Menopause is a condition which normally occurs later in a women’s life (typically between 40 – 58 years), although it can also occur earlier as a result of surgery and treatment of various cancers. When periods stop (amenorrhoea) and have not occurred for 12 months, menopause is said to have begun – the changeover time between the two being referred to as the perimenopause. During this time changes occur to the ovaries and they alter their secretion of hormones. Women can experience a variety of distressing symptoms including hot flushes, night sweats, palpitations, vaginal dryness, incontinence, altered sex drive and mood changes including depression.
Hot flushes and night sweats are some of the most troubling changes and occur in about 40% of women. They are referred to medically as a vasomotor symptom; that is, they are the result of an alteration in a part of the brain (vasomotor centre) which controls aspects of basic body functions including blood pressure. When hot flushes occur, many women feel heat in the face, neck, and chest, and the central (core) body temperature often drops. Sweating and palpitations (thumping heart rate) often occur at the same time.
Hot flushes and night sweats are some of the most troubling changes
How does acupuncture work during the menopause?
During acupuncture treatment for menopause, painless needles are inserted into points on the body including the shin, foot, wrists, and tummy. These points lie on acupuncture channels or ‘meridians’ and are said to affect the internal organs bringing them back into harmony and balancing their natural life energy or ‘Qi’. In traditional acupuncture hot flushes are said to result from ‘deficient heat’ which refers to an impairment of the body’s ability to cool itself. In addition, generally acupuncture often has the effect of improving sleep quality and reducing fatigue. Western medical science has confirmed that the effect of acupuncture is to stimulate nerves in the spinal cord and within an area of the brain called the hypothalamus. This region effects the autonomic nervous system, which in turn controls body functions such as sweating, stomach churning, and heart rate. During menopause alterations in hormones occurs due to a lowering of a chemical (beta endorphin) in the brain and spinal cord fluid. In those undergoing hormone replacement therapy (HRT) this chemical is increased which may explain its effect on hot flushes. As acupuncture has been shown to increase this chemical via the hypothalamus it may be acting in a similar way.
Treatment
A course of acupuncture for menopausal symptoms normally consists of 3-8 sessions. Initially, as symptoms are quite severe, treatment is given twice each week for three weeks. As you start to improve, treatment is reduced to weekly, and finally two treatments are given monthly. Often electroacupuncture is used, where a mild electrical stimulus is passed through the needle to give a pleasant pulsing sensation. Treatments typically last about 30-40 minutes.
What to expect
Initially your therapist will assess you, taking a history of your symptoms and how they affect you in day-to-day living. You may be asked to fill in a questionnaire such as the Women’s Health Questionnaire (WHQ) which will be completed at the end of your treatment as well. This questionnaire helps to show all the ways the menopause is affecting you, physically and emotionally. It considers things such as sleep, nausea, appetite, and pain as well as hot flushes and night sweats, so it gives your therapist a full picture of how your quality of life is affected. Treatment will be discussed with you and everything will be explained so you understand what to expect. Acupuncture is a subtle treatment which works gradually. It is likely that the first thing you notice changing will be your sleep patterns. It is common to feel tired on the night after the treatment, but you may not notice a change in your hot flushes until you have had a number of treatment sessions. This is because it takes time for the effects of acupuncture to build up.
Scientific studies
Over the years, a number of scientific studies have shown acupuncture to be an effective treatment for menopausal symptoms. For example, researchers from the University of Pittsburgh (1) looked at the effect of acupuncture on hot flushes, sleep disturbances and mood changes. Results showed a significant reduction in the severity of hot flushes, a decrease in sleep disturbance, and a reduction in mood swings. Meanwhile, a group from Stanford University (2) looked at women experiencing at least seven hot flushes each day and found that acupuncture decreased the severity of their hot flushes by 28% and the frequency by 47%. A Cochrane review was conducted on all the scientific evidence for the acupuncture treatment of hot flushes in 2013 (3) assessing many papers, they chose 16 which were of higher quality. These were randomized controlled trials (RCT) with 1155 women studied altogether. Eight of the studies compared acupuncture needling to a sham (false needle) and found no difference between the number of hot flushes (frequency) but the flushes were significantly less severe (severity). Three studies compared acupuncture to hormone replacement therapy (HRT) and showed HRT to reduce hot flush frequency better, but the severity was the same in both groups. Four studies compared acupuncture to no treatment (waiting list) and found acupuncture to be more effective in reducing hot flush frequency and severity, and one study compared acupuncture to relaxation and found the two groups to be about the same.
A more recent meta-analysis of 12 studies (869 women) published in 2015 (4) showed acupuncture to significantly reduce both frequency and severity of hot flushes and to improve quality of life. A major study conducted in 2016 (5) showed dramatic results and was reported in the Telegraph newspaper under the heading “Acupuncture can reduce hot flushes in menopausal women by half, researchers find” (6) In fact, the study looked at 209 women who received up to 20 acupuncture treatments over a year. Their vasomotor symptoms (flushes, night sweats, palpitations) were shown to reduce by 36.7% at 6 months compared to a control group (waiting list) whose symptoms increased by 6%. Importantly, significant improvement was observed after 3 acupuncture treatments, with maximal effects after 8 treatments and improvement lasting over the 12-month study period.
symptoms were shown to reduce by 36.7% at 6 months compared to a control group
So, it would seem that acupuncture is not an all-healing panacea for hot flushes and night sweats, and certainly not a ‘quick fix’, but may certainly be a useful alternative or adjunct to HRT. As with any medical intervention, the level of improvement will vary between individuals as everyone is different – some may get very good results (strong responder) while others may not (weak responder). In general, if acupuncture is going to help it may take some time, with a typical course of treatment ranging from 3-8 sessions to get a full effect.
If you are local to our Congleton clinic and would like to try acupuncture for menopausal symptoms, or would like to discuss this treatment option, phone us on 01260 290564
References
- Cohen et al 2003. Can acupuncture ease the symptoms of menopause? Holistic Nursing Practice. 17(6): 295-9
- Huang et al 2006 A randomized controlled pilot study of acupuncture for postmenopausal hot flushes. Fertility and Sterility. 86(3): 700-10
- Dodin S, Blanchet C, et al (2013) Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. Issue 7. Art. No.: CD007410.
- Chiu HY, Pan CH, Shyu YK, et al (2015) Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause. 22(2):234-44.
- Avis NE, Coeytaux RR, Isom S, et al (2016) Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause. 23(6):626-37.
- https://www.telegraph.co.uk/news/2016/10/03/acupuncture-can-reduce-hot-flushes-in-menopausal-women-by-half-r/ accessed January 2019.