Acupuncture vs. HRT for Hot Flashes: Can You Do Both?

Hot flash in a meeting. Hot flash in the car. Hot flash at 2 a.m. that leaves you kicking off the covers. At some point, you start googling your options.

And one of the first questions that pops up is: acupuncture or HRT? Should you try hormone therapy, go a more natural route or do a little of both? It’s a question we hear a lot from women here in Nashville, and it deserves an honest answer.

Spoiler: this isn’t a competition. Hormone therapy is a medical decision for you and your doctor, and acupuncture can be part of the plan either way. Let’s walk through what each one offers, what the research says and how they can work together. For the bigger picture, see our post on navigating menopause with acupuncture.

What does HRT do for hot flashes?

Hormone therapy (HRT, also called menopause hormone therapy) replaces some of the estrogen your body stops making after menopause. According to Mayo Clinic, systemic estrogen is the most effective treatment for hot flashes and night sweats.

A few basics from Mayo Clinic:

• It comes in different forms. Whole-body estrogen treats many symptoms, while low-dose vaginal estrogen mainly helps vaginal and urinary symptoms. If you still have your uterus, estrogen is usually paired with a progestogen.
• It can help beyond hot flashes, including vaginal dryness and bone protection.
• It has risks to weigh, like blood clots, stroke and certain cancers. Those risks depend on your age, health history, the type and dose and how long you take it.
• Timing matters. People who are generally healthy and start before age 60, or within 10 years of menopause, tend to benefit most.

Bottom line: for many women, HRT is a safe and very effective option. It’s a conversation worth having with your OB/GYN or menopause specialist.

How does acupuncture for hot flashes work?

From a Chinese medicine view, hot flashes are often a sign that your body’s cooling, calming energy (yin) is running low, especially Kidney yin. Without enough yin to anchor things, heat rises up, think flushed face, night sweats and a restless mind.

Acupuncture for hot flashes focuses on nourishing yin, clearing heat and calming your nervous system. We also look at sleep, mood, digestion and stress, since those often travel together with hot flashes.

What does the research say about acupuncture for hot flashes?

Research has linked acupuncture to fewer hot flashes, better sleep and a better quality of life for women going through menopause.

Here’s what stood out when we read the studies:

• The ACUFLASH trial (2009): Published in Menopause, this trial compared acupuncture plus self-care advice to self-care alone in postmenopausal women. Hot flashes dropped by 5.8 per day with acupuncture, compared with 3.7 per day with self-care alone. The acupuncture group also had better sleep and quality of life scores.
• A real-world U.S. trial (2016): In a study of 209 women summarized by the National Institutes of Health (NCCIH), individualized acupuncture reduced hot flashes and night sweats by as much as 36.7% compared with usual care. Sleep and anxiety improved too, and the benefits lasted at least six months after treatment ended.
• Results came quickly: In that same U.S. trial, women started to feel a difference after about three treatments, with the most benefit after about eight.

That’s why so many women add acupuncture to their menopause plan, whether or not they’re also using HRT.

Can you do acupuncture with HRT?

Yes. Many women do acupuncture with HRT. Acupuncture doesn’t involve any hormones or medications, and it can support things like sleep, stress and mood while hormone therapy does its job.

Some women use acupuncture while they’re deciding about HRT, during the first few months as their dose gets adjusted or as extra support for symptoms that hang on. Just keep your doctor and your acupuncturist in the loop.

Should I choose acupuncture or HRT?

You don’t have to choose one. The best choice depends on your symptoms, health history and preferences, and that decision belongs to you and your doctor.

A helpful way to think about it:

• HRT is the most effective medical treatment for hot flashes and also protects bone.
• Acupuncture is a low-risk way to support your whole body, including sleep, stress and mood, alongside medical care.
• Both together is a great option for a lot of women.

What if HRT isn’t right for you?

Some women aren’t good candidates for hormone therapy because of their health history, like certain cancers, blood clots, stroke or heart disease. Others simply prefer not to take it. If that’s you, you’re not out of options.

Mayo Clinic notes nonhormonal options like cognitive behavioral therapy, clinical hypnosis, weight loss and nonhormonal prescription medicines. If you’re looking for natural alternatives to hormone therapy, acupuncture is one more option many women explore, along with sleep habits, stress support and food that keeps you cool. Talk with your doctor about which mix makes sense for you.

How do we support menopause at Shen Medicine in Nashville?

At our office at 2505 21st Ave S, Suite 400, Nashville, TN, we build a plan around you, whether you’re on HRT, thinking about it or not a candidate. Here’s what that looks like:

• A full look at your symptoms: hot flashes, sleep, mood, digestion, energy and stress
• Acupuncture to help cool, calm and nourish
• Simple food and lifestyle guidance that fits your real life
• Care that works alongside your OB/GYN or menopause specialist

Learn more about our women’s health care, read about natural perimenopause relief or book your visit.

Quick FAQ

Is acupuncture a replacement for HRT? No. HRT is the most effective treatment for hot flashes. Acupuncture can be a supportive option alongside it, or an option to explore if HRT isn’t right for you.

How many acupuncture sessions does it take to help hot flashes? It varies. In the 2016 U.S. trial, benefit showed up after about three treatments, with the most benefit after about eight. We’ll build a plan with you at your first visit.

Is it safe to get acupuncture while on hormone therapy? Yes. Acupuncture is generally low risk when done by a licensed acupuncturist. Just let your doctor know you’re doing both.

Where can I get acupuncture for hot flashes in Nashville? Right here at Shen Medicine. Menopause and perimenopause support is a big part of our women’s health care.

Wherever you land on hormone therapy, we’d love to help you feel cooler and more like yourself here in Nashville.

With love (and very fine needles),
The Shen Medicine Team

Sources

• Mayo Clinic: Hormone therapy, is it right for you?
• Borud et al. The Acupuncture on Hot Flushes Among Menopausal Women (ACUFLASH) study, a randomized controlled trial. Menopause, 2009
• National Center for Complementary and Integrative Health: Acupuncture, as practiced in clinical settings, may significantly improve menopause-related symptoms (on Avis et al., Menopause, 2016)

This post is for education only and isn’t medical advice. Talk with your healthcare provider about what’s right for you.