She’s got moxi
Have you heard of or experienced moxibustion? Moxibustion is a technique used during acupuncture in which mugwort (or artemsia vulgaris) is burned to warm certain regions or acupuncture points. It can be direct (in which the moxa is placed directly on the acupuncture point) and indirect (in which the moxa is palced approximately 1 to 2 cm above the acupuncture point). The purpose of moxibustion is to encourage better blood and energy flow through the area to promote healing.
A study in the March 13 advanced online edition of Menopause suggests that moxibustion plus acupuncture can reduce both the frequency and severity of hot flashes.
In this study, researchers randomly assigned 51 women, ages 45 to 60 years who experienced at least 5 moderate to severe hot flashes daily to:
- 14 sessions of indirect moxibustion plus acupuncture at points consistent with evidence from clinical practice experience
- 14 sessions of indirect moxibustion plus acupuncture at points consistent with evidence from published literature
- no treatment
To ensure that researchers were able to distinguish between general improvements and improvements resulting from treatment, all study participants had to go through a 1-week period during which time they used not treatments at all.
Study findings showed that compared with no treatment at all, women in both moxibustion groups experienced significantly reductions in hot flash frequency (roughly 60% in both groups), and continuous reductions in hot flash severity through the fourth week of the study (by as much as 50%). 10 participants experienced side effects due to the moxi smoke (e.g. fatigue, stomach upset, flare-up and headaches ) and 5 reported burns to their skin).
Notably, women receiving moxibustion along points directed by published literature also experienced more improvements in quality of life scores, particularly as they related to symptoms and psychosocial issues.
This study appears to indicatethat moxibustion may help to enhance acupuncture’s effect on hot flashes during the menopause. Clearly, more studies with larger samples are needed.
Read MoreWhat’s your sleep number?
[Rembrandt van Rijn, Sleeping Woman, 1658]
On a scale of 1 to 5 would you say that your sleep number (the quality of your sleep) is:
- nonexistent, I never sleep
- occasional, I sleep one or two nights a week
- obstructed, I sleep but I wake up regularly throughout the night
- pretty good, I rarely wake up
- great, I typically sleep through the night
If you are like most peri- post menopausal women, it’s likely that you rate the quality of your sleep about a “3. ” In fact, a review in the journal Current Neurology and Neuroscience Reports suggests that 28% to 64% of peri- or postmenopausal women have some form of sleep disturbances that may aggravated by sleep apnea, periodic limb movements syndrome (restless leg syndrome) and psychological distress (anxiety, major depression).
One of the primary causes of sleep disruption during menopause is declining estrogen levels, which increase peripheral and central temperature, dilate blood vessels and lead to hot flashes. Unfortunately data also suggest that hot flashes double the time spent awake although ironically, they often follow rather than proceed awake times.
More good news: both sleep apnea and periodic limb movements syndrome increase with age. Menopausal women are espeically at risk due to declining progesteron levels and increased body mass index (and associated increases in neck circumference). Both sleep apnea (in which the airways become partially or totally obstructed) and periodic limb movements obviously interefere with sleep quality. In fact, sleep researchers have documented apnea, restless leg syndrome or both in up to 53% of women between the ages of 44 and 56.
The evidence is less certain for mood disturbances and sleep, although studies have shown clear links between reproductive hormonal changes and clinical depression in women going through menopause. What’s more, women in menopause who are clinically depressed have reported more frequent and longer times awake than those who do not have any mood disturbances.
Steps to take
I’ve written previously on this issue and there are a variety of non-pharmacologic steps that might improve sleep quality including standardized herbs and acupuncture.
Hypnosis, relaxation techniques that include breathing and/or biofeedback) may also assist. These strategies are part of a larger approach called cognitive-behavioral therapy for insomnia (CBT-I) which in a small study, was found to significantly improve anxiety, depression, partner relationships, sexuality and hot flashes in menopausal women.
Notably, the benefit of HRT for sleep/mood disturbances remains unclear and studies are inconclusive.
As with any issue associated with menopause, it’s critical to speak to a health practitioner about the issue so that the course of therapy can be safely individualized and personalized.
What about you? How’s your sleep? And what are you doing about it?
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Just when you thought it was safe…
Researchers now say vasomotor symptoms, such as hot flashes, night sweats and sleep disturbances, can last more than five years after menopause ends.
Clearly, this has a lot of implications of how we approach therapeutic interventions for hot flashes and other symptoms, as well as for planning ahead.
In this study, which is published on the advanced online edition of the journal Menopause, data were colllected from 438 menstruating women (ages 45-69 years) and then analyzed over a period of 13 years.
The findings showed that the mean duration of hot flashes over the study period was 5.5 years, regardless of whether or not women had ever used hormone replacement therapy. What’s more, study participants started experiencing hot flashes around age 53, and roughly a quarter of them continued to report having symptoms after the 13 year endpoint.
Importantly, the one factor that was associated with a shorter duration of hot flashes was exercise, with more exercise/physical activity associated with shorter symptom duration.
I’ve posted previously about the benefits of exercise and physical activity, which range from positive effects on bone health, sleep and mood to heart health and of course, overall symptoms. This study suggests an even more important reason to keep moving: slowing and perhaps eliminating menopausal symptoms sooner rather than later.
Move your bodies ladies – the evidence is in and it says it’s safe to step back in, one foot at a time.
Read MoreMore great news about needles
Tis the Season for needles…pine and otherwise!
Norwegian researchers are reporting that acupuncture plus self-care can reduce the frequency of hot flashes substantially in postmenopausal women! Now that’s a gift I can get my arms around!
In this study, published in the December 4 advanced, online edition of Menopause, 267 postmenopausal women who experienced at least 7 hot flashes every 24 hours for at least 7 consecutive days received:
1) 10 acupuncture treatments plus an informational brochure on self-care for menopause symptoms, or
2) An informational brochure on self-care for menopause symptoms only
The results showed that hot flash frequency decreased by 50% over 24 hours in women receiving acupuncture compared to those who only received self-care instructions. The researchers aso noted significant improvements in vasomotor (e.g. night sweats) , sleep and emotional/psychological symptoms among women receiving acupuncture.
I’ve written about the value of acupuncture for hot flashes and improved sleep quality previously. I’m glad to see that more evidence is accruing supporting this wonderful, safe modality to improve menopausal symptoms.
The American Association of Acupuncture and Oriental Medicine is also an excellent source for more information and help finding a qualified practitioner.
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