Acupuncture decreased hot flashes by 50% in half of the sample, whereas in the control group, only 16% of women reported that their hot flashes were cut in half. Hot flash reductions were statistically significantly greater in the acupuncture group over controls, and this also was associated with more sleep, which was also considered to be statistically significant. The primary weakness of this study was the lack of a control group to account for attention and provider interaction.
Hence, there are some compelling data to study acupuncture further, and the biggest challenge is to develop an adequate control that will not be active in the same way acupuncture is but will control for the nonspecific effects of the intervention (particularly attention). Although acupuncture may eventually be shown to do some good for some women with hot flashes, there is, as of this time, no definitive evidence base to prove its efficacy or to direct its use in clinical practice.
The authors of the three articles related to hot flash conundrums published in this issue of Menopause should be commended for tackling critically important issues related to the science of hot flash management. The future of effective interventions for hot flashes with low or no toxicity lies in the elucidation of hot flash physiology, mechanisms of interventions, new trial paradigms, and hot flash measurement.
Financial disclosure/conflicts of interest: None reported.
Charles L. Loprinzi, MD
Debra L. Barton, RN, PhD
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