Traditional Chinese Medicine Health for Menopause

Traditional Chinese Medicine (TCM) has been increasingly investigated as a potential complementary or alternative therapy for managing menopausal symptoms. Several randomized controlled trials (RCTs) have explored the efficacy and safety of various TCM interventions, such as herbal formulas and acupuncture, in alleviating the diverse physical and psychological challenges experienced by women during this life stage. These trials aim to provide evidence-based support for the use of TCM in menopause care.

Protocols Studied in Research

[1] Acupuncture (integrated with diet and self-massage) for hot flushes and other menopause symptoms. (Cited by: 5) (pmid: 24827469)

• Protocol: A randomized trial of 100 women with frequent hot flushes compared acupuncture plus diet/self-massage (group A) to delayed acupuncture plus diet/self-massage (group B). Acupuncture was twice weekly for 6 weeks in group A.
• Outcome: Acupuncture significantly reduced hot flushes, sweating, and other menopausal symptoms (sleep disorders, chest tightness, irritability, bone pain, depression) compared to delayed acupuncture.

[2] Electroacupuncture for menopausal symptoms during menopause transition. (Cited by: 3) (pmid: 30125529)

• Protocol: A prospective, multicenter, randomized, participant-blinded trial in China compared 8 weeks of electroacupuncture (at acupoints) versus sham electroacupuncture (at non-acupoints) in 360 women experiencing menopausal symptoms.
• Outcome: Electroacupuncture did not significantly relieve menopausal symptoms, as measured by the Menopause Rating Scale. However, it showed a statistically significant improvement in quality of life (Menopause-Specific Quality of Life Questionnaire), although less than the minimally clinically important difference for symptom relief.

[3] Acupuncture combined with Ningshen mixture for climacteric insomnia. (Cited by: 0) (pmid: 38669364)

• Protocol: A randomized controlled trial (RCT) of 82 climacteric insomnia patients. One group received conventional Western medicine; the other received acupuncture and Ningshen mixture. Neurotransmitter levels, TCM syndrome scores, and PSQI were assessed.
• Outcome: Acupuncture combined with Ningshen mixture showed significantly better curative effects, improved neurotransmitter levels (5-HT and beta-endorphin), reduced PSQI and TCM syndrome scores, and lower recurrence rates compared to the control group. No serious adverse effects were reported.

[4] Bushen Tiaogan formula (BSTG) plus Traditional Chinese Medicine-based Psychotherapy (TBP) for perimenopausal depression (PMD). (Cited by: 6) (pmid: 31513088)

• Protocol: A randomized, placebo-controlled trial in 307 Chinese women with PMD. Participants received either BSTG+TBP or placebo+TBP for 8 weeks, followed by 4 weeks of follow-up. Primary outcomes were GCS, SDS, and SAS scores.
• Outcome: BSTG plus TBP was significantly more effective than placebo plus TBP in reducing PMD symptoms, improving certain hormone and lipid levels, with no serious adverse events reported.

[5] Danzhi Qing'e formula (DZQE), Erzhi formula (EZ), and their combination for menopausal symptoms. (Cited by: 8) (pmid: 26671188)

• Protocol: A randomized, double-blind, placebo-controlled trial of 389 women (40-60 years) with hot flushes. Participants received 8 weeks of treatment followed by 4 weeks of follow-up, stratified by perimenopausal and early postmenopausal stages.
• Outcome: DZQE significantly improved Menopause-Specific Quality of Life (MENQOL) scores and vasomotor symptoms, particularly in perimenopausal women. The combined DZQE/EZ formula showed benefit only in perimenopausal women. EZ showed no significant benefit.

