Polycystic Ovarian Syndrome

What is polycystic ovarian syndrome?

PCOS is an endocrine (hormonal) problem. It is diagnosed by clinical or hormonal changes associated with irregular ovulation, increased androgen activity and insulin resistance, as well as an ultrasound assessment. PCOS can make it harder to fall pregnant naturally. Polycystic Ovary Syndrome (PCOS) is well treated with Chinese Medicine and acupuncture, but it is not resolved quickly.

What are polycystic ovaries?

The term ‘polycystic ovaries’ describes the appearance of the ovaries on an ultrasound scan – they contain many small follicles (12 or more) and the ovaries are often larger than average.

As many as 20% of women of childbearing age have ovaries that appear polycystic on ultrasound, but many will have no symptoms and do not have polycystic ovarian syndrome (PCOS). If you have polycystic ovaries but have regular cycles and are ovulating, your fertility will not be impaired. If you have any concerns please speak to your fertility specialist.

How do I know if I have PCOS?

The most common symptoms of PCOS include irregular periods (or no periods at all), increased facial and body hair growth, acne, weight gain and difficulty falling pregnant. The causes of PCOS include genetic predisposition, but the condition may not always be clinically evident.

Imbalances in hormonal production affect ovulation, which may occur irregularly or not at all. There may also be a mild increase in testosterone levels, causing darker and thicker hair growth and acne. Hormonal imbalances also cause problems with sugar metabolism, leading to insulin resistance and a higher risk of diabetes if you do fall pregnant.

How does PCOS affect my fertility?

  • Your menstrual cycle may be irregular and ovulation erratic,
  • Women who are obese have a reduced implantation rate, even with normal ovulation,
  • Increased risk of anaesthetic and pregnancy complications, mainly associated with weight, and
  • Women who are significantly overweight have an increased risk of miscarriage (this is not directly caused by PCOS).

All these issues mean the chance of getting pregnant naturally may be lower if you have PCOS and you should seek medical advice.

How do you test for PCOS?

An ultrasound scan may indicate the presence of many small follicles. Blood tests are required to make the diagnosis and may reveal altered hormonal patterns including slightly increased testosterone levels or normal levels with increased activity.

How do you treat PCOS?

There are a number of options available, which your fertility specialist will discuss with you, including:

  • Reducing your body mass index (BMI) if required. For women who are overweight, this is the most important form of medical treatment, and can return ovulatory cycles to normal as well as reduce long-term metabolic risks. Combining healthy eating with moderate exercise is of proven benefit.
  • Insulin sensitising agents.
  • Ovulation inducing drugs such as Clomiphene.
  • Injections of follicle stimulating hormone (FSH).
  • Assisted reproduction technologies, including IVF.

Treating PCOS with traditional Chinese medicine

Polycystic Ovary Syndrome (PCOS) is well treated with Traditional Chinese Medicine and acupuncture (TCM), but it is not resolved quickly. This is because Internal Dampness is a main contributing factor, and takes some time to address fully. PCOS is a complicated condition that takes some study to address utilizing natural herbal therapy.

Liver-Kidney Imbalances and PCOS

In Chinese medicine there is not a specific endocrine system; rather, hormonal imbalances are attributed to Liver-Kidney energetic organ system imbalances or insufficiencies. The earliest stages of PCOS with irregular menstruation and symptoms of PMS may be attributed to Liver Qi Stagnation, as the Liver stores the menstrual blood and is the basis of energetic Qi circulation; stagnation of Qi would result all types of menstrual irregularities and PCOS with breast tenderness, especially around menstruation.

Spleen Imbalances and PCOS

PCOS typically includes pathogenic Internal Dampness due to Spleen Qi insufficiencies according to TCM due to the formation of ovarian cysts. Improper diet or the Liver overacting on the Spleen are common causes of Spleen imbalances. Fatigue or weight gain would be indications of Spleen Qi Deficiency, and is common with PCOS. Internal Dampness would also be indicated with vaginal discharges, and a heavy feeling in the body. Additionally, PMS pains that are deep, achy, and relieved with pressure or heat would indicate Internal Cold-Damp accumulations.

Damp-Heat and PCOS

If Liver Qi Stagnation is allowed to worsen without proper treatment, the Liver will heat up and combine with the Internal Dampness creating Damp-Heat. PCOS with vaginal discharges that are yellow to orange, marked with blood, or have a strong odor would be indications of Damp-Heat.

Natural Herbal Therapy: Before moving on to other appropriate therapies consider clearing Damp-Heat with Peaceful Warrior formula and Restore the Middle Way formula used together

Essence-Jing Deficiency and PCOS

The Kidneys store the Ancestral Essence, or Jing, according to Chinese medicine. Essence is also the origin of menstrual Blood in TCM, and allows for reproduction. Weak Kidney Qi or Jing can lead to scanty periods, watery menstrual blood, and tiredness. A genetic predisposition to reproductive issues would also point to Essence Deficiency.

Qi and Blood Stagnation and PCOS

Because the Liver controls the free flow of Qi throughout the body, Liver Qi Stagnation can lead to Qi Stagnation in the Lower Jiao. Where Qi goes Blood goes, so long standing Qi Stagnation can form in to Blood Stagnation. Additionally, accumulating Internal Dampness will block the free flow of Qi and is common with PCOS.

Infertility and PCOS

The Conception Vessel is an Extraordinary acupuncture channel that runs midline along the front of the body. Internal Dampness can cause blockages of this meridian leading to reproductive imbalances. More importantly, Internal dampness creates obstructions of the ovaries which prevents the egg from being passed properly and infertility. A delayed menstrual cycle would be common along with the PCOS and this type of congestion. Those actively trying to conceive would only be able to take the appropriate formulas during the first half of their cycle; this course of treatment would be unrealistic because it would take so long. Taking a break from trying to conceive, while taking the herbs full time makes much more sense.