Louise came to me with a diagnosis of Polycystic Ovary Syndrome (PCOS), which she had received at the age of 17. PCOS is a multidimensional condition that impacts the ovarian function and often informed by hormonal imbalances. Common symptoms of PCOS include elevated androgens, which is a fancy way of saying male hormones, including testosterone, irregular periods, and physical signs like hirsutism, basically a lot of facial or body hair. Although Louise’s case was atypical: none of the classic signs of hyperandrogenism where visible, despite fluctuating menstrual cycles, this raised the possibility of a PCOS manifestation at times called “pseudo-PCOS,” where symptoms appear without any of the signature hormone abnormalities.
This variation aligns with findings that PCOS is a heterogeneous disorder with diverse hormonal and metabolic presentations (Zheng et al., 2022). Acupuncture’s capacity to balance a myriad of hormonal profiles encourages a promising approach for the management of both classic symptoms and atypical PCOS presentations.
Treating the Pattern, Not Just the Disease
In Traditional Chinese Medicine (TCM), treatment targets the underlying energetic imbalances rather than focusing solely on biomedical labels. PCOS may manifest through several patterns including kidney yin or yang deficiency, phlegm-damp accumulation, qi stagnation, blood stasis, and liver qi stagnation. Louise’s presentation involved a combination of liver qi stagnation, yin deficiency, and blood stasis, which explained her menstrual irregularities and discomfort.
Current research suggests that acupuncture may influence not only these traditional energetic patterns, but also physiological pathways related to inflammation, insulin resistance, and metabolic dysregulation, which are processes often described in TCM as “phlegm-damp” and “stagnation” (Wu et al., 2025). This reinforces acupuncture’s holistic approach that simultaneously targets reproductive, metabolic, and systemic imbalances common in PCOS.
The Acupuncture Approach
Treatment aimed to regulate Louise’s menstrual cycle by moving stagnated blood and restoring qi flow, with needles placed locally over the abdomen and ovarian areas, in addition to distal points to include:
- Kidney 3 (ankles): To nourish kidney energy governing reproduction.
- Liver 3 (feet/toes): To move liver qi and support hormonal and emotional balance.
- Stomach channel (lower leg): To boost support constitutional energy and to assist with the movement of stasis in the abdomen.
- Large Intestine 4 (hands): For systemic qi movement.
Additionally, specific lower abdominal points were targeted to help move stagnated follicles, thereby clearing cysts that had remained on the ovaries, much like barnacles clinging to a shell, a hallmark characteristic of polycystic ovarian syndrome (PCOS). Complementary lower back points were also used to address pain and internal stagnation caused by the pressure of ovarian cysts.
From a conventional medicine perspective, acupuncture acts centrally by regulating the hypothalamic-pituitary-ovarian (HPO) axis, helping normalise hormone secretion critical for ovulation (Zheng et al., 2022). Electroacupuncture, in particular, enhances ovarian blood flow and microcirculation, mechanisms associated with improved ovarian function and fertility outcomes (Wu et al., 2024).
Scientific Support for Louise’s Treatment
- Hormonal and Menstrual Regulation: Acupuncture significantly reduces luteinizing hormone (LH) and testosterone levels while increasing follicle-stimulating hormone (FSH), contributing to improved follicle development and cycle regulation (Zheng et al., 2022). Balancing this hormone is consistent with Louise’s rapid cycle normalisation.
- Endocrine and Metabolic Improvement: A large meta-analysis of 46 studies showed that acupuncture combined with metformin or herbal therapies improves insulin sensitivity, lowers fasting insulin, and reduces BMI and waist-hip ratio more effectively than either therapy alone (Wu et al., 2025). Acupuncture also positively affects lipid metabolism and reduces systemic inflammation, key factors in PCOS-related metabolic syndrome.
- Fertility Outcomes: Network meta-analysis evidence demonstrates that acupuncture and electroacupuncture notably increase ovulation rates, clinical pregnancy rates, and live births among infertile women with PCOS, outperforming several conventional treatments (Wu et al., 2024). Acupuncture supports reproductive function by improving blood flow to the uterus and ovaries and decreasing oxidative stress within ovarian tissue.
- Ongoing Clinical Investigation: Current high-quality RCTs using standardised acupuncture protocols are exploring acupuncture’s effects on hormonal profiles, ovarian reserve markers (such as anti-Müllerian hormone), metabolic parameters, psychological well-being, and long-term fertility outcomes in PCOS patients (de Oliveira et al., 2022). These studies will clarify acupuncture’s holistic benefits beyond immediate symptom relief.
Emotional Aspects: Holding Space Without Forcing Processing
Although PCOS is frequently accompanied by anxiety and mood disturbances, Louise presented as emotionally stable and pragmatic. The protocol outlined by Oliveira et al. (2022) includes psychological assessment recognising that physical improvements from acupuncture often precede or support emotional well-being. This aligns with the clinical observation that Louise’s physical treatment alone facilitated a positive shift in her overall health without the need for direct emotional processing.
A Remarkable Response
Within three acupuncture sessions, Louise’s menstrual cycles re-regulated, an outcome that resonates with the documented efficacy of acupuncture in improving ovulation and endocrine balance in PCOS (Zheng et al., 2022; Wu et al., 2024). Her case exemplifies how acupuncture can deliver swift, holistic benefits even in atypical or unclear Western diagnostic categories.
Conclusion
As the weeks went by, Louise required less and less treatment to regulate her periods. She remains asymptomatic and will continue without treatment unless symptoms reappear, at which point she will receive a tune-up.
Louise’s journey highlights the power of acupuncture and Traditional Chinese Medicine (TCM) in treating PCOS as a systemic, multifaceted condition. Supported by growing scientific evidence, acupuncture addresses the reproductive, metabolic, and emotional dimensions of PCOS through hormonal regulation, improved insulin sensitivity, enhanced blood flow, and reduced inflammation. These benefits, combined with excellent safety and tolerability, make acupuncture a valuable adjunct or alternative in the management of PCOS.
If you or someone you know is navigating hormonal imbalances or PCOS, acupuncture may offer a safe, effective, and integrative path to restoring balance and supporting reproductive health.
References
Zheng, Y., Liu, Y., Zhang, Y., Lin, W., Zhang, H., & Liu, L. (2022). Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews. Integrative Medicine Research, 11(2), 100843. https://www.sciencedirect.com/science/article/pii/S2095496422001261
Wu, T., Li, X., Ma, Y., et al. (2025). Improvement of endocrine and metabolic conditions in patients with polycystic ovary syndrome through acupuncture and its combined therapies: A systematic review and meta-analysis. Annals of Medicine, 57(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915742/
de Oliveira, N. M., Machado, J., Huang, Z., & Criado, M. B. (2022). Acupuncture in Women with Human Polycystic Ovary/Ovarian Syndrome: Protocol for a Randomized Controlled Trial. Healthcare, 10(10), 1999. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9602079/
Wu, Y., Xiao, Q., Wang, S., Xu, H., & Fang, Y. (2024). Effectiveness of Acupuncture for Infertility in Patients with Polycystic Ovary Syndrome: A Systematic Review and Network Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2024, Article ID 6644961. https://pubmed.ncbi.nlm.nih.gov/39313899/