A pilot RCT carried out in the USA has found that while both traditional acupuncture (TA) and sham acupuncture (SA) can improve menopause-related vasomotor symptoms (VMS), only TA shows an impact on the hypothalamic-pituitary-adrenal axis. Thirty-three peri- and post-menopausal women with at least seven VMS daily were randomised to TA, SA or a waiting-list control (WC). Both the TA and SA groups demonstrated improved VMS trends and both showed significantly improved scores for menopause-specific quality of life compared with the WC group. However, 24-hour urinary measures of total cortisol metabolites and dehydroepiandrosterone (DHEA) were lower only in the TA versus both the SA and WC groups. (A pilot randomized, single-blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause. Menopause. 2012 Jan;19(1):54-61).