Why women should use acupuncture to reduce hot flashes, night sweats and insomnia?

Every year over 1 million women are diagnosed with breast cancer worldwide and 55% are estrogen-receptor positive according to the findings of Boyle and Levin in 2008. In order to block estrogen’s stimulating effect, hormone treatments with Tamaxofen or aromatase inhibitor are frequently prescribed for women with positive estrogen-receptors after surgery and chemotherapy. When estrogen drops to a certain level, the hypothalamus (temperature control center in the brain) becomes very sensitive to small temperature changes. If the core temperature increases slightly due to stress, drinking hot water or multitasking, the temperature control center gets stimulated, blood vessels throughout the body surface dilate, causing hot flashes (HF) and other symptoms such as palpitation, sweating, anxiety, depression, and insomnia in women. The drastic dropping of estrogen, often accompanied by a decrease of beta-endorphine, progesterone and serotonin, also causes changes in the sympathetic nervous system. At the same time, the increase of the fight or flight hormones such as noradrenalin makes the sympathetic nerves even more sensit ive to temperature changes and stress.
Many women develop anxiety and insomnia due to a hyper-active nervous system. That is why women should avoid stimulations such as coffee, multi-tasking, over-thinking or even spicy foods during hormone treatment in order to calm down their nervous system. The hyperactive sympathetic nerves can also cause the immune system to be out of balance. If a woman can stay calm and sleep deeper, her balanced immune system can control the growth of cancer cells more efficiently. Everybody carries cancer cells, only when your immune function is weakened, do cancer cells advance uncontrollably. That is why, with the same treatment, some women survive while others fall into relapse.
Many randomized and controlled clinical trials have demonstrated that acupuncture can help women manage their hot flashes. Firsk compared electro-acupuncture with hormone replacement therapy in reducing hot flashes and night sweats for up to 24 months after finishing a series of acupuncture treatment. Flishie analyzed the treatment records of 182 women with breast cancer. His research suggests long term relief of hot flushes from one month to 6 years with an averages of 9 months after treatments with acupuncture and self acupuncture (Filshie et al. 2006) . Recently de Valois conducted a single arm study demonstrating a reduction in hot flushes for up to 18 weeks after the last of 8 treatments in 50 patients (Valois et al. 2010).
Jill Hervik and Odd Mialand did their first randomized, controlled long-term study recently investigating the effects of acupuncture treatments in breast cancer patients after surgery . Patients were randomized to either traditional Chinese acupuncture (n = 43) or sham acupuncture (n = 45), 15 treatments were administered over a 10 week period. Patients were monitored during the treatment period and for a further 12 weeks after acupuncture treatments. Although this study had limited size, it supports previous random controlled studies demonstrating that acupuncture is a safe and effective alternative treatment for hot flashes by relieving vasomotor problems due to changes of hormones. This study has demonstrated that the long term effect of acupuncture decreases with time, from around 12 weeks post-treatment. Although differences between the group receiving TCM acupuncture and those receiving sham after two years are not significant, the effect of treatment may still be present, but can have lost statistical significance due to limited sample size.
Then why is acupuncture a better alternative for breast cancer patients to relieve hot flashes, insomnia and other symptoms? Holmberg et al. (2004) randomized 434 women with previous breast cancer to either hormone replacement therapy (HRT) or best treatment without hormones; the study was stopped after 26 women in the HRT group suffered a new breast cancer while compared to 7 women in the non HRT- group, when 345 of the participants were followed up after 2 years. This study indicated that acupuncture is much safer treatment for breast cancer patients compared with hormone replacement.
During menopause low levels of estrogen and high levels of follicular stimulating hormone (FSH) are related to hot flashes, insomnia, anxiety and other symptoms in healthy women. To be a safe treatment acupuncture should not increase levels of estrogen in women with estrogen receptor positive breast cancer. A study by Dong demonstrated that there was no increase in estrogen in patients treated with acupuncture (Dong et al. 2001). This finding was confirmed by Liljegren who found no significant differences in hormone levels in blood, including FSH and estradiol, in a study comparing the effect of true acupuncture to sham in 84 breast cancer patients with hot flushes who use Tamoxifen (Liljegren et al. 2012). Since acupuncture is a very safe treatment for cancer patients, how can we increase the effects of acupuncture if women can only have acupuncture once a week or every other week, which is not a sufficient dosage? One safe and cheaper way is to combine intradermal ear needles with regular once a week treatments. We can leave the intradermal needles in shen men, endocrine, insomnia, heart points for up to a week. The other way is to teach women self-acupuncture as Flisher did. He taught women to use SP6 every day to help balance the nervous systems and strengthen the digestive system. This allows women to absorb vitamins and minerals more efficiently. Therefore, the adrenal gland can still produce a little bit of progesterone. In my 26 years of practice, I have had some very interesting cases where women using intradermal needles reduced hot flashes. One 62 year old woman used intradermal ear needles for hot flashes. She reported that as soon as she took out the ear needles, her hot flashes came back that night. She took out the ear needles at different time points after her regular acupuncture treatments. After much experimentation she and I finally believed that this was not just a psychological effect.
There is another way to treat hot flashes by using a fermented soy product, such as Tofu and tempei. A recent study about how Tofu can be a safer treatment for cancer patients indicated that the weak phytoestrogen in Tofu can combine with certain kinds of estrogen receptors and block the stimulating effect of bad estrogen, such as estradial. There are many kinds of estrogens. The good estrogen is called estriol, which can protect women from breast cancer. That is why pregnant women are usually protected by the high levels of estriol during pregnancy. But if a woman eats all the wrong food, she can have higher levels of bad estrogen such as estradial. That is why some pregnant woman develop breast cancer. Tofu can possibly serves as a very weak good estrogen to protect women from getting breast cancer.
If estrogen is the only factor causing breast cancer, why would women after menopause tend to develop breast cancer while their estrogen level is supposed to be dropping 50 to 60 percent? The reason is that the immune function and the percentage of good estrogen are changing radically as women get closer to menopause age. This changing balance is unpredictable and complex.