Many women report vasomotor symptoms, including hot flashes and night sweats, during the menopausal transition. While estrogen is clearly one of the most effective treatments for vasomotor symptoms, recent concerns regarding the use of hormone replacement therapy (HRT) have made treaters much more reluctant to recommend HRT, even for short-term management of vasomotor symptoms. A recent study has demonstrated that acupuncture may be an effective non-hormonal treatment for vasomotor symptoms.
In this prospective study conducted in Sweden, 102 postmenopausal women were recruited for two studies performed in parallel. In the first study, women were randomized to receive either transdermal estrogen or placebo. In the second study, women were randomized to three groups and received oral estrogen, acupuncture or applied relaxation for 12 weeks. Menopausal symptoms were measured with daily logs.
The number of hot flashes in a 24 hour period decreased significantly after 4 and 12 weeks in all treatment groups. Both at 4 and 12 weeks, acupuncture decreased the number of flashes more than placebo. Scores on the Kupperman menopausal index decreased in all groups except the placebo group.
While the results of this study are encouraging, other studies have yielded mixed results. A study conducted at Stanford University demonstrated that acupuncture was more effective than placebo in reducing both the severity and frequency of hot flashes in a group of postmenopausal women. Another study of hot flashes in breast cancer patients did not show acupuncture to be effective. A third study in menopausal women was also negative, although this study was much shorter in duration (with only 5 weeks of active treatment).
Ruta Nonacs, MD PhD
Zaborowska E, Brynhildsen J, Damberg, S et al. Effects of Acupuncture, Applied Relaxation, Estrogens and Placebo on Hot Flushes in Postmenopausal Women: an Analysis of Two Prospective, Parallel, Randomized Studies. Climacteric 2007 ;10(1):38-45. (Click here for full text)
I just read a recent study on breast cancer patients responding well to yoga as a way to ease menopause symptoms (here it is from the Wash Po: http://www.washingtonpost.com/wp-dyn/content/article/2008/03/08/AR2008030801120.html?referrer=emailarticle
One point the article brought up: medications used in breast cancer treatment might make hot flashes and other menopause symptoms worse. Maybe this also impacts how/where/when acupuncture can be used? Maybe it needed to be applied to different bladder points for max. effectiveness?
I’ve also found the Women to Women website (www.womentowomen.com) to be an invaluable tool in learning more about holistic approaches to treating hot flashes. Eating a nutritious diet, exercise, and certain vitamins and minerals (along with things like acupuncture, yoga, etc.) go a long way in helping women make the transition through menopause. Many great articles for people interested in this topic!
Unfortunately the study groups did not include one where participants were given fake acupuncture. Since acupuncture is, according to the best studies, an elaborate placebo, it is expected that acupuncture would yield a greater placebo response than meditation,
This article is from 2008. It is now 2016, and as the studies get better and things like retractable needles and toothpicks can be used, we are not seeing that acupuncture just elicits the placebo effect, and that it is not effective for menopausal symptoms. See
http://scienceblogs.com/insolence/2016/04/25/yet-again-acupuncture-does-not-work-for-menopausal-hot-flashes/
In the world of prior plausibility, one should actually demonstrate that “qi” which is claimed to be manipulated by inserting needles into the body, has never been demonstrated to exist. In a world where we can measure the spin on a single electron, doesn’t this strike you as strange?
People have suffered severe complications and even death from acupuncture treatments. Shouldn’t it be adequately tested before offering it as a treatment? And if good, scientific studies show it doesn’t work, shouldn’t it be abandoned as a treatment?
Oh for an edit function. Acupuncture just elicits the placebo effect.
If humans were only as predictable as electrons…
You bring up some very important points. We do not fully understand how acupuncture works, and in the absence of this important information, it may be difficult to recommend these interventions. That said, we use many medications without fully understanding how they work.
Many menopausal women with hot flashes cannot or do not want to use estrogen replacement therapy. Certain antidepressants are effective for managing hot flashes but have side effects that limit their use. It is important, therefore, to gather information on other options.
I would also have to ask what’s so bad about a placebo response if the patient feels better? We are only beginning to really understand what a placebo response is, and we now understand that placebos can have clinically relevant effects on physiology:
http://harvardmagazine.com/2013/01/the-placebo-phenomenon
If toothpicks work, let’s use toothpicks.
Safety is obviously an important issue. My understanding is that acupuncture carries much less risk than other interventions. If you have references suggesting otherwise, please send them my way.