Treating PCOS with Chinese Medicine
P.CO.S., Poly-cystic Ovarian Syndrome is one of the leading causes of infertility and very common, affecting 6 to 10% of premenopausal women. P.C.O.S. is the most common cause of anovulatory infertility (meaning no ovulation). In order to diagnose P.C.O.S., 2 out of the 3 key symptoms are needed:
Polycystic ovaries (determined by Ultrasound)
Irregular, or No Periods (Ammenorhea)
Specific Hormonal Imbalances (determined by lab work with a specific female hormonal, adrenal, thyroid panels)
Yes, you can have P.C.O.S. without having polycystic ovaries. P.C.O.S. is a disorder labeled as a syndrome because of it affecting many levels of the body. Women with P.C.O.S. do “not really have ovarian cysts in the true sense, they have underdeveloped follicles” (1). During our monthly cycles, there are 4 phases: menstruation, follicular, ovulation, and luteal phase. The follicular phase starts midway during our bleeding and ends at ovulation. The purpose of the follicular phase is to have the ovarian follicles start to develop the immature oocytes (our eggs). Normally, the strongest follicle will mature and release its oocyte at ovulation as the others die off (known as atresia). For women with P.C.O.S., the “ovarian follicles are stuck in their development leading to irregular ovulation” (1). This may look like 12 or more ovarian cysts, or little pearls on the ovaries, on an ultrasound.
Can Women with P.C.O.S. Stop Bleeding? Not completely. Usually, they will have “longer cycles with six to eight menstrual periods per year” because of the infrequent ovulation (1). This can decrease the chances of conception.
Hormonal Imbalances with P.C.O.S.: In Chinese Medicine, we consider the shift from the Follicular to the Luteal Phase as a Transition from Yin to Yang Phases of the menstrual cycle. The Follicular Phase is consider the Yin Phase where the focus is on building of Yin and Blood (maturing the oocytes). Women with P.C.O.S. are stuck within this phase. This may result in lab work showing “unpredictable estrogen levels, high testosterone, high luteinizing hormone (LH) (this stimulates ovulation), low sex hormone binding globulin (SHBG), and others.
There is no one cause of P.C.O.S. In Chinese Medicine, we focus on the flow of qi (gases across the tissue), blood, yin (fluids), and yang (energy levels), health of the organs, and flow of the channels. There are channels along the body known as meridians, which serve as a highway system connecting all tissues, organs, and structures. The reproductive systems have their own channels such as the the Bao Mai and Bao Luo. These provide direct connection to the brain, heart, and uterus.
Other symptoms of P.C.O.S. may include insulin resistance, which may show as acanthosis nigricans (dark patches of skin usually on the face), hirsutism (excessive facial hair), male pattern hair loss, and acne. Usually, the first line of treatment of P.C.O.S. is to loose 10 pounds to maintain a BMI (Body Mass Index) of less than 24.5. This may help jump-start ovulation, but blood sugar metabolism can cause of be caused by many of the hormonal imbalances that occur under P.C.O.S. It is possible for a woman, with a thinner build, to have P.C.O.S. as well. In Chinese Medicine, we need to consider gut health, liver health, stress levels, hormonal health, period health and cycle flow. The treatments usually include Acupuncture, Herbal medicine customized to individual pattern of P.C.O.S., and nutritional guidance.