Background Acupuncture is commonly used to treat menopausal symptoms and other gynaecological conditions. In this study, the authors aimed to investigate whether acupuncture has an effect on menopausal symptoms and to explore whether this effect is related to changes in hormone levels. Materials and methods A total of 53 postmenopausal women were alternately assigned into two treatment groups: acupuncture (n=27) and sham acupuncture (n=26). Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). The serum oestradiol, follicular stimulating hormone (FSH) and luteinising hormone (LH) levels were measured at baseline and again after the fi rst and last sessions. The Student t test was used for normally distributed data and the Wilcoxon signed rank test for not normally distributed data. The group differences in MRS scores were assessed using non-parametric Mann-Whitney U test. Results After treatment, total MRS, and the somatic and psychological subscale scores were signifi cantly lower in the acupuncture group than the sham group (all p=0.001). The severity of hot fl ushes was found to be signifi cantly decreased after treatment in acupuncture group (p=0.001). In the acupuncture group LH levels were lower and oestradiol levels were signifi cantly higher than sham group (p=0.046 and p=0.045, respectively) after treatment, but there was no difference in FSH levels. Conclusion Acupuncture was effective in reducing menopausal complaints when compared to sham acupuncture and can be considered as an alternative therapy in the treatment of menopausal symptoms. INTRODUCTIONPerimenopause syndrome, referred also as climacteric syndrome, results from the changing of relationship among the hypothalamus, pituitary and ovary during women's ageing process. Those changes take place fi rst in the ovary, then in the hypothalamus and pituitary, which are refl ected as the functional changes in the endocrinological and central nervous system, accompanied with a series of psychological symptoms.1 Oestrogen, either by itself or with progestins is the most consistently effective therapy for these symptoms. However, the Women's Health Initiative and Million Women Study have identifi ed important risk factors (coronary heart disease, stroke, breast and endometrial cancer) associated with hormone replacement therapy (HRT). [3][4][5][6] Those fi ndings have led to an expanded interest in non-hormonal therapies for managing menopausal symptoms. However, there are only limited data to support their use. The common conclusion in reviews regarding to complementary and alternative therapies for the management of menopause related symptoms was that the data were insuffi cient to recommend any alternative therapy and further investigation was still needed.7 8 In the area of complementary and alternative therapies, acupuncture and acupressure treatments are promising, however, the results of published randomised controlled trials of the effect of acupuncture on hormone levels and symptoms in postmenopausal women have been ...