A Review of Acupuncture for Menopausal Problems

This comprehensive review examines the scientific evidence on the use of acupuncture to treat hot flashes in women in menopause, both natural and induced by medical treatments. The authors analyzed controlled studies that investigated the efficacy of acupuncture compared with usual care and placebo controls. The main study, known as ACUFLASH, was a multicenter randomized clinical trial that included 267 postmenopausal women experiencing seven or more hot flashes per day. Participants were divided into two groups: one received 10 sessions of individualized traditional Chinese acupuncture plus self-care guidance, while the control group received only self-care guidance.

The results showed that acupuncture was superior to self-care alone, with a reduction of 5.8 hot flash episodes per day in the acupuncture group versus 3.7 in the control group, a statistically significant difference of 2.1 episodes (P < 0.001). The intensity of symptoms also decreased significantly more in the acupuncture group (3.2 points) compared with the control group (1.8 points). In addition, there were significant improvements in health-related quality of life, particularly in the vasomotor, sleep, and somatic symptom domains. The review also examined five smaller studies that compared real acupuncture with superficial needling controls at non-specific points.

Interestingly, these studies failed to demonstrate significant differences between real acupuncture and control, suggesting that the effect may not depend on the specific location of the points or the depth of insertion. For induced menopause, particularly in cancer patients who cannot use hormonal therapy, the evidence is also encouraging. Studies show that 79% of patients achieved a 50% reduction in the frequency of hot flashes, with effects maintained for up to 12 months after treatment. The proposed mechanisms involve the modern conceptualization of acupuncture as neurological stimulation, affecting neurotransmitters such as serotonin and beta-endorphins in the central nervous system, thus influencing the thermoregulatory center in the hypothalamus.

The theory suggests that the hormonal changes of menopause narrow the thermoneutral zone, causing small increases in body temperature to trigger hot flashes. Acupuncture may stabilize this system through modulation of endogenous endorphins and serotonin. The review concludes that acupuncture offers a clinically useful effect for hot flashes that goes beyond natural remission, being particularly valuable for women seeking alternatives to hormonal therapy or those with contraindications to its use.