PCOS - Liver Depression Transforming into Fire Pattern
TCM differentiation and treatment for PCOS with Liver
PCOS · Liver Depression Transforming into Fire Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Pelvis
Pattern Overview
Liver Depression Transforming into Fire is a common pattern in PCOS,
characterized by **elevated LH/FSH ratio, ovarian androgen excess,
irritability, acne, hirsutism, and emotional symptoms**. The core
pathogenesis is **chronic stress causing Liver Qi stagnation
transforming into Fire**, leading to elevated LH/FSH ratio, ovarian
androgen excess, and hyperandrogenism.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
menstruation/amenorrhea |
| Associated Symptoms |
|---|
premenstrual tension |
| Tongue and Pulse |
|---|
pulse |
| Pathogenesis | Liver Qi stagnation transforming into Fire |
|---|
| Etiology |
|---|
|
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Ganshu (BL18) | Lower back, 1.5 cun lateral to T9 |
|---|
of Liver meridian; soothes Liver Qi |
| Taichong (LR3) |
|---|
metatarsals | Source point of Liver meridian; clears Liver Fire |
| Xingjian (LR2) |
|---|
metatarsals, proximal to the web margin | Spring point of Liver
meridian; drains Liver Fire |
| Sanyinjiao (SP6) | 3 cun above the medial malleolus |
|---|
menstruation and nourishes Blood |
| Neiguan (PC6) |
|---|
| Relieves chest tightness and calms the spirit |
Clinical Recommendation: Filament needle, reducing method; Xingjian
may be pricked to bleed to enhance Liver Fire drainage.
Herbal Formula
Base Formula: Dan Zhi Xiao Yao San (丹栀逍遥散)
Composition:
Moutan (Dan Pi), Gardenia (Zhi Zi), Bupleurum (Chai Hu), White Peony
(Bai Shao), Angelica (Dang Gui), Atractylodes (Bai Zhu), Poria (Fu
Ling), Licorice (Gan Cao), Mint (Bo He)
Action: Soothes Liver Qi, clears Fire, and regulates menstruation.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe acne | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |
|---|
| Hirsutism | Add Xia Ku Cao, Mu Dan Pi to clear Liver Fire |
|---|
| Irritability | Add Zhi Zi, Dan Pi to clear Liver Heat |
|---|
| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |
|---|
Western Mechanism Reference
Elevated LH/FSH ratio causing increased ovarian androgen synthesis,
sympathetic hyperactivity, elevated cortisol, and hyperandrogenism.
Liver Depression Transforming into Fire corresponds to PCOS with
hyperandrogenism, where sympathetic hyperactivity and elevated cortisol
contribute to ovarian androgen excess.
References
1. Gynecology of TCM - PCOS with Liver Channel Fire.
2. Zang-Fu Pattern Differentiation: Liver Fire → Long Dan Xie Gan Tang
approach.
3. WHO. (2023). Women's health. World Health Organization.
Explore More
- Find your solution at MendGod.com –
Personalized herbal protocols and acupressure tools for women's health.
- Deepen your knowledge at TcmCIO.com – Full
research papers and clinical case studies on TCM gynecology.
Related TCM Patterns for Pcos
Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.