[6] Improved Gengnianchun (I-GNC), a traditional Chinese medicine formula, for menopausal symptoms (hot flushes, depression, anxiety, sleep quality) in Chinese peri- and postmenopausal women. (Cited by: 6) (pmid: 32379216)

• Protocol: A 12-week, randomized, single-blind, placebo-controlled trial of 98 peri- and postmenopausal women with high Kupperman Index scores. Participants received either I-GNC or placebo. Outcomes were measured at 4-week intervals.
• Outcome: I-GNC significantly reduced hot flush frequency, improved Kupperman Index scores, and decreased Hamilton depression and anxiety scores compared to placebo. No significant effect on sleep quality or hormone levels was observed. I-GNC was deemed safe.

[7] Acupuncture for peri-menopausal insomnia (PMI). (Cited by: 37) (pmid: 29029258)

• Protocol: A randomized, placebo-controlled trial with 76 peri-menopausal women with insomnia. Participants received 10 acupuncture sessions (or placebo acupuncture) over 3 weeks targeting specific acupoints.
• Outcome: Acupuncture significantly improved sleep quality (PSQI, ISI) and sleep parameters (PSG) compared to placebo acupuncture, demonstrating short-term efficacy in treating PMI.

[8] Chinese herbal medicine (CHM), acupuncture + CHM, and hormone therapy for menopause-related symptoms. (Cited by: 6) (pmid: 22314633)

• Protocol: A 2-month randomized controlled trial comparing three treatments in 57 Chinese women experiencing perimenopause or postmenopause. Treatments included CHM, acupuncture + CHM, and hormone therapy.
• Outcome: Acupuncture plus CHM was as effective as hormone therapy in reducing menopause symptoms, and more effective than CHM alone. While all treatments reduced symptom scores, only hormone therapy and acupuncture + CHM significantly lowered FSH levels.

[9] Traditional Chinese Medicine (TCM) acupuncture and Chinese herbal medicine (CHM) for hot flushes and quality of life in postmenopausal women. (Cited by: 10) (pmid: 23676632)

• Protocol: A four-arm randomized controlled pilot trial with 40 postmenopausal women experiencing frequent hot flushes. Participants received TCM acupuncture, sham acupuncture, verum CHM, or placebo CHM for 12 weeks.
• Outcome: TCM acupuncture significantly reduced hot flush frequency, severity, and overall menopausal symptoms compared to sham acupuncture and verum CHM. Verum CHM showed no significant benefit over placebo.

[10] Electroacupuncture (EA) for mild-to-moderate depression in perimenopausal women. (Cited by: 17) (pmid: 30003102)

• Protocol: A multicenter, randomized, controlled trial compared 36 sessions of EA to escitalopram in 242 perimenopausal women with mild-to-moderate depression. Outcomes included HAMD-17, MENQOL, and serum hormone levels.
• Outcome: Both EA and escitalopram improved depression symptoms (HAMD-17) and quality of life (MENQOL) at 24-week follow-up, with no significant difference between groups. EA was found to be safe and effective.

[11] Xiangshao granules for emotional disorders (depression and anxiety) in perimenopausal and postmenopausal women. (Cited by: 1) (pmid: 33016149)

• Protocol: A double-blind, randomized, placebo-controlled, multicenter trial involving 300 Chinese women (40-60 years old) who received either Xiangshao granules or a placebo for 8 weeks. HAMD and HAMA scores were assessed at baseline, 4 weeks, and 8 weeks.
• Outcome: Xiangshao granules significantly reduced depression and anxiety symptoms compared to placebo, with a higher cure rate and no significant difference in adverse events. The improvement was statistically significant.

[12] Jiawei Qing'e Fang (JQF), a Chinese herbal medicine preparation, for hot flashes and quality of life in perimenopausal women. (Cited by: 11) (pmid: 22089177)

• Protocol: A 12-week randomized, double-blind, placebo-controlled trial of 72 perimenopausal women with frequent hot flashes. Participants received JQF or placebo for 8 weeks, with a 4-week follow-up.
• Outcome: JQF was significantly better than placebo at reducing hot flashes and improving vasomotor and physical symptoms. JQF also showed potential for reducing triglyceride levels in women with high baseline levels. No serious adverse events were reported.

