A Randomized, Controlled Pilot Study of Acupuncture Treatment for Menopausal Hot Flashes

Nancy E. Avis, PhD; Claudine Legault, PhD; Remy R. Coeytaux, MD, PhD; May Pian-Smith, MD; Jan L. Shifren, MD; Wunian Chen, MD, LAc; Peter Valaskatgis, MAc

Disclosures

Menopause. 2008;15(6):1070-1078. 

In This Article

Discussion

This pilot study showed a significant decrease in hot flash frequency and index score for both TA and SA groups despite not having been powered for statistical significance. However, there were no observed clinical differences between the two acupuncture groups, as we had hypothesized. These results are remarkably consistent with those of Vincent et al,[34] who also found that hot flash frequency decreased in both TA and SA groups. Vincent et al,[34] however, did not have a UC group and were thus unable to determine whether both acupuncture treatments were equally effective or whether improvement was a result of time. The inclusion of the UC group in our study suggests that the decrease in hot flashes in both acupuncture groups was not due to time alone. The important question remains as to whether SA provides some benefit from the needling or whether the hot flash decrease was due largely to a placebo effect. Because we did not have an attention control group, a placebo effect cannot be ruled out.

Future research might use sham needling that does not penetrate the skin and/or include a placebo control group that does not receive any form of acupuncture, but receives an intervention that controls for attention and expectations, such as a psychoeducation group. It is possible that different acupuncture points might be more effective, but we do not think this is the case. Our acupuncture points were different from those used by Vincent et al,[34] yet our results were remarkably consistent. Future research might also include an objective measure of hot flashes to help determine whether sham acupuncture has a physiologic effect.

This study has several limitations. The time commitment for treatments was difficult for some women who had to travel, and less than half of the women in the TA group received at least 80% of the targeted treatments. To achieve better adherence to treatment, future research needs to make treatments more convenient for women and perhaps provide more incentives for adherence. Second, as a pilot study, the sample size was relatively small and was not powered to find significance on secondary outcomes (nor was it powered to find significance on primary outcomes). Our data, however, do not suggest any consistent trends in these outcomes. In addition, the small sample did not allow for analyses to examine characteristics of women who might benefit most from acupuncture.

The strengths of this study are the inclusion of both the SA and UC groups as controls, a wide range of secondary outcomes, and acupuncture based on TCM diagnosis.

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