{"entity":{"id":"acupuncture-hot-flushes","kind":"technology","name":"Acupuncture for hot flushes on endocrine therapy","aka":[],"tldr":"Hot flushes on tamoxifen or aromatase inhibitors are common and hormone replacement is off the table. Acupuncture reduced flushes in several randomised trials, in one about as well as the drug gabapentin and with fewer side effects, though sham-controlled results are mixed.","summary":"Hot flushes affect most women on adjuvant endocrine therapy and are a leading reason women stop treatment; oestrogen is contraindicated. In a randomised trial of 120 breast cancer survivors (Mao et al., JCO 2015), electroacupuncture reduced hot flush scores more than gabapentin 900 mg per day at eight weeks, with sham acupuncture also outperforming placebo pills and effects persisting at 24 weeks, which illustrates both a real effect and a large non-specific component. Other sham-controlled trials have been mixed. The SIO 2017 breast guideline grades acupuncture for hot flushes as a reasonable option to consider. Non-hormonal drugs (venlafaxine, gabapentin, oxybutynin, fezolinetant) remain the comparators with the most evidence, and cognitive behavioural therapy for menopausal symptoms is an alternative with randomised support.","status":"emerging","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Hot_flash","links":[{"label":"Electroacupuncture versus gabapentin for hot flashes in breast cancer survivors (JCO 2015)","url":"https://doi.org/10.1200/JCO.2015.60.9412"},{"label":"SIO clinical practice guideline: integrative therapies during and after breast cancer treatment (CA Cancer J Clin 2017)","url":"https://doi.org/10.3322/caac.21397"}],"tags":["complementary","supportive-care","evidence:moderate"],"related":[],"cancers":["breast-hr-positive"],"sections":["supportive-care","hormonal"],"technologies":["endocrine-therapy","integrative-oncology"],"targets":[],"drugs":["tamoxifen","letrozole","exemestane"],"companies":[],"institutions":[],"pathways":[],"terms":["aromatase-inhibitor","placebo"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":["paper-greenlee-ca-cancer-j-clin","paper-mao-j-clin-oncol-2015"],"journals":[],"dependsOn":[],"notes":[],"principle":"Acupuncture may reset hypothalamic thermoregulatory set points via beta-endorphin and serotonergic pathways; the sham response suggests attention and expectation contribute substantially.","strengths":["Fewer side effects than gabapentin or antidepressants","Effects persisted months after sessions","Useful when drugs are not tolerated"],"limitations":["Sham-controlled evidence inconsistent","Requires a course of visits","Not compared with newer non-hormonal drugs"]},"route":"/technologies/acupuncture-hot-flushes/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"}],"drug":[{"id":"exemestane","kind":"drug","name":"Exemestane","route":"/drugs/exemestane/"},{"id":"letrozole","kind":"drug","name":"Letrozole (and other aromatase inhibitors)","route":"/drugs/letrozole/"},{"id":"tamoxifen","kind":"drug","name":"Tamoxifen","route":"/drugs/tamoxifen/"}],"term":[{"id":"aromatase-inhibitor","kind":"term","name":"Aromatase inhibitor","route":"/terms/aromatase-inhibitor/"},{"id":"menopause-after-chemotherapy-breast","kind":"term","name":"Menopause symptoms after chemotherapy for breast cancer","route":"/terms/menopause-after-chemotherapy-breast/"},{"id":"placebo","kind":"term","name":"Placebo","route":"/terms/placebo/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-greenlee-ca-cancer-j-clin","kind":"paper","name":"Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment","route":"/key-papers/paper-greenlee-ca-cancer-j-clin/"},{"id":"paper-mao-j-clin-oncol-2015","kind":"paper","name":"Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial","route":"/key-papers/paper-mao-j-clin-oncol-2015/"}],"roadmap":[{"id":"hormonal-therapy-roadmap","kind":"roadmap","name":"Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test","route":"/roadmaps/hormonal-therapy-roadmap/"}]}}