Archive | 2019
Yoga and acupuncture versus ‘ ‘ sham ’ ’ treatments for menopausal hot flashes : how do they compare ?
Abstract
sessions), whereas the health and wellness education included W omen experiencing transition to menopause frequently report troubling vasomotor symptoms (VMS), especially hot flashes. Although hormone therapy (HT) is an effective pharmacological treatment, many women prefer nonpharmacological options. Furthermore, HT is contraindicated in some women and not without risk. For example, in women with existing cardiovascular disease or recent breast cancer, HT may not be an option. There is evidence that acupuncture is effective in reducing the frequency and duration of hot flashes. Similarly, yoga appears to be a safe and effective means of reducing menopausal symptoms comparable to other exercise interventions, but with an added effect on VMS. The article published in this issue of Menopause by Avis et al confirms the benefits of acupuncture and yoga on hot flashes, but also reports similar positive effects in attention control groups receiving either sham acupuncture or health and wellness education, compared to usual care and waitlist control. The article reports results of a pooled analysis of three trials with a total enrolment of 319 perimenopausal and postmenopausal women experiencing four or more hot flashes per day and not currently taking HT, with the primary outcome measure being percentage reduction in self-reported daily hot flashes. When comparing three active interventions (one yoga, two acupuncture), two attention control groups (sham acupuncture, health and wellness education classes), and three passive control groups (one usual care, two waitlist) they found similar significant effects on hot flashes in all active intervention and attention control groups over 8 weeks. Interestingly, the attention control groups were equally effective to the actual yoga and acupuncture treatments. The authors pose a number of possible explanations including the attention control conditions being active treatments; the effects of patient provider interactions; and treatment expectations/placebo effect. The sham acupuncture involved shallow needling twice a week for 8 weeks (30-minute treatment