Polycystic Ovary Syndrome (PCOS) is a widespread reproductive endocrine disorder that affects many women, characterised by irregular menstrual cycles, infertility, and obesity. Often accompanied by insulin resistance and metabolic disturbances, PCOS primarily stems from hormonal imbalances, such as elevated levels of androgens and luteinizing hormone. Traditional Chinese Medicine (TCM), which includes approaches like acupuncture and herbal formulas, has emerged as a promising treatment for managing PCOS with minimal side effects.

Understanding PCOS
PCOS is prevalent among women of childbearing age and significantly affects their reproductive, metabolic, and psychological health. Symptoms include irregular menstruation, high levels of male hormones (hyperandrogenemia), ovulation dysfunction, and multiple ovarian cysts. These issues impact fertility and overall quality of life. The prevalence rate for Australian women of reproductive age is between 12% and 21%. Up to 70% of women remain undiagnosed, leading to a high incidence of diabetes (around 26.5%) in this group.

Complex Nature of PCOS
PCOS is influenced by both genetic and environmental factors, involving changes in the hypothalamic–pituitary–ovarian axis, DNA methylation, hormone levels, and gut flora. Inflammation also plays a key role, contributing to ovarian dysfunction.

TCM’s Approach to PCOS
Ancient Chinese medicine did not specifically recognise PCOS but treated related symptoms like irregular menstruation and infertility. TCM aims to restore balance among the kidney, Tiangui, Chongren, and uterus, with Tiangui being crucial for menstruation and pregnancy. Disruptions in these areas can lead to the reproductive issues seen in PCOS. TCM’s holistic approach is gaining recognition for its effectiveness and safety.

Acupuncture and Herbal Formulas vs. Western Medicine
Acupuncture, a key component of TCM, offers individualised treatment based on channel theory and syndrome differentiation. It analyses the relationships of pathogenic factors at different stages and tailors treatment plans to the specific syndrome type, achieving remarkable clinical efficacy in managing PCOS symptoms.

Given the complexity of PCOS, no single pharmaceutical drug can address all symptoms. Oral contraceptives are commonly used for menstrual irregularities but are unsuitable for women trying to conceive. Insulin sensitisers help reduce insulin levels and hyperandrogenemia but often cause gastrointestinal issues. TCM, widely used in China for gynaecological issues and infertility, offers a holistic approach. Research shows that TCM can regulate endocrine functions, improve menstrual irregularities, and enhance ovulation and pregnancy rates by modulating ovarian blood flow and hormone levels.

Conclusion
PCOS presents a challenging array of symptoms and underlying causes, making effective management crucial. While Western medicine provides effective treatments, they often come with significant side effects. TCM offers a safer alternative, focusing on syndrome differentiation and individualised treatment plans. With growing clinical evidence supporting its efficacy, TCM represents a promising path for managing the endocrine and metabolic disruptions associated with PCOS.

References
Boyle, J., & Teede, H. J. (2012). Polycystic ovary syndrome: An update. Australian Family Physician, 41(10). Retrieved from https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome
Chen, H., Deng, C., Meng, Z., & Meng, S. (2023). Effects of TCM on polycystic ovary syndrome and its cellular endocrine mechanism. Frontiers in Endocrinology (Lausanne), 14, 956772. https://doi.org/10.3389/fendo.2023.956772