[13] Therapeutic acupuncture (TA) for hot flashes in breast cancer patients. (Cited by: 0) (pmid: 37851349)

• Protocol: A randomized, single-blind trial compared TA to sham acupuncture (SA) in 54 breast cancer patients experiencing >10 hot flashes/week. Participants recorded hot flash frequency and severity using a diary and the MenQoL scale.
• Outcome: TA significantly reduced hot flash severity compared to SA (p = .0064), with a sustained effect at 1-month follow-up. Larger studies are needed to confirm these findings.

[14] Gua sha therapy for perimenopausal syndrome. (Cited by: 8) (pmid: 27760084)

• Protocol: A randomized controlled trial of 80 women with perimenopausal syndrome. The intervention group received 15-minute Gua sha sessions weekly for 8 weeks in addition to conventional treatment; the control group received conventional treatment only.
• Outcome: Gua sha therapy significantly reduced perimenopausal symptoms and improved quality of life compared to conventional treatment alone, with no significant effect on serum hormone levels. The therapy was deemed safe and effective.

[15] HYYK formula (Traditional Chinese Medicine) for Premature Ovarian Insufficiency (POI). (Cited by: 0) (pmid: 39934764)

• Protocol: A multicenter, randomized, double-blind, placebo-controlled trial involving 102 women with POI. Participants received either HYYK formula or placebo for 24 weeks.
• Outcome: This is a study protocol; therefore, no outcomes are reported. The study aims to evaluate the efficacy and safety of HYYK in enhancing residual follicle activity and improving menstrual cycle regularity in POI patients.

[16] Acupuncture for menopausal syndrome. (Cited by: 0) (pmid: 10453593)

• Protocol: The abstract provides no details on the study design, participants, or acupuncture administration.
• Outcome: No outcome data is available as the abstract is missing.

[17] Acupoint therapy combined with spine pinching for menopausal syndrome. (Cited by: 1) (pmid: 33000587)

• Protocol: A randomized controlled trial comparing acupoint therapy plus spine pinching to tibolone therapy in 132 women with menopausal syndrome. The intervention was administered three times weekly for four weeks.
• Outcome: While the intervention improved Kupperman scores within the treatment group, it showed no overall superiority to tibolone. Positive effects were seen in women with moderate LH levels, but negative effects were observed in those with low FSH levels and BMI ≥25.7 kg/m².

[18] Acupuncture (Traditional Chinese Medicine and sham) for menopausal hot flashes. (Cited by: 29) (pmid: 18528313)

• Protocol: A randomized controlled pilot study of 56 peri- and postmenopausal women with frequent hot flashes. Participants were assigned to usual care, sham acupuncture, or Traditional Chinese Medicine acupuncture (twice weekly for 8 weeks).
• Outcome: All groups showed a significant decrease in hot flash frequency, but acupuncture groups (both sham and TCM) demonstrated a significantly greater reduction than the usual care group, suggesting a strong placebo effect or a genuine effect of acupuncture.

[19] Needle acupuncture for menopausal vasomotor symptoms (hot flushes and night sweats). (Cited by: 6) (pmid: 24925094)

• Protocol: A randomized, sham-controlled trial of 360 menopausal women with frequent hot flushes. Participants received either true or sham acupuncture (10 treatments over 8 weeks). Blinding was used.
• Outcome: The abstract does not present results; it describes a study protocol designed to assess the efficacy and safety of acupuncture for menopausal vasomotor symptoms. The anticipated outcome is to determine if acupuncture is an effective and safe treatment.

[20] Wuling Capsule (WC), a Chinese herbal medicine, for menopausal anxiety and depression. (Cited by: 3) (pmid: 19912735)

• Protocol: A randomized, positive-controlled trial comparing WC to Gengnianan Tablet in 96 female climacteric patients with depression and anxiety. Participants received oral medication for 6 weeks. Efficacy was measured using KMI, SDS, and SAS scales.
• Outcome: Both WC and Gengnianan Tablet improved symptoms. WC showed significantly greater reduction in anxiety scores compared to Gengnianan Tablet, and a greater reduction in depression scores after 6 weeks.

