Acupuncture for menopause

Acupuncture is a traditional component of traditional chinese medicine, in which thin needles are inserted into the skin at key points in the body to balance the flow of energy or chi. Evidence to support the use of acupuncture to ease a wide range of symptoms found in perimenopause and menopause is lacking, but some women do find it beneficial. Acupuncture for menopause is one of the choices if you are looking at alternatives to hormone replacement therapy.

The first part of this article is written by Dr Carys Sonnenberg, GP and BMS registered menopause specialist and the founder of Rowena Health.

I have to question evidence when I recommend any treatment to my patients. Is it safe? Is it effective? Is it worth them investing their money in this treatment? Is it best for their individual care? I have heard positive individual reports from friends and patients about this, but when I looked at the medical evidence what did I find in medical journals about acupuncture?

Evidence from references below

• A Cochrane review assessed eight low-quality studies and suggested that acupuncture, when compared with no treatment at all, reduced the intensity of hot flushes. This seems positive, however, when acupuncture was compared with sham acupuncture, there was no reported difference in relief of hot flushes. Sham acupuncture is as placebo acupuncture procedure, it mimics the physical experience of real acupuncture, like needle placement or the sensation of touch, but is designed not to have the same physiological or therapeutic effect). This suggests a large placebo effect and needling at acupuncture points does not appear to reduce the frequency or intensity of hot flushes and night sweats, and therefore cannot be recommended for the treatment of hot flushes and night sweats.
• One randomised controlled trial suggested reduction of hot flushes may be of more benefit in breast cancer survivors if practitioners are trained in menopause acupuncture.
• A systematic review of five trials (181 patients) demonstrated a reduction in aromatase-induced arthralgia (joint pain), suggesting a safe and effective non-pharmacological treatment.

It is important to consider that, lack of evidence, does not mean lack of benefit of a treatment for an individual. If you are consider acupuncture, it seems from the information above that it can be approached with an open mind and it is important to see a practitioner trained in menopause acupuncture.

In order to investigate this further, I was delighted to meet Melanie Cullis, who has written the rest of this article for education and to support a holistic approach for menopause care. She answers some of the more common questions about using acupuncture to manage the symptoms menopause.

Traditional Chinese Medicine is one of the oldest medical systems in the world. Originating in China over 2,000 years ago it is practised in all corners of the globe, making it one of the most widely recommended treatments worldwide. Many doctors refer to Traditional Acupuncturists to support their patients with countless health concerns, making it both a highly effective standalone and complementary medicine.

Acupuncture can treat hundreds of conditions, and its success in supporting women throughout their life stages is well documented and researched. Acupuncture is effective in harmonising menstrual cycles such as irregular, painful periods, PMS and assisting with conditions such as Endometriosis, PCOS, and infertility. Due to its key role in supporting hormonal imbalance, it is highly suited to help women as they go through perimenopause and menopause – whether they are taking HRT or not.

How can Acupuncture support me with perimenopausal/menopausal symptoms?

Acupuncture is fantastic at treating people, not conditions as it is a bespoke form of medicine. Every single woman will have a different experience of perimenopause and I see a vast range of symptoms in my clinic every day, therefore every treatment given is different. One woman may have debilitating hot flushes, one may have menstrual flooding and depression and others may feel a mix of hot and cold symptoms. One woman may have palpitations and insomnia, another may experience outbursts of anger and headaches. Chinese Medicine treats the root cause of the symptoms, so they don’t return.

Importantly, your Acupuncturist will also take into account any other existing or underlying health issues you may have such as gynaecological issues, hypothyroidism, chronic pain or autoimmune conditions. Acupuncture is effective at treating several health concerns at one time as all of this completes the picture of the symptoms you are having today. Your practitioner will also work with you on your diet and lifestyle as this very much plays a role in the success of the treatment.

A series of Acupuncture treatments will be recommended, and from my experience, depending on the severity of a client’s symptoms you can expect to see improvement in around six to eight appointments. Acupuncture is a preventative form of medicine, so I like to gradually progress my clients to less frequent visits every 3-4 weeks when they feel happy and more stable. If symptoms start to return for any reason, we then increase our frequency of treatments again.

Is there robust evidence on the effectiveness of Acupuncture and Menopause?

Yes, Menopause is one of the most widely researched areas of Acupuncture research showing some very encouraging long-term improvements in symptoms.

Several research studies reported a significant reduction in hot flushes in patients – reducing frequency and severity by half (50%) with positive effects lasting for up to six months. Studies also found that acupuncture improved menopause-related psychological symptoms (stress, anxiety) and urogenital symptoms (vaginal dryness, urinary urgency and UTIs) as well as an improvement in overall quality of life.

For further information on the research please see: https://www.evidencebasedacupuncture.org/acupuncture-menopause/

What if I’m taking HRT, but still experiencing some adverse symptoms?

