Acupuncture for menopausal symptoms in Chinese women: a systematic review

Qin, Y.; Ruan, Xiangyan; Jü, Rui; Pang, J; Zhao, Guogang; Hu, Xiaolin

doi:10.1080/13697137.2020.1795115

Cited by 5 publications

(4 citation statements)

References 39 publications

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“…Acupuncture demonstrated very few adverse events; additionally, acupuncture was associated with significantly decreased breast tenderness and gastrointestinal reactions compared to HT. Qin et al 26 summarized the evidence and safety of acupuncture and also shared their clinical experiences treatingg outpatient MP women in Beijing. They concluded that acupuncture improves Kupperman Index scores, hot flashes, and pain with few side effects and posit that acupuncture improves symptoms via neuroendocrine-immune systems.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the effects of traditional East Asian medicine on symptom clusters during the menopausal transition

Taylor-Swanson

Sdrales

Ali

et al. 2022

Preprint

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ImportanceGiven that many midlife women use evidence-based non-pharmacologic interventions for symptom management during the menopausal transition and early postmenopause and that many women experience two or more symptoms (symptom cluster), it is important to review recent evidence on said interventions for symptom clusters. This review focuses on randomized clinical trials (RCTs) of traditional East Asian Medicine (TEAM), including acupuncture, acupressure, moxibustion, and Chinese herbal medicine, for hot flashes and one or more co-occurring symptoms experienced during peri- or post-menopause.ObjectiveThe primary objective of the study was to review RCTs (published 2011-2021) of TEAM interventions for hot flashes and at least one other co-occurring symptom, including sleep problems, cognitive function, mood, and pain.Evidence ReviewWe searched Medline, CINAHL Plus, and PsychINFO for RCTs reported in English from July 7, 2011, to December 31, 2021. We included RCTs that assessed women in the menopausal transition or early postmenopause with masking as appropriate; TEAM interventions were studied as the treatment with one or more comparison groups; hot flushes and at least one additional symptom from at least one of the symptom clusters were reported as an outcome (from sleep, mood, cognition, pain symptom groups). Bias was assessed.FindingsOf 409 abstracts identified, 9 RCTs examined the effectiveness of therapies for hot flashes and at least one additional co-occurring symptom. One study reported separately on two TEAM interventions. The maximum trial duration was 6 months (range: 5 weeks – 6 months). Statistically significant improvement was reported in 2 or more symptoms: 5 of 6 studies of acupuncture, one acupressure study, one moxibustion study, 1 of 2 studies of Chinese herbal medicine.Conclusions and RelevanceOur systematic review summarizes the recent literature on TEAM interventions for symptom clusters during the MT and EPM. A majority of studies reported symptom reduction. Overall, our findings highlight the need for further investigation with studies that include whole systems TEAM as each intervention was studied separately in the reviewed trials. Clinical practice often includes concurrent use of acupuncture, moxibustion, CHM, and advice to patients to use self-acupressure. Studying each modality separately is a scientific abstraction that does not reflect clinical practice.Key PointsQuestion/ObjectiveWhat is the effect of traditional East Asian medicine (TEAM) therapeutics, including acupuncture, acupressure, Chinese herbal medicine, or moxibustion for hot flashes and one or more co-occurring symptoms during the menopausal transition (MT)?FindingsNine RCTs (n=811) evaluating the effects of TEAM therapeutics on MT symptoms were included. Statistically significant improvement was reported in these studies: acupuncture (5 of 6), 1 acupressure study, 1 moxibustion study, and Chinese herbal medicine (1 of 2).MeaningBased on the results of this systematic review, TEAM interventions demonstrate promising improvement of hot flashes and co-occurring symptoms experienced during the MT.

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Section: Discussionmentioning

confidence: 99%

A systematic review of the effects of traditional East Asian medicine on symptom clusters during the menopausal transition

Taylor-Swanson

Sdrales

Ali

et al. 2022

Preprint

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“…Different from interpretation of hypothalamic-pituitary-gonadal axis in Western medicine, TCM believes perimenopausal disorders including PMD are caused by imbalance/disharmony of Yin and Yang, and Zang-Fu, which is expected to be balanced/harmonized with the intervention of acupuncture (62). Until now, acupuncture is still widely used in China to manage various physical and mental symptoms associated with menopause (63). Despite the promising results, the evidence quality of two included trials comparing acupuncture vs. sham acupuncture was poor (35,36).…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

Acupuncture as an Independent or Adjuvant Management to Standard Care for Perimenopausal Depression: A Systematic Review and Meta-Analysis

Zhao

Kennedy

et al. 2021

Front. Psychiatry

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Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone.Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed.Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01].Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD.

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“…Acupuncture has become more popular as a traditional Chinese therapy with few adverse reactions. Acupuncture and electroacupuncture have definite effects in treating postmenopausal symptoms such as insomnia but are ineffective in relieving hot flashes (103)(104)(105). Current evidence shows that manual acupuncture is safer than HT (106).…”

Section: Complementary and Alternative Therapiesmentioning

confidence: 99%

Update on hormone therapy for the management of postmenopausal women

Pan

Zhou

et al. 2022

BST

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Hormone therapy (HT) has been used in postmenopausal women for decades in clinical practice. With further analysis and newer studies, the benefits and risks of HT have been repeatedly verified and discussed. HT is recommended for the treatment of vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM) and the prevention of osteoporosis. However, the precise association between HT and the risks of cardiovascular diseases, venous thromboembolism, neurodegenerative diseases, breast cancer, and endometrial cancer remains controversial. Therefore, determining how to take advantage of and control the risks of HT by adjusting the initiation time, regimen, and duration is crucial. Recent studies have indicated that HT is not related to the risk of all-cause, cardiovascular, or breast cancer mortality although it might increase the incidence of some chronic diseases. For symptomatic postmenopausal women under the age of 60 without contraindications, early initiation of HT is safe and probably has a mortality benefit over the long term. Initiating HT close to menopause at the lowest effective dose is more likely to have maximal benefits and the lowest risks. Transdermal and vaginal HT may have a lower risk, but recent evidence suggests additional clinical benefits of oral HT formulations in relieving VMS and preventing osteoporosis. The pooled cohort risk equation for atherosclerotic cardiovascular disease (ASCVD) and the free app named Menopro can be used to perform individual risk assessments. In addition, Chinese herbal medicines have benefits in alleviating hot flashes, depression, and menopausal symptoms, although further data are needed to strongly support their efficacy. Acupuncture and electroacupuncture have definite efficacy in the treatment of postmenopausal symptoms with few adverse effects, so they are a reasonable option as an alternative therapy for high-risk women. This review discusses the history of, guidelines on, and strategies for HT in order to make suggestions based on the most up-to-date evidence for the management of postmenopausal women.

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Acupuncture for menopausal symptoms in Chinese women: a systematic review

Cited by 5 publications

References 39 publications

A systematic review of the effects of traditional East Asian medicine on symptom clusters during the menopausal transition

A systematic review of the effects of traditional East Asian medicine on symptom clusters during the menopausal transition

Acupuncture as an Independent or Adjuvant Management to Standard Care for Perimenopausal Depression: A Systematic Review and Meta-Analysis

Update on hormone therapy for the management of postmenopausal women

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