PCOS and Chinese Medicine

Polycystic Ovary Syndrome (PCOS) is a syndrome that affects around 10% of women and 90% of women who have irregular menstrual cycles and involves large number of cysts contain immature eggs that do not get released. On average, 50% of teenagers will have cysts on the ovaries at any point. Traits of PCOS include mainly high androgen levels (male hormones such as testosterone) and a chronic lack of ovulation and can include any or some of the following symptoms:

• Few, if any, menstrual cycles

• Acne/Rosacea

• Cysts of ovaries

• Infertility

• Hirsutism (excess hair) or Alopecia (thinning of hair on head)

• Weight Gain

• Depression/Mood Swings

The cause of PCOS is still unknown although there is some speculation that issues in-utero may cause an increase in androgen dysfunction. That is not confirmed at this time. The physiopathology occurs when high levels of androgens are produced by cysts and connective tissue in the ovaries. These high levels block follicular development causing them to instead degenerate and preventing them to release as mature eggs. This often leads to infertility and is often the reason why women seek out Chinese medicine as a supplement to the conventional forms of fertility therapy they are utilizing.

The conventional forms of infertility treatment for PCOS involves the following:

• Clomid (Clomiphene Citrate) – Studies are beginning to show that combining clomid with Chinese herbs increases the success rates of falling pregnant. However, at this time, fertility specialists do not recommend it. Negative effects of long term use of clomid include thinner endometrium linings and less fertile mucus.

• Metformin – Treats the predominant insulin resistance and promotes weight loss, although some studies show that it isn’t more or less effective than lifestyle changes.

• In Vitro Fertilization – May be helpful, but can increase the chances of Ovarian Hyperstimulation Syndrome (OHSS) that can risk a patient’s life.

• Surgery – Used to burn away some parts of the ovaries and can sometimes stimulate a cycle, but can also run the risk of producing ovarian adhesions.

PCOS and Lifestyle. Perhaps the biggest contribution that can be made to combat PCOS is lifestyle changes. These include the following:

• High Protein/Low Glycemic Index (GI) Meals

• Large Breakfast/Small Dinner

• Losing 5-10% of body weight (which has been shown that is all that is needed to help stimulate ovulation)

• More Fiber (which helps to reduce insulin resistance)

• Curbing soy (may or may not cause issues with estrogen which can affect PCOS)

• Exercise (which increases insulin sensitivity and lowers cortisone, even if one does not lose weight doing it)

• Liver Detox and Liver Diet – includes foods rich in B-viamins ( meats/organ meats, leafy green vegetables, whole grains, herbs like dandelion root and milk thistle)

• Addition of Chromium (mineral that helps regulate sugar levels, prevents sugar cravings, influences insulin usage in body)

• Alpha-Lipoic Acid (works on preventing nerve damage related to insulin resistance/metabolic syndromes)

• N-Acetyal Cysteine (an antioxidant that some studies show may help with infertility/glucose intolerance)

PCOS and Traditional Chinese Medicine

As far as research studies are concerned, the debate over whether acupuncture or Chinese herbal therapy does or does not help with PCOS is still going on. Several studies are showing that electroacupuncture done on specific lower abdomen points increase the chances of ovulation in mice and some human trials. Other studies negate that. The research is more promising when it comes to utilizing Chinese herbal therapy, especially in conjunction with conventional fertility therapies. However, those trials are often done in China where Fertility Specialists are more willing to embrace the use of Chinese and Western Medicine than in other countries.

That said, this is what Chinese Medicine has to say about PCOS.

Chinese Medical Diagnosis

Keeping in mind that Chinese Medicine is a completely different medical system with their own language, the Chinese would view that PCOS first comes on from a dysfunction in the kidney meridian. The kidneys and the meridian that nourishes it and the lower torso are in charge of reproductive changes from birth on. They are also in charge of genetics in the form of ‘Kidney Jing’ (kidney pre-natal essence). Any issues with reproduction stem from this system and can eventually affect other meridian systems. It is said that in order to treat infertility, a practitioner needs to always treat the kidneys.

Other Chinese medical diagnoses associated with PCOS include:

• Chong/Ren Meridian Disharmony – these channels run down the center of the front torso and balance out the organs they intersect including the uterus and ovaries

• Spleen Qi Deficiency – includes symptoms related to metabolic syndrome (insulin resistance, diabetes, digestive disorders) and often diagnosed in cases of PCOS with weight gain

• Liver Qi Stagnation – often seen in PCOS patients without weight gain and associated with overworked, stressed out, high achievement type-A women

• Phlegm-Dampness – this is a diagnosis which is the end result of PCOS, that is the cysts. Ovarian cysts are swollen, damp, shiny and painful. The Chinese literally see this as a stagnation of fluids that cause “phlegm” and “dampness”.

While these diagnoses are different than conventional medicine and can lead to more questions than answers in the patient, correct diagnosis from a Chinese medical doctor can lead to improvement in the condition.

Chinese medical treatment includes:

• Acupuncture to these meridians to stimulate and open them up

• Chinese herbal therapy utilizing herbs that resolve phlegm and dampness and alleviate various symptoms associated with this disorder

• Diet Education

• Self-help techniques including Qigong and Acupressure.

Summary

PCOS is a very stubborn disorder and can be very taxing on a woman’s physical and emotional health. It is no easy endeavor to help a patient either with conventional medicine or Chinese medicine. The process is long, grueling and, in the case of Chinese medicine, requires many, many treatments just to get one ovulation cycle. That being said, studies are starting to show that acupuncture and Chinese herbs can be of some assistance in treating this syndrome. It is the author’s hope that Fertility Specialists become more open to utilizing Chinese medicine in the future for these cases that prove very difficult to treat with just conventional treatment alone.

Research Studies:

Efficacy of electroacupuncture in regulating the imbalance of AMH and FSH to improve follicle development and hyperandrogenism in PCOS rats.

[Electroacupuncture Combined with Clomiphene Promotes Pregnancy and Blastocyst Implantation Possibly by Up-regulating Expression of Insulin Receptor and Insulin Receptor Substrate 1 Proteins in Endometrium in Rats with PCOS].

A Single Bout of Electroacupuncture Remodels Epigenetic and Transcriptional Changes in Adipose Tissue in Polycystic Ovary Syndrome.

Chinese herbal medicine for female infertility: an updated meta-analysis.

Chinese Herbal Medicine for the Optimal Management of Polycystic Ovary Syndrome.