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Discusses Women's Health

Many of my patients are premenopausal or already have become menopausal. (Well all of us are pre-something.) And during this inevitable transition, 80% of women develop vasomotor symptoms…hot flashes, night sweats as well as vaginal dryness. These can become severe in nearly half of menopausal women and can last for 7 years. And to add insult to injury, 15% will continue to have symptoms for the rest of their lives! We know that estrogen therapy will alleviate these symptoms but many women either cannot or do not want to take hormone therapy. In a search for non hormonal alternatives, acupuncture has been considered and anecdotally has been deemed successful. Does it really work?

A recent article in the Annals of Internal Medicine claims that it does not. A study was conducted at The University of Melbourne. Researchers randomly assigned 327 women who were older than 40 in their late menopause transition or post menopausal and who experienced at least 7 hot flashes a day. They received either a standardized Chinese medicine acupuncture treatment or a non inserting blunt needle (sham) acupuncture treatment. The women all received 10 treatments over 8 weeks.

Both groups had the same 40% improvement in their hot flashes at the end of the treatment. And that improvement lasted 3 months and continued for 6 months after the trial. Additionally, there was no difference in the two groups with respect to their quality of life, anxiety or depression. The conclusion of the researchers was that the women responded to the fact that they were receiving treatment but that this response was unrelated to acupuncture needling.

The impact of sham treatment had been previously documented in a Cochrane review on this topic. (The Cochrane has become the gold standard for statistical analysis of medical studies; sort of the final jury).The review found that although studies have shown that acupuncture is more effective than no treatment in diminishing hot flashes it is not effective when compared with a sham control.

The conclusion so far: skin – penetrating acupuncture is not recommended as a first line (or second line) therapy for relief of hot flashes. It would be nice to report otherwise…

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