Key Finding
Different acupuncture modalities demonstrated symptom-specific efficacy for perimenopausal syndrome, with moxibustion showing highest overall effectiveness and electroacupuncture combined with Western medicine optimal for vasomotor symptoms and depression.
Researchers analyzed 49 studies involving 4,579 women to compare how different types of acupuncture help with perimenopausal symptoms like hot flashes, insomnia, mood swings, and anxiety. Perimenopause is the transition to menopause when hormonal changes cause uncomfortable symptoms that affect daily life. The study examined various acupuncture approaches, including traditional needle acupuncture, electroacupuncture (which adds mild electrical stimulation), ear acupuncture, moxibustion (warming therapy), and combinations with Chinese herbal medicine or Western medications. The findings showed that different acupuncture techniques worked best for different symptoms. Acupuncture combined with Western medicine was most effective for balancing hormones, while electroacupuncture with Western medicine worked best for reducing hot flashes and depression. Electroacupuncture alone was most helpful for anxiety, and combining ear and body acupuncture improved sleep the most. Moxibustion showed the highest overall effectiveness across multiple symptoms. What this means for patients: if you're experiencing perimenopausal symptoms, acupuncture offers several evidence-based options that can be tailored to your specific needs. Whether you're dealing primarily with hot flashes, sleep problems, anxiety, or a combination of symptoms, there's likely an acupuncture approach that can help. These treatments can be used alone or alongside other therapies you may already be taking. To get the best results, seek care from a qualified, licensed acupuncturist who can assess your individual symptoms and recommend the most appropriate treatment approach.
This network meta-analysis evaluated 49 RCTs (n=4,579) comparing acupuncture modalities for perimenopausal syndrome through June 2025. Data sources included eight databases; risk of bias assessment used Cochrane tools, and analysis was performed in Stata 15 and R 4.3. Results demonstrated intervention-specific efficacy profiles: acupuncture combined with Western medicine (AWM) showed superior outcomes for hormone regulation; acupuncture plus Chinese medicine (ACM) optimized TCM symptom patterns; electroacupuncture with Western medicine (EAWM) was most effective for vasomotor symptoms and depression; electroacupuncture (EA) monotherapy best addressed anxiety; auricular-body acupuncture combination (AAA) maximized sleep quality; and moxibustion (M) demonstrated highest overall effectiveness rates. Clinical takeaway: Treatment selection should be symptom-specific, with combination therapies (AWM, EAWM) particularly effective for hormone-mediated symptoms, EA for psychological manifestations, AAA for insomnia, and moxibustion for comprehensive symptom management. Authors acknowledge need for additional high-quality RCTs to validate rankings and inform evidence-based protocol development.
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