Acupuncture Ineffective in Relieving Hot Flashes

Ricki Lewis, PhD

January 20, 2016

Acupuncture was no more successful in reducing the number or intensity of hot flashes per week than a sham procedure, according to a study published online January 18 in the Annals of Internal Medicine.

"We found no evidence of an advantage of acupuncture over sham acupuncture on quality of life, anxiety, or depression," Carolyn Ee, MBBS, from the University of Melbourne, Australia, and colleagues conclude.

Hot flashes affect up to 75% of menopausal women, but many women are hesitant to use hormone replacement or selective serotonin reuptake inhibitors because of the associated risks. Studies of the efficacy of another approach, acupuncture, have been too flawed to yield reliable conclusions, according to the authors.

To get around those previous issues, they conducted a randomized controlled clinical trial of acupuncture. They recruited women from Australia in late menopausal transition or postmenopause who had a hot flash (HF) score of at least 14 or who had kidney yin deficiency.

The researchers derived HF score from the numbers of mild, moderate, severe, and very severe vasomotor events multiplied by 1, 2, 3, and 4, respectively, that occurred during a week, divided by 7. Kidney yin deficiency is an imbalance in Chinese medicine used to select acupuncture sites. Two of the authors developed the protocol based on kidney yin deficiency. Participants received 10 treatments over the course of 8 weeks.

The acupuncturists administered sham treatments using a device that is a blunt needle in a plastic ring and guide tube held to the skin with an adhesive ring (the base unit). With pressure, the needle retreats from the skin, but feels like a needle stick. Sham insertions were not at true acupuncture points, and the same base unit was used for participants in both groups. The acupuncturists performed the standard 10-minute manipulation after true acupuncture or sham insertion.

A questionnaire administered at baseline asked about demographic characteristics, acupuncture experience, and risk factors for vasomotor events. Two other instruments assessed health-related quality-of-life and anxiety and depression symptoms.

Acupuncture was performed on 163 women, and the sham procedure on 164, with 16% of the acupuncture group and 13% of the sham group lost to follow-up. Mean HF scores after acupuncture were 15.36 and after sham treatment 15.04, with mean difference 0.33 (95% confidence interval [CI], −1.87 to 2.52; P = .77). Both groups had an approximately 40% improvement by the end of the study. No serious adverse events were reported.

Demographic characteristics and risk factors for vasomotor events were similar for the groups, although more participants in the sham group reported a past positive experience with acupuncture.

Limitations of the study include use of an imperfect sham device and simplified acupuncture, the fact that most participants were Caucasian, and exclusion of women who had undergone bilateral salpingo-oophorectomy or breast cancer.

Support was provided by the National Health and Medical Research Council. The authors have disclosed no other relevant financial relationships.

Ann Int Med. Published online January 18, 2016. Abstract

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