Efeitos da acupuntura na qualidade de vida e sintomatologia de mulheres na perimenopausa: um ensaio controlado randomizado

Abstract

Perimenopause is a transitional phase marked by hormonal changes that provoke symptoms such as hot flashes, insomnia, and anxiety, representing a considerable challenge to women's health. It is estimated that more than 80% of women present symptomatology in this phase, with about one third experiencing severe symptoms. In this scenario, integrative practices such as acupuncture have been investigated for their ability to promote symptomatic relief and wellbeing. This study aimed to evaluate the effects of acupuncture on the quality of life and symptomatology of women in perimenopause. This is a randomized controlled trial, conducted from September 2024 to June 2025 with women aged 40 to 60 years residing in the municipality of Xaxim/SC. The sample was selected by convenience via social networks and invitation letters, with 64 eligible participants after screening of 91 recruited, randomized (1:1) into control (n=31) and intervention (n=33) groups by the principal researcher using a Microsoft Excel spreadsheet, in blocks of 6, ensuring equitable distribution between the intervention (acupuncture) and control (no intervention during the study) groups. The primary outcome, symptom intensity, was assessed by the IMK, and the secondary outcome, quality of life, was measured by the SF-36 instrument. Data were collected at baseline and post-intervention and analyzed in the Stata software. The intervention group received five weekly acupuncture sessions (20 minutes of needling, standardized protocol, by a qualified acupuncturist). The groups were similar in the baseline assessed characteristics, except for physical activity practice (p=0.046). In the intervention group, the IMK reduced significantly (26.9 ± 8.1 to 12.4 ± 6.9; p<0.001), with relief of hot flashes (-3.9; p<0.001), vertigo (-1.6; p<0.001), insomnia (-2.5; p<0.001), nervousness (-1.9; p<0.001), fatigue (-0.9; p<0.001), arthralgia/myalgia (-0.7; p<0.001), headache (-0.7; p=0.002), and tachycardia/palpitations (-0.5; p=0.013). In the SF-36, comparing the groups post-intervention (intervention vs. control), significant differences were observed in seven of the eight domains: physical aspects (88.6 ± 21.7 vs. 55.6 ± 39.2; p<0.001), pain (77.5 ± 19.5 vs. 53.0 ± 14.9; p<0.001), general health (65.6 ± 16.5 vs. 56.2 ± 17.1; p=0.029), vitality (66.4 ± 17.0 vs. 47.3 ± 15.3; p<0.001), social aspects (79.2 ± 21.6 vs. 64.1 ± 16.4; p=0.003), emotional aspects (78.8 ± 34.2 vs. 32.3 ± 33.9; p<0.001), and mental health (71.6 ± 13.9 vs. 54.9 ± 14.8; p<0.001), with no significant difference in functional capacity (83.8 ± 14.8 vs. 79.8 ± 15.5; p=0.301), possibly due to the timing of the effect. Limitations include the short follow-up time and convenience sample, which may affect the generalization of the results. The results suggest that acupuncture was effective in reducing symptoms and improving quality of life, aligning with the guidelines of the National Policy on Integrative and Complementary Practices and the National Policy on Comprehensive Care for Women's Health. This research contributes to addressing gaps in the Brazilian literature, providing primary evidence from a randomized controlled trial with implications for practices in the Unified Health System.