PCOS and Traditional Chinese Medicine in Singapore: What the Evidence Says

If you grew up in Singapore, Traditional Chinese Medicine (TCM) probably wasn't something unusual. It may have been the herbal soup your grandmother brewed when you were unwell, the acupuncturist your aunt recommended for irregular periods, or the familiar advice to avoid "cooling" foods during your cycle.

So when you're diagnosed with PCOS — now referred to as PMOS following the 2026 Lancet international recommendation — it's only natural to wonder:

Can TCM actually help?

The short answer is yes — for some aspects of PCOS, but not all.

Some TCM treatments have encouraging scientific evidence behind them. Others remain supported mainly by tradition or lower-quality research. Rather than asking whether Western medicine or TCM is "better", a more useful question is:

Which parts of each approach have the strongest evidence, and how can they work together?

That's what we'll explore here.

How TCM understands PCOS

TCM doesn't diagnose "PMOS". Instead, practitioners identify patterns within the body. Women with PCOS are often described as having combinations of phlegm-dampness (痰湿), liver qi stagnation (肝郁) and kidney deficiency (肾虚).

These concepts are different from modern medical terminology, but it's interesting that they often describe many of the same symptom clusters — irregular periods, weight that won't shift, fatigue, acne, stress-related flare-ups and fertility difficulties.

Rather than asking which system is "correct", it's often more helpful to ask:

Which treatments actually improve outcomes that matter to women?

That's where evidence-based medicine becomes valuable.

Acupuncture: the strongest evidence within TCM

Among TCM treatments, acupuncture has been studied the most extensively for PCOS.

A 2024 umbrella review combining 38 meta-analyses involving more than 27,000 women found that acupuncture was associated with improvements in ovulation, menstrual regularity, testosterone levels, luteinizing hormone (LH), and insulin resistance. Other pooled analyses have reported similar findings.

However, the same reviews also reached an important conclusion.

Current evidence has not shown that acupuncture reliably improves live birth rates or pregnancy outcomes, and researchers still don't fully understand the biological mechanisms involved.

A Cochrane review reached a similar conclusion: the results are encouraging, but the available studies are too small and too variable to draw firm conclusions.

What this means for you

Acupuncture may be a reasonable complementary treatment if you're hoping to improve menstrual regularity or reduce some hormonal symptoms.

It should not replace the foundations of PCOS care — nutrition, physical activity, sleep, weight management where appropriate, and medical treatment when indicated.

Think of acupuncture as an additional tool, not the main treatment.

Chinese herbal medicine: promising, but evidence is still developing

Chinese herbal medicine often combines herbs such as Dang Gui (当归, Angelica sinensis), Bai Shao (白芍, Paeonia lactiflora), and Huang Qi (黄芪, Astragalus membranaceus) into personalized formulas.

These treatments have also been studied in women with PCOS, although the evidence remains considerably less certain than for acupuncture.

A 2021 Cochrane review examining Chinese herbal medicine for women with PCOS-related infertility concluded that the available evidence was too limited and at too high a risk of bias to make firm recommendations.

More recent meta-analyses suggest potential improvements in ovulation and some metabolic markers. However, they consistently highlight several important limitations, including small study sizes, different herbal formulas used across studies, variable study quality, and the need for larger, well-designed clinical trials.

Herbs also carry a caution acupuncture doesn't — they're pharmacologically active. They can interact with metformin, the pill or fertility medication, and quality varies between products. In Singapore, finished Chinese Proprietary Medicines are regulated by the Health Sciences Authority (HSA) for safety and quality, which helps — but it doesn't remove the need to tell your doctor exactly what you're taking.

What this means for you

Chinese herbal medicine may benefit some women, but we still cannot confidently predict who is most likely to benefit or which herbal combinations work best.

Unlike acupuncture, herbs are biologically active and may interact with medications including metformin, hormonal contraception and fertility treatments.

If you choose to use herbal medicine, always let both your doctor and your TCM practitioner know exactly what you're taking.

Where TCM and modern medicine agree

Although TCM and Western medicine describe PCOS differently, they often arrive at similar practical recommendations. Both approaches commonly encourage regular, restorative sleep, consistent physical activity, managing chronic stress, eating mostly minimally processed foods, and avoiding extremes of dieting or overtraining.

TCM may describe these recommendations as supporting qi (气) and strengthening the spleen (脾), whereas modern medicine explains many of the same lifestyle habits through their effects on insulin sensitivity and metabolic health, and hormonal regulation. While the underlying theories differ, there is meaningful overlap in the practical lifestyle advice offered by both approaches.

This shared focus on lifestyle is also where the strongest scientific evidence exists for improving long-term health and many symptoms associated with PCOS.

If you're considering TCM in Singapore

If you'd like to include TCM as part of your care, a few practical principles can help.

Choose a practitioner registered with Singapore's TCM Practitioners Board. Registration provides an important level of professional regulation and accountability.

Tell your healthcare team about every herb or supplement you're taking, particularly if you're trying to conceive or using prescription medication.

Use TCM as a complement — not a replacement — for evidence-based care.

Finally, keep the same evidence standard regardless of whether advice comes from Eastern or Western medicine. If anyone promises to "cure" PCOS, it's worth being cautious. Current evidence simply doesn't support that claim.

Where should you start?

The first step usually isn't deciding between Western medicine and TCM.

It's understanding what is driving your own PCOS symptoms.

Some women are primarily affected by insulin resistance. Others struggle more with ovulation, androgen-related symptoms or chronic stress.

Once you understand your own pattern, it becomes much easier to decide which lifestyle changes, medical treatments and complementary therapies are most likely to help.

That's exactly what Oestra is designed to do. Our free 5-minute assessment helps identify your personal PCOS pattern and explains the evidence-based strategies most relevant to you — so you can make informed decisions before investing in supplements, treatments or complementary therapies.

Citations

• Umbrella review of acupuncture for PCOS and premature ovarian insufficiency — Frontiers in Medicine, 2024 (38 meta-analyses, >27,000 women): higher ovulation and lower LH/testosterone/insulin resistance; live birth/pregnancy not supported; mechanisms unclear.
• Cochrane review — acupuncture for polycystic ovary syndrome (CD007689).
• Cochrane review — Chinese herbal medicine for subfertile women with PCOS (Zhou K, 2021; CD007535): evidence limited, high risk of bias.
• Traditional Chinese Medicine Practitioners Act 2000; registration of acupuncturists and TCM physicians with the TCM Practitioners Board (MOH; all practitioners registered from 2004).
• Chinese Proprietary Medicines regulated by the Health Sciences Authority (HSA), Singapore.