Acupuncture cannot be shown to have any positive effect on hot flushes during the menopause. This is the conclusion of a systematic review of literature by three groups in Daejon, Busan (South Korea) and Exeter (UK), published in the current edition of the peer-reviewed journal Climacteric.
Many women are concerned by the unfavourable publicity given to HRT use, but still have to deal with the symptoms which can occur during and after the menopause. A significant minority of women look for alternatives to HRT to deal with these symptoms. Often these alternatives are untested, and it can be impossible to balance the risks and benefits of these treatments against the risks and benefits of conventional treatments or the discomfort of untreated menopause.
The researchers reviewed studies on the use of acupuncture for the relief of hot flushes during the menopause. They identified 106 studies in total, which they eventually narrowed down to the six most relevant to the study. These six studies were randomised controlled trials (RCTs), which included testing the effects of real acupuncture against the effect of sham acupuncture. Only one RCT reported favorable effect of acupuncture on the frequency and severity of hot flush after 4 weeks follow-up, while the other five RCTs demonstrated no such effects.
Researchers caution that the quality of good studies is not great, and that because of this the use of acupuncture cannot be completely ruled out. However, the available literature indicates that acupuncture does not seem to be effective in the treatment of menopausal hot flushes.
Lead researcher, Dr Myeong Soo Lee (Korea Institute of Oriental Medicine, South Korea) said
Although the availability of good Randomised Controlled Trials is too small to draw any firm conclusion, in general the evidence from sham-controlled RCTs for the effects of acupuncture for treating menopausal hot flush is not convincing. We would always recommend that women wanting relief from menopausal symptoms consult their clinician before undertaking any course of treatment.
Commenting, Dr David Sturdee (President of the International Menopause Society) said:
There's no doubt that many women need relief from the symptoms associated with the menopause. They need to make sure that the treatment they choose works, and is right for them. I would always recommend that a woman consult her clinician before starting any treatment.
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Notes for Editors
This press release is based on the following paper Acupuncture for treating menopausal hot flushes: a systematic review, which is published in the journal 'Climacteric' (Lee MS, Shin B-C, Ernst E., Climacteric 2009;12:1625-25, February 2009). Climacteric is the journal of the International Menopause Society.
Conflict of Interest: none reported
Source of funding: M. S. Lee was supported by the Acupuncture, Moxibustion and Meridian Research Project of Korea Institute of Oriental Medicine.
Acupuncture for treating menopausal hot flushes: a systematic review
M S. Lee, B.-C. Shin* and E. Ernst†
Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea; *Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Pusan National University, Pusan, South Korea; †Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK
Objective To assess the effectiveness of acupuncture as a treatment option for menopausal hot flushes.
Design We have searched the literature using 17 databases from inception to May 2008, without language restrictions. We included randomized, clinical trials (RCTs) of acupuncture versus sham acupuncture. Their methodological quality was assessed using the modified Jadad score.
Results In total, six RCTs could be included. Four RCTs compared the effects of acupuncture with needle acupuncture on non-acupuncture points. All of these trials failed to show specific effects on menopausal hot flush frequency, severity or index. One RCT found no effects of acupuncture on hot flush frequency and severity compared with penetrating sham acupuncture on acupuncture points that are not relevant for the treatment of hot flushes. The remaining RCT tested acupuncture against nonpenetrating acupuncture on non-acupuncture points. Its results suggested favorable effects of acupuncture on menopausal hot flush severity. However, this study was too small to generate reliable findings.
Conclusion Sham-controlled RCTs fail to show specific effects of acupuncture for control of menopausal hot flushes. More rigorous research seems warranted.