CUPPING AND FEMALE REPRODUCTIVE PROBLEMS: A NARRATIVE REVIEW

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Published Oct 1, 2024
https://doi.org/10.55116/IJICM.V5I2.89
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Vol. 5 No. 2 (2024): International Journal of Islamic and Complementary Medicine

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Dewi Anggraini Padmaningtyas
Universitas 'Aisyiyah Yogyakarta
https://orcid.org/0009-0000-8953-7565
Sesaria Lukman
Universitas 'Aisyiyah Yogyakarta
https://orcid.org/0009-0006-9460-6143
Andari Wuri Astuti
Universitas 'Aisyiyah Yogyakarta
https://orcid.org/0000-0003-3643-4022
Septiana Ade Amalia
Universitas 'Aisyiyah Yogyakarta

Abstract

Al-hijamah, or cupping therapy, uses a cupping device to vacuum suction the skin. The recommendation and virtues of cupping are found in various hadiths of the Messenger of Allah (peace and blessings of Allah be upon him). It has been used traditionally for centuries and is gaining recognition for its potential health benefits, especially in women's reproductive health. The aim of this review is to map the research results on the cupping method (Al-hijamah) as an evidence-based treatment method for addressing reproductive problems in women. This narrative review uses databases, including PubMed, ScienceDirect, EBSCO, and Grey Literature, as well as Google Scholar and Research Rabbit. Based on the results of the inclusion and exclusion criteria, 13 articles were retrieved, and 2 themes were obtained, namely the role of cupping therapy for women's reproductive health and various combinations of cupping with other methods. Cupping therapy can have a positive impact on various aspects of female reproductive health, including menstrual disorders and infertility. Studies have shown improvements in menstrual cycles, reduction in menstrual pain, and increased fertility rates in women who undergo cupping therapy. In addition, cupping therapy has also shown promise in treating conditions such as Polycystic Ovarian Syndrome (PCOS) and anemia associated with excessive menstrual bleeding.


 

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Dewi Anggraini Padmaningtyas, Sesaria Lukman, Andari Wuri Astuti, Septiana Ade Amalia. CUPPING AND FEMALE REPRODUCTIVE PROBLEMS: A NARRATIVE REVIEW. International J. of Islamic and Complementary Medicine [Internet]. 2024 Oct. 1 [cited 2024 Nov. 21];5(2):136-48. Available from: https://islamicmedicine.or.id/index.php/ijim/article/view/89

References

  1. CUPPING AND FEMALE REPRODUCTIVE PROBLEMS: A NARRATIVE REVIEW
  2. Dewi Anggraini Padmaningtyas1*, Septiana Ade Ammalia,1, Sesaria Lukman1, Andari Wuri Astuti1
  3. Master of Midwifery Study Program, Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta, Indonesia
  4. *Email : dewianggrainip@gmail.com
  5. ABSTRACT
  6. Al-hijamah, or cupping therapy, uses a cupping device to vacuum suction the skin. The recommendation and virtues of cupping are found in various hadiths of the Messenger of Allah (peace and blessings of Allah be upon him). It has been used traditionally for centuries and is gaining recognition for its potential health benefits, especially in women's reproductive health. The aim of this review is to map the research results on the cupping method (Al-hijamah) as an evidence-based treatment method for addressing reproductive problems in women. This narrative review uses databases, including PubMed, ScienceDirect, EBSCO, and Grey Literature, as well as Google Scholar and Research Rabbit. Based on the results of the inclusion and exclusion criteria, 13 articles were retrieved, and 2 themes were obtained, namely the role of cupping therapy for women's reproductive health and various combinations of cupping with other methods. Cupping therapy can have a positive impact on various aspects of female reproductive health, including menstrual disorders and infertility. Studies have shown improvements in menstrual cycles, reduction in menstrual pain, and increased fertility rates in women who undergo cupping therapy. In addition, cupping therapy has also shown promise in treating conditions such as Polycystic Ovarian Syndrome (PCOS) and anemia associated with excessive menstrual bleeding.
  7. Keywords: cupping, hijamah, reproductive health, infertility, dysmenorrhea
  8. ABSTRAK
  9. Al-hijamah yang dikenal dengan sebutan terapi bekam, adalah prosedur terapi yang melibatkan penyedotan vakum pada kulit dengan menggunakan alat bekam. Anjuran dan keutamaan berbekam terdapat dalam berbagai hadits Rasulullah Shalallahu ‘Alaihi Wassalam. Terapi ini telah digunakan secara tradisional selama berabad-abad dan mulai dikenal karena potensi manfaatnya bagi kesehatan, terutama dalam kesehatan reproduksi wanita.
