Evidence-based Chinese medicine clinical practice guideline on menopausal syndrome in Hong Kong

Introduction: Menopause is usually accompanied by physical and mental health problems in women, including hot flashes, night sweats, insomnia, depression, and anxiety, which significantly affect their quality of life. Chinese medicine (CM) treatment for menopause is based on syndrome differentiation with few side effects. At present, there is no systematic and acceptable guideline to support clinical decisions on menopause management. Therefore, we aim to develop a guideline to assist clinical decisions on menopause management using CM approaches. Methods: This guideline referred to the WHO handbook for guideline development and followed six main steps. The recommendation followed the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system, which contained four levels of evidence quality and four categories of recommendation. All the recommendations were based on the evidence from current research and experienced experts’ opinions. Results: Seven types of menopausal syndrome and their main symptoms were identified. A total of thirteen prescriptions were suggested with various grade of recommendation. Acupuncture for menopause was also recommended, the most common acupoints were San-yin-jiao (SP 6), Tai-xi (KI 3), Tai-chong (LV 3), and Zu-san-li (ST 36). Conclusion: This is the first CM guideline for menopause management in Hong Kong, which provides essential suggestions and support for clinical practice. However, further assessment of the guideline implementation is needed.