Side Effects and Risks of Fertility Acupuncture | Regarding Internal Bleeding, Fatigue, and Pain
Regarding the side effects and risks of fertility acupuncture, we will honestly explain everything from common issues like internal bleeding, fatigue, and pain, to points of caution related to pregnancy.
In Eastern medicine, since acupuncture and moxibustion work on the body, it has been considered natural for some kind of reaction to occur. That is precisely why we believe that not obscuring these risks and communicating them honestly is one way to approach acupuncture and moxibustion, which have a long history. In this article, we will explain the common risks of acupuncture and moxibustion, such as internal bleeding, fatigue, and pain, as well as points of caution related to pregnancy, without being overly alarmist or dismissive.
Who this page is for
Those considering fertility acupuncture but are worried about side effects and risks
Those who have experienced internal bleeding or fatigue and want to know if it is a normal reaction
Those who want to know about the risks of acupuncture and moxibustion during pregnancy or early pregnancy
(The above is an inference based on search trends and is not definitive.)
Please note that this article is not intended for the diagnosis or treatment of specific symptoms or diseases. Please be sure to consult a medical institution for judgments regarding your own condition.
Explanation of terms
Internal bleeding: When a needle is inserted, subcutaneous capillaries are damaged, leaving a bruise-like mark.
Healing crisis (Kouten-hanno): Sometimes used to refer to temporary physical changes that appear after treatment, but it is not a strictly defined medical term (discussed later).
Eastern medical concepts and theories
Eastern medicine is a medicine with its own unique system born from the accumulation of thousands of years of clinical observation. It is a different paradigm from Western medicine, but it is not inferior. In Japan, a chapter on acupuncture and moxibustion was included in the 984 AD 'Ishinpō', and during the Edo period, acupuncture was considered an official medical field by the shogunate (for details, please see 'What is Fertility Acupuncture | Honestly Explaining What Can and Cannot Be Done').
In Eastern medicine, temporary fatigue or drowsiness after treatment is sometimes viewed as a reaction in the process of the body becoming balanced. This is a concept based on the idea that it occurs in the process of changes in the circulation of 'Qi and Blood (Kiketsu)'. However, it is not appropriate to use this as a reason to treat risks and side effects as evidence of effectiveness, such as saying 'it is working because you feel fatigued.' Precisely because we value Eastern medicine, we believe it is necessary to accurately convey fatigue and internal bleeding as one of the body's reactions and risks associated with the treatment.
(The above is a unique theoretical system that Eastern medicine has built up through many years of clinical observation. It is based on a philosophy different from Western medicine, and the effectiveness of individual theories has not been verified by modern medicine.)
Tests and treatments generally performed at medical institutions
Risks regarding medical procedures in fertility treatment (egg retrieval, embryo transfer, etc.) are explained by doctors at medical institutions. This article deals only with the risks associated with acupuncture and moxibustion treatment, which are different from the risks of the medical procedures themselves.
What is done in acupuncture and moxibustion
Fertility acupuncture is a treatment aimed at improving physical condition using acupuncture and moxibustion. Although thin needles are used, as it is a treatment that pierces the skin, certain risks are unavoidable. The specific details are introduced below.
What is known from research
Pain, internal bleeding, and fatigue are widely known as common risks associated with acupuncture and moxibustion.
What is not yet known
Regarding the frequency and severity of internal bleeding, fatigue, etc., there are significant differences depending on the practitioner's skill and individual constitution, and uniform figures have not been confirmed.
Based on this, in this article, we will not use expressions that treat risks as proof of effectiveness, such as "internal bleeding or fatigue is a sign that it is working."
Our clinic's approach
At our clinic, we check your physical condition and state of health before treatment, and perform the procedure after explaining the risks in advance. In particular, during periods that require consideration of the body's condition, such as early pregnancy, we pay attention to adjusting the amount of stimulation and selecting the treatment site. If you have any symptoms or concerns, please do not hesitate to let us know, whether before or after the treatment.