  10. Tujuan artikel ini adalah untuk memetakan hasil penelitian tentang metode bekam (Al-hijamah) sebagai metode pengobatan berbasis bukti dalam mengatasi masalah reproduksi pada wanita. Tinjauan naratif ini menggunakan database antara lain PubMed, ScienceDirect, EBSCO, dan Grey Literature menggunakan Google Scholar dan Research Rabbit. Terdapat 13 artikel berdasarkan hasil kriteria inklusi dan ekslusi dan diperoleh 2 tema yaitu peran terapi bekam bagi kesehatan reproduksi perempuan dan macam-macam kombinasi bekam dengan metode lainya Terapi bekam dapat memberikan dampak positif pada berbagai aspek kesehatan reproduksi wanita, termasuk gangguan menstruasi dan infertilitas. Penelitian menunjukkan adanya perbaikan dalam siklus menstruasi, pengurangan nyeri haid, dan peningkatan tingkat kesuburan pada wanita yang menjalani terapi bekam. Selain itu, terapi bekam juga menjanjikan dalam menangani kondisi seperti Polycystic Ovarian Syndrome (PCOS) dan anemia yang berhubungan dengan perdarahan menstruasi yang berlebihan.
  11. Kata kunci: bekam, hijamah, kesehatan reproduksi, infertilitas, dismenore
  12. Correspondence Author :
  13. Dewi Anggraini Padmaningtyas
  14. Master of Midwifery Study Program, Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta, Indonesia
  15. Email: @dewianggrainip@gmail.com
  16. INTRODUCTION
  17. Al-hijamah, or cupping, is a minor surgical excretory procedure with a medical and scientific basis in cleansing the blood and interstitial space from harmful substances and Causative Pathological Substances (CPS). Modern and prophetic medicine has proven the benefits of wet cupping therapy in treating various diseases with different etiologies and pathogenesis1. According to Ibnul Qayyim Al-Jauzziyah in Zadul Ma'ad, hijamah removes blood from the peripheral skin surface.
  18. The medical method of cupping or hijamah has been known for thousands of years in various cultures, including the Chinese, ancient Egyptians, Indians, Greeks, Romans, Persians, and Arabs. The history of cupping can be traced through relics such as drawings on the tomb of King Thot Enoch Amon (1333-1323 BC) and reliefs at the temple of Kom Ombo. The use of glass cups for skin suction has also been practiced since ancient Egypt. They were also known to use leeches for treatment. In a medical book from the Han dynasty in 1973, cupping was mentioned as an attempt to cure various diseases2.
  19. Some of the companions of the Messenger of Allah (peace and blessings of Allah be upon him), such as Abu Talhah, were known to be experts in cupping. The use of hijamah was not only for preventing diseases but also for treating diseases. In the period after the Prophet, Al Hijamah continued to be practiced as a sunnah. El Sayyed et al. mentioned that one of the pioneers of the development of Al Hijamah and its publication was Ibn Sina's book Al-Qanon Fi Al-Tib. Ibn Sina detailed the use of Al Hijamah to treat various diseases.3.
  20. Cupping is known to be effective in treating a variety of health problems. The recommendation and virtues of cupping are found in various hadiths. One of them, from Anas bin Malik, the Messenger of Allah (Sallallahu' Alaihi wa Sallam), said, "Indeed, the ideal treatment that you use is al-hijamah (cupping) and qusthul bahri" (Hadith takhrij Ahmad no. 12906, Al Bukhari no. 5371, Muslim no. 1577, and At-Tirmidzi no. 1278).
  21. Reproductive health is one of the most critical aspects of health for women of childbearing age, the most active and productive phase of life, but also vulnerable to various health problems that can affect the quality of life and productivity. The most common reproductive health problems experienced by women of childbearing age include infertility, miscarriage, and menstrual problems. Some studies suggest that cupping therapy could be a promising method for overcoming infertility in women4,5. Cupping is also used to treat menstrual disorders6 and reduces menstrual pain7. Other benefits include general health improvements felt by women of childbearing age in Palestine after cupping8.
