Acupuncture for Polycystic Ovarian Syndrome (PCOS): Regulating Reproductive Hormones & Promoting Ovulation

Polycystic ovarian syndrome (PCOS) is actually a metabolic condition (rather than a reproductive condition) affecting the whole body, with common symptoms including irregular periods, heavy periods, fertility issues, weight gain, acne and oily skin, excessive hair growth, hair loss, sleep issues, anxiety, and mood changes.

Key features of this condition are high levels of androgens (such as testosterone), insulin resistance (reduced sensitivity of your cells to insulin), and a disordered hypothalamic–pituitary–ovarian axis (disrupted communication between the brain and ovaries).

As a metabolic condition affecting your whole body, PCOS also increases the chance of other chronic conditions developing, such as cardiovascular issues, stroke, type 2 diabetes, and metabolic syndrome.

How acupuncture & Chinese herbal medicine can help:

  1. Improving ovarian function & promoting ovulation, regulating reproductive hormones (2,10,11)

  2. Improving glucose metabolism (2,10,11)

    • This study found that

      • acupuncture did not improve insulin sensitivity and insulin resistance as well as metformin did (in women with PCOS) (16) (note: I would not expect acupuncture to be stronger than metformin)

      • BUT acupuncture is actually better than metformin at improving glucose metabolism, which may reduce the risk of type 2 diabetes (16) 

      • acupuncture has less side effects than metformin (16)

  3. Improving the way your endocrine system functions as a whole, and the way your brain & ovaries communicate (‘HPO axis’)

  4. Regulating reproductive hormones - regulating the cycle, managing premenstrual symptoms, heavy bleeding, reducing the frequency and severity of acne breakouts

  5. Relieving stress & anxiety, improving sleep, and reducing the impact of stress on your body and hormones

I recommend a whole-body, holistic approach to managing PCOS, whether you are planning a pregnancy, or want to manage unwanted symptoms and improve your health. My recommendations includes eating a healthy, balanced diet, managing stress, and including the right kind of exercise alongside acupuncture and Chinese herbal medicine formulas.

  • Acupuncture & Chinese herbal medicine can help improve your metabolic health, regulate your cycle and reproductive hormones, promote ovulation, and help with stress relief, sleep support and emotional wellbeing.

  • Stress can contribute to disrupted communicated between your brain & ovaries (HPO axis) - which is a key aspect of PCOS.

    Acupuncture is wonderful for relieving stress & reducing its impact on your body and cycle.

  • Acupuncture & Chinese herbal medicine can help with cyclical symptoms (midcycle and/or premenstrual symptoms such as breast tenderness and swelling, headaches, bloating and digestive symptoms, acne, mood changes, anxiety and sleep issues.)

  • PCOS can result in irregular/missed periods, which can cause the lining of your uterus to build up, resulting in heavy bleeding. Acupuncture can help by regulating your cycle.

  • Acupuncture and herbal medicine can both help improve metabolic health.

    Acupuncture: While a research shows metformin is better than acupuncture at improving insulin resistance, acupuncture has less side effects - and is actually better at improving the metabolism of glucose (which can help reduce your chance of getting type 2 diabetes).

    Herbal medicines can help by reducing inflammation & oxidative stress (7), and Chinese herbal medicines have “demonstrated significant protective effects against diabetes” (9)

  • Acupuncture and herbal medicine can help by easing stress and anxiety, supporting peaceful sleep and promoting emotional wellbeing. These therapies act by regulating the nervous system and promoting the release of your natural biochemicals such as serotonin and dopamine, helping put your body into a parasympathetic (rest and digest) state

  • Oily skin and acne breakouts are a common issues among women with PCOS, and are commonly caused by high levels of androgens (such a testosterone). I usually recommend a comdination of acupuncture, herbal medicines, gentle skincare, stress management & lifestyle changes.

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Acupuncture & Chinese herbal medicines for PCOS management

  1. This study looked at how Chinese herbal medicine formula can help women with PCOS and recommended it “be used as an adjunctive therapy for the treatment of PCOS”. Some of the ways Chinese herbal medicine can help mentioned include: improving hormone levels, reducing insulin resistance and hyperinsulinemia, reducing inflammation, modulating gut flora, and improving mood. (1)

  2. This study also found that herbal medicines reduced inflammation & oxidative stress in women with PCOS (both those with normal & hyperinsulinaemia).(7)