Anonymous cases and in-house data
At our clinic, we have compiled records of 374 people and a total of 425 cases that resulted in pregnancy over the 7 years from 2019 to 2025 (details are introduced in the article "For those looking for fertility acupuncture in Tokyo | How to choose an acupuncture clinic you won't regret"). However, this data does not include records regarding the frequency of side effects and risks.
Guidelines for clinic visits
Guidelines for the frequency of clinic visits are introduced in "Frequency and duration of fertility acupuncture visits | Explained from in-house data."
Costs
In principle, acupuncture and moxibustion treatments are not covered by health insurance and are fully out-of-pocket expenses. Our clinic's costs are as follows (tax included).
Item Cost Initial consultation fee 5,500 yen Acupuncture, manual therapy, and manipulative therapy (1 session) 8,000 yen
Initial total 13,500 yen From the 2nd session onwards 8,000 yen
For details on costs, please refer to "How much does fertility acupuncture cost? Explaining expenses, number of sessions, and medical expense deductions."
Risks and points to note
The general risks associated with acupuncture and moxibustion treatment are as follows.
Pain: You may feel temporary pain at the acupuncture site. The needles used are extremely thin, and individual sensitivity to pain varies.
Internal Bleeding: Internal bleeding (bruising) may occur at the acupuncture site. It generally fades naturally within a few days to a week, though some people may be more prone to it depending on their constitution.
Fatigue/Lethargy: Some people feel temporary fatigue after treatment. In most cases, this subsides within a few hours to the next day, but please consult your practitioner if it persists or if symptoms are severe.
Cases where you should prioritize visiting a medical institution
In the following cases, it is recommended to visit a medical institution promptly rather than an acupuncture clinic.
If you have symptoms that are considered urgent, such as severe abdominal pain or heavy bleeding.
If you feel the internal bleeding is beyond the normal range, such as covering a wide area or not disappearing for a long period.
If physical changes after treatment persist for more than a few days and you are concerned.
Acupuncture is not a substitute for examination, diagnosis, or treatment at a medical institution.
Frequently Asked Questions
Q1. Is internal bleeding proof that it is working?
No, that is not necessarily true. Internal bleeding is a common reaction associated with the procedure that occurs when a needle touches a subcutaneous capillary, and it is not an indicator of effectiveness.
Q2. How long does post-treatment fatigue last?
In most cases, it subsides within a few hours to the next day, but there are individual differences. Please consult your practitioner if it persists or if symptoms are severe.
Q3. Is it safe to receive acupuncture during early pregnancy?
Yes. It is perfectly fine. However, we perform treatments at our clinic using gentle and soft stimulation.
Q4. Does acupuncture hurt?
The needles used are extremely thin, and individual sensitivity to pain varies. You can consult with us regarding the adjustment of stimulation levels.
Q5. What should I do if I am worried about side effects?
If you inform us of your physical condition or any concerns before the treatment, we will take them into account when adjusting the stimulation level and selecting treatment sites. If you have any symptoms that concern you, please do not hesitate to tell us even after the treatment.
Summary
Fertility acupuncture has common risks such as internal bleeding, fatigue, and pain. While there is no need to be overly anxious about these, it is important to receive treatment with a proper understanding of them. Expressions such as "it is working because there is internal bleeding" substitute risks for evidence of effectiveness, and our clinic does not provide such guidance. If you have any concerns, please feel free to consult us.
References
Acupuncture for women undergoing in vitro fertilization: An updated systematic review and meta-analysis with trial sequential analysis. (2025) https://www.sciencedirect.com/science/article/abs/pii/S0020748925001063
Japan Health Insurance Association "How to use acupuncture, moxibustion, and massage services" https://www.kyoukaikenpo.or.jp/g3/sb3080/r140/
Author/Supervisor/Update Date
Written by: Shimpei Fukumoto
Supervised by: Shimpei Fukumoto (Director of Fukumoto Acupuncture Clinic, Licensed Acupuncturist/Moxibustionist)
Update Date: August 13, 2026