Acupuncture May Improve Quality of Life in Menopausal Women: A Meta-Analysis of Randomized Controlled Trials
Li et al. · Complement Med Res · 2017
OBJECTIVE
Evaluate whether acupuncture relieves menopausal symptoms and improves quality of life
WHO
Perimenopausal and postmenopausal women
DURATION
Treatments of 2-3 months, 1- to 3-month follow-up
POINTS
Various points used, compared with sham acupuncture
🔬 Study Design
Acupuncture
n=209
True acupuncture 2-3x/week
Control
n=210
Sham acupuncture (placebo)
📊 Results in numbers
Reduction in total MRS score at end of treatment
Improvement maintained at follow-up
Improvement in psychological symptoms
Improvement in somatic symptoms
📊 Outcome Comparison
Reduction in MRS score (0-44)
This meta-analysis suggests that acupuncture may help menopausal women feel better, reducing symptoms such as hot flashes, irritability, and sleep problems. Although the results are promising, the quality of evidence is still low, and further studies are needed for confirmation.
Article summary
Plain-language narrative summary
This meta-analysis examined the efficacy of acupuncture in treating menopause-related symptoms through a systematic review of randomized controlled trials. Investigators analyzed six studies including a total of 419 perimenopausal and postmenopausal women, comparing true acupuncture with sham acupuncture (placebo). The primary objective was to determine whether acupuncture can relieve menopausal discomfort and improve health-related quality of life. The methodology involved a comprehensive search of medical databases between 2010 and 2016, including PubMed, Cochrane Library, and Chinese databases.
Inclusion criteria were rigorous, focusing only on studies that used the Menopause Rating Scale (MRS) as the outcome measure. This scale evaluates 11 menopause-related symptoms in three dimensions: psychological (mood, anxiety, sleep), somatic (hot flashes, joint problems), and urogenital (dryness, urinary problems). Results showed that acupuncture was effective in significantly reducing MRS scores both at the end of the treatment period and during the 1- to 3-month follow-up. This indicates that women who received true acupuncture experienced greater symptom relief compared with those who received placebo treatment.
Subgroup analysis revealed improvements in all three scale dimensions: psychological symptoms (depression, anxiety, sleep problems), somatic symptoms (hot flashes, sweating, muscle pain), and urogenital symptoms (vaginal dryness, urinary problems). Typical treatments consisted of 20- to 30-minute sessions, 2-3 times per week for 8-12 weeks. Various acupuncture point protocols were used in the included studies, reflecting varied clinical practice. However, the authors emphasize that the overall quality of evidence was considered low to moderate due to several methodological limitations.
Many studies presented risk of bias due to small sample size, lack of appropriate clinical trial registration, and insufficiently detailed protocols. In addition, there was significant heterogeneity among studies regarding treatment protocols, session frequency, and duration. Clinical implications suggest that acupuncture may be a beneficial therapeutic option for women seeking alternatives or complements to menopausal hormone therapy. The findings are especially relevant given that many women seek nonpharmacologic treatments due to concerns about the risks associated with hormone therapy, such as increased risk of cardiovascular disease and cancer.
The relatively safe profile of acupuncture, with few reported adverse effects, makes it an attractive option. However, the researchers caution that additional studies of higher methodological quality are needed to establish more definitive clinical recommendations on the use of acupuncture in menopause.
Strengths
- 1Comprehensive analysis of multiple menopausal symptom domains
- 2Use of validated scale (MRS) for outcome assessment
- 3Evaluation of both immediate and follow-up effects
- 4Comparison with appropriate placebo control
Limitations
- 1Overall quality of evidence low to moderate
- 2Significant heterogeneity among treatment protocols
- 3Small number of included studies (only 6)
- 4Relatively small sample sizes in individual studies
Expert Commentary
Prof. Dr. Hong Jin Pai
PhD in Sciences, University of São Paulo
▸ Clinical Relevance
The menopausal transition represents a genuine therapeutic challenge, especially given the restrictions on hormone therapy imposed after the Women's Health Initiative findings. In this context, the present meta-analysis consolidates evidence that acupuncture produces significant reductions in the Menopause Rating Scale across its three domains — psychological, somatic, and urogenital — compared with sham acupuncture, with benefit sustained for 1 to 3 months after treatment ends. The protocol of 2 to 3 weekly sessions for 8 to 12 weeks is entirely feasible in specialized outpatient practice. Women with contraindications to hormone replacement — personal history of breast malignancy, thromboembolism, or established cardiovascular disease — represent the population that benefits most from this alternative, making the findings directly applicable to everyday practice.
▸ Notable Findings
The most relevant finding of this analysis is not the overall MRS improvement itself, but the consistency of the effect across the three subdomains evaluated. The psychological dimension — encompassing depressed mood, anxiety, and sleep disturbances — shows a significant response, something not always anticipated in predominantly somatic interventions. The persistence of benefit for 1 to 3 months after active treatment ends suggests durable neuromodulatory effects, consistent with what we know about acupuncture's modulation of the hypothalamic-pituitary axis and the serotonergic and endogenous opioid systems. The comparative design with sham acupuncture — and not merely passive control — confers greater rigor to causal inference, isolating the specific effect of stimulation at the selected points.
▸ From My Experience
In my practice at the Pain Center of HC-FMUSP, I have followed perimenopausal and postmenopausal women for decades, and the response pattern described in this work is quite consistent with what we routinely observe. I typically notice the first objective improvements in sleep and irritability around the third or fourth session; hot flashes tend to subside more gradually, generally after the sixth session. We usually conduct an initial cycle of 10 to 12 sessions and, if response is maintained, space them to biweekly visits for another two to three months. I frequently combine acupuncture with sleep hygiene counseling and regular aerobic exercise — a combination that, in my experience, amplifies and prolongs gains. The patient profile that responds best is the one with predominantly moderate vasomotor symptoms and complaints of reactive anxiety, without untreated major depression. In severe climacteric syndrome cases, I maintain multidisciplinary discussion with gynecology before excluding hormone replacement.
Full original article
Read the full scientific study
Complement Med Res · 2017
DOI: 10.1159/000479630
Access original articleScientific Review
Marcus Yu Bin Pai, MD, PhD
CRM-SP: 158074 | RQE: 65523 · 65524 · 655241
PhD in Health Sciences, University of São Paulo. Board-certified in Pain Medicine, Physical Medicine and Rehabilitation, and Medical Acupuncture. Scientific review and curation of every entry in this library.
Learn more about the author →Medical disclaimer: This content is for educational purposes only and does not replace consultation, diagnosis, or treatment by a qualified professional. Some information may be assisted by artificial intelligence and is subject to inaccuracies. Always consult a physician.
Content reviewed by the medical team at CEIMEC — Integrated Centre for Chinese Medicine Studies, a reference in Medical Acupuncture for over 30 years.
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