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Efficacy of acupuncture therapies for polycystic ovary syndrome: a network meta-analysis

In brief

Electroacupuncture ranked highest for overall PCOS symptom improvement (SUCRA 99%)

A network meta-analysis of 92 RCTs found electroacupuncture to be the top-ranked acupuncture modality for total efficacy in polycystic ovary syndrome, with the highest probability of benefit among 15 techniques. Other approaches that add heat or sustained stimulation also performed well, but no clear advantage was seen over single-method treatments. The evidence is limited by study quality, so better trials are needed before routine use can be recommended.

Journal
Frontiers in medicine (Q1)
Published
29 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Ning Yang, Yunxi Li, Hailin Jiang, Rulin Wang, Qi Zhang, Qingqing Tang, et al.
PMID
42591356
DOI
10.3389/fmed.2026.1895421

Why clinicians should know about it

Abstract

BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent gynecological disorder that significantly impairs quality of life and reduces patient confidence in treatment. The efficacy of current Western pharmacological therapies is limited. Acupuncture has shown promise in the management of PCOS, but comparative research on different acupuncture modalities remains scarce. METHODS: PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database were comprehensively searched from database inception to 18 August 2024. Two reviewers independently screened studies, extracted data, and assessed the risk of bias in the eligible studies. Network meta-analysis was conducted using STATA 15.1 and R 4.4.1. RESULTS: Ninety-two randomized controlled trials (RCTs) involving 15 acupuncture-based interventions or combinations were included. According to the surface under the cumulative ranking curve (SUCRA) analysis, for total efficacy (TE), electroacupuncture (99.03%), filiform needle + thunder fire moxibustion (74.77%), and filiform needle with electroacupuncture (64.02%) ranked the highest. For follicle-stimulating hormone (FSH) regulation, fire needle (90.99%) ranked first, followed by filiform needle + electroacupuncture (75.29%) and filiform needle + warming needle moxibustion + electroacupuncture (66.76%). For luteinizing hormone (LH) regulation, warming needle moxibustion (86.75%) ranked first, followed by warming needle moxibustion + electroacupuncture (72.76%) and filiform needle alone (69.55%). For testosterone reduction, filiform needle + moxibustion (96.53%) ranked first, followed by catgut embedment in acupoint + moxibustion (85.64%) and electroacupuncture (82.33%). For LH/FSH ratio improvement, catgut embedment in acupoint (77.73%), warming needle moxibustion + electroacupuncture (72.87%), and filiform needle + warming needle moxibustion + electroacupuncture (66.39%) ranked the highest. For adverse events, fire needle (91.69%) ranked highest, followed by Western medicine (83.17%) and catgut embedment in acupoint (64.08%). CONCLUSION: No statistically significant differences were observed between single and combined acupuncture therapies. However, modalities incorporating electrical, thermal, or sustained stimulation appear to be more effective. Given the methodological limitations of the included studies, high-quality, rigorously designed RCTs are warranted to validate these findings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42024609903.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.