Acupuncture Continuing Education

Acupuncture Perimenopause Relief

Acupuncture is safe and effective for the treatment of perimenopause. Researchers from Heilongjiang University of Chinese Medicine and Henan University of Chinese Medicine investigated the effects of acupuncture on perimenopausal syndrome as it relates to metabolism, reproductive endocrinology, and the immune system. Abdominal points used in TCM gynecology. Clinical and laboratory findings reveal important biochemical benefits induced by acupuncture and electroacupuncture.

Onset of perimenopause may occur years prior to menopause. It may occur in the 40s, 30s, or earlier and is related to a decrease in estrogen production by the ovaries. Perimenopause typically lasts approximately four years. Indications of perimenopause include hot flashes, fatigue, increased premenstrual syndrome (PMS), irregular menstrual cycles, insomnia, vaginal dryness, decreased libido, mood swings, anxiety, and breast tenderness. Conventional treatments include hormone replacement therapy, antidepressants, and vaginal lubricants.

The researchers note that a reduction of serum estradiol in perimenopausal women leads to changes in the hypothalamic-pituitary-ovarian (HPOA) axis thereby causing pathologies. Citing several investigations in their meta-analysis, the researchers note that acupuncture regulates the HPOA and levels of serum estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH). Additionally, they document the clinical success of acupuncture for the treatment of hot flashes.

The meta-analysis covered a large body of research. Jin et al. compared acupuncture with Premarin oral intake. Premarin is a brand name for conjugated estrogens. The acupuncture group received the administration of Back-Shu acupoints. The acupuncture group demonstrated superior patient outcomes over the group taking oral conjugated estrogens.

Shang et al. document that Yuan-Primary and Back-Shu acupoints are effective for the regulation of estradiol, FSH and LH in perimenopausal women. Qin et al. conclude that electroacupuncture applied to acupoint SP6 (Sanyinjiao) effectively modulates reproductive endocrine system functions in perimenopausal women. Li et al. measured significant beneficial increases of estradiol levels in perimenopausal women after the application of either of two acupuncture point prescriptions. Prescription #1 was:

  • Guanyuan (CV4)
  • Sanyinjiao (SP 6)

Prescription # 2 was:

  • Neiguan (PC6)
  • Zusanli (ST36)

Human clinical trials are augmented by laboratory research. Chen et al. conducted an experiment entitled “Effects of electroacupuncture on the expression of estrogen receptor protein and mRNA in rat brain.” Electroacupuncture increased estradiol levels while downregulating other factors thereby normalizing “the function of hypothalamic-pituitary-ovarian axis.” The work of Yao et al. confirms that electroacupuncture can increase estradiol levels and expression of prolactin releasing peptide in the medulla oblongata. The researchers cited several other studies demonstrating that acupuncture increases estradiol levels by transforming androgen into estrogen and by “promoting aromatase activity and mRNA expression in adipose and liver tissues.” 

The above findings are but a few covered by the researchers. They examined the regulatory effects of acupuncture on the immune and neuroendocrine systems plus the regulatory effects of acupuncture on metabolism. This broad body of research confirms acupuncture’s ability to regulate bodily systems. 

Upper body acudoll.

The researchers conclude that acupuncture is effective in the treatment of perimenopause “by improving clinical symptoms such as menstrual disorders, hot flashes, sweating, insomnia, and mood disorders.” They add that acupuncture benefits perimenopausal women by:

  • increasing estrogen levels
  • decreasing levels of FSH and LH
  • increasing estrogen receptor protein expression
  • inhibiting GnRH
  • transforming androgen into estrogen

Immunity system benefits of acupuncture include increasing E-selectin and L-selectin and also by regulating immune cell estrogen receptor expression. Neuroendocrine benefits of acupuncture include:

  • increasing dopamine and GABA
  • decreasing aspartate and glutamate
  • free radical regulation via nitric oxide and superoxide dismutase
  • blood lipid regulation
  • oxidative stress suppression
  • bone metabolism regulation of alkaline phosphatase and DPD

The researchers note that the goal of their study was to investigate and summarize the mechanisms by which acupuncture affects perimenopausal women. They document clinical benefits and important biological regulatory effects induced by acupuncture and electroacupuncture. Given the large body of supportive research, the investigators recommend a multicenter study to further evaluate the effects of acupuncture on perimenopause.