[21] Body acupuncture, with or without auricular acupuncture, for menopause insomnia attributed to heart-kidney disharmony in Traditional Chinese Medicine. (Cited by: 5) (pmid: 31368284)

• Protocol: A randomized controlled trial comparing body acupuncture alone (control) versus body plus auricular acupuncture (treatment) in 111 women with menopausal insomnia. Acupuncture was administered three times a week for three weeks. Sleep quality was assessed using the PSQI scale.
• Outcome: Both interventions improved sleep quality and TCM symptoms. However, body acupuncture combined with auricular acupuncture showed significantly greater improvement in PSQI scores, symptom reduction, and overall effective rate.

[22] Traditional Chinese Medicine (TCM) acupuncture plus self-care for hot flushes in postmenopausal women. (Cited by: 3) (pmid: 17324253)

• Protocol: A multi-center, randomized controlled trial comparing TCM acupuncture plus self-care to self-care alone in 286 postmenopausal women experiencing ≥7 hot flushes daily. Participants received 10 acupuncture sessions over 12 weeks.
• Outcome: The abstract describes the study protocol; no results or conclusions are presented as it's an ongoing trial.

[23] Oral porcine placental extract (PPE) for mild menopausal symptoms in climacteric women. (Cited by: 8) (pmid: 28112981)

• Protocol: A 12-week, randomized, double-blind, placebo-controlled study of 50 Japanese women, with participants receiving either 300 mg/day of PPE or placebo. Menopausal symptoms were assessed using the Simplified Menopausal Index (SMI).
• Outcome: Oral PPE significantly improved total SMI scores and subscores related to vasomotor, psychological, and somatic symptoms, without altering serum estradiol or FSH levels. No adverse events were reported.

[24] Acupuncture for menopause-related symptoms in tamoxifen-treated breast cancer survivors. (Cited by: 10) (pmid: 12088252)

• Protocol: A pilot study of 15 women receiving acupuncture treatment based on Traditional Chinese Medicine principles. Assessments using the Greene Menopause Index were conducted at baseline and at 1, 3, and 6 months.
• Outcome: Acupuncture showed improvement in anxiety, depression, somatic, and vasomotor symptoms; libido remained unchanged. The treatment appeared safe and effective, but larger, placebo-controlled trials are needed for confirmation.

[25] Guizhi Gancao Longgu Muli Tang (GGLMT), a Traditional Chinese Medicine decoction, for sleep disturbances in menopausal women. (Cited by: 3) (pmid: 29956898)

• Protocol: A 2-week randomized controlled trial (RCT) was conducted on 162 menopausal women with sleep difficulties. Participants received 200 mL of GGLMT twice daily for two weeks. Sleep quality was assessed using PSQI, and other symptoms were measured using MRS and WHOQOL-BREF.
• Outcome: GGLMT significantly improved sleep quality (PSQI scores decreased), particularly in women with more severe menopausal symptoms (MRS ≥16). Treatment was generally safe, with only minor, reversible side effects reported.

[26] Soy isoflavones (120mg/day) for peri-menopausal symptoms. (Cited by: 0) (pmid: 20364590)

• Protocol: A single-blind, randomized controlled trial of 50 peri-menopausal women; one group received 120mg/day soy isoflavones for 8 weeks, the other a placebo. Hormone levels and menopausal symptoms were measured.
• Outcome: Soy isoflavones significantly reduced hot flashes, Kuppermann scores, and other menopausal symptoms. Estrogen, progesterone, and testosterone levels increased, while FSH decreased, suggesting a positive impact on hormone balance.

