US researchers investigated the feasibility of conducting an RCT of the effect of acupuncture in decreasing hot flushes in peri- and post-menopausal women. Fifty-six women aged 44 to 55 years with no menses in the past 3 months and at least four hot flushes per day were recruited from two clinical centres and randomised to one of three treatment groups: usual care (n = 19), sham acupuncture (n = 18) or TCM acupuncture (n = 19). Acupuncture treatments were scheduled twice weekly for 8 consecutive weeks. The sham acupuncture group received shallow needling in non-therapeutic sites. The TCM acupuncture group received one of four treatments based on a TCM diagnosis. Usual care participants were instructed to not initiate any new treatments for hot flushes during the study. Daily diaries were used to track frequency and severity of hot flushes. The mean daily index score was based on the number of mild, moderate and severe hot flushes. Follow-up analyses were adjusted for baseline values, clinical centre, age and BMI. There was a significant decrease in mean frequency of hot flushes between weeks 1 and 8 across all groups, although the differences between the three study groups were not significant. However, the two acupuncture groups showed a significantly greater decrease than the usual care group, but did not differ from each other. Results followed a similar pattern for the hot flush index score. There were no significant effects for changes in hot flush interference, sleep, mood, health-related QoL, or psychological well-being.