To search for studies with relevant data, the researchers used several databases and screened 1,024 articles related to acupuncture and PCOS. They found 27 RCTs that passed their criteria for analysis; 25 of those came from studies done in China, while two came from Sweden, one came from America, and one came from Australia and China. The RCTs involved a total of 2093 women, some of whom had both PCOS and subfertility problems, while the others had obesity-type PCOS. Of the 27 RCTs, 12 trials evaluated the effects of acupuncture alone. The other trials focused on the effects of acupuncture in conjunction with commonly used PCOS medications such as clomiphene citrate (CC), Diane-35, and metformin. Acupuncture was also used with Chinese herbal medicine in some of the studies.
Acupuncture improves insulin levels in women with PCOS
In the trials that looked at the benefits of acupuncture alone, sham acupuncture was used as the control. The researchers, however, were quick to point out that the type of acupuncture used across all trials varied greatly. Despite further discrepancies in acupoint selection, length of treatment, and the number of sessions the women received, manual acupuncture displayed a positive effect by improving the fasting insulin levels of women in four different trials. Two trials also reported an improvement in the ovulation rates, monthly menstruation rates, and testosterone levels of the participants who were treated with acupuncture alone. Pregnancy was also reported in ten different trials; four trials supported it with evidence of blood tests, ultrasound, and self-reports. However, six of the ten trials did not state their diagnostic criterion. Due to the small number of samples, pregnancy was not considered in the evaluation of acupuncture's benefits. (Related: Acupuncture produces amazing results in reversing infertility.)
Acupuncture, combined with medication, improves hormone and insulin levels
The effects of acupuncture versus different PCOS medications were also examined. Six RCTs reported an improvement in monthly menstruation rates but there was no significant difference detected in terms of testosterone levels. On the other hand, when acupuncture was used together with medication, it improved luteinizing hormone (LH) levels, LH/FSH (follicle-stimulating hormone) ratios, and fasting insulin levels in women with PCOS. LH is involved in the process of ovulation in women. A surge in LH triggers ovulation; however, in women with PCOS, LH is already present in high levels so no surge in LH occurs. The normal ratio of LH to FSH – the hormone responsible for the growth of follicles in the ovaries – is 1:1. But for women with PCOS, their LH levels are usually higher than FSH. Surprisingly, when acupuncture was used with a combination of two PCOS medications, it only improved LH levels, suggesting that acupuncture should be used with only one PCOS medication to obtain favorable results.
Overall, only eleven RCTs reported adverse events during the course of the treatment. In seven of the eleven trials, no such events occurred in patients receiving acupuncture. And while the authors emphasized the need for further studies, the results of their analysis regarding the effects of acupuncture on PCOS were very promising.
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