Pelvic floor dysfunction is the name for problems that arise when the muscles and connective tissue at the base of the pelvis stop supporting the bladder, bowel and uterus or stop working in coordination. A 2017 review in Current Urology Reports lists what the term covers: disorders of urination and defecation, sexual dysfunction, pelvic organ prolapse and chronic pain. The same review found pelvic floor muscle training (PFMT), a supervised programme of exercises for those muscles, of benefit across all of them, and named acupuncture among the treatments studied for pelvic pain.
Two of those conditions have pages of their own here, because each has its own Cochrane review and sham-controlled trials: urinary incontinence and, in men, chronic prostatitis and chronic pelvic pain syndrome. This page reports the rest: the pelvic floor after childbirth, pelvic organ prolapse, faecal incontinence and chronic pelvic pain in women. Most of its trials add acupuncture to pelvic floor training and compare the combination with training alone, which tells a reader whether the combination did better but not whether needling at the chosen points was the reason.
After childbirth
Four reviews published since 2023 pool trials in women with stress urinary incontinence after giving birth, which is leakage on coughing, sneezing or exercise.
| Review | Trials | Comparison | Finding |
|---|---|---|---|
| Liu 2023, network meta-analysis | 17, with 1,859 women | 13 treatments ranked against each other on the rate of women judged effectively treated | Acupressure plus PFMT ranked first; PFMT alone ranked eleventh |
| Chen 2024 | 17 | Conservative treatments of every kind | PFMT with acupuncture reduced symptom severity more than PFMT alone |
| Chu 2025 | 21, with 1,867 women | Acupuncture plus pelvic floor rehabilitation against rehabilitation alone | Questionnaire score 2.3 points lower and leakage on a 1-hour pad test 1.8 g lower with the combination |
| Zhang 2026 | 9, with 865 women | Acupuncture plus PFMT against PFMT alone | Heterogeneity too high to pool the pad test or questionnaire; low to very low certainty |
The questionnaire in Chu's and Zhang's reviews is the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF), scored from 0 to 21. Zhang and colleagues, who searched to October 2024, found the trials so unlike each other that a pooled pad-test or questionnaire figure would mean little, and reported signs of publication bias in the one outcome that could be pooled, the same effective-treatment rate Liu ranked on. They graded the evidence low to very low on GRADE, the scale Cochrane uses to say how much confidence a result supports. All four reviews searched Chinese databases, and each compared acupuncture with training or another active treatment rather than with a sham.
One trial did. Dai and colleagues in 2024 randomised 70 women after a first birth, all with pelvic floor muscle injury, to warm acupuncture at BL54 (Zhibian) or a sham version, each with Kegel exercises, three times a week for 4 weeks. Muscle strength, ultrasound measures of how far the bladder neck descends, questionnaire scores and incontinence all improved more in the acupuncture group. Warm acupuncture heats the needle handle with burning moxa; moxibustion describes the method.
Pelvic organ prolapse
Prolapse is the descent of the bladder, uterus or bowel into the vagina. No completed sham-controlled trial of acupuncture for prolapse appears on PubMed. The EAPOP protocol, published in 2022 by a group at Guang'anmen Hospital in Beijing, planned to randomise 160 women with stage II or III prolapse in six hospitals to electroacupuncture or sham electroacupuncture, 24 sessions over 12 weeks. Its registry entry was last updated in October 2020, gives an estimated primary completion date of December 2021, shows its status as unknown and has no results posted.
The National Institute for Health and Care Excellence (NICE) covers prolapse in NG123, its guideline on urinary incontinence and pelvic organ prolapse in women. For prolapse it recommends lifestyle advice, vaginal oestrogen in some women and, as a first option for stage 1 or 2 prolapse with symptoms, supervised PFMT for at least 16 weeks. Its prolapse recommendations do not mention acupuncture. For urinary incontinence and overactive bladder, a 2006 recommendation carried into the same guideline advises against recommending complementary therapies.
Faecal incontinence
Two studies from outside China report on acupuncture for loss of bowel control. A 2009 pilot study in Italy gave 15 women weekly acupuncture for 10 weeks, with no control group; their continence score fell from a median of 10 to 0, and squeeze pressure in the anal canal rose. A 2024 trial at Singapore General Hospital randomised 85 patients to 30 acupuncture sessions or 3 sessions of biofeedback therapy, both over 10 weeks. At week 15 the acupuncture group reported fewer incontinence episodes, a lower St Mark's incontinence score and better quality of life. The trial compared two active treatments given openly, with ten times as many sessions in one arm, and its authors noted that longer follow-up is needed.
Chronic pelvic pain in women
Starzec-Proserpio and colleagues in 2025 reviewed 38 randomised trials of non-drug, non-surgical treatments in 2,168 women with chronic pelvic pain, searched to December 2023. Multimodal physical therapy lowered pain intensity, with high certainty in the short term. For acupuncture the pooled result did not reach statistical significance and pointed toward the control treatment, and the authors judged the evidence too limited to give it any certainty rating.
In Edinburgh, a 2018 feasibility study randomised 30 women with chronic pelvic pain to electroacupuncture with a traditional Chinese medicine consultation, the consultation alone, or NHS standard care, to test whether a full trial could recruit and keep participants. It found a full trial feasible with changes to its design: 53% of women in the consultation-only group stayed to follow-up, against 80% with electroacupuncture and 87% with standard care. Endometriosis and period pain report the trials in women whose pelvic pain has those causes.
What the evidence could not settle
For pelvic floor problems after childbirth, the pooled trials compared acupuncture added to training with training alone, so the women and the staff knew who received the extra treatment, and a further treatment given in addition can look better for that reason alone. The one sham-controlled trial had 70 women and lasted 4 weeks. For prolapse, the trial designed to answer the question has not reported. For faecal incontinence, the only randomised trial compared acupuncture with a treatment given a tenth as often. For chronic pelvic pain in women, the review that pooled the trials could not say acupuncture did anything, and no trial larger than the Edinburgh feasibility study has followed it. Sham acupuncture explains what a sham control can and cannot rule out.
AcuiQ's pelvic floor dysfunction page lists the protocols individual studies prescribed, each with its citation, as do the pages for postpartum pelvic floor dysfunction, uterine prolapse, faecal incontinence and chronic pelvic pain.