Acupuncture and Chinese Medicine for PCOS
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine imbalance in females. An estimated 1-2 in 10 women will face a diagnosis in their lifetime (and many more cases will go undiagnosed). Despite its commonality, PCOS can have substantial impacts on quality of life, which we’ll dive into shortly. In this article we’ll define PCOS, talk about its impacts and discuss how Traditional Chinese Medicine can treat the underlying hormonal imbalances that drive it.
What is PCOS
PCOS is a hormonal imbalance typically characterized by high levels of androgens and menstrual cycle irregularities. In many cases, a pelvic ultrasound will also show the ovaries have a polycystic appearance. In order for a diagnosis of PCOS to officially be made, 2 out of the following 3 criteria must be met:
1. Hyperandrogenism
2. Ovulatory dysfunction (reflected in irregular or absent menstrual cycles)
3. Polycystic ovaries
Symptoms of PCOS
If you’re dealing with PCOS, you’re probably familiar with some of the following symptoms: pelvic pain, bloating, irregular or missed periods, irregular or lack of ovulation (and subsequent challenges with fertility), body-wide increases in hair growth, scalp hair thinning or loss, acne, weight gain, and anxiety, depression and other mood-related symptoms.
Causes of PCOS
While there is no definitive cause of PCOS, high levels of androgens, insulin resistance and genetics are the strongest correlated factors for developing PCOS. Disruption of the hypothalamic-pituitary-ovarian (HPO) axis is thought to be an important component of PCOS because it leads to an increased ratio of luteinizing hormone (LH) to follicle stimulating hormone (FSH). This is critical because LH is what stimulates androgen production in the ovaries.
When androgen levels are high, they can prevent the normal maturation of ovarian follicles. When follicles repeatedly failing to mature and release eggs, this results in a congestion of immature follicles on the periphery of the ovary leading to a polycystic appearance on ultrasound.
Insulin resistance comes into play because it can stimulate the pituitary to release more LH, reinforcing its androgenic effects.
Simultaneously, high androgen levels can worsen insulin resistance, leading to a sticky and complex cycle where insulin resistance and hyperandrogenism reinforce one another.
Long-Term Impacts of PCOS
Long term studies show people with PCOS are more likely to develop specific health conditions including type 2 diabetes, hypertension, high cholesterol, heart disease, infertility and endometrial cancer. The increased risk for these health conditions is thought to be the result of endocrine imbalance with both insulin and reproductive hormones (whether driven by genetics, lifestyle choices or environmental factors) left unchecked.
3 Common Misconceptions about PCOS
Having a PCOS diagnosis means I will need IVF to get pregnant. This is absolutely untrue. Though PCOS is the leading cause of anovulatory infertility, having PCOS does not guarantee you’ll have trouble conceiving. Many females are able to conceive without IVF, especially with proper treatment of PCOS.
I have to lose weight to treat my PCOS. There’s a wide range of how PCOS can show up, across a wide range of bodies. Because PCOS is a metabolic disease, weight may impact prognosis and healing for some, but not all. Females who are slender or unweight can have PCOS, and it wouldn’t be appropriate (and may even be harmful) to lose weight. If extra weight is a factor, it is important to consider people with PCOS often have a genetic tendency to insulin resistance. Coupled with environmental factors, this makes it far easier for them to gain weight vs. people with a different genetic makeup. Approaching weight management with PCOS should be approached with great care and consideration, and discussed on a case-by-case basis.
I’m not supposed to have androgens as a female. It’s normal (and necessary) for every body (even female ones) to have androgens. All bodies produce testosterone (and other androgens) and a lack of them would lead to serious, life-threatening health conditions. The key is for these hormones to be in balance with other sex hormones like estrogen and progesterone.
Challenges with Conventional Care
Conventional care approaches for PCOS can be helpful, but also may fall short for various reasons, including symptom masking, life-long dependence on medication and concerning side effects.
How Chinese Medicine Views PCOS
PCOS is viewed as a deficiency of the Kidney Organ System with imbalances in the Governing, Conception and Penetrating Vessels (Du, Ren and Chong Mai). In most cases there is an accumulation of Damp-Phlegm (polycystic ovaries are a physical manifestation of Damp-Phlegm) and Spleen Organ System deficiency (the Spleen Organ System encompasses the pancreas and its function of insulin secretion). Blood flow may be impaired, reflected in conditions of Blood Stasis or Blood Deficiency, and mood-related symptoms of PCOS are often tied to a stagnation of Liver Qi.
Treating PCOS with Chinese Medicine
Chinese Medicine tackles PCOS using a combination of acupuncture, herbal medicine and lifestyle adjustments. Treatment requires patience and diligence. PCOS develops over many years and in order to shift endocrine system patterns, treatment takes place over several months (typically 3-6), and up to a full year in cases where symptoms are severe. Treatments are administered one a week during the beginning of treatment, and taper off to every other week or once a month during the mid and later stages of treatment.
