Effect of acupuncture on the endocrine axis in patients with perimenopausal insomnia: A case series study

Objective

To explore the clinical efficacy of acupuncture in perimenopausal insomnia and its impact on the hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-ovarian (HPO) axis.

Methods

Acupuncture was performed on 42 patients with perimenopausal insomnia in the prone position. Acupoints included Băihuì (百会BL20), Sìshéncōng (四神聪EX-HN1), Fēngfŭ (风府GV16), Ānmián (安眠EX-HN18), Shéndào (神道GV11), Gānshū(肝俞BL18), Píshū (脾俞BL20), Shènshū (肾俞BL23), Shénmén (神门HT7) and Sānyīnjiāo (三阴交SP6). Acupuncture was performed once every 2 days, three times weekly, and the needles were retained for 30 min each time. The duration of treatment was 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) score and HPA- and HPO-related hormones were evaluated before and after treatment.

Results

The PSQI score was lower after treatment than before treatment. The score of each item (subjective sleep quality, sleep latency, sleep maintenance, habitual sleep efficiency, sleep disturbance, sleep medication, and daytime dysfunction) was also lower after treatment than before treatment. The levels of HPA-related hormones (cortisol, adrenocorticotrophin, and corticotropin-releasing hormone) and HPO-related hormones (follicle-stimulating hormone and luteinizing hormone) all decreased after treatment. In contrast, the level of estrogen (E₂) increased. The differences before and after treatment for all the indicators were statistically significant (all P < 0.05).

Conclusion

Acupuncture can alleviate clinical symptoms and improve hormone levels in patients with perimenopausal insomnia. Acupuncture is safe and should be considered in clinical practice.