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Effects of acupuncture-related therapies on endocrine and metabolic outcomes in obese women with polycystic ovary syndrome: a systematic review and network meta-analysis

Liu Y, Sheng P, Li J, Weng E, Wang S, Lu M, An X

Frontiers in medicine, 2026

3,500 participants

Abstract

Background: Evidence on the effectiveness of acupuncture and combination therapies for metabolic and hormonal disturbances in obese women with PCOS remains limited. This NMA compared the relative efficacy of acupuncture-related interventions.

Methods: RCTs evaluating acupuncture-based therapies for metabolic outcomes (BMI, HOMA-IR, TG) and endocrine parameters (T, LH/FSH ratio) in obese women with PCOS were included. A Bayesian NMA assessed the comparative effects of ten modalities. Continuous outcomes were reported as MD with 95% CrIs. SUCRA was used to rank the relative efficacy of each intervention, and certainty of evidence was evaluated using CINeMA. The study was registered in PROSPERO (CRD420251118032).

Results: Forty-one RCTs involving 3,500 obese women with PCOS were included. Methodological quality was generally moderate, and certainty of evidence was low. Acupuncture and related therapies produced greater metabolic and hormonal improvements than Western medication. Mox_ACE showed the strongest metabolic benefits across BMI, HOMA-IR, and TG, while ACWM provided the most favorable hormonal regulation, improving both T and LH/FSH ratio. AC ranked within the top three for HOMA-IR, LH/FSH ratio, and TG, and AbdA ranked second to ACWM in reducing T.

Conclusion: Acupuncture and related therapies may offer meaningful improvements in metabolic and endocrine profiles in obese women with PCOS. Low-certainty evidence suggests that acupuncture-related therapies may improve…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,500 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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