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Stanford Report, May 21, 2003

Acupuncture as hot flash treatment studied in trial Unique research will attempt to put hard science behind anecdotal evidence


Each year, millions of women experience the discomfort and annoyance of the dreaded hot flash, yet treatment options for this menopausal symptom remain less than perfect. Medical center researchers are now studying whether acupuncture, a traditional form of Chinese medicine that has gained popularity as an alternative therapy in the United States, can help alleviate hot flashes.

Although no formal studies have been conducted on acupuncture to treat hot flashes, there is anecdotal evidence suggesting it could be effective, said the researchers. The Stanford study is the first to fully explore its potential usefulness and comes on the heels of reports that the risks of hormone replacement therapy or HRT, which is a current treatment for hot flashes, may outweigh benefits.

"There is awareness among women that HRT is not risk free, and women are concerned about it," said Rachel Manber, PhD, assistant professor of psychiatry and behavior sciences at the School of Medicine, who is leading the study. "Exploring alternative options is timely and important."

According to the Northern American Menopause Society, there are more than 475 million menopausal women in the world. The menopause process, during which the body’s production of female hormones is reduced, can last anywhere from six to 13 years, leading to side effects such as night sweats and hot flashes.

Up to 75 percent of menopausal women experience some form of hot flashes. These episodes, caused by a rapid decline of estrogen levels in the body, can lead to sleep disturbance, intense heat and rapid heartbeat. More than a passing nuisance, hot flashes can make it difficult to concentrate, disrupting a woman’s regular routine.

"This isn’t a disease — it’s a state — but it’s very disruptive to women," said study coordinator Yael Nir, MD, a visiting physician from Israel who is volunteering her time to work on the study with Manber. "The solutions offered by medicine today are not satisfactory."

In 1976, the FDA approved the use of HRT for treating menopausal symptoms such as hot flashes, yet many women have been reluctant to take hormones. Concerns over HRT were heightened by recent Women’s Health Initiative studies showing that the treatment may increase the risk of heart attack, stroke and breast cancer. In an accompanying editorial to the most recent study, it was suggested that women taking HRT for hot flashes consider alternatives.

Although the Stanford study is the first to focus on acupuncture for treating hot flashes, a recent pilot study in England found that acupuncture reduced the frequency and severity of hot flashes in women being treated with tamoxifen for breast cancer. And Nir said she has had success in treating postmenopausal women with acupuncture in her own practice.

"My hope was that the hot flashes would decrease, but some of the women became hot flash-free," said Nir. "The impact was amazing."

During the one-year, placebo-controlled study at Stanford, volunteers may receive 10 treatments over an eight-week period. Volunteers must be in natural menopause, between the ages of 45 and 65, in good health and not currently on HRT. They also should be experiencing bothersome hot flashes. Interested volunteers may call 724-8956.

Manber is collaborating on the study with Bertha Chen, MD, assistant professor of obstetrics and gynecology.

Manber is also recruiting patients for a study on the use of acupuncture and massage for pregnant women with depression, and on a comparison of acupuncture and Paxil to treat depression in both men and women. Interested volunteers for the first study should call 724-4431; for the second, call 723-5886.

Hormone-replacement therapy study abruptly halted (8/10/02)