Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis

Deanna Befus, Remy R. Coeytaux, Karen M. Goldstein, Jennifer R. McDuffie, Megan Shepherd-Banigan, Adam P. Goode, Andrzej Kosinski, Megan G. Van Noord, Soheir S. Adam, Varsha Masilamani, Avishek Nagi, John W. Williams

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Objectives: Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatment options such as acupuncture. Design: An umbrella systematic review (SR) was conducted, supplemented by a search of published randomized controlled trials (RCTs), that assessed the effectiveness of acupuncture for VMSs, health-related quality of life (HRQOL), and adverse effects of treatment in perimenopausal or postmenopausal women. Meta-analyses were conducted using a random-effects model when data were sufficient. Results: Three SRs and four new RCTs were identified that met eligibility criteria. Meta-analyses of this study revealed statistically significant standardized mean differences (SMDs) associated with acupuncture compared with no acupuncture at reducing VMS frequency (SMD -0.66, 95% confidence interval [CI] -1.06 to -0.26, I2 = 61.7%, 5 trials) and VMS severity (SMD -0.49, 95% CI -0.85 to -0.13, I2 = 18.1%, 4 trials) and improving HRQOL outcomes (SMD -0.93, 95% CI -1.20 to -0.67, I2 = 0.0%, 3 trials). SMDs were smaller or not statistically significant when acupuncture was compared with sham acupuncture. Conclusions: Evidence from RCTs supports the use of acupuncture as an adjunctive or stand-alone treatment for reducing VMSs and improving HRQOL outcomes, with the caveat that observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects. The safety of acupuncture in the treatment of VMSs has not been rigorously examined, but there is no clear signal for a significant potential for harm.

Original languageEnglish (US)
Pages (from-to)314-323
Number of pages10
JournalJournal of Alternative and Complementary Medicine
Volume24
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

Fingerprint

Acupuncture
Menopause
Meta-Analysis
Randomized Controlled Trials
Quality of Life
Confidence Intervals
Acupuncture Therapy
Therapeutics
Hormones
Safety

Keywords

  • acupuncture
  • health-related quality of life
  • hot flashes
  • nonpharmacologic treatment
  • vasomotor symptoms

ASJC Scopus subject areas

  • Complementary and alternative medicine

Cite this

Befus, D., Coeytaux, R. R., Goldstein, K. M., McDuffie, J. R., Shepherd-Banigan, M., Goode, A. P., ... Williams, J. W. (2018). Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. Journal of Alternative and Complementary Medicine, 24(4), 314-323. https://doi.org/10.1089/acm.2016.0408

Management of Menopause Symptoms with Acupuncture : An Umbrella Systematic Review and Meta-Analysis. / Befus, Deanna; Coeytaux, Remy R.; Goldstein, Karen M.; McDuffie, Jennifer R.; Shepherd-Banigan, Megan; Goode, Adam P.; Kosinski, Andrzej; Van Noord, Megan G.; Adam, Soheir S.; Masilamani, Varsha; Nagi, Avishek; Williams, John W.

In: Journal of Alternative and Complementary Medicine, Vol. 24, No. 4, 04.2018, p. 314-323.

Research output: Contribution to journalReview article

Befus, D, Coeytaux, RR, Goldstein, KM, McDuffie, JR, Shepherd-Banigan, M, Goode, AP, Kosinski, A, Van Noord, MG, Adam, SS, Masilamani, V, Nagi, A & Williams, JW 2018, 'Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis', Journal of Alternative and Complementary Medicine, vol. 24, no. 4, pp. 314-323. https://doi.org/10.1089/acm.2016.0408
Befus, Deanna ; Coeytaux, Remy R. ; Goldstein, Karen M. ; McDuffie, Jennifer R. ; Shepherd-Banigan, Megan ; Goode, Adam P. ; Kosinski, Andrzej ; Van Noord, Megan G. ; Adam, Soheir S. ; Masilamani, Varsha ; Nagi, Avishek ; Williams, John W. / Management of Menopause Symptoms with Acupuncture : An Umbrella Systematic Review and Meta-Analysis. In: Journal of Alternative and Complementary Medicine. 2018 ; Vol. 24, No. 4. pp. 314-323.
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abstract = "Objectives: Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatment options such as acupuncture. Design: An umbrella systematic review (SR) was conducted, supplemented by a search of published randomized controlled trials (RCTs), that assessed the effectiveness of acupuncture for VMSs, health-related quality of life (HRQOL), and adverse effects of treatment in perimenopausal or postmenopausal women. Meta-analyses were conducted using a random-effects model when data were sufficient. Results: Three SRs and four new RCTs were identified that met eligibility criteria. Meta-analyses of this study revealed statistically significant standardized mean differences (SMDs) associated with acupuncture compared with no acupuncture at reducing VMS frequency (SMD -0.66, 95{\%} confidence interval [CI] -1.06 to -0.26, I2 = 61.7{\%}, 5 trials) and VMS severity (SMD -0.49, 95{\%} CI -0.85 to -0.13, I2 = 18.1{\%}, 4 trials) and improving HRQOL outcomes (SMD -0.93, 95{\%} CI -1.20 to -0.67, I2 = 0.0{\%}, 3 trials). SMDs were smaller or not statistically significant when acupuncture was compared with sham acupuncture. Conclusions: Evidence from RCTs supports the use of acupuncture as an adjunctive or stand-alone treatment for reducing VMSs and improving HRQOL outcomes, with the caveat that observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects. The safety of acupuncture in the treatment of VMSs has not been rigorously examined, but there is no clear signal for a significant potential for harm.",
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AU - McDuffie, Jennifer R.

AU - Shepherd-Banigan, Megan

AU - Goode, Adam P.

AU - Kosinski, Andrzej

AU - Van Noord, Megan G.

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AB - Objectives: Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatment options such as acupuncture. Design: An umbrella systematic review (SR) was conducted, supplemented by a search of published randomized controlled trials (RCTs), that assessed the effectiveness of acupuncture for VMSs, health-related quality of life (HRQOL), and adverse effects of treatment in perimenopausal or postmenopausal women. Meta-analyses were conducted using a random-effects model when data were sufficient. Results: Three SRs and four new RCTs were identified that met eligibility criteria. Meta-analyses of this study revealed statistically significant standardized mean differences (SMDs) associated with acupuncture compared with no acupuncture at reducing VMS frequency (SMD -0.66, 95% confidence interval [CI] -1.06 to -0.26, I2 = 61.7%, 5 trials) and VMS severity (SMD -0.49, 95% CI -0.85 to -0.13, I2 = 18.1%, 4 trials) and improving HRQOL outcomes (SMD -0.93, 95% CI -1.20 to -0.67, I2 = 0.0%, 3 trials). SMDs were smaller or not statistically significant when acupuncture was compared with sham acupuncture. Conclusions: Evidence from RCTs supports the use of acupuncture as an adjunctive or stand-alone treatment for reducing VMSs and improving HRQOL outcomes, with the caveat that observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects. The safety of acupuncture in the treatment of VMSs has not been rigorously examined, but there is no clear signal for a significant potential for harm.

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