  22. Cupping therapy has a solid historical and cultural foundation supported by scientific evidence and clinical practice. By understanding the therapeutic potential of cupping therapy in addressing women's reproductive health issues. Broader integration of this practice in modern healthcare systems could significantly contribute to improving women's overall well-being and productivity. This review aims to map the current research on cupping (Al-hijamah) as an evidence-based treatment approach. The main focus is to identify the clinical benefits and potential application of this therapy in addressing women's reproductive health issues. Thus, the results of this review are expected to provide a solid scientific basis for health practitioners to consider cupping therapy as part of a holistic approach to women's reproductive health care.
  23. METHOD
  24. This research is a Narrative Review that focuses on cupping therapy in overcoming reproductive health problems in women. The databases used in this literature review are PubMed, ScienceDirect, EBSCO, and Search engines, namely Google Scholar and Research Rabbit. In the process of searching for articles, researchers used several strategies, such as truncation marks (*) and Boolean operators (OR, AND). The keywords used in the review include:
  25. (((((((((((((cupping) OR (cupping therap*)) OR (cupping treatment)) OR (hijamah)) AND (female)) OR (women)) OR (woman)) AND (reproductiv*)) OR (reproduction)) OR (infertility)) OR (infertilities)) OR (dysmenorrhea)) OR (menstrual pain)) OR (PCOS).
  26. In identifying relevant articles, the authors determined the inclusion and exclusion criteria. Inclusion criteria included: 1) Articles in Indonesian and English, 2) Journal research topics on cupping methods in overcoming reproductive problems in women based on existing scientific evidence and clinical practice, 3) Original Research, and 4) Articles published in the last ten years (2015-2024). The exclusion criteria were: 1) Review articles, protocol reviews, opinions, and brief reports.
  27. RESULTS
  28. The narrative review resulted in 13 relevant articles that met the inclusion criteria. Seven of these articles discussed the use of cupping in infertility, and eight discussed the role of cupping in menstrual problems. Each article was numbered A1-A13 and entered into the data charting table to facilitate searching, as shown in Table 1.
  29. Tabel 1. Data Charting
  30. No Author and Country Design Aim Results
  31. A1 9
  32. China
  33. Case report
  34. Investigating the potential of acupuncture combined with cupping as a therapeutic approach for female infertility. Combining acupuncture with cupping therapy may offer a promising approach to treating infertility.
  35. A2 10
  36. Indonesia Quasi-experiment
  37. Comparing and assessing the effectiveness of dry cupping therapy versus wet cupping therapy in raising hemoglobin levels during menstruation in late adolescents. Studies indicate that both dry and wet cupping therapy significantly boosts hemoglobin levels in women during menstruation, making it an effective treatment option for anemia caused by heavy menstrual bleeding.
  38. A3 4
  39. Saudi Arabia Pilot study
  40. Evaluating the efficacy of wet cupping (Hijama) as a treatment for female infertility. Out of 59 women, 31 (52.5%) had primary infertility, and 28 (47.5%) had secondary infertility, with infertility lasting 1 to 22 years. After hijama, 12 women (20.3%) became pregnant. Factors affecting pregnancy rates were the absence of dysmenorrhea, secondary infertility, and a history of OCP use.
  41. A4 11
  42. Iran Randomized Clinical Trial Evaluate the effect of Mindfulness-Based Cognitive Therapy (MBCT) on the quality of life-related to fertility in women with polycystic ovary syndrome (PCOS) who are experiencing infertility. The study found that MBCT therapy significantly improved fertility-related quality of life for women with PCOS. However, it did not increase pregnancy rates compared to the control group receiving dry cupping therapy. MBCT was more effective in enhancing emotional, body-mind, and social well-being.
  43. A5 12
  44. Turkey
  45. Evaluative Study Assess the impact of alternative and complementary therapies on the conception status of women undergoing infertility treatment. It revealed a significant link between ACT use and conception rates, but further research is necessary to clarify the specific effects of certain therapies, such as cupping.
  46. A6 8Palestine
  47. Cross sectional Understanding the use of cupping therapy among women of reproductive age. The findings support the hypothesis that cupping therapy positively impacts the treatment of menstrual disorders, migraines, infertility, and back pain.
  48. A7 6
  49. Iran Pilot RCT Comparing the efficacy of fennel seed infusion combined with dry cupping therapy versus metformin in managing oligomenorrhea in patients with PCOS. Both fennel seed infusion combined with dry cupping therapy and metformin were equally effective in decreasing the interval between menstrual cycles in patients with oligomenorrhea due to PCOS.
