Abstract: Professor Tan Yong, based on the theory of monarch fire and minister fire in The yellow emperor’s inner classic and her extensive clinical experience, proposes that disturbance of monarch fire constitutes one of the critical pathogeneses of ovulatory dysfunction in polyendocrine metabolic ovarian syndrome (PMOS). In the early stage of the disease, the condition is predominantly caused by excess fire disturbance; after prolonged illness, the interaction between monarch fire and minister fire leads to reckless movement of minister fire and consumption of genuine yin, resulting in internal disturbance of deficiency fire. Treatment should align closely with the rhythmic characteristics of the post-menstrual and inter-menstrual phases. The core therapeutic strategy involves clearing the heart to calm the monarch fire and nourishing the kidney to subdue the minister fire, supplemented by strengthening the spleen and regulating the middle burner, harmonizing the heart and kidney, and calming the monarch fire and minister fire, thereby improving follicular development and restoring normal ovulation. This perspective elucidates the relationships of mutual aid (yin-yang interdependence) and mutual restraint (dynamic balance) between monarch fire and minister fire, as well as between heart fire and kidney water. It also broadens the understanding of the pathogenesis underlying various types of ovulatory dysfunction, such as ovulation from small follicles and follicle discharge failure, thereby providing a theoretical basis for treating this condition by addressing the heart and kidney.