Dodin, S., Blanchet, C., Marc, I., Ernst, E., Wu, T., Vaillancourt, C., . . . Maunsell, E. (2013). Acupuncture for menopausal hot flushes. The Cochrane Database of Systematic Reviews, 7, CD007410. 

DOI Link

Purpose

STUDY PURPOSE: To determine whether acupuncture is effective and safe for reducing hot flashes and improving the quality of life of menopausal women with vasomotor symptoms

TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, CINAHL, PsycINFO, Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), VIP database, Dissertation Abstracts International, Current Controlled Trials, Clinicaltrials.gov, National Center for Complementary and Alternative Medicine (NCCAM), BIOSIS, AMED, Acubriefs, and Acubase
 
KEYWORDS: Acupuncture; hot flashes; hot flushes
 
INCLUSION CRITERIA: Randomized controlled trials comparing any type of acupuncture to no treatment/control or other treatments for reducing menopausal hot flashes and improving the quality of life in symptomatic perimenopausal and postmenopausal women
 
EXCLUSION CRITERIA: Qualitative and observational research; case history and abstracts of annual meeting with no further scientific publication of their results; insufficient data information related to vasomotor symptoms in order to meet the review inclusion criteria; duplication studies; and no randomization

Literature Evaluated

TOTAL REFERENCES RETRIEVED = 384
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Identified and screened 384 references; excluded 322 references based on the title and abstract, and retrieved 62 references for more detailed evaluation

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 16
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,155 women 
  • KEY SAMPLE CHARACTERISTICS: Mean participant age 51–57 years; experiencing hot flashes at baseline including perimenopausal, menopausal, and postmenopausal women

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

When acupuncture was compared with sham acupuncture, there was no evidence of any difference in their effects on hot flashes. When acupuncture was compared with no treatment, there appeared to be a benefit from acupuncture, but acupuncture appeared to be less effective than hormonal therapy. In assessing quality of life measures, acupuncture was significantly less effective than hormonal therapy, but traditional acupuncture was significantly more effective than no intervention. One small study compared acupuncture with relaxation and showed no significant difference between the groups. Five studies included women with breast cancer; one study excluded them. No significant difference existed between acupuncture and other interventions on quality of life. Data on adverse effects was lacking. The diary of vasomotor symptoms was the most commonly used tool to quantify hot flash frequency and severity.

Conclusions

Studies that compared acupuncture versus sham acupuncture did not provide sufficient evidence to show whether acupuncture is an effective treatment for vasomotor symptoms. A debate exists about whether sham acupuncture is a placebo intervention or possesses an active effect related to peripheral sensory stimulation. Currently, insufficient evidence exists to determine whether acupuncture is effective as a treatment for hot flashes. Data on adverse effects were not included. Further high-quality studies are needed to determine the effect of acupuncture on vasomotor symptoms. An exclusion of the one study with breast cancer survivors comparing acupuncture with sham acupuncture had shown no difference related to hot flush severity.

Limitations

The evidence was of low or very low quality, and the studies comparing acupuncture versus no treatment or hormone therapy were not controlled with sham acupuncture or placebo hormone therapy. Most had small sample sizes and questionable methodological quality. Many had an inadequate level of blinding and no intention-to-treat analysis.

Nursing Implications

This review included menopausal women and women with breast cancer. Risk of infection should be considered in immunosuppressed patients. Studies with larger sample sizes of women with breast cancer are needed to determine the effectiveness of acupuncture for treating hot flashes in this group.

Legacy ID

4098