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J Altern Complement Med. 2018 Apr;24(4):314-323. doi: 10.1089/acm.2016.0408. Epub 2018 Jan 3.

Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis.

Author information

1 Department of Family and Community Medicine, Center for Integrative Medicine , Wake Forest School of Medicine, Winston-Salem, NC.
2 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, NC.
3 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, NC.
4 Duke Clinical Research Institute , Durham, NC.
5 Department of Orthopaedic Surgery, Duke University Medical Center , Durham, NC.
6 Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham NC.
7 Duke University Medical Center Library , Durham, NC.
8 Department of Medicine, Duke University Medical Center , Durham, NC.



Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatment options such as acupuncture.


An umbrella systematic review (SR) was conducted, supplemented by a search of published randomized controlled trials (RCTs), that assessed the effectiveness of acupuncture for VMSs, health-related quality of life (HRQOL), and adverse effects of treatment in perimenopausal or postmenopausal women. Meta-analyses were conducted using a random-effects model when data were sufficient.


Three SRs and four new RCTs were identified that met eligibility criteria. Meta-analyses of this study revealed statistically significant standardized mean differences (SMDs) associated with acupuncture compared with no acupuncture at reducing VMS frequency (SMD -0.66, 95% confidence interval [CI] -1.06 to -0.26, I2 = 61.7%, 5 trials) and VMS severity (SMD -0.49, 95% CI -0.85 to -0.13, I2 = 18.1%, 4 trials) and improving HRQOL outcomes (SMD -0.93, 95% CI -1.20 to -0.67, I2 = 0.0%, 3 trials). SMDs were smaller or not statistically significant when acupuncture was compared with sham acupuncture.


Evidence from RCTs supports the use of acupuncture as an adjunctive or stand-alone treatment for reducing VMSs and improving HRQOL outcomes, with the caveat that observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects. The safety of acupuncture in the treatment of VMSs has not been rigorously examined, but there is no clear signal for a significant potential for harm.


acupuncture; health-related quality of life; hot flashes; nonpharmacologic treatment; vasomotor symptoms

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