Acupuncture treats hot flushes – but there’s a catch

Traditional Chinese acupuncture treatment is no better than fake acupuncture for treating menopause symptoms, a study of 327 menopausal Australian women has revealed.

In a surprise twist, women who received both the real and sham treatments reported a 40 per cent improvement in the severity and frequency of their hot flushes at the end of eight weeks of treatment.

The benefits were still felt six months after treatment.

The University of Melbourne study, funded by the National Health and Medical Research Council and supported by Jean Hailes for Women’s Health, is the largest of its kind to date. It was published in the Annals of Internal Medicine.

Menopause occurs after a woman’s final menstrual period, which usually occurs between the ages of 45 and 55.

Fluctuations in the hormones oestrogen and progesterone during menopause can lead to increased body temperature (known as hot flushes). Around three-quarters of menopausal women suffer from will experience hot flushes.

With 15 per cent of Australians close to – or at – menopausal age, many women are turning to alternative therapies to alleviate their symptoms.

Acupuncture is a popular choice. This traditional Chinese medicine treatment involves thin needles inserted into the body at specific points.

A group of 327 Australian women aged over 40 who had at least seven moderate hot flushes a day, were enrolled into the University of Melbourne study.

Half the group was given 10 sessions of standard Chinese medicine acupuncture. The other half received fake or ‘sham’ acupuncture, that is, stimulation of the skin using blunt-tipped needles, which has a milder effect without penetrating the skin.

Lead author of the study, Dr Carolyn Ee is a general practitioner trained in Chinese medicine. She is a PhD student with the University of Melbourne’s Department of General Practice.

“This was a large and rigorous study and we are confident there is no additional benefit from inserting needles compared with stimulation from pressuring the blunt needles without skin penetration for hot flushes,” Dr Ee says.

“I was hoping there would be a difference as penetrating techniques are expected to have a more potent effect.

As a GP, I see a lot of women in mid-life who suffer from hot flushes. Many don’t want to have hormone replacement therapy because they worry about unwanted side effects.

She says the placebo effect is one possible reason why both groups experienced a benefit, adding that even attending a clinic to talk about symptoms could help. And hot flushes tended to improve spontaneously with time, she says.

“If women want to consider having acupuncture for hot flushes, they should know that although it is better than doing nothing, needling does not appear to make a difference.”

But – she says – perhaps women should not discount acupuncture as a treatment altogether, given the ‘sham’ treatment did have a mild physiological effect, so could not be considered a true placebo.

“In Chinese medicine, there are many ways to stimulate acupuncture points including skin penetration with needles and techniques like acupressure and Chinese massage,” Dr Ee says.

“So sham acupuncture does a have mild effect, given the blunt needles still stimulate nerves in the skin, albeit not as intensely as real needles.

Laboratory-based research suggests acupuncture affects serotonin levels, and abnormal serotonin levels are linked to hot flushes.

“There is a plausible biological mechanism for its action on hot flushes.”

Laya Ross, a family therapist from Upwey in Melbourne’s Dandenong Ranges, took part in the study.

Ms Ross, 54, was suffering from extreme hot flushes up to 15 times a day.

“The flushes focussed around my head, so when one would come on, it was really visible. I’d be in a meeting with a client and all of a sudden I’d go beetroot red and have rivers of sweat running down my face,” Ms Ross says.

Honestly, the amount of heat my body was generating was scary and I’d get so hot, I’d wonder if spontaneous human combustion was possible.

As part of the study, Ms Ross was given real acupuncture to treat the symptoms. She was not told if she was in the sham or real group until the study concluded. She said the result wasn’t immediate, but gradually, her condition improved.

“It wasn’t a miracle and it wasn’t a huge instantaneous change, but it did seem to make a significant, noticeable change over time,” she said.

Ms Ross acknowledges it could have been a placebo effect at work, but for her, placebo or not, it was a life-changer.

“For me, it doesn’t matter (if it was real or not). The result was improved health and no longer scaring my clients. For women going through menopause I’d suggest giving acupuncture a go.”

Dr Ee says that women like Ms Ross, without complex health conditions, were hand picked for the study.

She stresses it’s important to note women with breast cancer or who have had both ovaries removed were not included, because their needs are different.

“These women suffer hot flushes that are more severe and often earlier in life, so we think they warrant specific research because breast cancer survivors can’t take Hormone Replacement Therapy,” Dr Ee explains.

“While acupuncture is a relatively safe treatment, women should discuss all treatment options with their doctor.”

Previous studies have shown acupuncture is effective for chronic pain, including low back pain, neck pain, and osteoarthritis, tension-type headache, chemotherapy-induced nausea and vomiting, period pain and hayfever.

The study was funded with a project grant from the National Health and Medical Research Council of Australia and was a collaboration between the Universities of Melbourne, RMIT University, Monash University, and Southern Cross University and Jean Hailes for Women’s Health.

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