  50. A8 7
  51. Indonesia Kuantitatif Evaluating the effectiveness of cupping therapy and abdominal stretching exercises in alleviating menstrual pain in Pepe Village, Sedati, Sidoarjo. Both cupping therapy and abdominal stretching exercises effectively reduced menstrual pain among adolescents in Pepe Village, Sedati, Sidoarjo.
  52. A9 13
  53. India
  54. Case Report Emphasizes the positive effects of static cupping on primary dysmenorrhea and related non-specific lower back pain. Cupping therapy, which targets deep muscles, can be effectively used alongside conventional treatments for dysmenorrhea pain due to its safety, cost-effectiveness, and accessibility.
  55. A10 14
  56. Iran
  57. RCT Assess the effectiveness of dry cupping in managing excessive menstrual blood loss in menorrhagia, using well-validated menstrual pictograms, and compare it with medroxyprogesterone acetate. Dry cupping demonstrated greater effectiveness in reducing the intensity of bleeding and the number of bleeding days during menstruation than medroxyprogesterone acetate.
  58. A11 15
  59. Indonesia
  60. Pre Experimental Study Evaluating the effectiveness of wet cupping therapy on menstrual pain (dysmenorrhea) among nursing students. This study employed a pre-experimental research design with a pre-post-test model involving 15 participants. Wet cupping therapy effectively alleviates menstrual pain in Stikes Surya Global Yogyakarta nursing students.
  61. A12 16
  62. India RCT To assess the effectiveness and safety of dry cupping and fenugreek seeds in reducing pain intensity associated with primary dysmenorrhea. Fenugreek seeds and dry cupping are effective, safe, cost-efficient, and well-tolerated.
  63. A13 17
  64. Turkey
  65. Experimental Study Investigating the impact of wet cupping therapy on anxiety levels and thiol/disulfide balance in rats with premature ovarian failure (POF) induced by cyclophosphamide (CYC). Wet cupping therapy did not alleviate anxiety in rats with experimentally induced premature ovarian conditions, but it did improve the chemical balance in the body.
  66. Article Characteristics
  67. Article characteristics by country can be seen in Chart 1.
  68. Chart 1. Articles by Country
  69. This narrative review used research articles from several countries, namely Saudi Arabia, China, India, Indonesia, Iran, Palestine, and Turkey. The characteristics of articles based on method can be seen in Chart 2.
  70. Chart 2. Articles by Method
  71. This narrative review selected 13 articles. The research articles comprised two case reports, four RCTs, one Pilot RCT, one evaluative Study, one Cross-Sectional, one Quasi-Experimental, one Quantitative, and one Experimental.
  72. Through a meticulous process of theme identification using data extraction, the key themes from the selected research articles have been discerned and are presented in Table 2.
  73. Table 2: Analysis and Mapping of Themes in Research Articles
  74. No Theme Sub Themes References
  75. ,1 The role of cupping therapy for women's reproductive health Cupping in infertility A1, A3, A4, A5, A6, A7, A13
  76. Cupping on menstruation A2, A6, A7, A8, A9, A10, A11, A12,
  77. Various combinations of cupping with other methods Combination of dry cupping and wet cupping A2
  78. Combination of cupping with other methods A1, A7, A9, A12
  79. DISCUSSION
  80. Cupping therapy is a therapeutic procedure that involves vacuuming (suctioning with negative pressure) the skin using a suction device18.
  81. The ruling on learning the science of cupping is fardhu kifayah. This is the opinion of Imam Al Ghazali, quoted in the book Taysirul Fiqh lil Muslimil Mu'ashir by Dr. Yusuf Qardhawi, which reads, "Al Hijamah / cupping is fardhu kifayah. If no one in a region learns it, all the people will sin. However, if there is one who does it and is sufficient, then the obligation of the others is removed."2
  82. When discussing cupping and its benefits, starting the discussion of its virtues can be referred to the explanation of the Messenger of Allah (peace and blessings of Allah be upon him) in the following hadith: Ibn Mas'ud said: "The Messenger of Allah (peace and blessings of Allah be upon him) told us about the night when he was taken up, that he did not pass by a group of angels but they ordered him: Command your Ummah to practice cupping!". The hadeeth is reported by al-Tirmidhi (2053), al-Tirmidhi (3477) and al-Tajah (3477) and is saheeh by Shaykh al-Albany in Saheeh al-Jami' (5671).
