Acupuncture against hot flushes in menopause

The Research Council of Norway has granted 4.5 mill NOK over 3 years to a randomised controlled study of acupunctural treatment of hot flushes in menopause. Does acupunctural treatment in menopause result in any substantial improvement regarding the number of hot flushes and regarding health related quality of life compared to what women can do themselves to relieve the discomforts?

Why acupuncture?
Until a few years ago oestrogen was recommended to relieve discomforts in menopause. However, international and Norwegian studies have shown that the use of oestrogen in fact increases the risk of breast cancer and cardiovascular diseases. In Norway the sale of oestrogen has decreased 40% since 2001. Acupunctural treatment can be an alternative to prevent these kinds of discomforts. A smaller Swedish study reports 70% reduction of hot flushes after acupunctural treatment. A couple of unpublished Norwegian series of patient histories (case-series) imply that acupuncture could prevent hot flushes at menopause. This is not sufficient evidence to recommend acupuncture for discomforts in menopause, but this form of treatment should be examined further.

Traditional Chinese medical acupuncture
In Norway it is mainly the traditional Chinese medical (TCM) acupuncture that is practiced. The treatment involves that the acupuncturist makes a diagnosis based on traditional Chinese medicine and gives an individual treatment. Experienced acupuncturists consider that a minimum of 6 treatments is necessary to demonstrate an effect and a minimum of 8-10 treatments to give a more durable effect. We will recruit experienced TCM-acupuncturists to the treatment-team of this study.

Start-up in March 2006
The study will take place in Tromsø, Oslo, Trondheim and Bergen. Around 300 Norwegian women will participate. They will be recruited by means of media publicity and announcements. Women who wish to participate have to register their hot flushes, and if they have a certain amount of hot flushes pr. day they will be included in the study. At start-up they will be separated into 2 groups. One group will receive 10 acupunctural treatments. The other group (the control group) will not receive any treatment but will receive a list of things they can do themselves to relieve the torments. We will measure the occurrence of hot flushes before and after treatment (primary end point) and the health related quality of life (Women’s Health Questionnaire, secondary end point). The study will last for 12 weeks. In addition we want to follow up the participants after 6 and 12 months. Participants who complete the long-run follow-up will be given a gift-coupon worth kr.500.

Who is behind this study?
A widely composed multidisciplinary group works with this study which is based in Tromsø:
Project manager Sameline Grimsgaard, dr.med., MPH (University Hospital of North Norway),
Project worker Sissel Andersen (Institute of Community Medicine, University of Tromsø),
Research fellow Sigrid Brækkan, MSc, pharmacist (NAFKAM, University of Tromsø),
Researcher Terje Alræk Bac, PhD, acupuncturist (NAFKAM, University of Tromsø),
Researcher Adrian White, Dr.med., acupuncturist (Peninsula Med.School, Plymouth, UK).

In addition professor Vinjar Fønnebø (NAFKAM, University of Tromsø) and associate professor Anne Elise Eggen (Pharmaceutical Institute, University of Tromsø) are related to the project.