[27] Sequential vs. simultaneous GnRHa and chemotherapy for ER-positive premenopausal breast cancer. (Cited by: 13) (pmid: 29332135)

• Protocol: A phase 3, randomized controlled trial comparing sequential and simultaneous administration of GnRHa and chemotherapy in 216 premenopausal women with ER-positive breast cancer.
• Outcome: No significant difference in early menopause rates, menstruation resumption, disease-free survival, or overall survival was found between sequential and simultaneous GnRHa and chemotherapy administration. Delaying GnRHa until after chemotherapy is a viable option.

[28] Menoprogen (herbal remedy) for menopausal symptoms in Chinese women. (Cited by: 3) (pmid: 19769480)

• Protocol: A prospective, multi-center pilot study in China involving perimenopausal and postmenopausal women seeking alternatives to HRT. Participants received two capsules of Menoprogen twice daily.
• Outcome: Menoprogen significantly reduced Kupperman Menopausal Index scores, increased estrogen and progesterone levels, and showed no evidence of endometrial hyperplasia. Results suggest a rationale for a larger, controlled trial.

[29] Acupuncture combined with modified Xiangfu Decoction for menopausal insomnia due to liver Qi stagnation. (Cited by: 2) (pmid: 32281361)

• Protocol: A randomized controlled trial (RCT) with 120 menopausal women with insomnia attributed to liver Qi stagnation. Participants were randomly assigned to either an estazolam group or an acupuncture plus modified Xiangfu Decoction group for 16 weeks. Sleep quality, anxiety, and hormone levels were assessed.
• Outcome: The combined acupuncture and herbal treatment group showed significantly greater improvement in sleep quality, anxiety levels, and hormone balance compared to the estazolam group, with a lower incidence of adverse effects. The treatment was deemed effective and worthy of clinical application.

[30] Chinese herbal medicine (CHM) and hormone replacement therapy (HRT) for menopausal symptoms. (Cited by: 12) (pmid: 17689896)

• Protocol: A double-blind, double-dummy, randomized placebo-controlled trial of 31 peri- and postmenopausal Dutch women. Participants received CHM, HRT, or placebo for 12 weeks, followed by 4 weeks of observation. CHM prescriptions were individualized.
• Outcome: CHM significantly reduced hot flushes compared to placebo (29% vs. 30% reduction), although less effectively than HRT (almost 50%). While statistically significant, the qualitative improvement was not substantial. A larger study with a more specific questionnaire is recommended.

[31] Acupuncture treatment for menopausal vasomotor symptoms (VMS). (Cited by: 7) (pmid: 27676631)

• Protocol: A randomized controlled trial of 209 perimenopausal and postmenopausal women (aged 45-60) with frequent VMS. Participants received up to 20 acupuncture treatments over 6 months or were waitlisted. VMS frequency was tracked weekly.
• Outcome: Acupuncture reduced VMS frequency in about half the treated group, with varying degrees of response. Predicting individual response to acupuncture remains difficult. Baseline VMS frequency, treatment received, and TCM diagnosis influenced response.

[32] Acupuncture plus artificial tears (AC + AT) versus artificial tears (AT) only for postmenopausal dry eye disease. (Cited by: 20) (pmid: 28280333)

• Protocol: A randomized controlled trial of 28 postmenopausal women with dry eye disease. Participants received either AC + AT or AT only for 2 months. Tear samples were analyzed using 2D nano-LC-MS/MS and Western blot.
• Outcome: Both treatments improved dry eye symptoms, but the AC + AT group showed significantly greater improvement in symptom scores. Acupuncture appeared to increase protein synthesis and secretion in tears, suggesting a potential mechanism for its effectiveness.

[33] Leuprolide acetate for preventing chemotherapy-induced premature menopause in premenopausal breast cancer patients. (Cited by: 28) (pmid: 23904400)

• Protocol: A phase II randomized trial comparing cyclophosphamide-doxorubicin chemotherapy alone versus the same chemotherapy plus leuprolide acetate in 220 premenopausal breast cancer patients. Ovarian preservation was assessed by menses resumption and hormone levels.
• Outcome: Leuprolide acetate, given concurrently with chemotherapy, significantly reduced the risk of premature menopause compared to chemotherapy alone, as evidenced by improved rates of menses resumption and restoration of premenopausal hormone levels.

