Unpublished MSc thesis, Wiener Schule für Osteopathie, 2008/02, 99, type of study: ,cs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.osteopathicresearch.org/s/orw/item/2956)

Keywords:

infertility [22]
hirsutism [1]
hormones [4]
hyperandrogenaemia [1]
OMT [3925]
osteopathic manipulative treatment [3946]
polycystic ovary syndrome (PCOS) [1]
case series [63]
WSO [508]

Abstract:

Backround: In Europe about 14% of the couples have difficulties to conceive. In about 25% thereason for infertility is found in the hormonal system. A main pathology of the female hormonal system is hyperandrogenaemia. On the one hand, an androgen excess leads to distortions of themenstrual cycle, oligo-/amenorrhoea and anovulation. On the other hand women suffer from theapparent external changes due to hyperandrogenaemia: hirsutism, acne, alopecia and android fatdistribution. Research question: Does osteopathic treatment influence the hormone level ofhyperandrogenaemic infertile women? Study design: with-in subject design. Methods: A pilot study comprising 10 test persons was conceptualised, but only a case series of 3 subjects could be gathered. Appropriated and reasonable in- and exclusion criteria were applied. Each woman got 6 treatments every 2 weeks. Blood samples (testosterone, LH, FSH, TSH) were taken before, during and after treatment including an observation period of at least one monthduring which no treatment occurred. Additional questionnaires were filled in by the subjectsbefore and after the treatment period. Results: The testosterone level of two women deduced to a normal value. The one of the third woman remained unimproved, but she became pregnant after 4 treatments. Of note, this woman could not be considered as infertile referring to the definition of the WHO (“Infertility: failure to conceive after at least one year of unprotected coitus”). The LH-FSH-ratio was normal (<2) throughout all measurements in two patients. Only in subject 3 the LH-FSH-ratio was abnormally high (3.4) and normalised after three treatments and remained normal after further three treatments. It should be noted that the same patient had shown normal LH-FSH-ratio two years before. TSH values were normal in all subjects at the beginning of the study, suggesting normal thyroid functioning. Discussion: Due to the problem of the recruitment of infertile hyperandrogenaemic women,only this small number of 3 test persons could be recruited. None of these women with pathological elevated testosterone level was infertile. Blood measuring should have included the SHBG level (sex hormone binding globulin) in order to estimate the free testosterone level as only the unbound free testosterone can exert a hyperandrogenaemic effect. Conclusion: The results of these three cases after osteopathic treatment do not allow anystatement on the effectiveness of osteopathic treatment on the hormone level of hyperandrogenaemic women. Further studies are needed to be conducted on a large scale. These studies should be proceed in two steps: preferably first including hyperandrogenaemic women and afterwards hyperandrogenaemic and infertile women. If once it is proven that osteopathic treatment reduces testosterone levels, infertile hyperandrogenaemic women will be recruited more easily.