Efficacy and safety of acupuncture-related therapies in improving insulin resistance, reproductive endocrine outcomes, and ovarian morphology in polycystic ovary syndrome: a systematic review and network meta-analysis.

Polycystic ovary syndrome (PCOS) affects millions of women worldwide, causing hormonal imbalances, irregular periods, and fertility challenges. One of its underlying drivers is insulin resistance — when the body struggles to use insulin properly — which can worsen symptoms and make conception more difficult. Researchers wanted to know whether acupuncture and related treatments could help.

A large scientific review analyzed 53 high-quality clinical trials involving 4,406 women with PCOS. Researchers compared 12 different acupuncture-based approaches — including traditional acupuncture, electroacupuncture, moxibustion, laser acupuncture, and acupoint injection — against standard medications and placebo treatments.

The results were encouraging. Several acupuncture therapies significantly improved insulin resistance, a key marker of metabolic health in PCOS. Acupuncture combined with moxibustion led to meaningful reductions in BMI, while electroacupuncture helped reduce waist-to-hip ratio. Laser acupuncture stood out for lowering testosterone and luteinizing hormone (LH) — two hormones that are often elevated in PCOS and contribute to symptoms like excess hair growth and irregular cycles. Traditional acupuncture also helped reduce the number of small cysts on the ovaries and overall ovarian size, which are hallmarks of the condition.

Importantly, side effects were minor and temporary across nearly all the treatments studied, suggesting these therapies are generally safe when used alongside conventional care.

What does this mean for you? If you have PCOS, acupuncture-based therapies may offer a safe, complementary option to support your hormonal health, metabolism, and even ovarian function — not as a replacement for your doctor's care, but as a meaningful addition to it.

Always seek treatment from a licensed, qualified acupuncture practitioner who has experience working with hormonal and reproductive health conditions.

This network meta-analysis (NMA) of 53 RCTs (n = 4,406) evaluated 12 acupuncture-related therapy (ART) regimens for PCOS across metabolic, endocrine, and morphological outcomes. Acupoint injection therapy (AIT) demonstrated the greatest reduction in HOMA-IR (MD = 2.20, 95% CI 0.44–3.96) and fasting insulin (MD = 7.30, 95% CI 0.83–13.77). Acupuncture plus moxibustion significantly reduced both HOMA-IR (MD = 1.06) and BMI (MD = 5.80). Laser acupuncture produced the most significant reductions in testosterone (MD = 0.59) and LH (MD = 3.00). Electroacupuncture reduced WHR (MD = 0.06). Standard acupuncture ranked consistently across multiple outcomes, reducing fasting insulin, AFC, and ovarian volume. Adverse events were transient and non-serious. Clinically, ARTs — particularly acupuncture, AIT, and combined protocols — represent evidence-supported adjunctive interventions for PCOS management targeting insulin resistance, androgen excess, and ovarian morphology.