[34] Shenqi Guchong Recipe (SGR) for peri-menopausal anovulatory dysfunctional uterine bleeding (ADUB) of qi deficiency blood stasis syndrome type (QDBS). (Cited by: 0) (pmid: 20929121)

• Protocol: A randomized controlled trial comparing SGR to Kunning Oral Liquid in 78 women with ADUB-QDBS. SGR was administered orally. Hemostatic effects, blood biomarkers (6-K-PGF1α, TXB2), T-lymphocyte subsets, and serum calcium were measured.
• Outcome: SGR demonstrated a significantly better hemostatic effect than the control (Kunning Oral Liquid). Improvements in blood biomarkers and immune parameters suggest mechanisms involving microcirculation, immune function, and uterine microenvironment.

Research Interpretation: Summary and Conclusion

Multiple randomized controlled trials (RCTs) investigated Traditional Chinese Medicine (TCM) interventions, including acupuncture (various forms), herbal remedies (e.g., BSTG+TBP, DZQE, I-GNC, Xiangshao granules, JQF, Menoprogen, HYYK formula, Ningshen mixture, SGR), and Gua Sha, for managing various menopausal symptoms. Study designs varied, employing placebo controls, sham acupuncture, and comparisons to conventional Western medicine or other TCM modalities. While many studies demonstrated statistically significant improvements in hot flushes, sleep quality, depression, anxiety, and overall quality of life compared to controls, the magnitude of effects varied considerably across interventions and patient subgroups. Some studies highlighted the potential benefit of combining acupuncture with herbal remedies. Inconsistencies exist, with some interventions showing no significant benefit or only benefit in specific menopausal stages. Larger, well-designed RCTs, particularly those with standardized TCM diagnoses and outcome measures, are needed to confirm these findings and establish clinical guidelines. The role of placebo effects also requires careful consideration.

Publications

[1] Baccetti S; Da Fre M; Becorpi A; Faedda M; Guerrera A; Monechi MV; Munizzi RM; Parazzini F (2014). Acupuncture and traditional Chinese medicine for hot flushes in menopause: a randomized trial Journal of alternative and complementary medicine (New York, N.Y.) 20 (7) :550-7.

[2] Liu Z; Ai Y; Wang W; Zhou K; He L; Dong G; Fang J; Fu W; Su T; Wang J; Wang R; Yang J; Yue Z; Zang Z; Zhang W; Zhou Z; Xu H; Wang Y; Liu Y; Zhou J; Yang L; Yan S; Wu J; Liu J; Liu B (2018). Acupuncture for symptoms in menopause transition: a randomized controlled trial American journal of obstetrics and gynecology 219 (4) :373.e1-373.e10.

[3] Cai Y; Zhang X; Li J; Yang W (2024). Effect of acupuncture combined with Ningshen mixture on climacteric insomnia: A randomized controlled trial Medicine 103 (17) :e37930.

[4] Cao XJ; Huang XC; Wang X (2019). Effectiveness of Chinese herbal medicine granules and traditional Chinese medicine-based psychotherapy for perimenopausal depression in Chinese women: a randomized controlled trial Menopause (New York, N.Y.) 26 (10) :1193-1203.

[5] Fu SF; Zhao YQ; Ren M; Zhang JH; Wang YF; Han LF; Chang YX; Fan GW; Wang H; Huang YH; Zhai JB; Dong JY; Li X; Ai JQ; Zhang H; Zhu Y; Zhang BL; Sun LK; Fan X; Gao XM (2016). A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine granules for the treatment of menopausal symptoms by stages Menopause (New York, N.Y.) 23 (3) :311-23.

[6] Zhang Y; Cao Y; Wang L (2020). The effects of a new, improved Chinese medicine, Gengnianchun formula granules, on hot flushes, depression, anxiety, and sleep in Chinese peri- and postmenopausal women: a randomized placebo-controlled trial Menopause (New York, N.Y.) 27 (8) :899-905.

