Acupuncture and Traditional Chinese Medicine for Hot Flushes in Menopause: A Randomized Trial

This randomized controlled trial investigated the efficacy of an integrated Traditional Chinese Medicine system to treat menopausal hot flushes and associated symptoms. Conducted in Italy between 2005 and 2008, the study included 100 women in spontaneous menopause (45-56 years) who experienced at least three daily episodes of hot flushes. Participants were randomized into two groups: Group A immediately received complete treatment (TCM-based diet, Tuina self-massage, and acupuncture), while Group B initially received only diet and self-massage, with acupuncture starting after 6 weeks. The acupuncture protocol consisted of 12 sessions over 6 weeks, using specific points such as GV-23, CV-22, BL-2, LI-11, LI-4, SP-10, SP-6, GV-20, CV-4, CV-6, ST-37, and LR-3, with differentiated electrostimulation (dispersion at 100 Hz and tonification at 40 Hz).

Additionally, seven-star (plum-blossom) needle therapy was applied to the dorsal C7-T5 region. The diet was personalized according to TCM yin-yang principles, with most participants receiving foods of yin nature to balance the yang symptoms of hot flushes. Results demonstrated statistically significant improvements (p < 0.001) in Group A compared with Group B for hot flushes, sudden sweating, sleep disturbances, irritability, bone pain, depression, headache, chest pain, memory loss, vaginal dryness, skin changes, urinary problems, and genital pruritus. Group A showed an average reduction of 1.3 points in hot flushes and 1.2 points in sudden sweating compared with the control group.

Notably, 82% of women in Group A reported overall improvement in health (40% definitive improvement, 42% mild improvement), while 86% of Group B reported no change. Specifically for menopausal symptoms, 94% of Group A reported improvement (64% definitive, 30% mild) versus only 8% of Group B. At 4-month follow-up, most benefits were maintained, except for vaginal dryness, which showed some regression. The study suggests that diet and self-massage alone were not sufficient to significantly relieve symptoms, indicating that acupuncture was the principal therapeutic component.

Proposed mechanisms include effects on the hypothalamic-pituitary-ovarian axis, modulation of neurotransmitters such as serotonin and β-endorphins, and regulation of nocturnal melatonin secretion. Limitations include the non-blind control design and the inability to determine which specific component of acupuncture (particular points, electrostimulation, or plum-blossom therapy) contributed most to the results. This study provides robust evidence for acupuncture as an integrated treatment for menopausal symptoms, especially relevant for women who cannot use hormone therapy because of oncologic risks or medical contraindications.