ACUPUNCTURE
Acupuncture focuses on addressing organ-system and extraordinary vessel imbalances to improve endocrine function. Reviews of clinical trials spanning 22-43 studies (with ~2,000 – 4,000 participants) demonstrated acupuncture is effective in recovering menstrual cycle regularity and downregulating androgen and LH levels.¹,²
Evidence also shows insulin resistance can be improved by acupuncture in combination with herbal medicine.2 Additionally, acupuncture in combination with oral metformin (a commonly prescribed medication in PCOS used to treat insulin resistance) improved insulin resistance more than taking metformin alone.²
HERBAL MEDICINE
In addition to acupuncture, herbal medicine can help address endocrine disorders on a systemic level.
A small-scale study of 40 females looked at the treatment of PCOS-related menstrual cycle irregularities with both standardized and individualized Chinese Herbs over six months.³ Significant improvements in both hirsutism and mensuration rate were observed in both groups.
Another study compared herbal medicine + lifestyle interventions vs. lifestyle interventions alone in a subset of 122 clinically overweight females with PCOS aged 18-44.⁴ Key findings, at three months into the study, are summarized below:
The herbal medicine group’s average menstrual cycle length was 43 days lower (i.e. they experienced more regular periods) than for those in the lifestyle-only (control) group.
The herbal medicine group showed normal length menstrual cycles (20-34 days) at a rate more than double of their controls.
Waist circumference and fasting insulin were significantly lower in the herbal medicine group vs. the control group.
The herbal medicine group saw an increase in follicular-phase estradiol and a decrease in androgen-driving luteinizing hormone (LH) compared to controls.
Conception rates significantly increased in the herbal medicine group vs. the control group.
The herbal medicine group reported statistically significant improvements in concerns over body hair, body weight, menstrual problems and emotions in contrast to the control group.
Reductions in anxiety, depression and stress were also significant in the herbal medicine group vs. the control group.
As mentioned earlier, PCOS can show up in many different ways, in many different bodies. A female dealing with irregular cycles, polycystic ovaries, fatigue and obesity would have a very different herbal treatment plan than a female dealing with irregular cycles, acne, excessive hair growth and no notable weight changes or ultrasound findings. Each case would require a unique herbal approach to re-regulate the menstrual cycle and bring the body back into harmony.
LIFESTYLE ADJUSTMENTS
30 minutes of moderate to vigorous exercise. Regular movement is important in healing from PCOS because it can help crack the stubborn insulin-androgen cycle. Exercise directly improves insulin sensitivity by stimulating muscles to take up glucose, reducing the need for insulin to transport it. 30 minutes of exercise per day not only helps improve insulin sensitivity, but can have a life-changing impact on mood. There is an overflowing amount of neuroscience research that shows how a little daily exercise can be immensely beneficial for mental health, and it is even cited by major scientific journals as a treatment for depression.⁵
Implement a blood sugar friendly diet. Fueling the body with nutrient-dense foods that reduce spikes in blood sugar can play a major role in reducing insulin resistance and subsequent androgen production. Orienting around a mediterranean-style diet (MSD) rich in whole-grains, vegetables, healthy proteins and fats is a good starting place. The MSD has some of the least restrictive guidelines and has been correlated to a reduction of many chronic diseases. There is a wonderful phrase “you can’t out diet stress”, so if making dietary shifts begins to feel overwhelming, this is a sign to reassess and consider working with a nutritionist or other qualified professional.
Weekly acupuncture to balance hormones and reduce stress. As discussed above, acupuncture and herbal medicine can gently but powerfully help the body shift out of the stubborn hormone cycles that are characteristic of PCOS. In order for treatment to be successful, consistency is key. Regular acupuncture treatments also serve as a blissful avenue for self-care, relaxation and restoration.
PCOS Treatment at Alamere Acupuncture
Contact us to directly to learn more about our approach to holistic treatment of PCOS and how we can support you. hello@alamereacupuncture.com
Our clinic is located in Mill Valley, in Marin County.
1. 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). May 29 2020;99(22):e20441. doi:10.1097/MD.0000000000020441
2. Wu T, Liu Y, Kong F, et al. Improvement of endocrine and metabolic conditions in patients with polycystic ovary syndrome through acupuncture and its combined therapies: a systematic review and meta-analysis. Ann Med. Dec 2025;57(1):2477295. doi:10.1080/07853890.2025.2477295
3. Lai L, Flower A, Prescott P, Wing T, Moore M, Lewith G. Standardised versus individualised multiherb Chinese herbal medicine for oligomenorrhoea and amenorrhoea in polycystic ovary syndrome: a randomised feasibility and pilot study in the UK. BMJ Open. Feb 3 2017;7(2):e011709. doi:10.1136/bmjopen-2016-011709
4. Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. Phytother Res. Sep 2017;31(9):1330-1340. doi:10.1002/ptr.5858
5. Noetel M, Sanders T, Gallardo-Gomez D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. Feb 14 2024;384:e075847. doi:10.1136/bmj-2023-075847
