Summary:
Perimenopause describes the transition period before menopause and the first year after menstruation stops, during which declining ovarian function and fluctuating estrogen levels can lead to a range of physical and psychological symptoms. Common problems include hot flushes, sleep disturbance, fatigue, mood changes, urinary and sexual symptoms, musculoskeletal discomfort, and abnormal bleeding, all of which may reduce quality of life and increase emotional and social burden. Hormone replacement therapy is widely recommended as a first-line treatment, but concerns about long-term risks such as breast cancer, endometrial cancer, cardiovascular disease, and stroke have encouraged interest in complementary therapies. Acupuncture has been suggested as a safe alternative. This study is a meta-analysis of randomized controlled trials examining the effectiveness of different acupuncture approaches for managing perimenopausal syndrome. The analysis included 49 randomized controlled trials involving 4,579 participants. Results suggested that different acupuncture modalities may be better suited to specific clinical outcomes. Acupuncture combined with Western medicine showed the greatest benefit for hormonal regulation, while electroacupuncture combined with Western medicine appeared most effective for overall menopausal symptoms and depressive symptoms. Electroacupuncture alone demonstrated the strongest effect on anxiety, auricular plus body acupuncture showed the greatest improvement in sleep, and moxibustion demonstrated the highest overall effectiveness across outcomes. Acupuncture combined with Chinese medicine was most beneficial for traditional Chinese medicine symptom measures. Overall, this study indicates that several acupuncture approaches may provide meaningful symptom relief for women experiencing perimenopausal syndrome, supporting the use of individualized treatment strategies.
Abstract:
Background: Perimenopausal women commonly suffer from symptoms like hot flashes, insomnia, and mood swings, impacting quality of life. While acupuncture is a widely used and effective non-pharmacological treatment, the relative efficacy of different acupuncture modalities remains unclear. This study aimed to compare the effects of various acupuncture approaches on perimenopausal symptoms through a network meta-analysis. Methods: A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CBM, and VIP databases for randomized controlled trials (RCTs) comparing acupuncture interventions for perimenopausal syndrome, with the search updated to June 27, 2025. Risk of bias was assessed using the Cochrane tool. Network meta-analysis was performed using Stata 15 and R version 4.3. Results: A total of 49 RCTs with 4,579 participants were included. Acupuncture combined with Western medicine (AWM) was most effective for hormone regulation. Acupuncture plus Chinese medicine (ACM) best improved traditional Chinese medicine (TCM) symptoms, while electroacupuncture combined with Western medicine (EAWM) was optimal for menopausal symptoms and depression. Electroacupuncture (EA) alone was most effective for anxiety, auricular plus body acupuncture (AAA) improved sleep the most, and moxibustion (M) showed the highest overall effectiveness. Conclusion: Various acupuncture modalities show beneficial effects on perimenopausal syndrome, particularly AWM, EAWM, EA, AAA, and M. These findings provide evidence-based guidance for individualized treatment selection, although further high-quality RCTs are warranted for validation.
Article Publication Date: 15/01/2026
DOI: 10.3389/fneur.2025.1696085
