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When compared with usual care, acupuncture treatments may
significantly reduce hot flashes and other vasomotor symptoms and
improve some quality-of-life measures associated with menopause. These
findings, the results of a year-long NCCIH-funded study, conducted by
researchers from Wake Forest School of Medicine and Duke University
School of Medicine, were published in the journal Menopause.
The study population included 209 women age 45–60 who had at least
four vasomotor symptoms per day and had not had a menstrual period for
at least 3 months. The researchers’ major goal was to compare true
acupuncture to no acupuncture for short- and medium-term clinical
effects and for safety (thus, sham acupuncture was not included). The
primary outcome was the number and severity of daily vasomotor symptoms.
Multiple secondary outcomes pertained to health-related quality of
life, such as hot flash interference with daily activities, sleep
quality, and mood or memory symptoms.
After initial assessment, each participant was randomized to one of
two groups. The first group received individualized acupuncture
treatments during the first 6 months and usual care for the second 6
months. In the second group (the control group), that order was
switched: they had usual care for the first 6 months and acupuncture for
the second 6. Acupuncture care consisted of up to 20 treatments (the
specific number was determined by the participant and practitioner); was
given by licensed, experienced acupuncturists in a “real world”
clinical setting; and included diagnoses from traditional Chinese
medicine, a history, a physical examination, and an individualized
treatment plan. All participants kept a daily diary on the frequency and
severity of their vasomotor symptoms. They underwent study assessments
at 2, 4, 6, 9, and 12 months after group assignment.
The researchers found that acupuncture significantly reduced
vasomotor symptoms by as much as 36.7 percent and improved several
quality-of-life measures, such as hot flash interference, sleep quality,
physical symptoms, memory symptoms, and anxiety. All these benefits
persisted at least 6 months beyond the end of acupuncture treatment. The
researchers also gained insights about “dosing”; they began to see
significant benefits after three acupuncture treatments, and they saw
maximum clinical benefits after a mean of eight treatments. Three women
reported adverse effects: two reported pain during treatment and a third
reported numbness.
The authors offer some cautions when interpreting these results. For
example, it isn’t clear whether benefits on sleep and other symptoms
were directly from acupuncture or from reduced vasomotor symptoms;
self-reporting has limitations; and there could be, as in clinical
practice, bias from potential confounders. However, they conclude that
their results ultimately support a significant and persistent benefit of
acupuncture on menopausal vasomotor symptoms. Future explorations may
include mechanisms and the role of nonspecific effects (such as
receiving care and attention from a practitioner) in the observed
clinical responses.
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