  83. Studying and developing research on cupping is essential to ensure the method is safe and effective. With proper research, cupping can be integrated into modern medical practice with a better understanding of its indications, contraindications, and potential benefits and risks. Based on the narrative review conducted, several themes and subthemes were generated as follows:
  84. Theme 1: The Role of Cupping Therapy for Women's Reproductive Health
  85. Traditional and alternative medicine practitioners have been using cupping therapy for centuries. Growing data suggests that it can help treat pain-related disorders in recent years19. The results showed that cupping therapy positively affected women of childbearing age9. The widespread use of cupping in obstetrics and gynecology has a positive effect in alleviating various conditions. Research shows that cupping therapy has positive effects on women's reproductive health, especially in addressing menstrual disorders, migraines, and infertility. Cupping therapy is significantly associated with improved menstrual cycles, decreased menstrual pain, and increased fertility in women9.
  86. Cupping in Infertility
  87. Studies show that cupping therapy has the potential to help women experiencing infertility. Research conducted by Abduljabbar (2016) showed that several women with primary and secondary infertility experienced improvements after undergoing cupping therapy. Hormonal profiles also experienced significant changes after cupping therapy4. This is in line with other studies which state that patients who have problems with fertility experience improvements in hormonal terms after receiving cupping therapy; patients who initially have anxiety and insomnia problems, after routine cupping therapy, patients will feel calm and rested, so the state of the body becomes better and ready for pregnancy9. Other studies highlight a significant link between the use of cupping therapy and conception rates, with a large percentage of women reporting successful pregnancies after using this therapy12.
  88. Polycystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women of childbearing age, with an estimated prevalence of about 4 to 12%. It is a lifelong multisystem genetic disorder and is traditionally first recognized at puberty as menstrual irregularities and weight gain1. Wet cupping therapy can also increase sexual potency in infertile men, improve damaged semen quality and impaired sexual function, improve spermatogenesis in men, and produce healthy offspring in women. The wife of the man who did the therapy became pregnant after two months of wet cupping therapy. Wet cupping therapy can be effective in treating individuals with infertility19.
  89. Meyari's research (2020) examines the importance of alternative medicine, especially in overcoming oligo/amenorrhea, especially in patients with PCOS. The results showed that wet cupping affected menstruation in women with PCOS and fertilization20. The results of another study showed that both fennel seed infusion and dry cupping therapy were effective in reducing the time interval between two consecutive menstrual cycles in patients suffering from oligomenorrhea due to PCOS syndrome. Both groups significantly reduced the number of days between menstrual cycles after the intervention11. Results showed that factors such as no dysmenorrhea, diagnosis of secondary infertility, and history of oral contraceptive use were associated with increased pregnancy rates after cupping therapy4.
  90. Cupping and Menstruation
  91. Adolescence is a critical phase of transition from childhood to adulthood characterized by various reproductive health challenges; anemia is a common problem, with approximately 10% of women experiencing significant hemoglobin loss through menstrual bleeding. Cupping therapy, either using Cupping Puncturing Cupping - Wet Cupping Therapy (CPC-PWT) technique or wet or dry cupping, can potentially increase hemoglobin levels in adolescents during menstruation. Wet cupping is especially considered more effective than dry cupping. Therefore, both methods can be considered viable alternative interventions to increase hemoglobin levels in adolescents during menstruation10.
  92. Cupping therapy has been shown to have a significant impact on hemoglobin levels. Studies have reported an increase in hemoglobin levels after undergoing this therapy. Notably, one study noted a significant increase in hemoglobin levels with a p value of less than 0.05, indicating an average difference after the therapy. Other studies have also noted an increase in hemoglobin levels after cupping therapy. In addition, cupping therapy is said to reduce hemoglobin levels in certain clinical conditions such as hypertension, obesity, and liver cirrhosis by thinning the blood21,22. Research conducted by Mourad, et al showed that anemia is not a side effect of wet cupping or hijamah therapy23
  93. The widespread use of cupping in obstetrics and gynecology positively alleviates various conditions. Cupping therapy is identified as an effective method to improve primary dysmenorrhea, chronic pelvic pain, hypercholesterolemia in menopausal women, oligomenorrhea, idiopathic menorrhagia, low back pain due to pregnancy and labor, perineal pain due to labor and postpartum anxiety24. Almost all women in the world have experienced menstrual pain or dysmenorrhea. The incidence ranges from 45-95% of women of reproductive age with varying degrees, ranging from excruciating sores around the pelvis and inside to menstrual pain that forces women to rest or results in decreased quality of performance and daily life7.
