Acupuncture During Perimenopause and Menopause: How It Sits Alongside HRT and Your GP

For a lot of women, it doesn't start with a hot flush. It starts with something harder to name. Sleep that used to be reliable goes patchy. A cycle that ran like a train timetable for twenty years starts arriving early, then late. You find yourself reading the same email three times. Somewhere in your mid-forties, you begin to wonder whether this is what everyone else meant by perimenopause, and whether anyone is going to give you a straight answer about it.

This guide is my straight answer about where acupuncture and Chinese medicine fit, and where they don't.

What perimenopause and menopause are

The NHS defines menopause as the point when periods have stopped for twelve months because of falling hormone levels. It usually happens between 45 and 55, and the average age in the UK is 51. Perimenopause is the stretch before that, when hormone levels are changing and symptoms can begin while periods are still happening, often irregularly. It can last several years.

The NHS lists a wide range of possible symptoms, including changes to your periods, hot flushes and night sweats, difficulty sleeping, low mood or anxiety, problems with memory and concentration, joint aches, headaches, vaginal dryness and reduced libido. Every woman's experience is different, and some notice very little.

Start with your GP

NICE's menopause guideline, NG23, was updated in 2024. It sets out hormone replacement therapy (HRT) as the main treatment to discuss for menopausal symptoms, and cognitive behavioural therapy (CBT) as an option for some symptoms, including hot flushes and low mood. Those are conversations to have with your GP or a menopause clinic, and if you haven't had one yet, I'd encourage you to book it.

Some symptoms around this time of life aren't caused by menopause at all, which is another reason to be assessed. Thyroid problems, anaemia and depression can all overlap with perimenopause, and they need medical diagnosis and treatment.

What the research says about acupuncture and menopause

Acupuncture for hot flushes has been studied a fair amount. A 2013 Cochrane review brought those trials together. When acupuncture was compared with sham acupuncture, there was no clear difference for hot flushes and night sweats. Comparisons with no treatment appeared more favourable, but those trials were low in quality, and acupuncture appeared less effective than HRT.

On that evidence, UK advertising regulators don't accept claims that acupuncture treats menopausal symptoms, and I don't make them. I'd rather you knew that before you booked than discovered it after a course of sessions.

So why do women come?

Because this stage of life is about more than a list of symptoms. Many women in their forties and fifties are looking after teenagers and ageing parents at the same time, often while working, and the changes in their body arrive at the busiest point of their lives. What many of them tell me they want is an hour where someone asks how they actually are, listens to the whole answer, and doesn't rush them out of the door.

Acupuncture gives that hour a shape. You talk, you're treated, and then you lie still in a calm room for twenty to thirty minutes, which is something a lot of women say they rarely get. Many describe feeling relaxed and more settled afterwards. Those are the terms in which I'm comfortable describing what acupuncture offers here.

“I have been going to Andrea at Resolve Acupuncture for over 10 years. Her attention to detail, professionalism and relaxed approach are second to none… We have recommended several friends to go to Andrea as we know they will be well looked after.”

How Chinese medicine describes this stage of life

Traditional Chinese medicine has its own long-standing way of describing menopause. The classical texts talk about women's lives in seven-year stages, with the reproductive years drawing to a close around the seventh stage, at 49. In that framework, menopause is a natural transition in which the body's reserves, described as Kidney Yin and Kidney Yang, are rebalancing. Women who tend to feel hot, restless and dry are described differently from women who tend to feel cold, tired and heavy.

I find this framework useful for organising what you tell me, and many women find it a kinder way to think about this time than as a hormone deficit. It is a traditional model, though, and it sits alongside your medical diagnosis rather than replacing it.

What treatment with me involves

Your first appointment lasts 60 to 75 minutes. I'll ask about your cycle history, sleep, temperature, mood, energy, digestion and any medication, including HRT. I'll also look at your tongue and take your pulse, which are part of traditional Chinese medical assessment. Then you'll lie comfortably while I place a small number of fine needles, and rest for twenty to thirty minutes. If you're nervous about needles, my guide to your first acupuncture appointment explains exactly what they feel like.

Most women start with weekly sessions. After a few weeks we review together whether you feel it's worth continuing, and how often. Some people settle into a monthly session for the longer term, and some stop. Either is fine.

Headaches and migraines can change around this time, and some women notice a pattern that follows their cycle. If that's you, my article on acupuncture for migraine and tension headaches covers that area, where the UK guidance is clearer. If your periods are still coming but changing, my guide to irregular cycles has a tracking routine that's useful for both me and your GP.

A note on Chinese herbs and HRT

Acupuncture doesn't interact with HRT, so you can have both. Chinese herbal medicine is different. Some herbs may not be suitable alongside hormone treatment or other medication, so I always check a formula against everything you're taking, and I'd ask you to let your GP know. My guide to Chinese herbal medicine explains how consultations, sourcing and safety checks work. Please don't use herbal products as a replacement for HRT you've been prescribed.

Cost and getting here

As of April 2026, an initial acupuncture appointment is £76 and follow-ups are £56. The clinic is in Upper Rissington, with off-road parking, and women come from Bourton-on-the-Water, Stow-on-the-Wold, Burford and Cheltenham. There's more about my wider work on the women's health page.

Frequently asked questions

Can I have acupuncture while taking HRT?

Yes. Acupuncture does not interact with HRT. Keep taking your HRT as prescribed and talk to your GP or menopause clinic before changing it. Chinese herbs are different, because some may not be suitable alongside hormone treatment, so herbal formulas are always checked against your medication.

What does the research say about acupuncture and hot flushes?

A 2013 Cochrane review found no clear difference between genuine and sham acupuncture for hot flushes and night sweats. Comparisons with no treatment were too low in quality to draw firm conclusions, and acupuncture appeared less effective than HRT. UK regulators do not accept claims that acupuncture treats menopausal symptoms.

Is acupuncture an alternative to HRT?

No. HRT is the main medical treatment NICE recommends discussing for menopausal symptoms, and decisions about it belong with your GP or menopause specialist. Acupuncture can be used alongside medical care for wellbeing and support, but it should not replace it.

At what age does menopause usually happen in the UK?

According to the NHS, menopause usually happens between 45 and 55, with an average age of 51 in the UK. Perimenopause, when symptoms start but periods have not yet stopped, can begin several years earlier. Symptoms before 45 should be discussed with a GP.

What happens in a menopause-focused acupuncture appointment?

The first appointment includes a detailed conversation about your cycle history, sleep, temperature, mood, energy and medication, followed by treatment while you rest for twenty to thirty minutes. Follow-ups are 45 to 60 minutes. Most people start weekly and review progress together after a few sessions.