Acupuncture and hot flashes – a winning combination
There have been a lot of naysayers of late with regards to acupuncture. However, one of the largest studies to date examining its impact on menopausal hot flashes has been completed. The results? Acupuncture plus self-care can significantly reduce hot flashes and improve quality of life during menopause!
In the ACUFLASH study, researchers randomized 399 postmenopausal women (1 year since last menstrual period) regularly experiencing at least 7 hot flashes daily to acupuncture or no treatment. Moxibustion was used at the practitioner’s discretion and sessions could also be extended by two weeks (from 12 weeks), if needed. Although the practitioners met beforehand to discuss possible diagnoses and recommended treatment points, all treatment was individualized. Both groups of patients also received self care recommendations, which consisted of a one-page information leaflet on care of menopausal symptoms (e.g. soy, herbs, physical activity and relaxation techniques) which they were free to add at their own discretion.
Overall, the mean frequency of hot flashes declined by 48% in women receiving acupuncture compared with 28% of women using self-care methods only. This means that 50% of women receiving acupuncture experienced a 50% or greater reduction in how often their hot flashes occurred, compared to 16% of women using self-care. Significant reductions were also seen in hot flash intensity. Additionally, the acupuncture group reported significant improvements in vasomotor, sleep, and somatic symptoms over the course of the study.
The researchers have pointed out that previous studies (which have shown mixed results) have relied on smaller numbers of patients, have used sham needles that did not penetrate the skin, and have relied on a standardized practice. In contrast (and in keeping in line with the edicts of eastern medicine) ACUFLASH practitioners individualized treatment according to patients’ needs. This may help to account for the positive results.
I have long argued for a need to modify western methods so that aspects of eastern practice that both make it unique and also form its foundation, may remain intact. This study remained true to the practice of acupuncture while also insuring that certain scientific tenets were followed. I am hopeful that the size of the study coupled with its approach, will open the door for future studies and provide an evidence-based path for women who choose a non-pharmacologic approach to menopause.
Read MoreWednesday Bubble: weathering your hot flashes
Hey Ladies! This week’s bubble comes to you c/o my Twitter friend Gloria Bell, who asked an interesting question: does climate affect hot flashes?
Apparently it does. Although there are not a lot of studies that have been conducted specifically on this topic, an extensive analysis of data from 54 studies suggests that climate may indeed, influence the frequency of hot flashes. Investigators focused the mechanisms underlying hot flashes ( i.e., small elevations in core body temperature within a temperature range where a woman would not normally shiver or sweat –also called the thermoneutral zone), hypothesizing that these zones might actually be climate-specific.
The study:
- Researchers examined information on the frequency of hot flashes from 54 studies and evaluated the correlations between hot flash frequency and geographical latitude, elevation and annual temperatures. Additional analyses were conducted on data derived from studies that included women no older than age 60.
What they learned:
- Among women up to age 60, the average temperature of the coldest month could actually predict how frequently women experienced hot flashes almost a third of the time.
- Among all women, the difference between the hottest climates and the coldest climates significantly predicted hot flash frequency about 26% of the time.
- A climate’s mean annual temperature also predicted hot flash frequency.
Overall, women who lived in warmer temperatures tended to report fewer hot flashes than those in the coldest regions. Hot flashes also tended to increase in areas where there were more seasonal fluctuations.
Although climate plays a role, other factors, such as hormonal imbalance, smoking and diet have also been shown to influence hot flash severity and frequency. Still, it is interesting to learn that where we live may influence the challenges we may face when weathering the menopause storm!
Read MoreNews Flash: Hot hot hot
[youtube=http://www.youtube.com/watch?v=nrhf_zgtmAg]
Think that hormone replacement therapy is going to get rid of those hot flashes forever? Think again. Indeed, researchers have discovered that the majority women who start hormone therapy because of hot flashes and then stop, may experience a recurrence of symptoms!
In this study, which appears in the Ahead of Print edition of Menopause, 1,733 women between the ages of 53 and 54 completed a validated questionnaire looking at menopause, hormone therapy and vasomotor symptoms. Among the women who submitted completed surveys (~73%), 242 had previously used hormones and 69% indicated that they had vasomotor symptoms before starting therapy. Regardless of how long hormone therapy was used, symptoms returned in 87% women who stopped, even if they had completed menopause (although hot flashes were reportedly less frequent and bothersome).
The bottom line: Research has shown that disease risks, e.g. breast cancer, increase when hormone therapy is used more than five years. So clearly, remaining on hormones to address returning symptoms is not a wise option. Rather, safer and equally effective alternatives are needed to address return of symptoms as well as aid in disease prevention.
Read MoreWednesday bubble: age ain’t nothing but a…
Number?
