Reflexology and Fertility

According to a recent study published in Fertility and Sterility, foot reflexology may not significantly improve ovulation or pregnancy rates among women with fertility problems.

Foot reflexology is a type of therapy that involves applying pressure to specific areas of the feet called "reflex points." These points are thought to correspond to other parts of the body. Proponents claim that pressing on these points may have beneficial health effects. Despite a lack of evidence, foot reflexology is popularly used in the United Kingdom to treat infertility.

This latest study included 48 women with fertility problems resulting from polycystic ovarian syndrome, a hormonal disorder that is characterized by irregular menstrual periods, excessive hair growth and weight gain. The women were randomly assigned to receive either eight sessions of foot reflexology or a sham therapy with gentle massage for 10 weeks. None of the women had experienced foot reflexology before this study.

Both groups had similar ovulation and pregnancy rates. Eleven out of the 26 women in the reflexology group (42.3 percent) had serum progesterone levels indicative of ovulation, and four women (15.3 percent) became pregnant. In the massage group, 10 out of the 22 (45.5 percent) women ovulated and two (nine percent) became pregnant.

The results of this study are limited by the small sample size. The authors noted that recruitment was difficult, and they did not meet their goal sample size of 104 women. Also, the sham treatment may not have been an adequate control since the massage may have had a relaxing effect on the body.

Reflexology has been studied for several other medical conditions, such as anxiety and pain, but the available evidence is limited.

For more information about reflexology, please visit Natural Standard’s Health & Wellness database.

Comments

[Barry]

Does this paper mention the efficacy of massage or touch, in general regarding fertility? I would have liked to see a control group who did not receive any specific touch therapy since the reviewer suggests that it may have had some measurable effect.

[haley]

Reflexology does seem to be gaining notice and respect. I noticed an NPR report in 2008 that said the huge International Medical Center in Jeddah, Saudi Arabia, was going to include an alternative treatment center that would include reflexology. Apparently, this Center has a relationship with the Cleveland Clinic Foundation.

[ASR]

I had never heard of foot reflexology, so this is quite the interesting article. Is it used in the US? I would be interested in seeing other studies using this therapy for infertility given this study's limitations.

[RG]

I have a friend who is having trouble conceiving. Because she and her husband would very much like to have a baby, my friend has to endure a daily regiment of rather painful injections in order to increase her chances of ovulation. In addition to the shots themselves, her condition is a source of great stress to her, as I imagine it is to anyone struggling with infertility (for example, because of the polycistic ovarian symptoms). This is an interesting study on the effectiveness of reflexology for the treatment of infertility, but for the sake of my friend, I wish the results were more positive. An inherently pleasant and relaxing treatment would have been wonderful for a condition that is so wrought with anxiety.

[C. Roe]

I think the ability to effectively blind would be difficult to do in any study involving reflexology or physical manipulation. According to this study, in the true reflexology group, 11 out of 22 (50%) reported that they had received the true treatment, compared with 4 out of 17 (23.5%) in the sham group. All the others in both groups were unsure which group they were in. No one thought they were in the sham group. I think it would be difficult to evaluate any placebo response in studies such as these.

[Laurence]

It seems like the best control in this case would simply be to deliver no treatment to the control group. This would eliminate the question of whether or not the sham had an effect on the results. Either way, it doesn’t really matter in this case because they did not reach their required sample size. If you don’t reach your required sample size, the results are not statistically significant.

[Amiya]

I took a look at the NS monograph on reflexology and infertility is not mentioned, but other conditions such as depression, edema (pregnancy related) and labor are mentioned. However, all received a "C" grade for quality of evidence. I would be interested in seeing a similar study conducted in a larger population. Also, I have heard that other factors such as diet (avoiding caffeine, alcohol, etc.) and taking certain supplements can help with infertility. I wonder if these suggestions have any scientific evidence behind them.

[Maurice]

I don't really believe reflexology is effective for infertility because I think the most important thing is to know what day in the month that I am most fertile (can do ovulation test) to conceive with my husband. I think reflexology is good for other conditions such as when there is pain in the foot or some other minor thing, but not infertility.

[Lynn]

In women who are not ovulating though, no time in their cycle will be fertile since no egg is released. So many factors can play a role in ovulation. Stress, obesity, nutritional status and other factors can all influence a woman's cycle and whether or not she ovulates. Some women experience cyclical bleeding, but may in fact be anovulatory.

A great book to check out is "Taking Charge of Your Fertility" by Toni Weschler. It is an excellent book for both natural birth control and pregnancy achievement. It talks about monitoring basal body temperature, cervical position changes and cervical fluid changes to determine if a woman has ovulated or not.

[Chris]

It certainly seems that supportive data are lacking a bit. There are probably other more effective measures, such as mentioned by Maurice above, to be taken first. However, I find that often times an integrative approach to things is the best method. So perhaps reflexology would be a good complementary therapy to some of the more proven methods to increase fertility.

[lo]

I am not very familiar with reflexology, so I took a look at the monograph on Natural Standard, and I found that reflexology is primarily based on Western physiological concepts of reflexes and the nervous system, rather than Oriental concepts of energy meridians or acupuncture points.Thus, reflexology was not introduced as a form of energy medicine per se, but rather as a form of massage therapy and bodywork based on Western anatomical principles. After reading this, I think reflexology can help with anxiety or mild pain but maybe not so much with ovulation or pregnancy rates. There definitely should be better-conducted studies evaluating the efficacy of reflexology for this indication.

[bbm]

I don't see how these results can be reliably correlated to either reflexology or massage. Over 10 weeks, all hormone levels fluctuate, and there's no way to know the timing of treatment during the menstrual cycle unless you took serum hormone levels at each treatment. A more precise method must be developed to study this treatment option. Hormone levels must be taken at baseline and before and after each treatment to find a correlation. Right now, these results could have been purely by chance. Also, in order to eliminate the effect of relaxation, other relaxing therapies besides massage should be compared.

[pr]

A major limitation of this study is the sample size. The authors wanted 104 women, which were hard to get because of their inclusion criteria. In order to broaden their population and add strength to their results, they could recruit women without gynecologic problems such as PCOS. They could look for women who have regular menstrual periods and may or may not have trouble getting pregnant. This might be a better starting point for research in this area since baseline values could be obtained in women with normal progesterone levels. Once the effects of reflexology can be correlated to those levels, specific populations that might benefit from this treatment can be determined, like women with abnormal levels of progesterone or other hormones due to various medical problems.

[Crystal]

I have never heard of foot reflexology before, but it seems like a very interesting new field. Along the same line, it seems like foot massages also relieves a lot of tension and probably contributes to the overall feeling of well-being, which would help with fertility. Since the science behind this technique is not well known, a lot more research needs to be done on a large scale in order to convince skeptics about the potential benefits of this therapy, if there are any. It does not seem to have major adverse effects, and the idea of something resembling a foot massage would be alluring to prospective patients, so designing a large-scale study would not be as difficult as in the case of some new medications.

[tubal reversal]

The search for a diagnosis to explain ovarian cysts should be done with complete awareness of all of the possibilities. Ovarian cysts can result from a devastating process such as ovarian cancer, or may be simply normal, enlarged follicles in a young patient who is ovulating. The reason for the cyst(s) must be determined in order to provide appropriate medical care.