  94. Research by Siddiqui et al. (2022) noted that during menstruation, women often experience dysmenorrhea, which is a painful pain in the lower abdomen, often accompanied by a cramping sensation. This pain radiates to the thighs and lumbosacral region, causing discomfort. Research shows a decrease in pain to 2 out of 10 pain scales in the abdomen after receiving cupping therapy13 is in line with previous research conducted by Alshawish (2021), which shows that cupping therapy has a positive effect in reducing menstrual disorders, migraines, and back pain in women of childbearing age. The positive effects of cupping therapy were also seen in reducing menstrual pain and menorrhagia8. A study conducted by Andi and Setyawan (2022) showed that wet cupping therapy is effective in reducing pain intensity in nursing students who experience dysmenorrhea. The study results showed a significant decrease in the mean value of dysmenorrhea after wet cupping intervention. This shows that wet cupping therapy successfully reduces the intensity of menstrual pain8. In another study, static cupping significantly reduced low back pain and abdominal pain related to primary dysmenorrhea. After therapy, there was a reduction in pain and increased range of motion. Specifically, pain intensity decreased to 2 out of 10 on the Numerical Pain Rating Scale (NPRS) for abdominal and low back pain, both during activity and at rest13.
  95. Theme 2: Various combinations of cupping with other methods
  96. The research concludes that cupping therapy can be used in conjunction with other therapies/interventions to treat abdominal and lower back pain associated with dysmenorrhea, as the former is safe, cost-effective, and readily available13. Such therapies include a combination of dry and wet cupping25, acupuncture9, and herbal materials11,16.
  97. Combination of Dry Cupping and Wet Cupping
  98. Dry and wet cupping techniques can be applied simultaneously to enhance the therapeutic effect. Dry cupping is generally used for general relaxation and pain reduction, while wet cupping is more intensive, detoxifying and improving blood circulation25. Cupping is commonly applied for relaxation and reducing pain, while wet cupping is used for more intensive treatments, such as detoxification and improving blood circulation9,25. Whether performed with dry or wet cupping techniques, Cupping therapy has a significant positive impact on increasing hemoglobin levels in women during menstruation. This makes cupping therapy an effective option to treat anemia due to excessive menstrual bleeding10.
  99. Combination of Cupping with Other Methods
  100. Acupuncture and cupping therapy have shown positive effects in treating infertility, as demonstrated by the case of a 39-year-old woman who successfully conceived naturally after 28 treatment sessions. In addition, various studies have shown that acupuncture can improve pregnancy rates and reproductive outcomes by improving blood flow, reducing stress, and potentially increasing the success of assisted reproductive therapy. However, further research is needed to verify the effectiveness and understand the mechanisms and benefits of acupuncture in the treatment of female infertilityClick or tap here to enter text.. A meta-analysis review suggests that acupuncture may have a positive impact on the fertility of women undergoing infertility treatments, such as in vitro fertilization. Acupuncture was associated with increased rates of live births, biochemical pregnancy (resulting in a positive pregnancy test result, but the pregnancy could not be maintained), and ongoing pregnancy (defined as any pregnancy showing a positive heartbeat on ultrasound after 12 weeks of gestation) compared to the control group. However, there was no significant difference in the rate of ongoing pregnancy. Adverse events were slightly higher in the actual acupuncture group, and subgroup analysis showed variable results depending on the type of acupuncture and control group used in the study. Further research with larger samples and better-quality literature is needed to understand the impact of acupuncture on infertility fully27.
  101. A study combining fennel seed infusion with dry cupping therapy proved effective and safe in reducing the interval between two menstrual periods and overcoming oligomenorrhea. However, this study had some limitations, such as a limited sample population and insufficient data on the effects of dry cupping. Future research should integrate measurements such as ultrasound and hormone level analysis to understand better this therapeutic intervention11. Another study on the combination of cupping with the use of herbal materials concluded that fenugreek seeds coupled with dry cupping therapy had comparable effectiveness to standard medication (mefenamic acid) in reducing pain severity in women with primary dysmenorrhea. The mean VAS scores for back pain intensity and lower abdominal pain decreased significantly in all groups16.
  102. CONCLUSION
  103. Cupping therapy has various benefits for women's reproductive health. It can help with menstrual disorders, migraines, infertility, and Polycystic Ovary Syndrome (PCOS). Cupping therapy can also increase hemoglobin levels during menstruation and reduce menstrual pain. Combining cupping therapy with other methods, such as acupuncture and herbal ingredients, may enhance the therapeutic effect. Nonetheless, further research is needed to validate the results and understand the mechanism of action of these treatments.
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