Sometimes it is just that. And sometimes it’s not.
Confused yet? I certainly am.
Australian researchers suggest that many of the more common complaints of menopause may be possibly related to aging in general and not specifically the transition. In fact, in a study presented during last month’s 8th European Congress on Menopause, they reported that menopause is strongly associated with some but not other common complaints.
So what about the other symptoms? After reviewing data from 58,724 women (ages 45 to 50) participating in the Australian Longitudinal Study on Women’s Health, the strongest associations were seen between menopause and hot flashes/night sweats. These findings remained after adjusting for age during the study, age at menopause, smoking history, body mass index, sociodemographics (i.e. education, income, marital status and geographic location) and other factors that might influence outcomes. Other symptoms, including difficulty sleeping, stiff/painful joints and poor or fair self-reported health were also associated with menopause but to a much lesser extent. Headaches, migraines and incontinence appeared to be more strongly related to the aging process.
The researchers say that treatment (in this case, HRT) should be geared primarily towards alleviating vasomotor symptoms. Less clear, however, is how long therapy should be continued, since some symptoms can last for more than seven years. This study is scheduled to appear in Menopause.
Last September, I wrote a post about a survey being reported at the North American Menopause Society’s Annual meeting suggesting that women can actually discern the symptoms of menopause from those of aging. Interestingly, many of the symptoms overlapped; in fact, 84%, 72%, and 77% of respondents associated vaginal dryness, urinary stress incontinence and weight gain, respectively, strictly with menopause, even though they can also be caused by aging as well.
So, what’s the primary point? It can be difficult to tease apart the effects of aging and the effects of menopause. Clearly, these new Australian data add a bit more to the confusion, and reinforce the point that more research and funding is needed in this particular area.
In the interim, I am just as happy to blame the ‘pause for my symptoms as I am to blame age. And equally as happy to take positive steps to overcome some of the more troublesome effects of the transition, regardless of whether it is a direct effect of menopause or not.
All in all, a good thing, right?
Read MoreFuturistic Friday – the bedfan
Besides the awful name (what comes to mind is “bed pan”) this whimsical device may actually save a few partnerships or marriages. The bedfan – a “device that blows a cool breeze under the covers.” Now, granted, it’s not quite as nifty as cleavage coolers, but it still might address those night sweats and flashes and make bedtime more pleasurable, for both parties!
Read MoreWednesday Bubble: Black cohosh strikes again…
I’m beginning to see a pattern in my Wednesday Bubble posts. It certainly is not deliberate. But there’s more good news about black cohosh and I’d like to share it.
A Yale School of Medicine researcher and physician has presented findings of a web-based survey examining the use of Remifemin black cohosh standardized extract among 692 women, ages 35 to 45. The study results, which were displayed this week at the American College of Obstetrics and Gynecology annual meeting, demonstrate that women are using black cohosh to avoid HRT. Okay, no big news there; I’ve posted about the utility of standardized black cohosh in lieu of HRT for almost a year now.
However, not only did almost 90% of women report being satisfied or highly satisfied with black cohosh, but approximately 88% noted that they felt it was effective or very effective for treating their symptoms.
More importantly, however, the study revealed that women are discussing the use of this standardized form of black cohosh with their health practitioners (mostly ob/gyns or family doctors). And, over half — an estimated 53.7% — said that their physicians were supportive of their decision to use black cohosh.
Personally, I find these results very encouraging; not only do they support a long-standing contention that black cohosh, namely Remifemin, is effective for hot flashes, night sweats, and other perimenopausal symptoms, but they also provide evidence that the communication channels between menopausal women and their practitioners are starting to open.
Notably, black cohosh is one of the few herbs that has been consistently shown to alleviate vasomotor symptoms like hot flashes and night sweats. Although there has been some questions about its safety, particularly with regards to liver toxicity, there are accumulating data disputing some of these claims. Indeed, at this year’s ACOG meeting, another researcher examined and compared liver function in 142 patients taking standardized black cohosh extract and 138 taking placebo and found no statistically sigificant changes in liver function. Moreover, analysis of a smaller group of with abnormal liver function values found only one case where there was a significant difference between the groups. This led the researchers to conclude that standardized black cohosh, namely Remifemin, can be used safely.
Personally, I’ve been using Remifemin for over a year now. Recommended by a health practitioner and endorsed by my Ob/Gyn, along with a variety of other Chinese and Western herbs, I’ve been fortunate and have found significant relief from night sweats.
Like any herbal preparation, be sure to speak with a health practitioner who is certfied in practicing herbal medicine and can monitor your progress to insure that your regimen is safe and effective. But it is wonderful to know that traditional Western practitioners may be finally opening their eyes to HRT alternatives. Bravo!
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