Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects 1 in 10 women in their child-bearing years. At Eastern Bench Holistic Healthcare in Salt Lake City, I see many women who are diagnosed with PCOS or have a suspected diagnosis. I have found that a combination of acupuncture, Chinese medicine and lifestyle changes can really help. PCOS is a complex metabolic and endocrinologic disorder that is characterized by several factors: disordered hormone signaling, high androgen levels, insulin resistance, and inflammation. PCOS is associated with several serious medical conditions decreased sensitivity to insulin which can lead to diabetes mellitus, increased risk to stroke and cardiovascular disease, and an association with endometrial and uterine cancers. PCOS is characterized as a syndrome because there are many different presentations or “phenotypes” with no precise or uniform cause. There are three phenotypes that have been identified: classic PCOS, ovulatory PCOS, and norm androgenic PCOS.
PCOS is the number one reproductive endocrinological disorder in the world and is the leading cause of ovulatory infertility. The primary features are elevated androgens (hyperandrogenism), menstrual dysfunction, and small, collections of fluid (follicles) that never fully develop leading to the ovaries not functioning properly and, in some cases, never releasing an egg. These features, in different combinations, make up the diagnostic criteria and determine an individual’s phenotype. It is important to realize that all of these do not need to be present to diagnose PCOS. This may be one of the reasons that PCOS is so difficult to diagnose.
The current Western medical treatments for PCOS include the oral contraceptive pill, anti-androgen medications, insulin-sensitizing medication (Metformin is the most well-known), laparoscopic ovarian drilling, and assisted reproductive technology. All these options come with some form of side effect, whether it be suppressing the symptoms, causing liver toxicity, or expense. When using Traditional Chinese medicine to treat PCOS, we allow the science to inform what we do, and we treat PCOS for what it is and how it is presenting in the individual.
Chinese medicine is said to be the original root cause medicine. This means that we treat the cause of health concerns as well as the symptoms (the branches). In Chinese medicine, disordered hormone signaling is attributed to Chong/Ren disharmony (menstrual dysfunction and excess androgens) and/or Liver qi stagnation (excess androgens). Insulin resistance and inflammation, the most common causes are Liver/Spleen disharmony combined with some sort of heat (inflammation) and sometimes phlegm or damp accumulation (fluid filled cysts). At Eastern Bench, we use three levels of diagnosis and treatment for PCOS: Chong/Ren and Liver Qi, insulin resistance and inflammation and the root and branch treatment. This comprehensive diagnosis and treatment allow me to treat you and how PCOS is showing up in you.
For those women presenting with “the string of pearls”, electroacupuncture has been shown to help those immature follicles develop into mature oocytes. Acupuncture also helps to regulate menstruation and induce ovulation for those women who have the classic or ovulatory PCOS phenotypes. The herbs ling zhi (Ganoderma), he shou wu (polygonum multiflori), and suo yang (cynomorii) inhibit secretion of androgens and berberine helps to lower blood sugar and alleviate insulin resistance. Dang gui (tangkuei) helps to balance hormones, while huang jing (polygonatunum) helps to lower inflammation and calm an overactive system. Zao jiao ci (spina gleditsiae sinensis) has been shown to dissolve the waxy coat around the cysts. These herbs will be combined into a formula to fit the specific patient and their needs.
Some lifestyle changes that are usually recommended include losing just 10% of body weight to improve ovulation, limiting simple carbohydrate consumption and include more whole grains to balance blood sugar, take N-Acetyl Cysteine to reduce circulating testosterone and insulin, consume plenty of antioxidants to reduce inflammation, exercise at least 30 minutes five days per week or 75 minutes of high intensity exercise one time per week, and practice stress management to help reduce testosterone and other androgens. Treatment for PCOS using Chinese medicine takes 3-6 months of regular acupuncture and Chinese herbal formulas and a lifetime commitment to a healthy lifestyle. I hope this gives some hope to the millions of women who are suffering needlessly with PCOS. You do have options to address PCOS in a natural way.