Acupuncture may help ease troublesome menopausal symptoms

Author: Caroline White
Acupuncture may help ease troublesome menopausal symptoms

A brief course of acupuncture may help to ease troublesome menopausal symptoms, suggests a small study* published in the online journal BMJ Open.

Among women with moderate to severe symptoms, acupuncture was associated with reductions in hot flushes, excess sweating, mood swings, sleep disturbance, and skin and hair problems, although a placebo effect can’t be rule out, say the researchers.

Hot flushes are one of the most common symptoms and can go on for several years. Others include heavy sweating, emotional vulnerability, sleep disturbances, fatigue, ‘fuzzy’ brain, joint pain, vaginal dryness and reduced sex drive.

Hormonal and other drug treatments all come with side effects. And the evidence for alternative approaches, such as exercise, relaxation, and herbal/dietary remedies, isn’t very convincing, say the researchers.

Previous research suggests that acupuncture might be helpful, but design flaws or quality issues have undermined the findings, say the researchers.

In a bid to try and address this, they randomly allocated 70 menopausal women to either five weekly 15-minute sessions of standardised Western medical acupuncture, using pre-defined acupuncture points, or no acupuncture until after six weeks.

Each session was delivered by Danish family doctors who had additionally trained in acupuncture and had been practising it for an average of 14 years.

Each participant completed a validated Meno Scores (MSQ) questionnaire–designed to measure outcomes from the patient’s perspective–before their first session and then again after three, six, right, 11 and 26 weeks.

The MSQ comprised 11 graded scales for each of: hot flushes; day and night sweats; general sweating; sleep disturbance; emotional vulnerability; memory changes; skin and hair problems; physical symptoms; abdominal symptoms; urinary and vaginal symptoms; and fatigue.

At six weeks most (80%) of the women in the acupuncture group, said that they felt that the sessions had helped them. And they were significantly less troubled by hot flushes–a difference that was already apparent after three weeks.

Statistically significant differences also emerged between the two groups in the severity/frequency of day and night sweats, general sweating, sleep disturbances, emotional and physical symptoms, and skin and hair problems.

The drop-out rate was low, with just one woman failing to complete all five acupuncture sessions, and no serious side effects were reported.

The researchers acknowledge that the treatment period lasted just five weeks and that a major difficulty in all acupuncture trials is the lack of a proper comparator.

This means that a placebo effect can’t be ruled out, and further discussions are warranted about what level of evidence is therefore acceptable, particularly when it’s impossible to accurately explain the underlying factors behind the results, they add.

Nevertheless, they suggest that their findings show that a brief course of acupuncture by suitably trained professionals is feasible in routine primary care.

“Not all menopausal women need or request treatment, and we believe this acupuncture intervention is most relevant to women who experience moderate-to-severe menopausal symptoms,” they write.

“Acupuncture for menopausal symptoms is a realistic option for women who cannot, or do not wish to use [hormone therapy],” they conclude.

“Menopausal flushes will affect most women at some point. Hormone replacement therapy (HRT) is an excellent treatment but is not tolerated by all women. Also, HRT cannot be given to women with certain types of cancer. This leaves a huge ‘gap in the market’ for simple and safe therapies to reduce hot flush symptoms,” points out Dr Channa Jayasena, member of the Society for Endocrinology and clinical senior lecturer and consultant in reproductive endocrinology at Imperial College London & Hammersmith Hospital. 

“The authors show that acupuncture can reduce flush symptoms. However, we also know that flush symptoms can more than halve with a placebo. I suspect that most (if not all) of the effect of acupuncture is a placebo effect; but is that a really bad thing? Anything that is safe, affordable and helps the well-being of patients while reducing symptoms is worth considering if HRT is not an option.”

*Lund KS, Siersma V, Brodersen J, et al. Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study).