title: Acupuncture for menopausal hot flashes: clinical evidence update and its relevance to decision making.
abstract: OBJECTIVE
  There is conflicting evidence on the efficacy and effectiveness of acupuncture for menopausal hot flashes. This article synthesizes the best available evidence for when women are considering whether acupuncture might be useful for menopausal hot flashes.
  
  
  METHODS
  We searched electronic databases to identify randomized controlled trials and systematic reviews of acupuncture for menopausal hot flushes.
  
  
  RESULTS
  The overall evidence demonstrates that acupuncture is effective when compared with no treatment, but not efficacious compared with sham. Methodological challenges such as the complex nature of acupuncture treatment, the physiological effects from sham, and the significant efficacy of placebo therapy generally in treating hot flashes all impact on these considerations.
  
  
  CONCLUSIONS
  Acupuncture improves menopausal hot flashes compared with no treatment; however, not compared with sham acupuncture. This is also consistent with the evidence that a range of placebo interventions improve menopausal symptoms. As clinicians play a vital role in assisting evidence-informed decisions, we need to ensure women understand the evidence and can integrate it with personal preferences. Some women may choose acupuncture for hot flashes, a potentially disabling condition without long-term adverse health consequences. Yet, women should do so understanding the evidence, and its strengths and weaknesses, around both effective medical therapies and acupuncture. Likewise, cost to the individual and the health system needs to be considered in the context of value-based health care.
authors.affiliation: 1National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia 2Department of General Practice, University of Melbourne, Melbourne, Australia 3School of Rehabilitation Therapy, Queen's University, Kingston, Canada 4School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Melbourne, Australia 5Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Ee
authors.forename: Simon D
authors.initials: SD
authors.lastname: French
authors.forename: Charlie C
authors.initials: CC
authors.lastname: Xue
authors.forename: Marie
authors.initials: M
authors.lastname: Pirotta
authors.forename: Helena
authors.initials: H
authors.lastname: Teede
mesh_terms: D005260:Female; D006801:Humans; D026881:Acupuncture; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D019584:Hot Flashes / Q000628:therapy; D008593:Menopause; D016032:Randomized Controlled Trials as Topic