{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:51:44Z","timestamp":1770749504614,"version":"3.50.0"},"reference-count":57,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>(1) Background: Human polycystic ovary\/ovarian syndrome (PCOS) is linked to endocrine, metabolic, and psychological complications. We propose a randomized controlled pilot study for an acupuncture protocol regarding the management of PCOS symptoms based on TCM diagnosis; (2) Methods: We will randomly allocate 120 women diagnosed with PCOS into two groups. The study group will be treated with acupuncture for points known to act upon the autonomous regulation of the hormonal, metabolic and emotional components. (3) Results and Conclusions: We expect to provide evidence of high methodological quality related to the effects and safety of an acupuncture protocol based on the perspective of a TCM diagnostic.<\/jats:p>","DOI":"10.3390\/healthcare10101999","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T22:18:13Z","timestamp":1665526693000},"page":"1999","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acupuncture in Women with Human Polycystic Ovary\/Ovarian Syndrome: Protocol for a Randomized Controlled Trial"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1699-6338","authenticated-orcid":false,"given":"Nat\u00e1lia M.","family":"de Oliveira","sequence":"first","affiliation":[{"name":"ICBAS-Abel Salazar Institute for Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal"},{"name":"CBSin-Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4570-5445","authenticated-orcid":false,"given":"Jorge","family":"Machado","sequence":"additional","affiliation":[{"name":"ICBAS-Abel Salazar Institute for Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal"},{"name":"CBSin-Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal"},{"name":"LABIOMEP\u2013Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"Zaiwei","family":"Huang","sequence":"additional","affiliation":[{"name":"IEC-International Education College, Zhejiang Chinese Medical University, Hangzhou 310053, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1750-5614","authenticated-orcid":false,"given":"Maria Bego\u00f1a","family":"Criado","sequence":"additional","affiliation":[{"name":"CBSin-Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal"},{"name":"TOXRUN-CESPU Toxicology Research Unit, University Institute of Health Sciences, CESPU, 4585-116 Gandra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"ref_1","unstructured":"Rasquin Leon, L.I., and Mayrin, J.V. (2020). Polycystic Ovarian Disease, StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/S1472-6483(10)61644-6","article-title":"PCOS: A diagnostic challenge","volume":"8","author":"Azziz","year":"2004","journal-title":"Reprod. Biomed. Online"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Rotterdam ESHRE\/ASRM, and Sponsored PCOS Consensus Workshop Group (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril., 81, 19\u201325.","DOI":"10.1016\/j.fertnstert.2003.10.004"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ho, C.-W., Chen, H.-H., Hsieh, M.-C., Chen, C.-C., Hsu, S.-P., Yip, H.-T., and Kao, C.-H. (2020). Increased Risk of Polycystic Ovary Syndrome and It\u2019s Comorbidities in Women with Autoimmune Thyroid Disease. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072422"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3389\/fendo.2020.00641","article-title":"Role of Anti-M\u00fcllerian Hormone in the Pathogenesis of Polycystic Ovary Syndrome","volume":"11","author":"Dewailly","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1056\/NEJMoa1513873","article-title":"Fresh versus Frozen Embryos for Infertility in the Polycystic Ovary Syndrome","volume":"375","author":"Chen","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1530\/JOE-20-0155","article-title":"Hyperandrogenism and insulin resistance modulate gravid uterine and placental ferroptosis in PCOS-like rats","volume":"246","author":"Zhang","year":"2020","journal-title":"J. Endocrinol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"bqaa061","DOI":"10.1210\/endocr\/bqaa061","article-title":"Androgen Action in Adipose Tissue and the Brain are Key Mediators in the Development of PCOS Traits in a Mouse Model","volume":"161","author":"Cox","year":"2020","journal-title":"Endocrinology"},{"key":"ref_9","first-page":"CD002249","article-title":"Clomiphene and anti-oestrogens for ovulation induction in PCOS","volume":"4","author":"Brown","year":"2009","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","first-page":"694","article-title":"Endocrine characteristics of polycystic ovary syndrome (PCOS)","volume":"41","year":"2003","journal-title":"Indian J. Exp. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1038\/s41390-019-0615-1","article-title":"Curtailing PCOS","volume":"87","author":"Witchel","year":"2020","journal-title":"Pediatr Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s40618-019-01133-3","article-title":"Clinical, hormonal and metabolic parameters in women with PCOS with different combined oral contraceptives (containing chlormadinone acetate versus drospirenone)","volume":"43","author":"Podfigurna","year":"2019","journal-title":"J. Endocrinol. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1093\/humupd\/dmz036","article-title":"Cardiometabolic health in offspring of women with PCOS compared to healthy controls: A systematic review and individual participant data meta-analysis","volume":"26","author":"Gunning","year":"2019","journal-title":"Hum. Reprod. Updat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s00404-019-05305-7","article-title":"Oxidative stress indicators in Chinese women with PCOS and correlation with features of metabolic syndrome and dependency on lipid patterns","volume":"300","author":"Wang","year":"2019","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_15","first-page":"434","article-title":"Metabolic characteristics of women diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria\u2014Our own experience","volume":"39","author":"Szosland","year":"2019","journal-title":"Neuro Endocrinol. Lett."