction of labour, low back pain, malposition of fetus, morning sickness, nausea and vomiting.”
    2. “Conditions effectively treated: female infertility, female urethral syndrome, hypo-ovarianism, labour pain, lactation deficiency, polycystic ovary syndrome, premenstrual syndrome, recurrent lower urinary-tract infection.”

    The numerous conditions mentioned by WHO give an idea for what kind of problems would someone benefit from undergoing a series of acupuncture sessions. The names of ailments is the “language” that is easily understood, however, I always feel cautious giving out specific conditions as it is rather limiting for the vast scope of acupuncture. Even though it may sound a banal statement to make, everyone can benefit from acupuncture even if they just would like to feel in a better shape in general.

    How does acupuncture benefit someone having fertility problems?
    Where there is a medically recognised fertility problem, acupuncture may help in the following ways (citing the British Acupuncture Council’s research fact sheets):
    • regulating fertility hormones
    • inducing ovulation, also in women with polycystic ovary syndrome (PCOS)
    • increasing blood flow to the reproductive organs, so increasing the chances of embryo implantation
    • increasing egg production and quality
    • enhancing luteal function, so increasing the chances of embryo implantation
    • regulating follicle stimulation hormone-receptor expression
    • normalising cortisol and prolactin levels on IVF medication days
    • reducing stress (in my experience it also includes anxiety about the pregnancy)
    • promoting embryo implantation (balancing of hypothalamic-pituitary-ovarian axis)
    • promotion of the pregnancy rate in assisted reproduction therapy (ART)
    • increasing pregnancy rate in in vitro fertilisation (IVF)

    Acupuncture is also effective in male fertility issues. Low sperm count or quality account for 19% of all infertility cases in the UK. Again citing British Acupuncture Council’s research fact sheets, acupuncture may help in the treatment of male infertility by:
    • improving sperm motility
    • increase sperm count and quality
    • treating psychogenic erectile dysfunction
    • lowering scrotal temperature
    • enhancing local microcirculation
    • reducing inflammation
    • by improving sperm maturation in the epididymis, increasing testosterone levels, and reducing liquid peroxidation of sperm
    I have found acupuncture to be particularly helpfull in medically unexplained cases, that is where nothing abnormal has been diagnosed from the western medical point of view. Yet, no medical diagnosis leaves couples hopeless as to where to look for help. According to Isaksson (2004) research on infertility 10-20% of infertility cases in the UK are unexplained medically. The chinese medicine looking at the person in its entirety can give an explanation for those conditions.

    Do you advise to patients to combine conventional techniques with alternative medicine when having fertility problems?
    Yes, for example, if they have decided to go with the in vitro fertilisation treatment, I would suggest to programme in the acupuncture sessions to improve the potential of embryo implantation. There’s clinical research to support the efficacy of complementary acupuncture to the IVF and the ART treatment. In some cases, the condition that was the cause of infertility in the first place is not fully treated before the in vitro fertilisation, as the aim of the medical procedure is to achieve a pregnancy. Here, the woman can benefit from the acupuncture treatments to prepare her system for a healthy pregnancy. In such cases, I would advise periodic treatments over 3-6 months prior to conception, depending on the state of health of the woman and her age.

    Is there any scientific proof that acupuncture aids fertility?
    There are clinical trials and studies that generally support the use of acupuncture for fertility, however, there have been relatively few trials on larger scale, that means involving more patients and being more detailed. Large scale research is too costly for small acupuncture organisations. For such purposes, acupuncture cannot be compared to the industrial level of drug medicine. From the clinical trials carried out on acupuncture for infertility, six studies have shown it aids:
    - embryo transfer in in vitro fertilisation;
    - increased pregnancy rate;
    - increased number of live births.
    (cited from British Acupuncture Council’s fact sheets)
    Some other attempts to understand acupuncture and to measure it scientifically include:
    1. Neuroimaging studies that show acupuncture calms areas of the brain that register pain and activate those involved in rest and recuperation.
    2. Doppler ultrasound shows that acupuncture increases blood flow in treated areas.
    3. Thermal imaging shows acupuncture can make inflammation subside.
    Scientific measurement or research has an important value, but we need to be aware that it only looks at the quantitative effects as the qualitative aspects are not scientifically measurable; such as: feeling generally better in yourself or your life circumstances improving with the treatment. Also, the improvement of complaints secondary to the main problem are often not considered in the research outcomes.
    Let’s be conscious of the fact that science is also a developing field so if we reject what is not scientifically confirmed by double-blind quantitative research, we are rejecting a lot of useful things in life.

    What help can you offer to woman during pregnancy?
    I can help her with the typical conditions that women suffer during pregnancy, such as:
    nausia and other digestive problems - musculoskeletal conditions - oedema - hypertention - urinary infections - skin conditions - fatigue - insomnia - anxiety. Then, I can help with issues related to the fetus retarted growth or breech positions. In addition, acupuncture can assist in preparation for the delivery, including induction of the delievery, and can assist at each stage of the delivery.  If the pregnancy progresses well I would not suggest any acupuncture treatment. I would limit my help to educating the woman on the progressive care in each month of pregnancy. For example, when the fetus reinforces its limbs, muscular movement and the spinal column in the sixth month, it is important that the woman is a little bit more active than in other months of pregnancy but without ever exhausting herself.

    Chinese Medicine etiology is very helpful for both natural treatment and for drawing lifestyle advice from. For example, the morning sickness in the third month is due to accumulation of blood in the womb to feed the fetus, which is natural. However, that may leave the woman not having enough blood elsewhere in the body into which she would absorb the digested food or ‘digested’ emotions (especially if these are very strong emotions) and that would lead to sickness.

    Finally, just as in the general health prevention, a check-up with an acupuncturist as to the general state of health would be of benefit for anyone trying to conceive or better 3-6 months prior to commencing trying, depending on the age and lifestyle.

    How do people get in touch with you?
    It is best to call me directly on (+39) 329 0065 921, or alternatively to write to: dorota@dorotakowal.com

    December 2012