Factors associated with a clinically relevant reduction in menopausal symptoms of a standardized acupuncture approach for women with bothersome menopausal symptoms

Frans Boch Waldorff, Christine Winther Bang, Volkert Siersma, John Brodersen, Kamma Sundgaard Lund, Frans Boch Waldorff, Christine Winther Bang, Volkert Siersma, John Brodersen, Kamma Sundgaard Lund

Abstract

Background: Little is known about factors associated with a clinically relevant reduction in menopausal symptoms through a brief acupuncture approach for women with moderate-to-severe menopausal symptoms.

Methods: Post hoc analysis of a randomized controlled trial where participants were allocated to early versus late standardized acupuncture. Both the early group and the late group are included in this study. The late group got an identical intervention parallel staged by 6 weeks. By means of the relative importance, the effect was evaluated for both early versus late women with a 6-week follow-up. We included four symptom subscales from the validated MenoScores Questionnaire: hot flushes, day and night sweats, general sweating, menopausal-specific sleeping problems, as well as an overall score, which is the sum of the four outcomes in the analysis.

Results: 67 women with moderate to severe menopausal symptoms were included of whom 52 (77.6%) experienced a clinically relevant reduction in any of the four surveyed symptom subscales or overall score. 48 (71.6%) women experienced a clinically relevant reduction in any of the vasomotor symptom subscales: hot flushes, day and night sweats, general sweating. Women with vocational education were most likely to experience improvement compared to women with higher education. Beyond education, other factors of some importance for a clinically relevant reduction were no alcohol consumption, two or more births and urinary incontinence.

Conclusions: Level of education was the most consistent factor associated with improvement. Beyond education, other factors of some importance were no alcohol consumption, two or more births and urinary incontinence.

Trial registration: This study was registered in ClinicalTrials.gov at April 21, 2016. The registration number is NCT02746497 .

Keywords: Acupuncture; Clinical trials; Menopause; Primary care.

Conflict of interest statement

None declared.

References

    1. Whiteley J, Wagner JS, Bushmakin A, Kopenhafer L, Dibonaventura M, Racketa J. Impact of the severity of vasomotor symptoms on health status, resource use, and productivity. Menopause (New York, NY). 2013;20(5):518–24.
    1. Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009;62(2):153–159.
    1. Geukes M, van Aalst MP, Robroek SJ, Laven JS, Oosterhof H. The impact of menopause on work ability in women with severe menopausal symptoms. Maturitas. 2016;90:3–8.
    1. Nelson HD. Menopause. Lancet (London, England). 2008;371:760–70.
    1. Stearns V, Ullmer L, Lopez JF, Smith Y, Isaacs C, Hayes D. Hot flushes. Lancet (London, England). 2002;360(9348):1851–61.
    1. Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–539.
    1. Col NF, Guthrie JR, Politi M, Dennerstein L. Duration of vasomotor symptoms in middle-aged women: a longitudinal study. Menopause (New York, NY). 2009;16(3):453–7.
    1. Pachman DR, Jones JM, Loprinzi CL. Management of menopause-associated vasomotor symptoms: current treatment options, challenges and future directions. Int J Women's Health. 2010;2:123–135.
    1. Lund KS, Siersma VD, Christensen KB, Waldorff FB, Brodersen J. Measuring bothersome menopausal symptoms: development and validation of the MenoScores questionnaire. Health Qual Life Outcomes. 2018;16(1):97.
    1. Lund KS, Siersma V, Brodersen J, Waldorff FB. Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study) BMJ Open. 2019;9(1):e023637.
    1. Lund KS, Siersma V, Bang CW, Brodersen J, Waldorff FB. Sustained effects of a brief and standardised acupuncture approach on menopausal symptoms: post hoc analysis of the ACOM randomised controlled trial. Acupunct Med. 2020;964528420920280.
    1. Avis NE, Coeytaux RR, Levine B, Isom S, Morgan T. Trajectories of response to acupuncture for menopausal vasomotor symptoms: the acupuncture in menopause study. Menopause. 2017;24(2):171–179.
    1. White A. Western medical acupuncture: a definition. Acupuncture in medicine : journal of the British Medical Acupuncture Society. 2009;27(1):33–35.
    1. Lund KS, Brodersen J, Siersma V, Waldorff FB. The efficacy of acupuncture on menopausal symptoms (ACOM study): protocol for a randomised study. Danish medical journal. 2017;64(3).
    1. Johnson JWLJ. History and use of relative importance indices in organizational research. Organ Res Methods. 2004;7:238–257.
    1. Ekholm O JH, Davidsen M, Christensen AI. Alternativ behandling. Sundheds- og sygelighedsundersøgelsen 2017. Copenhagen: Statens Institut for Folkesundhed, SDU.
    1. Vase L, Baram S, Takakura N, Yajima H, Takayama M, Kaptchuk TJ, et al. Specifying the nonspecific components of acupuncture analgesia. Pain. 2013;154(9):1659–1667.
    1. Torgerson DJ, Thomas RE, Campbell MK, Reid DM. Alcohol consumption and age of maternal menopause are associated with menopause onset. Maturitas. 1997;26(1):21–25.
    1. Gavaler JS, Imhoff AF, Pohl CR, Rosenblum ER, Van Thiel DH. Alcoholic beverages: a source of estrogenic susbstances? Alcohol Alcoholism. 1987;1:545–549.
    1. Avis NE, Legault C, Coeytaux RR, Pian-Smith M, Shifren JL, Chen W, et al. A randomized, controlled pilot study of acupuncture treatment for menopausal hot flashes. Menopause. 2008;15(6):1070–1078.
    1. Borud EK, Alraek T, White A, Fonnebo V, Grimsgaard S. The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH) study: a study protocol of an ongoing multi-Centre randomised controlled clinical trial. BMC Complement Altern Med. 2007;7:6.
    1. Kim KH, Kang KW, Kim DI, Kim HJ, Yoon HM, Lee JM, et al. Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women--a multicenter randomized clinical trial. Menopause. 2010;17(2):269–280.
    1. Nedeljkovic M, Tian L, Ji P, Deglon-Fischer A, Stute P, Ocon E, et al. Effects of acupuncture and Chinese herbal medicine (Zhi mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial. Menopause. 2014;21(1):15–24.
    1. Painovich JM, Shufelt CL, Azziz R, Yang Y, Goodarzi MO, Braunstein GD, et al. A pilot randomized, single-blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause. Menopause. 2012;19(1):54–61.
    1. Vincent A, Barton DL, Mandrekar JN, Cha SS, Zais T, Wahner-Roedler DL, et al. Acupuncture for hot flashes: a randomized, sham-controlled clinical study. Menopause. 2007;14(1):45–52.
    1. Rosted P Akupunktur: på naturvidenskabeligt grundlag. 1th ed. Århus: Klim; 2003.
    1. Ee C, French SD, Xue CC, Pirotta M, Teede H. Acupuncture for menopausal hot flashes: clinical evidence update and its relevance to decision making. Menopause (New York, NY). 2017;24(8):980–7.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel