Randomised controlled trials (RCTs) that compared acupuncture with no treatment, placebo, medication or non-pharmacological interventions for severe vasomotor symptoms in perimenopausal or postmenopausal women were eligible for inclusion. Studies of any form of traditional or contemporary acupuncture were eligible, provided the points of stimulation were acupuncture-related.
The primary review outcome was frequency and severity of vasomotor symptoms, either self-reported or measured with a validated tool. Secondary outcomes were sleep, quality of life and adverse events. Studies that combined acupuncture with other therapies or compared different forms of acupuncture or different acupoints were excluded. Studies of women with past or current breast cancer were excluded.
Mean age of women in the included studies ranged from 46 to 57 years. They received various types of acupuncture, such as individualised, standardised and semi-standardised (set acupoints plus individually chosen points). Treatment frequency varied widely. Treatment duration ranged from one to three months. Treatment procedures were generally consistent with the recommendations of guidelines and other reviews. Controls received sham or non-penetrating acupuncture, standard drugs or oryzanol (rice bran oil).
The most commonly reported outcomes were frequency and severity of hot flushes and vasomotor symptom scores based on the Kupperman index. Studies were set in China, USA, Sweden and Korea.
A single reviewer conducted initial study selection and conferred with a second reviewer where there was uncertainty.