Effect of different acupuncture modalities on sex hormone levels in perimenopausal women: a network meta-analysis
In brief
Abdominal moxibustion most improves menopausal symptom scores among acupuncture techniques
A network meta-analysis of 36 RCTs (1,480 perimenopausal women) found that abdominal moxibustion lowered Kupperman symptom scores more than other acupuncture modalities and control treatments. Acupoint application and standard acupuncture also reduced FSH and LH and raised estradiol, but each method showed a different hormonal profile. While promising as a non-drug option, the evidence varies in quality and direct comparisons remain limited.
- Journal
- Frontiers in endocrinology (Q1)
- Published
- 24 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Shuyue Pang, Zhongtian Wang, Lili Zhang, Qi Qin, Xiuxiang Zhang, Rui Ma, et al.
- PMID
- 42568455
- DOI
- 10.3389/fendo.2026.1880483
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (top studies of the week, 9 August 2026).
- Picked for Pharmacology (medical) (top studies of the week, 9 August 2026): Acupuncture modalities on hormones, NMA
Abstract
BACKGROUND: Acupuncture, a common intervention in traditional Chinese medicine (TCM), has been widely applied for regulating hormonal fluctuations in perimenopausal women. However, the efficacy of various acupuncture modalities is not comprehensively compared. This network meta-analysis (NMA) evaluated the effects of different acupuncture approaches on sex hormone levels, specifically estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), in perimenopausal women. METHODS: PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang, and the VIP Database were searched until March 17, 2026. Randomized controlled trials (RCTs) on acupuncture interventions for perimenopausal women were included. The risk of bias was assessed for included studies, and data were synthesized based on a Bayesian NMA framework. RESULTS: 36 studies on 1, 480 participants were included. Compared with control interventions, acupoint application (AA) and acupuncture therapy (AT) significantly reduced Kupperman scores. In terms of FSH reduction, AA, abdominal moxibustion (AM), and AT were superior to control. For LH, AA, AT, and AM demonstrated notable reductions compared with control. As for E2 elevation, AA, AT, and compression acupuncture (PN) achieved statistically significant improvements. CONCLUSIONS: AM, AT, and AA significantly improved Kupperman scores, with AM being the most effective. Catgut implantation acupoint (CA) and PN showed significant effects in reducing FSH levels, followed by AT and AM, whereas plum blossom needling exhibited the greatest efficacy in increasing E2 levels. Overall, acupuncture presents a promising non-pharmacological strategy for modulating hormonal balance and alleviating menopausal symptoms in perimenopausal women. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251066613.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.