[7] Fu C; Zhao N; Liu Z; Yuan LH; Xie C; Yang WJ; Yu XT; Yu H; Chen YF (2017). Acupuncture Improves Peri-menopausal Insomnia: A Randomized Controlled Trial Sleep 40 (11).

[8] Azizi H; Feng Liu Y; Du L; Hua Wang C; Bahrami-Taghanaki H; Ollah Esmaily H; Azizi H; Ou Xue X (2011). Menopause-related symptoms: traditional Chinese medicine vs hormone therapy Alternative therapies in health and medicine 17 (4) :48-53.

[9] Nedeljkovic M; Tian L; Ji P; Deglon-Fischer A; Stute P; Ocon E; Birkhauser M; Ausfeld-Hafter B (2014). Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial Menopause (New York, N.Y.) 21 (1) :15-24.

[10] Li S; Li ZF; Wu Q; Guo XC; Xu ZH; Li XB; Chen R; Zhou DY; Wang C; Duan Q; Sun J; Luo D; Li MY; Wang JL; Xie H; Xuan LH; Su SY; Huang DM; Liu ZS; Fu WB (2018). A Multicenter, Randomized, Controlled Trial of Electroacupuncture for Perimenopause Women with Mild-Moderate Depression BioMed research international 2018 :5351210.

[11] Chen R; Tang R; Zhang S; Wang Y; Wang R; Ouyang Y; Xie X; Liu H; Lv S; Shi H; Zhang Y; Xie M; Luo Y; Yu Q (2021). Xiangshao granules can relieve emotional symptoms in menopausal women: a randomized controlled trial Climacteric : the journal of the International Menopause Society 24 (3) :246-252.

[12] Xia Y; Zhao Y; Ren M; Zhang J; Wang Y; Chang Y; Fu S; Fan G; Zhu Y; Huang Y; Gao X (2012). A randomized double-blind placebo-controlled trial of a Chinese herbal medicine preparation (Jiawei Qing'e Fang) for hot flashes and quality of life in perimenopausal women Menopause (New York, N.Y.) 19 (2) :234-44.

[13] Serra D; Fleishman SB; White C; Leung TM; Chadha M (2023). Acupuncture Reduces Severity of Hot Flashes in Breast Cancer: A Randomized Single-Blind Trial Holistic nursing practice 37 (6) :330-336.

[14] Meng F; Duan PB; Zhu J; Lou QQ; Fang ZH; An HL; Liu LY; Hu Y; Hu Q (2017). Effect of Gua sha therapy on perimenopausal syndrome: a randomized controlled trial Menopause (New York, N.Y.) 24 (3) :299-307.

[15] Peng Y; Liu J; Li Y; Nie G; Cheng F; Feng D; Du Q; Huang J; Yang H (2025). Efficacy and safety of HYYK formula for residual follicle revival in premature ovarian insufficiency: a multicenter, randomized, double-blind, placebo-controlled trial protocol BMC complementary medicine and therapies 25 (1) :46.

[16] Wu L; Zhou X (1998). 300 cases of menopausal syndrome treated by acupuncture Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan 18 (4) :259-62.

[17] Jiang G; Li Y; Xu D; Gong X; Wu W; Kubota K; He L; Jia C (2020). Effect of acupoint therapy combined with spine pinching in patients with menopausal syndrome: a randomized controlled trial Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan 40 (5) :855-862.

[18] Avis NE; Legault C; Coeytaux RR; Pian-Smith M; Shifren JL; Chen W; Valaskatgis P (2008). A randomized, controlled pilot study of acupuncture treatment for menopausal hot flashes Menopause (New York, N.Y.) 15 (6) :1070-8.

[19] Pirotta M; Ee C; Teede H; Chondros P; French S; Myers S; Xue C (2014). Acupuncture for menopausal vasomotor symptoms: study protocol for a randomised controlled trial Trials 15 :224.

