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Trajectories of response to acupuncture for menopausal vasomotor symptoms

the Acupuncture in Menopause study

Avis, Nancy E. PhD; Coeytaux, Remy R. MD, PhD; Levine, Beverly PhD; Isom, Scott MS; Morgan, Timothy PhD

doi: 10.1097/GME.0000000000000735
Original Articles

Objective: To examine the trajectories of responses to acupuncture treatment for menopausal vasomotor symptoms (VMS) and the characteristics of women in each trajectory.

Methods: Two hundred nine perimenopausal and postmenopausal women aged 45 to 60 years experiencing at least four VMS per day were recruited and randomized to receive up to 20 acupuncture treatments within 6 months or to a waitlist control group. The primary outcome was percent change from baseline in the mean daily VMS frequency. Finite mixture modeling was used to identify patterns of percent change in weekly VMS frequencies over the first 8 weeks. The Freeman-Holton test and analysis of variance were used to compare characteristics of women in different trajectories.

Results: Analyses revealed four distinct trajectories of change in VMS frequency by week 8 in the acupuncture group. A small group of women (11.6%, n = 19) had an 85% reduction in VMS. The largest group (47%, n = 79) reported a 47% reduction in VMS frequency, 37.3% (n = 65) of the sample showed only a 9.6% reduction in VMS frequency, and a very small group (4.1%, n = 7) had a 100% increase in VMS. Among women in the waitlist control group, 79.5% reported a 10% decrease in VMS frequency at week 8. Baseline number of VMS, number of acupuncture treatments in the first 8 weeks, and traditional Chinese medicine diagnosis were significantly related to trajectory group membership in the acupuncture group.

Conclusions: Approximately half of the treated sample reported a decline in VMS frequency, but identifying clear predictors of clinical response to acupuncture treatment of menopausal VMS remains challenging.

1Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC

2Department of Community and Family Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC

3Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Address correspondence to: Nancy E. Avis, PhD, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063. E-mail:

Received 8 April, 2016

Revised 11 July, 2016

Accepted 11 July, 2016

Funding/support: This study was supported by grant R01AT005854 from the National Center for Complementary and Integrative Health (NCCIM).

Financial disclosure/conflicts of interest: R.R.C. has a financial interest in two organizations involved in recruiting study subjects and administering acupuncture treatments at one of the two study sites. His spouse is the primary shareholder of Chapel Hill Doctors, which is an organization that was subcontracted by Wake Forest School of Medicine as a site for subject recruitment and treatment. A conflict of interest management plan was developed by Duke University and is available upon request.

© 2017 by The North American Menopause Society.