Acupuncture for mood disorders in perimenopausal women: A meta-analysis of randomized controlled trials

BACKGROUND: Acupuncture reportedly improves mood disorders in perimenopausal women, but the effect is controversial. The aim of this study is to evaluate the effect of acupuncture in the treatment of mood disorders in perimenopausal women. METHODS: Through the electronic retrieval from English and Chinese databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, the China National Knowledge Infrastructure databases, Wangfang databases, VIP databases, and the Chinese Biomedical Literature databases), randomized controlled trial literature regarding acupuncture treatment of mood disorders in perimenopausal women till June 2024 was collected. All of the studies were available in English. Risk ratio, standardized mean differences (SMDs), 95% confidence intervals (CIs), and heterogeneity were calculated. RESULTS: A total of 49 randomized controlled trials were included. Acupuncture was effective for mood disorders in perimenopausal women (risk ratio = 0.13; 95% CI = 0.09-0.16; P = .00; I2 = 34.42%). In pooled analysis, the acupuncture group could significantly improve Hamilton Depression Scale score (SMD = -0.57; 95% CI = -0.70 to -0.44; P = .00; I2 = 64.20%). In anxiety analysis with Hamilton Anxiety Scale and Self-Rating Anxiety Scale scores, there was significant improvement after treatment in Hamilton Anxiety Scale (SMD = -1.11; 95% CI = -0.79 to -0.44; P = .00; I2 = 91.52%) and Self-Rating Anxiety Scale (SMD = -1.05; 95% CI = -1.87 to -0.23; P = .01; I2 = 90.87%). Compared with drugs, acupuncture significantly improved the Kupperman Index score (SMD = -0.84; 95% CI = -1.23 to -0.46; P = .00; I2 = 91.87%) and follicle-stimulating hormone level (SMD = -0.45; 95% CI = -0.84 to -0.05; P = .03; I2 = 84.98%). There was no significant difference in luteinizing hormone level (SMD = -0.14; 95% CI = -0.32 to 0.04; P = .12; I2 = 0.00%) and estradiol level (SMD = 0.14; 95% CI = -0.46 to 0.74; P = .64; I2 = 92.69%). CONCLUSIONS: This meta-analysis demonstrates that acupuncture is effective in the treatment of mood disorders in perimenopausal women. However, due to some shortcomings in the methodology and quality of the included studies, more rigorously designed, large sample size and multicenter randomized controlled trials are needed to further support the above conclusions.