Insights & Discussion
Acupuncture alone or combined with standard care was associated with significant improvements in perimenopausal depression and reductions of other menopausal symptoms.
Our review found that acupuncture was better than standard care alone in reducing HAMD score by 1.4–3.6, which is of clinical significance—acupuncture is better than or at least equivalent to antidepressant in improving perimenopausal women's depression. In addition to the satisfactory short-term effects, the intermediate- and long-term benefits of acupuncture against PMD outlast those of antidepressants. Long-term clinical efficacy is crucial in the management of depressive symptoms, as depression is characterized by a high recurrence rate. Frequent relapse of depression and withdrawal symptoms of antidepressants are also two major reasons for numerous patients reject psychotropic agents and seek help from CAM therapy.
It is interesting to note that acupuncture also improved perimenopausal symptoms (decreased KI scores), better than either antidepressant alone or antidepressant combined with HRT, reflecting different underlying mechanisms of the two interventions (acupuncture vs. pharmacotherapy).
Discover Related Insights
Acupuncture can improve both perimenopausal depression and insomnia with short-medium term effects while being a safe treatment.
2023 Frontiers in Public Health Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial Zhao FY, Zheng Z, Fu QQ, Conduit R, Xu H, Wang HR, et al.
Randomised Controlled Trial Perimenopausal Depression
The experiment involved seventy eligible participants who were randomly assigned to either a real-acupuncture (RA) or a sham-acupuncture (SA) group. They were given 17 sessions of either RA or SA treatments over an 8-week timeframe. The primary outcomes for mood and sleep were evaluated using the 17-item Hamilton Depression Rating Scale and the Pittsburgh Sleep Quality Index scores. Secondary outcomes included an evaluation of anxiety symptoms, perimenopausal symptoms, and quality of life. Also, participants' experiences and overall satisfaction with treatment were assessed. Blood samples were collected as well to measure reproductive hormone levels.
Reports indicate that 65 participants completed all treatment sessions while 54 and 41 participants completed the 8-week and 16-week follow-ups respectively. The results showed the RA group to have a bigger reduction of Pittsburgh Sleep Quality Index scores at post-treatment and 8-week follow-up compared to the sham-acupuncture group. Although, the change in the Hamilton Depression Rating Scale scores for the RA group wasn’t significantly different from the sham group. There were no significant mean differences for the Hamilton Depression Rating Scale or the Pittsburgh Sleep Quality Index between the two groups from the beginning to the 16th-week follow-up, nor were any differences noted in serum reproductive hormone levels among the groups. No major adverse events were reported.
The present study indicated that acupuncture had an advantage over hormone replacement therapy in reducing serum FSH level and increasing serum E2 level in women with premature ovarian insufficiency.
2020 Journal of Acupuncture and Tuina Science Acupuncture for premature ovarian insufficiency: a systematic review and meta-analysis Yin, Yq., Xu, Hf., Fang, Yg. et al.
Systematic Review FSH HRT Ovarian Function
Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level and a remarkable elevation in the basal E2 level in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone and acupuncture plus HRT, while a remarkable elevation of E2 was only found in acupuncture plus HRT. There was no significant difference in the LH level between acupuncture and HRT, only one trial reported AMH, and no significant difference was found between acupuncture and HRT.