[20] Wang XJ; Li J; Zou QD; Jin L (2009). [Wuling Capsule for climacteric patients with depression and anxiety state: a randomized, positive parallel controlled trial] Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine 7 (11) :1042-6.

[21] Zhang S; Jia SH; Yang LJ; Jin ZG (2019). [Clinical trials of treatment of woman menopause insomnia due to disharmony between heart and kidney by body and auricular acupuncture] Zhen ci yan jiu = Acupuncture research 44 (7) :516-9.

[22] Borud EK; Alraek T; White A; Fonnebo V; Grimsgaard S (2007). The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH) study: a study protocol of an ongoing multi-centre randomised controlled clinical trial BMC complementary and alternative medicine 7 :6.

[23] Kitanohara M; Yamamoto T; Masunaga S; Ohishi M; Komatsu Y; Nagase M (2017). Effect of porcine placental extract on the mild menopausal symptoms of climacteric women Climacteric : the journal of the International Menopause Society 20 (2) :144-150.

[24] Porzio G; Trapasso T; Martelli S; Sallusti E; Piccone C; Mattei A; Di Stanislao C; Ficorella C; Marchetti P (2002). Acupuncture in the treatment of menopause-related symptoms in women taking tamoxifen Tumori 88 (2) :128-30.

[25] Wang Z; Ke D; Huang X; Ding Y; Wang C (2017). Effect of Guizhi Gancao Longgu Muli Tang on sleep disturbances in menopausal women Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan 37 (1) :23-9.

[26] Li Y; Liu K; Lei W; Zhang K (2010). [Effect of soy isoflavones on peri-menopausal symptom and estrogen] Wei sheng yan jiu = Journal of hygiene research 39 (1) :56-9.

[27] Zhang Y; Ji Y; Li J; Lei L; Wu S; Zuo W; Jia X; Wang Y; Mo M; Zhang N; Shen Z; Wu J; Shao Z; Liu G (2018). Sequential versus simultaneous use of chemotherapy and gonadotropin-releasing hormone agonist (GnRHa) among estrogen receptor (ER)-positive premenopausal breast cancer patients: effects on ovarian function, disease-free survival, and overall survival Breast cancer research and treatment 168 (3) :679-686.

[28] Liu D; Lu Y; Ma H; Wei RC; Li J; Fang J; Mahady GB (2009). A pilot observational study to assess the safety and efficacy of Menoprogen for the management of menopausal symptoms in Chinese women Journal of alternative and complementary medicine (New York, N.Y.) 15 (1) :79-85.

[29] Yan XL; Yu YD; Yang DD (2020). [Clinical efficacy of acupuncture combined with modified Xiangfu Decoction in treatment of menopausal insomnia cause by liver Qi stagnation] Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica 45 (6) :1460-1464.

[30] Kwee SH; Tan HH; Marsman A; Wauters C (2007). The effect of Chinese herbal medicines (CHM) on menopausal symptoms compared to hormone replacement therapy (HRT) and placebo Maturitas 58 (1) :83-90.

[31] Avis NE; Coeytaux RR; Levine B; Isom S; Morgan T (2017). Trajectories of response to acupuncture for menopausal vasomotor symptoms: the Acupuncture in Menopause study Menopause (New York, N.Y.) 24 (2) :171-179.

[32] Liu Q; Liu J; Ren C; Cai W; Wei Q; Song Y; Yu J (2017). Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry International journal of nanomedicine 12 :1663-1671.

[33] Song G; Gao H; Yuan Z (2013). Effect of leuprolide acetate on ovarian function after cyclophosphamide-doxorubicin-based chemotherapy in premenopausal patients with breast cancer: results from a phase II randomized trial Medical oncology (Northwood, London, England) 30 (3) :667.

[34] Ye Q; Song W; Zhang LJ (2010). [Clinical observation on effect of shenqi guchong recipe in treating peri-menopausal anovulatory dysfunctional uterine bleeding] Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine 30 (7) :686-8.