Researchers put acupuncture to the test once again.
Menopause typically begins in the sixth decade of life and continues for an average of 4–5 years.
The symptoms of menopause can reduce overall well-being and affect every facet of life.
Although the symptoms of menopause are treatable, the current methods are far from perfect.
For this reason, some people choose nonhormonal therapies. However, these often come with a list of unpleasant side effects too, including sleep disturbance, dizziness, nausea, and fatigue.
Due to this, finding nonpharmaceutical interventions for the symptoms of menopause is high on the agenda.
An alternative approach
With an ancient pedigree and legions of passionate supporters, acupuncture has shouldered its way ever closer to mainstream medicine.
The most recent study, which researchers from the University of Copenhagen, Denmark, and the University of Southern Denmark, Odense led, pits acupuncture's power against the symptoms of menopause.
Although other studies have looked at acupuncture as a possible remedy for the symptoms of menopause, definitive evidence has not been forthcoming.
As the authors of the current study write, earlier studies "have been criticized for methodological limitations, for example, poor design, inadequate sample size, inadequate control or placebo groups, absence of standardized protocols, and a lack of data on adverse effects."
Acupuncture and hot flashes
To investigate further, the researchers decided to focus predominantly on one outcome — hot flashes. Often continuing for a number of years, hot flashes affect more than three-quarters of people who experience the menopause, and they can be distressing.
Their study included 70 women who were experiencing menopause. The team gave half of the women one 15-minute session of standardized acupuncture a week for 5 weeks. The acupuncturists involved in the study had an average of 14 years' worth of experience.
The remaining individuals were part of the control group, and they received no intervention. The study findings feature in the journal BMJ Open this week.
Each of the participants completed a questionnaire that assessed their experience of menopause symptoms. They filled this out before the study began and then after 3, 6, 8, 11, and 26 weeks. The questionnaire covered the most common symptoms, including hot flashes, sleep problems, memory changes, urinary and vaginal symptoms, and skin changes.
After just 3 weeks, the participants in the acupuncture group noted a decrease in hot flashes.
At the 6-week mark, 80 percent of the women in the acupuncture group believed that the sessions had helped them.
The acupuncture did not only reduce hot flashes. Those in the experimental group also experienced significant drops in the severity or frequency of sweating (including night sweats), sleep disturbances, emotional symptoms, and skin and hair problems.
The placebo problem
Although the results were statistically significant, the authors note that there were relatively few participants, and the duration of the study was only short.
Also, an old foe — the lack of a placebo — haunts the findings. As the authors explain, "At present, no validated acupuncture placebo comparator exists."
The placebo effect can be particularly strong in situations where an individual receives one-on-one attention from a practitioner as opposed to simply receiving a pill.
One technique that the researchers say might be useful for future studies is sham acupuncture.
To untrained observers and participants, sham acupuncture looks like standard acupuncture. The critical difference is that the practitioner either does not position the needles in acupuncture points or does not pierce the skin with them.
However, sham acupuncture is not ideal as a control either. A placebo intervention should be inactive and, according to some authors, sham acupuncture imparts a more significant effect than other, truly inactive placebos.
As the authors explain, "a study testing sham versus real acupuncture is not a placebo-controlled study but rather a study testing two different types of acupuncture."
The lack of a suitable placebo has hindered, and will continue to hinder, the study of acupuncture. As it stands, it is very easy to imagine how it might be possible to achieve any measured benefits of acupuncture in other ways. For instance, attention from a doctor, a relaxing break from the cut and thrust of daily life, soothing words, and, of course, expectations could all potentially have a similar effect.
As the authors concede, "although [the acupuncturists] were instructed to behave neutrally, their beliefs in acupuncture could have affected their interaction with the participants and possibly have intensified a placebo effect."
That said, for women who have decided not to use standard treatments, acupuncture — whether its benefits come via the placebo effect or not — might be a useful option. There is little danger of serious adverse events and, if someone perceives that their symptoms have improved after acupuncture, that is surely the goal of any intervention.