Acupuncture as a treatment for “hot flashes” associated with ADT

Many patients have sought out acupuncture as a method to gain relief from hot flashes associated with androgen deprivation therapy (ADT). However, data from prospective clinical trials is at best limited.

Ashamalla et al. have reported the results of a small, prospective clinical trial of acupuncture in 17 men on ADT who were suffering three of more hot flashes a day. Patients could not have been receiving any other form of therapy for their hot flashes.

The investigators used a hot flash score (HFS) to assess the severity of each patients hot flashes. They then multiplied each patient’s HFS by the frequency of the patient’s hot flashes to obtain a composite score. The baseline scores (measured before the patient receive acupuncture) were compared with scores taken at 2 and 6 weeks and at 8-month average follow-up. Clinical improvement for each patient was defined as the percent decrease in the mean HFS at each time point.

Acupuncture treatment was given by a single, experienced, licensed acupucturist. Ten bilateral acupuncture points were targeted in each patients, and after needle placement, electrostimulation at 2 Hz was carried out at 4/10 acupuncture points. The patients received acupuncture sessions twice weekly for 4 weeks.

The results of this study, as reported by the authors, include the following:

  • 3/17 patients dropped out of the study before receiving any treatment, so the resulst are based exclusively on the 14 patients who received therapy.
  • There were no apparent side effects of therapy during treatment, immediately after treatment, or at 8 months of follow-up.
  • The average (mean) HFS at baseline was 28.3.
  • The mean HFS dropped to 10.3 at 2 weeks, to 7.5 at 6 weeks, and 7.0 at 8 months post-treatment.
  • The mean clinical improvements were
    • 68.4 percent at week 2 (mean HFS decreased from 37.409 to 11.836)
    • 89.2 percent at week 6 (mean HFS decreased from 37.409 to 4.05)
    • 80.3 percent at 8 months (mean HFS decreased from 37.409 to 7.385).

The authors report that, at their clinic, acupuncture appears to offer excellent control of hot flashes in men with a history of ADT, and that the absence of other side effects is an obvious benefit for patients.

It would be helpful to see a larger, multi-center clinical trial of acupuncture as a means for the relief of hot flashes, based on a standardized multi-center protocol.

3 Responses

  1. Acupuncture has been found to provide relief for a number of ailments. The downside to treatment with acupuncture is lack of coverage by insurers, including Medicare. I agree with the last paragraph, above, and would hope that with successful statistics acupuncture would be considered an acceptable method of treatment with eventual Medicare coverage. The eight treatments in the study would cost a patient somewhere around $600.00 based on the $75 per treatment at a local Chinese school of acupuncture where I live.

  2. It’s important for scientific investigators to include a report of which ADT agent was used and when it was administered to test patients. Determining how long before acupuncture ADT was administered, and if it was administered again during the experimental treatment would likely make a big difference in the extent to which hot flashes were reduced. For instance, if ADT were administered in the middle of a course of acupuncture treatment, hot flashes might recur “in spades” despite repeated acupuncture efforts, with little difference between the initial baseline and test measurements toward the end of acupuncture treatment as reported here.

  3. Dear Rabbi Ed:

    My suspicion is that the full paper provides the data you refer to. Not surprisingly it does not appear in the abstract. My guess would be that all these patients were receiving at least LHRH agonist therapy that continued throughout their acupuncture. I’d be very surprised if a journal of the stature of the International Journal of Radiation Oncology, Biology, Physics would have accepted the paper under other circumstances.

    Unfortunately I do not have easy access to full text of articles in this particular journal.

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