  3. This study looked at how acupuncture (compared to metformin) can help with insulin sensitivity in women with PCOS & insulin resistance. They found that while metformin was better than acupuncture at improving insulin sensitivity (I would not expect acupuncture to be stronger than metformin), acupuncture was however better at “improving glucose metabolism (which might reduce the risk of type 2 diabetes) and has less side effects”.(2) Metformin also “had a higher incidence of gastrointestinal adverse effects than acupuncture groups, and thus acupuncture might be a non-pharmacological treatment with low risk for women with PCOS.” (2)

  4. This research review also noted that acupuncture can “promote the recovery of menstrual cycles as well as downregulate the levels of LH [luteinizing hormone] and testosterone in patients with PCOS”. (3)

  5. Findings from this research review suggest that while acupuncture used alone may assist in recovering the menstrual cycle & improving pregnancy rates; in combination with medication, acupuncture may also improve ovulation rates and LH:FSH hormone ratio. (4)

  6. This research studied a specific type of acupuncture, and found that it may improve insulin resistance in PCOS patients, and “may result in improved oocyte [egg] quality and embryonic development potential.” (5)

  7. A three month course of herbal medicine was found to reduce “body weight, Body Mass Index (BMI), waist circumference and hip circumference”. (7)*

  8. You can read more here about some of the specifics (6)

References

  1. Fu LW, Gao Z, Zhang N, Yang N, Long HY, Kong LY, et al. Traditional Chinese medicine formulae: A complementary method for the treatment of polycystic ovary syndrome. J Ethnopharmacol. 2024 Apr 6;323:117698. doi: 10.1016/j.jep.2023.117698. Epub 2024 Jan 1. PMID: 38171464.

  2. Wen Q, Hu M, Lai M, Li J, Hu Z, Quan K, et al. Effect of acupuncture and metformin on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance: a three-armed randomized controlled trial. Hum Reprod. 2022 Mar 1;37(3):542-552. doi: 10.1093/humrep/deab272. PMID: 34907435; PMCID: PMC8888993.

  3. Wu J, Chen D, Liu N. Effectiveness of acupuncture in polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020 May 29;99(22):e20441. doi: 10.1097/MD.0000000000020441. PMID: 32481448.

  4. Yang H, Xiao ZY, Yin ZH, Yu Z, Liu JJ, Xiao YQ, Zhou Y, Li J, Yang J, Liang FR. Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews. J Integr Med. 2023 Mar;21(2):136-148. doi: 10.1016/j.joim.2022.12.002. Epub 2022 Dec 28. PMID: 36635165.

  5. Xiang S, Xia MF, Song JY, Liu DQ, Lian F. Effect of Electro-acupuncture on Expression of IRS-1/PI3K/GLUT4 Pathway in Ovarian Granulosa Cells of Infertile Patients with Polycystic Ovary Syndrome-Insulin Resistance of Phlegm-Dampness Syndrome. Chin J Integr Med. 2021 May;27(5):330-335. doi: 10.1007/s11655-020-3219-z. Epub 2020 Jun 22. PMID: 32572779.

  6. Ye Y, Zhou CC, Hu HQ, Fukuzawa I, Zhang HL. Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies. Front Endocrinol (Lausanne). 2022 Oct 24;13:1035929. doi: 10.3389/fendo.2022.1035929. PMID: 36353235; PMCID: PMC9637827.

  7. Lu C, Zhao X, Li Y, Li Y, Yuan C, Xu F, et al. Serum metabolomics study of traditional Chinese medicine formula intervention to polycystic ovary syndrome. Journal of Pharmaceutical and Biomedical Analysis. 2016 Feb;120:127–33. doi:10.1016/j.jpba.2015.12.020

  8. Ding N, Yue R, Wang L, Yang H. Chinese herbal medicine on treating obese women with polycystic ovary syndrome. Medicine. 2020 Dec 4;99(49). doi:10.1097/md.0000000000022982

  9. Ni Y, Wu X, Yao W, Zhang Y, Chen J, Ding X. Evidence of traditional Chinese medicine for treating type 2 diabetes mellitus: from molecular mechanisms to clinical efficacy. Pharm Biol. 2024 Dec;62(1):592-606. doi: 10.1080/13880209.2024.2374794. Epub 2024 Jul 19. PMID: 39028269; PMCID: PMC11262228.

  10. Rashidi B, Tehrani E, Hamedani N, Pirzadeh L. Effects of Acupuncture on the Outcome of in Vitro Fertilisation and Intracytoplasmic Sperm Injection in Women with Polycystic Ovarian Syndrome. Acupuncture in Medicine. 2013;31(2):151-156

  11. Johansson J, Redman L, Veldhuis P, Sazonova A, Labrie F, Holm G et al. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. American Journal of Physiology-Endocrinology and Metabolism. 2013;304(9):E934-E94