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"326","DOI":"10.4103\/ijem.IJEM_30_19","article-title":"Comparison of the different PCOS phenotypes based on clinical metabolic, and hormonal profile, and their response to clomiphene","volume":"23","author":"Gainder","year":"2019","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/17446651.2019.1556094","article-title":"Cardiometabolic risks in PCOS: A review of the current state of knowledge","volume":"14","author":"Kakoly","year":"2018","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11892-017-0956-2","article-title":"Cardiometabolic Risk in PCOS: More than a Reproductive Disorder","volume":"17","author":"Torchen","year":"2017","journal-title":"Curr. Diabetes Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.mehy.2017.10.019","article-title":"An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS)","volume":"110","author":"Barry","year":"2018","journal-title":"Med. Hypotheses"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Jiskoot, G., Benneheij, S., Beerthuizen, A., de Niet, J., de Klerk, C., Timman, R., Busschbach, J., and Laven, J. (2017). A three-component cognitive behavioural lifestyle program for preconceptional weight-loss in women with polycystic ovary syndrome (PCOS): A protocol for a randomized controlled trial. Reprod. Health, 14.","DOI":"10.1186\/s12978-017-0295-4"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/bs.acc.2019.11.004","article-title":"Neurotransmitter, neuropeptide and gut peptide profile in PCOS-pathways contributing to the pathophysiology, food intake and psychiatric manifestations of PCOS","volume":"96","author":"Ilie","year":"2020","journal-title":"Adv. Clin. Chem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s11325-019-01946-9","article-title":"The impact of depression, self-esteem, and body image on sleep quality in patients with PCOS: A cross-sectional study","volume":"24","author":"Amirjani","year":"2020","journal-title":"Sleep Breath."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1017\/S0033291718002076","article-title":"Depression, anxiety and perceived stress in women with and without PCOS: A community-based study","volume":"49","author":"Damone","year":"2019","journal-title":"Psychol Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1210\/jc.2016-3863","article-title":"Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women with PCOS Symptoms: 15-Year Follow-Up","volume":"102","author":"Karjula","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"hoz026","DOI":"10.1093\/hropen\/hoz026","article-title":"The benefits and harms of receiving a polycystic ovary syndrome diagnosis: A qualitative study of women\u2019s experiences","volume":"4","author":"Copp","year":"2019","journal-title":"Hum. Reprod. Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.steroids.2011.12.008","article-title":"Mood and anxiety disorders in women with PCOS","volume":"77","author":"Dokras","year":"2012","journal-title":"Steroids"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.5694\/mja18.00656","article-title":"Translation and implementation of the Australian-led PCOS guideline: Clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome","volume":"209","author":"Teede","year":"2018","journal-title":"Med. J. Aust."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1093\/humrep\/dez185","article-title":"Recommendations for epidemiologic and phenotypic research in polycystic ovary syndrome: An androgen excess and PCOS society resource","volume":"34","author":"Azziz","year":"2019","journal-title":"Hum. Reprod."},{"key":"ref_29","first-page":"101894","article-title":"Implementing the international evidence-based guideline of assessment and management of polycystic ovary syndrome (PCOS): How to achieve weight loss in overweight and obese women with PCOS?","volume":"50","author":"Douma","year":"2020","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sun, J., Jin, C., Wu, H., Zhao, J., Cui, Y., and Liu, H. (2013). Effects of electro-acupuncture on ovarian P450arom, P450c17\u03b1 and mRNA expression induced by letrozole in PCOS rats. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0079382"},{"key":"ref_31","first-page":"304","article-title":"Effect of electro-acupuncture on the spindle and oocytes quality in patients with PCOS","volume":"35","author":"Li","year":"2015","journal-title":"Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongguo Zhongxiyi Jiehe Zazhi Chin. J. Integr. Tradit. West. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"R1124","DOI":"10.1152\/ajpregu.90947.2008","article-title":"Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS","volume":"296","author":"Cajander","year":"2009","journal-title":"Am. J. Physiol. Integr. Comp. Physiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/ebmed-2017-110828","article-title":"Acupuncture is not as effective as infertility treatment in women with PCOS","volume":"22","author":"Xu","year":"2017","journal-title":"Evid.-Based Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1186\/s13063-019-3667-y","article-title":"Manual acupuncture for the infertile female with polycystic ovary syndrome (PCOS): Study protocol for a randomized sham-controlled trial","volume":"20","author":"Wang","year":"2019","journal-title":"Trials"},{"key":"ref_35","first-page":"385","article-title":"Acupuncture ameliorates negative emotion in PCOS patients: A randomized controlled trial","volume":"40","author":"Zhang","year":"2020","journal-title":"Zhongguo Zhen Jiu Chin. Acupunct. Moxibustion"},{"key":"ref_36","first-page":"620","article-title":"An analysis on correlation between acupoint and target organs of acupuncture-moxibustion from the perspective of modern medical sciences","volume":"44","author":"Chen","year":"2019","journal-title":"Zhen Ci Yan Jiu Acupunct. