Key Finding
Electroacupuncture combined with Western medicine and manual acupuncture combined with Chinese herbal medicine were the most effective treatments for perimenopausal depression and anxiety, outperforming Western medicine alone across multiple outcome measures.
Researchers analyzed 54 studies involving 4,406 women to determine which acupuncture treatments work best for depression and anxiety during perimenopause—the transition period before menopause. They compared different types of acupuncture, both alone and combined with Chinese herbs or Western medications, against standard Western medicine treatments.
The study found that acupuncture-based treatments were more effective than Western medicine alone for improving mood, reducing anxiety, relieving menopausal symptoms like hot flashes, and balancing hormone levels. The most effective approaches were electroacupuncture (acupuncture with mild electrical stimulation) combined with Western medicine, and manual acupuncture combined with Chinese herbal medicine. These combination treatments consistently ranked highest across multiple measures including depression scores, anxiety levels, and overall menopausal symptom relief.
Specifically, electroacupuncture with Western medicine produced the greatest reductions in depression scores and significantly improved estrogen levels. Manual acupuncture combined with Chinese herbs also substantially reduced depression and anxiety while helping balance reproductive hormones like FSH and LH. Even electroacupuncture alone significantly decreased anxiety symptoms.
What this means for you: If you're experiencing depression or anxiety during perimenopause, acupuncture—especially when combined with either conventional medication or Chinese herbs—may offer meaningful relief. The treatments appear safe, with few reported side effects. However, the researchers noted that study quality was moderate, so more rigorous research is needed. If you're considering acupuncture for perimenopausal symptoms, seek treatment from a licensed, qualified acupuncturist who can discuss whether combination therapy might be appropriate for your situation.
This frequentist network meta-analysis of 54 RCTs (n=4,406) compared acupuncture-related interventions for perimenopausal depression and anxiety. Studies were predominantly moderate quality with low-to-moderate evidence certainty per CINeMA assessment. Acupuncture interventions demonstrated superiority over Western medicine across multiple outcomes. For clinical response rates, MA+CHM (RR=1.52, 95% CI: 1.12-2.08) and EA+CHM (RR=1.49, 95% CI: 1.05-2.12) were most effective. On HAMD scores, EA+WM achieved greatest depression reduction (MD=-5.04, 95% CI: -6.97 to -3.12). For HAMA anxiety scores, EA alone significantly reduced symptoms (MD=-8.40, 95% CI: -14.31 to -2.49). Regarding menopausal symptoms, MA+WM (MD=-5.37) and MA+CHM (MD=-5.00) showed greatest Kupperman Index improvements. Hormonally, MA+WM increased E2 (MD=26.25), while EA+WM and MA+CHM decreased FSH and LH. SUCRA rankings identified EA+WM and MA+CHM as top-performing interventions across most outcomes. Clinical takeaway: Combination acupuncture therapy (particularly EA+WM or MA+CHM) appears more effective than monotherapy for perimenopausal psychiatric symptoms.
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