By Xianmin Yu, R.Ac, R.TCMP

Polycystic ovary syndrome (PCOS) is a common health issue among women of childbearing age, with the incidence as high as 10%. It is characterised by hormonal imbalance, and may be accompanied by many other abnormal metabolism. The ovaries may not be able to develop eggs or release eggs regularly.

What are the symptoms of PCOS?

Most commonly observed clinical symptoms are:

  • Irregular menstrual period, including prolonged or irregular periods, or even stopped periods.
  • Weight problems, including weight gain and very difficult to lose weight.
  • Abnormal hair growth and loss in unwanted areas, including excess facial and body hair which are due to elevated levels of male hormone, and/or hair loss on the head.
  • Acnes on face and chest, sometimes upper back.

What are the complications of PCOS?

Infertility. Studies indicate that PCOS is one of the most common causes of infertility in women1.

Diabetes. Due to the abnormal metabolism, women with PCOS have a much higher risk of developing prediabetes and type 2 diabetes than women without PCO 2.

Hypertension. High blood pressure is a leading cause of cardiovascular disease. Women with PCOS also have a greater risk of having high blood pressure compared with women without PCOS 3.

Depression and anxiety.

Endometrial cancer. The risk of getting endometrial cancer is higher in women with PCOS 4.

 

What are the common causes of PCOS?

Excessive insulin. Insulin is secreted by the pancreas to allow cells to use blood sugar which is transformed from the foods you eat. The blood sugar level could become abnormally high if the body’s cells do not response well to insulin, and then the body tends to produce even more insulin. This forms a vicious circle to accumulate excessive insulin in the body.

Excessive androgens. Androgens are related to development of male traits. While the ovaries generate excessive androgens, it could cause abnormal hair growth and loss in unwanted areas and acnes.

Heredity. Although there is no single PCOS gene, a wide variety of genes seem to work on development of PCOS with a wide range of symptoms for women. A few genetic studies indicate that genes affecting hormone levels and insulin resistance play a role in development of PCOS 5-7.

 

How is PCOS explained in traditional Chinese medicine (TCM)?

According to TCM theory, PCOS is due to kidney deficiency and blood stasis. Kidney deficiency leads to malfunction of the conception vessel and penetrating vessel, which affect ovulation directly. In addition, liver qi stagnation also contributes to PCOS greatly.

Although there is no exact definition of PCOS at that time, it has been included in the following chapters: “scanty menstruation”, “amenorrhea”, “infertility”, “late menstruation”, “uterine bleeding”, etc.

Typical patterns are as follows:

  • Kidney deficiency, which is characterized by scanty periods or amenorrhea, lower back sore and knee weakness, infertility, or irregular periods.
  • Kidney deficiency and Liver stagnation, which is characterized easily get irritated, hypochondriac pain, irregular periods, lower back sore and knee weakness, and low sexual desire.
  • Kidney deficiency and Qi stagnation and blood stasis, which is characterized by dysmenorrhea, large clots in periods, or prolonged periods, or amenorrhea, and lower back sore and knee weakness.

 

What could acupuncture do to help with PCOS?

In brief, acupuncture, together with the herbs, is used to sooth the liver, get rid of phlegm, activate blood, and tonify the kidney.

According to meridians and collaterals theory in TCM, three main extraordinary meridians originate from uterus, i.e., the Conception vessel, the governor vessel, and the penetrating vessel. In addition, there are a few meridians passing through uterus and ovaries area, namely Liver channel, Spleen channel, and Kidney channel. Once these channels are regulated and the related organs are functioning normally, the uterus is expected to function well.

In the last two decades, quite a few randomised controlled studies suggest that acupuncture and herbs may promote blood circulation and adjust nutritional metabolism around uterus and ovaries, and thus further influence reproductive axis to promote healthy ovulation. Thus, it is recommended as a possible method to help with PCOS.

 

How many sessions are needed?

Usually it is recommended once a week for continuous 8-12 weeks, and then the practitioner will reassess your body condition and discuss with you about the next treatment plan.

 

 

 

References:

  1. Hanson, B., Johnstone, E., Dorais, J., Silver, B., Peterson, C. M., & Hotaling, J. (2017). Female infertility, infertility-associated diagnoses, and comorbidities: a review. Journal of assisted reproduction and genetics34(2), 167-177.
  2. Kakoly, N. S., Khomami, M. B., Joham, A. E., Cooray, S. D., Misso, M. L., Norman, R. J., … & Moran, L. J. (2018). Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression. Human reproduction update24(4), 455-467.
  3. Joham, A. E., Boyle, J. A., Zoungas, S., & Teede, H. J. (2014). Hypertension in reproductive-aged women with polycystic ovary syndrome and association with obesity. American journal of hypertension28(7), 847-851.
  4. Hardiman, P., Pillay, O. S., & Atiomo, W. (2003). Polycystic ovary syndrome and endometrial carcinoma. The lancet361(9371), 1810-1812.
  5. Wood, J. R., Nelson, V. L., Ho, C., Jansen, E., Wang, C. Y., Urbanek, M., … & Strauss, J. F. (2003). The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new candidate PCOS genes defined by microarray analysis. Journal of Biological Chemistry278(29), 26380-26390.
  6. Diamanti-Kandarakis, E., Kandarakis, H., & Legro, R. S. (2006). The role of genes and environment in the etiology of PCOS. Endocrine30(1), 19-26.
  7. Goodarzi, M. O., Dumesic, D. A., Chazenbalk, G., & Azziz, R. (2011). Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nature reviews endocrinology7(4), 219.