Case Studies

Heart Rate and Autonomic Nervous System Activity Relationship During Acupuncture Associated with Postural Change and Effect on Menopausal Symptoms:

Kristen Sparrow • November 05, 2022

In addition to showing that just 4 weeks of acupuncture improved menopausal symptoms, these authors show that vagal activity is enhanced with acupuncture needling in real time.

This study looks at the effect of postural change on HR and HRV in menopausal women receiving once per week acupuncture.  They compare the verum acupuncture group with the sham group.  I don’t have access to the full study, but I will try to get it.

The patients had markedly improved symptoms with acupuncture and showed HF (high frequency HRV=parasympathetic activity) increased with acupuncture.  Interestingly, the HR decreased with both insertion and withdrawal of needles.  Napadow found that this decrease in HR may be an “orienting” response rather than a fear response.  79% of subjects had this.

I will write to the authors to get the papers.

Kouzuma N, Taguchi T, Higuchi M. Heart Rate and Autonomic Nervous System Activity Relationship During Acupuncture Associated with Postural Change and Effect on Menopausal Symptoms: A Prospective Randomized Trial. Med Acupunct. 2022 Oct 1;34(5):299-307. doi: 10.1089/acu.2022.0004. Epub 2022 Oct 17. PMID: 36311889; PMCID: PMC9595640.


Objective: The autonomic nervous system (ANS) has been assessed using heart rate variability (HRV), and HRV has been used to evaluate acupuncture. This study investigated the relationship between heart rate (HR) and ANS activity during acupuncture and postural change.

Materials and methods: Subjects (48 menopausal women) were assigned randomly to acupuncture and sham groups. Japanese-style acupuncture at 7 points was performed weekly for 4 weeks. For sham treatment an acupuncture tube was pressed at the same 7 points. Measurements of HR were taken at: stage 1 (supine position before acupuncture; control); stage 2 (acupuncture for 10 minutes), and stage 3 (after standing for 10 minutes). During the experiments, the following HRV indices were obtained: high (0.15 – 0.40 Hz) frequency (HF) power and low frequency (LF) power/high frequency power ratio (LF/HF) as an index of the parasympathetic nervous system activity and sympathetic nervous system activity, respectively. Participants’ menopausal symptoms were assessed using a visual analogue scale.

Results: Reduction in HR during needle insertion and removal was significantly lower than that of retention (P < 0.01). There was a significant positive correlation between HR reduction during insertion and removal of needles (r = 0.732; P = 0.000). HR decreased by ≥5% in 79% (19/24) of the acupuncture-treated subjects. HF was increased significantly during acupuncture, while LF/HF decreased during standing. Menopausal symptoms were alleviated significantly.

Conclusions: Stimulation during acupuncture-needle insertion and removal regulated ANS function, causing a decreased HR. This technique relieve patients’ menopausal symptoms.

Keywords: acupuncture; autonomic nervous system; heart rate; menopause; postural change.