Chinese herbal medicine for management of polycystic ovary syndrome: current evidence and future directions

Polycystic ovary syndrome (PCOS) affects 13% of women of reproductive age and is characterised by endocrine and metabolic disturbances. Current treatments include lifestyle changes and pharmacological options, but patient dissatisfaction with medications is high due to side effects. Women with PCOS appear to favour complementary approaches such as Chinese herbal medicine (CHM). This paper reviews the evidence for CHM in the management of PCOS, which typically includes multiherb prescriptions like Gui Zhi Fu Ling Wan and Cang Fu Dao Tan Tang as well as individual herbs such as Coptis chinensis (Huang Lian). CHM has shown potential in improving reproductive outcomes and metabolic health as well as for reducing inflammation through mechanisms like hormone regulation and modulation of gut microbiota. However, the methodological quality of CHM research is often low, and barriers to effective implementation of research findings remain. Future research should focus on improving methodological rigor, enhancing generalisability and conductance of pragmatic RCTs comparing real-world interventions. Addressing these challenges can help to further integrate CHM into clinical practice for managing PCOS to improve patient choice and potentially improve health outcomes for this population.