Polycystic Ovarian Syndrome (PCOS) with TCM

Like so many other medically defined conditions, polycystic ovarian disease, or PCOS, simply is not a concept that existed in ancient Traditional Chinese Medicine (TCM). The ancient sages of TCM recognised symptom patterns that we now call PCOS, but herbal treatment for the condition is both more and less than medical intervention.

What Does a TCM Practitioner See When a Woman Comes In With PCOS?

Most practitioners of TCM are also trained in conventional medicine, so you can discuss your concerns with confidence. The choice of herbal treatments, however, depends on symptoms as they are traditionally defined.

Sometimes the TCM practitioner will see that symptoms require “warming up” the body. For this, the patent medicine might be Gui Zhi Fu Ling Wan, which is also known as the Cinnamon and Poria Pill. Sometimes the TCM practitioner might see that primary problem is “redirecting” the body’s energies away from the center of the body, where they are “congealing” in the ovaries. For this symptom pattern, the remedy might be Dan Gui Shao Yao San, which is also known as Dong Quai and Peony Powder. This is the same remedy that is used in older women to treat hot flushes.

But sometimes the problem is that the menstrual cycle simply needs to be reset. In Western terms, there is an excess of luteinizing hormone. In almost all cases of PCOS, there is a problem with too much testosterone.[1] The ovaries make both estrogen and testosterone. PCOS causes the ovaries to burn lots of sugar, which they use to make both hormones to excess. It is necessary at least to reduce the production of testosterone. Low-calorie diets (exercise without diet won’t work) reduce the supply of sugar to the ovaries and reduce the production of estrogen. But clinical trials show that the herbal formula Wen Jing Tang, which is also known by its Japanese name unsei-to,  normalizes both luteinizing hormone and the balance of estrogen and testosterone.[2] In the terminology of TCM, this formula “Warms the Menses” to restart ovulation and fertility.

When Would TCM “Warm the Menses”?

Not every woman should get the Wen Jing Tang formula. There are some very specific indications that the formula will help.

  • Traditionally, this formula was used for women who had abdominal distension. That could be bloating, or it could be belly fat. In TCM, both bloating and belly fat indicate the same kind of disturbance in the flows of Chi through their channels. A “harder” kind of stasis only meant that the energy had been in the wrong channels so long that bloat turned into fat. But the misdirection of energy was the same.
  • Warm the Menses formula usually is given to women who have some uterine bleeding, but not necessarily menstruation. Their periods may come late or not at all. But there is still some bleeding.
  • This formula is not intended for women who have fevers, who have hot flushes, or who have express (however deservedly) outbursts of rage. It adds energy to the body, so it’s best to avoid this formula if there is already too much energy in the body.

Usually, this isn’t the first combination a TCM practitioner would try. But this is the combination that works best with Western medicine.

TCM Augments Medications and Supplements

The herbal formulas of Traditional Chinese Medicine do not replace any other medications your doctor prescribes. They don’t take the place of any supplements you may be taking, such as inositol. Your medications and supplements help to determine the pattern of symptoms for which your TCM practitioner chooses appropriate combinations of hepcosrbs.

What kinds of medications and supplements also make a difference? Documented clinical experience gives some insights.

Here are some examples:

  • The most commonly prescribed medication for PCOS is metformin. It  is considered especially useful when symptoms include obesity.[3] However, at least one clinical trial has found that myo-inositol is effective than metformin.[4]
  • Myo-inositol can be combined with the fertility drug clomiphene. Fertility researchers at the Alexandrovska University Hospital in Bulgaria gave 50 women both myo-inositol and clomiphene for three months. In just three months, 29 women started ovulating again and 11 became pregnant. After the other women in the study went off myo-inositol, they continued on clomiphene. In that group, six more women became pregnant.[5]
  • Another team of doctors at the Hôpital Jeanne de Flandre in Lille, France asked 26 women to consent to treatment with myo-inositol in addition to clomiphene. Their pregnancy rates were 35 percent higher than the pregnancy rates for women who received clomiphene alone.[6]


Would these women get even better results if they took some doctor-supervised combination of metformin, myo-inositol, clomiphene, and/or Wen Jing Tang? It all depends on symptoms. Whether or not a woman takes any other medications, Wen Jing Tang works best when the energetic need of the body is to warm and gently stimulate the reproductive organs.


How Should Women Pursue TCM Treatment for PCOS?


PCOS is never simply a matter of eating the wrong foods in the wrong amounts at the wrong times, but it is often helped by diet. Dieting puts the brakes on some of the hormonal processes that perpetuate the disease. A clinical study has found that no matter what treatments women choose for infertility associated with PCOS, they get better results if they diet first.[7]


Beyond dieting, it’s important to get good medical care and good alternative medical care. Be up front with your doctor about any herbs you are using. Be open with your TCM practitioner about any medications you are taking. You don’t have to be a purist to get good results from TCM, but you do need a skilled practitioner who thoroughly understands and respects your choices.


Will you overcome PCOS with Wen Jiang Tang? Maybe you will, but chances are your TCM practitioner will try one of two other herbal remedies first. Wen Jiang Tang is something you take when your body is ready for it, perhaps In the second of third month of treatment. You may have to wait a few months for results, but working with your TCM practitioner will still get a better and faster result than you can expect from one mode of treatment alone.


[1] Barber TM, Franks S. Genetic basis of polycystic ovary syndrome. Expert Review of Endocrinology & Metabolism. 2010. 5(4):549-61.pcos

[2] Ushiroyama T, Hosotani T, Mori K, Yamashita Y, Ikeda A, Ueki M. Effects of switching to wen-jing-tang (unkei-to) from preceding herbal preparations selected by eight-principle pattern identification on endocrinological status and ovulatory induction in women with polycystic ovary syndrome. Am J Chin Med 2006;34(2):177-87. doi: 10.1142/S0192415X06003746. PMID: 16552830.

[3] Tagliaferri V, Romualdi D, Immediata V, De Cicco S, Di Florio C, Lanzone A, Guido M. Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study.

Clin Endocrinol (Oxf). 2017 May;86(5):725-730. doi: 10.1111/cen.13304. Epub 2017 Feb 10. PMID: 28092404.

[4] Jamilian M, Farhat P, Foroozanfard F, Afshar Ebrahimi F, Aghadavod E, Bahmani F, Badehnoosh B, Jamilian H, Asemi Z. Comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in polycystic ovary syndrome: A randomized controlled clinical trial. Clin Endocrinol (Oxf). 2017 Aug;87(2):194-200. doi: 10.1111/cen.13366. Epub 2017 Jun 8.

[5] Kamenov Z, Kolarov G, Gateva A, Carlomagno G, Genazzani AD. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance.

Gynecol Endocrinol. 2015 Feb;31(2):131-5. doi: 10.3109/09513590.2014.964640. Epub 2014 Sep 26.

PMID: 25259724.

[6] Rolland AL, Peigné M, Plouvier P, Dumont A, Catteau-Jonard S, Dewailly D. Could myo-inositol soft gel capsules outperform clomiphene in inducing ovulation? Results of a pilot study. Eur Rev Med Pharmacol Sci. 2017 Jun;21(2 Suppl):10-14.PMID: 28724178.

[7] Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, Gnatuk CL, Estes SJ, Allison KC, Sarwer DB, Diamond MP, Schlaff WD, Casson PR, Christman GM, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Zhang H, Eisenberg E, Coutifaris C, Dokras A. Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. J Clin Endocrinol Metab. 2016 Jul;101(7):2658-66. doi: 10.1210/jc.2016-1659. Epub 2016 May 12. PMID: 27172435.