This does not matter. A degree-level trained Traditional Acupuncturist will have the knowledge of how to integrate their treatments with all medications, including HRT, and will ask for this information at the time of booking your first appointment.

What if I can’t take HRT?

I have worked with several clients who are unable to take HRT due to their medical background. Some women have gone through cancer treatment causing them to go into early menopause or are at a high risk of breast cancer, for example. Acupuncture is an excellent alternative to HRT and I see fantastic results with these clients, helping them to manage hot flushes, palpitations and insomnia which are prevalent symptoms in these women.

I feel I need some support with stress and anxiety – can Acupuncture help?

Acupuncture treats the person as a whole, on both a physical and emotional level. It has been proven to down-regulate our ‘fight or flight’ response and activate our ‘rest and relaxation’ response. This helps to dramatically reduce stress levels. Stress can manifest in a multitude of ways, including recurrent infections, digestive complaints like IBS, frequent coughs/colds, gynaecological issues and chronic and complex health concerns.

Acupuncture has been proven to release endorphins, our feel-good hormones – 200 times more potent than morphine – and regulates mood-boosting serotonin. 

What can I expect from a treatment?

You can expect to feel very relaxed. Many of my clients fall asleep during their treatments.

On your first appointment, a full history will be taken including a lot of detail on all of your symptoms, then we look at the tongue and feel the pulse as we use these to diagnose. Then you have a nice lie-down.

Help, I’m a bit afraid of needles.

Acupuncturists use very fine, single-use needles that are as thin as human hair. You should never feel pain, you may experience a fleeting dull ache for a few seconds which is a good sign that the treatments are working. Mostly the needles will be located on your legs and arms.

I have worked with clients who have been a bit unsure at first and then have been completely converted to Acupuncture when they experience a huge improvement in their symptoms and feelings of great relaxation. They are also less stressed, have more energy and sleep better. Many clients mention to me in my clinic that Acupuncture makes them feel really robust and balanced. I would encourage you to give it a try, you may just learn to love it.

I’ve been treated with needles before by a Chiropractor / Osteopath / Physio, is this the same?

Whilst the needles used are similar (very fine, single use), a Chiropractor or Osteopath is using these to treat musculoskeletal issues– this is referred to as ‘dry needling’. Whilst Traditional Chinese Medicine is great for musculoskeletal issues, it also works on a deeper level to support the body’s internal systems, including but not limited to hormonal imbalance, stress, trauma, anxiety, insomnia and emotional concerns.

A fully licensed Traditional Acupuncturist will have at least three years of full-time training under strict supervision, including over 400 clinical hours of in-person safe needle training. It’s really important to look at the credentials of the person that is treating you, that they are a member of a recognised UK-based organisation such as the British Acupuncture Council and ideally have had additional CPD (continuous professional development) on Menopause.

How can I find a reputable Traditional Acupuncturist near me?

The best and recommended route to find a registered acupuncturist local to you is via the British Acupuncture Council (BAcC) postcode search tool.

The British Acupuncture Council (BAcC) is the UK’s largest, member-led, professional body for Traditional acupuncturists and here you can be assured that you will find a practitioner with the highest level of training recognised in the UK, that they are fully insured and complete continuous professional development every year to maintain their member status.

Once you’ve found a local Acupuncturist, I would encourage you to have a chat with them and read their reviews. Reputable acupuncturists should offer a no-obligation telephone consultation prior to booking an appointment to discuss any questions or concerns you may have. As you will be working with this person over a fair amount of time, I think it’s useful to find out if you are a good fit for each other. It’s very much a collaboration on your health and wellbeing.

I learnt a great deal from meeting with Melanie and from having my first session of acupuncture. I was grateful for her gentle and thorough approach during this and I would like to thank her for writing this article, which will help inform women about all the choices to support their holistic menopause care. Although evidence is lacking, this treatment may help you as an individual approach to your menopause care.

To find Melanie: Melanie Cullis LicAc., MBAcC is a degree-level trained Acupuncturist with clinics located in Cobham and Godalming, Surrey. Please visit her website for further information: https://www.theacupuncturepractice.com/

For an appointment at Rowena Health, we offer appointments online if you are in the UK. Please visit our website for further information: https://rowenahealth.co.uk/

Clinical references

Djapardy V, Panay N. Alternative and non-hormonal treatments to symptoms of menopause. Best Pract Res Clin Obstet Gynaecol. 2022 May;81:45-60. doi: 10.1016/j.bpobgyn.2021.09.012. Epub 2021 Nov 17. PMID: 34952794.

Mullin, S. and Manley, K. (2025), Menopause care: alternatives to hormone replacement therapy. Obstet Gynecol, 27: 308-320. https://doi.org/10.1111/tog.70010