In related research, Tan et al. concluded that acupuncture combined with Chinese herbal medicine is effective in the relief of insomnia due to perimenopause. The researchers combined administration of the herbal formula Zi Shen Tiao Gan Tang with acupuncture. The total effective rate of the combined therapy increased significantly over using acupuncture as a standalone therapy. Acupuncture achieved a total effective rate of 74.60% but the combined therapy achieved a 96.83% total effective rate.

Online Courses
At the Healthcare Medicine Institute (HealthCMi), we offer many acupuncture continuing education courses for the treatment of gynecological related conditions. The course entitled The Menstrual Cycle covers the treatment of menorrhagia, PCOS, painful menstruation and many other important health concerns. The course entitled Free the Qi and Blood covers treatments for ovarian cysts, leukorrhea, uterine bleeding, PMS, breast nodules, and more. There are many other online courses at HealthCMi including Herbal Insights: Tonify Blood, which covers the treatment of menopause, dysmenorrhea, PMS, and late menstruation. This course is presented by Prof. Richard Liao, L.Ac. and is available 24/7 for acupuncture CEUs and  NCCAOM PDAs through the HealthCMi online learning system.

Li, Rui-li, Jin-ying Fu, Ying-ying Deng, Wen-juan Shen, Hong-li Ma, Wei Li, and Xiao-ke Wu. "Review of acupuncture treatment for perimenopausal syndrome." Journal of Acupuncture and Tuina Science 2, no. 13 (2015): 129-133.

Chen BY. Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis. Acupunct Electrother Res, 1997, 22(2): 97-108.

Zhao H, Tian ZZ, Chen BY. Electroacupuncture stimulates hypothalamic aromatization. Brain Res, 2005, 1037(1-2): 164-170.

Cheng K, Tian SL. Effects of preventive- electroacupuncture of “Guanyuan” (CV 4) and “Sanyinjiao” (SP 6) on hypothalamus-pituitary-ovary axis in ovariectomized rats. Zhen Ci Yan Jiu, 2012, 37(1): 15-19.

Hu L, Wang HL, Gao XZ, Shen XM, Jin R, Zhu QC, He ZB. Comparison of regulative effects of electro- acupuncture at “Guanyuan” (CV 4) and “Sanyinjiao” (SP 6) on sex hormones and hypothalamic β-endorphin in perimenopausal model rats. Zhongguo Zhen Jiu, 2004.

Jin H, Liu TT, Wang R. Clinical observation on acupuncture at the five-zangshu for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2007, 27(8): 572-574.

Shang YJ, Bhang Y, Kong LL, Wang YY, Wang DS, Li J. Clinical observation on combination of source point and Back-Shu point for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2009, 29(6): 444-448.

Qin ZY, Ling H, Xia XH, Meng L, Wu ZJ. Effects of electroacupuncture of Sanyinjiao (SP 6) on genito- endocrine in patients with perimenopausal syndrome. Zhen Ci Yan Jiu, 2007, 32(4): 255-259.

Li Y, Xia Y, Liu SM, Ju ZY, Shi XL, Chen MG, Cheng L, He JS. Effect of electroacupuncture on serum sex hormones in patients with perimenopausal syndrome. Shanghai Zhenjiu Zazhi, 2010, 29(4): 199-201.

Chen BY, Cheng LH, Gao H, Ji SZ. Effects of electroacupuncture on the expression of estrogen receptor protein and mRNA in rat brain. Shengli Xuebao, 1998, 50(5): 495-500.

Yao X, Wang XQ, Ma SL, Chen BY. Electroacupuncture stimulates the expression of prolactin-releasing peptide (PrRP) in the medulla oblongata of ovariectomized rats. Neurosci Lett, 2006, 411(3): 243-248.

Tan KP, Yao X, Li XW. Observation on clinical effect of acupuncture plus Zi Shen Tiao Gan Decoction for perimenopausal insomnia. J Acupunct Tuina Sci, 2015, 13 (1): 49-53.

Acupuncture Continuing Education Credits