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/GCO.0000000000000582","article-title":"The efficacy of using acupuncture in managing polycystic ovarian syndrome","volume":"31","author":"Chen","year":"2019","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_38","first-page":"CD008583","article-title":"Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women","volume":"7","author":"Tang","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_39","first-page":"CD007689","article-title":"Acupuncture for polycystic ovarian syndrome","volume":"7","author":"Lim","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s00424-011-1017-3","article-title":"Ancient Chinese medicine and mechanistic evidence of acupuncture physiology","volume":"462","author":"Yang","year":"2011","journal-title":"Pfl\u00fcgers Arch. Eur. J. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Lim, D.C.E., Chen, W., Cheng, L.N.C., Xue, C.C., Wong, F.W.S., O\u2019Sullivan, A.J., and Liu, J.P. (2011). Acupuncture for polycystic ovarian syndrome. Cochrane Database Syst. Rev., CD007689.","DOI":"10.1002\/14651858.CD007689.pub2"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"473","DOI":"10.3109\/09513591003686304","article-title":"Current evidence of acupuncture on polycystic ovarian syndrome","volume":"26","author":"Lim","year":"2010","journal-title":"Gynecol. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Johansson, J., Manner\u00e5s-Holm, L., Shao, L., Olsson, A., L\u00f6nn, M., Billig, H., and Stener-Victorin, E. (2013). Electrical vs Manual Acupuncture Stimulation in a Rat Model of Polycystic Ovary Syndrome: Different Effects on Muscle and Fat Tissue Insulin Signaling. PLoS ONE, 8, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/23349861.","DOI":"10.1371\/journal.pone.0054357"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e15890","DOI":"10.1097\/MD.0000000000015890","article-title":"The prescription patterns of traditional Chinese medicine for women with polycystic ovary syndrome in Taiwan: A nationwide population-based study","volume":"98","author":"Lin","year":"2019","journal-title":"Medicine"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Lyttleton, J. (2013). Treatment of Infertility with Chinese Medicine, Churchill Livingstone, Elsevier Health Sciences. E-Book.","DOI":"10.1016\/B978-0-7020-3176-2.00007-4"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1016\/j.fertnstert.2016.07.1121","article-title":"Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: Systematic review and meta-analysis","volume":"106","author":"Lizneva","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_47","first-page":"136","article-title":"Characteristics and obstetrics outcomes of different traditional Chinese medicine syndromes in women with polycystic ovary syndrome: A secondary analysis","volume":"43","author":"Wang","year":"2017","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_49","unstructured":"Ross, J. (1995). Acupuncture Point Combinations: The Key to Clinical Success, Churchill Livingstone."},{"key":"ref_50","unstructured":"Ciconelli, R.M. (1997). Medical Outcomes Study 36-Item Short-Form Heal. [Doutorado Thesis, Universidade Federal de S\u00e3o Paulo]."},{"key":"ref_51","first-page":"191","article-title":"Afericao da Escala de Auto-valiacao de Ansiedade de SAS numa amostra da populacao portuguesa-IR da aplicacao numa amostra de populacao normal","volume":"3","author":"Ponciano","year":"1982","journal-title":"Psiquiatr. Cl\u00edn."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.parkreldis.2009.07.010","article-title":"Validity of a Brazilian version of the Zung self-rating depression scale for screening of depression in patients with Parkinson\u2019s disease","volume":"16","author":"Chagas","year":"2010","journal-title":"Park. Relat. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"762615","DOI":"10.1155\/2013\/762615","article-title":"Polycystic Ovary Syndrome: Effect and Mechanisms of Acupuncture for Ovulation Induction","volume":"2013","author":"Johansson","year":"2013","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ctim.2019.04.016","article-title":"The efficacy of Tung\u2019s acupuncture for sex hormones in polycystic ovary syndrome: A randomized controlled trial","volume":"44","author":"Cao","year":"2019","journal-title":"Complement. Ther. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"113","DOI":"10.15171\/jlms.2018.22","article-title":"Effectiveness of Laser Acupoints on Women with Polycystic Ovarian Syndrome: A Randomized Controlled Trial","volume":"9","year":"2018","journal-title":"J. Lasers Med Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2909","DOI":"10.3892\/etm.2016.3715","article-title":"Effect of acupoint catgut embedding therapy combined with Chinese medicine for nourishing the kidneys and promoting blood circulation and improving blood glucose and lipid levels as well as the pregnancy rate in obese PCOS patients with infertility","volume":"12","author":"Qin","year":"2016","journal-title":"Exp. Ther. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.arthe.2016.03.001","article-title":"Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): Extending the CONSORT statement","volume":"3","author":"MacPherson","year":"2015","journal-title":"Acupunct. Relat. Ther."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/10\/1999\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:49:58Z","timestamp":1760143798000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/10\/1999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":57,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["healthcare10101999"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10101999","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]}}}