Six studies were included for the review (n=132). One randomised controlled trial (RCT) (n=31) and five uncontrolled observational studies (n=101). One RCT scored 5 on the Jadad and five observational studies scored 1. Dropout rate ranged from 0% to 50%. Three observational studies were only available in abstract form.
The RCT reported that the frequency of hot flushes at 12 weeks reduced by 50% or more in 47% of patients who received manual acupuncture alone (p=0.001) and 57% of patients who received manual acupuncture plus electro-acupuncture (p=0.002) compared to baseline levels. A more than 50% reduction in distress at 12 weeks compared to baseline was observed in 50% of patients treated with manual acupuncture plus electro-acupuncture (p=0.003) and in 60% of patients treated with manual acupuncture alone (p=0.001).
There continued to be a significant reduction in distress for patients treated with manual acupuncture and those treated with manual acupuncture plus electro-acupuncture at 12 months follow up (p=0.036 for manual and p=0.016 manual plus electro). There were no significant differences between the groups in terms of hot flush frequency or severity at 12 months.
The three observational studies reported beneficial effects of acupuncture on hot flush frequency either at end of treatment or at follow-up (p values ranged from p≤0.01 to p≤0.05). One study reported that hot flush severity significantly reduced with manual acupuncture during the day (p≤0.05) and during the night (p≤0.05).
Two studies reported mild adverse events of fatigue, haematoma, treatment-related distress and transient increase in vasomotor symptoms. One study reported no adverse events.