Summary:
Polycystic ovary syndrome (PCOS) is an endocrine condition affecting people of reproductive age and is defined by a combination of ovulatory dysfunction, elevated androgens, and/or polycystic ovaries. Alongside reproductive and metabolic features such as infertility, obesity, acne, and hirsutism, PCOS is strongly associated with psychological symptoms such as anxiety and depression. Current guidelines indicate that there is no curative treatment for PCOS, and management is largely symptom-focused. Psychological symptoms are typically addressed using psychotherapy or pharmacological medicines. Acupuncture has been increasingly used within complementary medicine for a range of conditions involving emotional and neuroendocrine dysregulation. It has been proposed to influence serotonin and norepinephrine systems, as well as hormonal and gut-brain axis interactions. This study, a systematic review and meta-analysis of randomised controlled trials, specifically evaluated the effects of acupuncture on anxiety and depression in individuals with PCOS. The review included 12 randomised controlled trials involving 2,127 participants, with 1,059 receiving acupuncture and 1,068 in control groups. Findings showed that acupuncture was associated with reductions in both anxiety and depression compared with control conditions. Improvements were also observed in some metabolic and hormonal measures, including body mass index, waist-to-hip ratio, and testosterone levels, while no clear effect was seen on insulin resistance. Safety outcomes suggested a low rate of adverse events. Overall, this study suggests that acupuncture may be a useful therapy for psychological symptoms in PCOS.
Abstract:
Background: Acupuncture is increasingly utilized to address anxiety and depression in polycystic ovary syndrome (PCOS), yet evidence for non-pharmacological interventions remains limited. This study aimed to rigorously evaluate the efficacy and safety of acupuncture in alleviating anxiety and depression among women with PCOS, while exploring its potential mechanisms. Methods: Eight Chinese/English databases (CNKI, Web of Science, PubMed, Embase, etc.) were searched from inception to March 1, 2025. Two investigators independently screened studies, extracted data, and assessed quality via the Cochrane risk-of-bias tool. The meta-analyses were performed with RevMan 5.4. Additionally, data mining methods were used, including frequency statistics to analyze the frequency of acupuncture points and the meridians involved. Results: Twelve RCTs (n = 2,127 patients; acupuncture = 1,059, control = 1,068) were included. Compared with the control, acupuncture significantly reduced anxiety scores [MD = −6.42, 95% CI (−8.91, −3.56); p < 0.00001] and depression scores [MD = −5.89, 95% CI (−9.01, −2.78); p = 0.0002] versus controls. Acupuncture also improved testosterone [MD = −0.05, 95% CI (−0.11, 0.00); p = 0.05], BMI [MD = −0.70, 95% CI (−1.19, −0.21); p = 0.005], and the waist-hip ratio [MD = −0.06, 95% CI (−0.11, −0.01); p = 0.03], with no significant adverse effects [OR = 0.08, 95% CI (0.01, 0.81); p = 0.03]. The effects on insulin resistance were not significant [MD = −0.41, 95% CI (−1.18, 0.37); p = 0.31]. Data mining revealed that Foot Taiyin Spleen Meridian (SP), Conception Vessel (CV), and Foot Yangming Stomach Meridian (ST) were the most frequently used, and the most commonly used combination of points included SP6, LR3, and ST36. Conclusion: Acupuncture, particularly manual and short-term protocols, is a safe and effective adjunct for reducing anxiety and depression in PCOS. These benefits may be mediated via modulation of androgen levels, adiposity, and neuroendocrine pathways. Nevertheless, conclusions are limited by sample size, methodological heterogeneity, and inadequate adverse event reporting. Higher-quality RCTs are needed to confirm the safety and efficacy of these methods.
Article Publication Date: 21/01/2026
DOI: 10.3389/fmed.2026.1738629
