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Polycystic ovary syndrome (PCOS)

polycystic ovary

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS), also known by the names polycystic ovarian syndrome, polycystic ovary disease, hyperandrogenic anovulation syndrome or Stein-Leventhal syndrome, is a complex endocrine and metabolic condition that affects 5%–10% of women of reproductive age. It occurs when the ovaries produce too much of the male hormones (androgens) that cause women to have a variety of symptoms.

During a normal menstrual cycle, many small follicles grow in the ovaries and form eggs, with only one egg being released (ovulation) at mid-cycle, while the other follicles over-ripen and break down. However, in PCOS, the follicles do not break down, but fill with fluid, turning into cysts. These cysts and the connective tissue surrounding them, the stroma, produce male hormones called androgens. The high levels of androgens block follicular development, and as a result, inhibit ovulation.

Polycystic ovaries contain a large number of cysts that are no bigger than 8mm each. The cysts are under-developed follicles that fail to release the egg. Furthermore, these follicular cysts can cause the ovaries to enlarge and create a thick outer covering which may prevent ovulation from occurring.

PCOS is thought to be one of the leading causes of infertility and endocrine and metabolic problems, such as obesity, diabetes, hypertension and hypercholesterolemia, in women of childbearing age.

What causes polycystic ovary syndrome?

The exact cause of polycystic ovary syndrome (PCOS) is unknown. Most experts believe that several factors can lead to its development, including:

  • Genetic factors – women with PCOS are more likely to have a family history of PCOS.
  • Hormonal imbalance – the main underlying problem of PCOS. Higher levels of LH (luteinizing hormone) and lower levels of FSH (follicle-stimulating hormone) are often found in a woman with PCOS, and remain so throughout the cycle. LH stimulates the cells of the ovary to produce androgens, which block follicular development, causing the follicles to degenerate. This decreases the chances of ovulation occurring. Raised levels of prolactin may be seen in some women with PCOS. The exact cause of how and why this hormonal imbalance occurs is not clear. It has been suggested that the problem may start within the ovary itself, and/or in the pituitary gland and part of the brain that controls it.
  • Insulin resistance – the body’s tissues are resistant to the effects of insulin, and so the body is unable to process insulin properly. The body therefore has to produce extra insulin to compensate. Excess insulin can also causes the ovaries to produce too much testosterone (androgen), which interferes with the development of the follicles, and prevents normal ovulation.

What are the symptoms and complications of PCOS?

The symptoms of PCOS can vary from person to person. Some of the most common symptoms of PCOS include:

  • Irregular, heavy or infrequent periods, or no periods at all
  • Infertility
  • Hirsutism – excessive hair growth
  • Obesity
  • Acne or oily skin
  • Thinning hair or hair loss
  • Mood changes, depression, anxiety and insomnia
    pcos ultrasound
    Ultrasound of a polycystic ovary

If you suspect you may have PCOS, you should consult your doctor, and undertake appropriate medical examinations such as ultrasound and blood tests.

Women with PCOS have greater chances of developing several serious health conditions, including life-threatening diseases, such as:

  • Metabolic Syndrome – a cluster of conditions, including hypertension, high cholesterol levels, obesity, insulin resistance and diabetes, which increase the risk of heart disease and stroke later in life.
  • Endometrial cancer – failure to ovulate causes women have infrequent periods, which results in a build-up of the lining of the uterus (endometrium). This may increase the risk of the uterine lining producing mutated cells, which can turn into cancer.

What are the treatment options for PCOS?

From the perspective of western medicine, PCOS can’t be cured. Treatment will depend on your symptoms and how severe they are, and whether you wish to get pregnant or not. Common treatment options include:

  • Losing weight and adopting a healthy lifestyle to help reduce insulin resistance and promote ovulation.
  • Hormone treatment, such as progestogen or the contraceptive pill, to induce regular periods; anti-androgen drugs which block the effects of male hormones on the body; or steroids, to balance the androgen hormonal effects.
  • Drugs such as metformin to improve the body’s sensitivity to insulin.
  • Fertility treatment may include medication such as clomiphene citrate, which stimulates the ovary to grow follicles, so that a mature egg is released mid-cycle. If these drugs fail, more complex treatment such as IVF or other ART is recommended.
  • Surgery to treat the ovaries known as laparoscopic ovarian drilling (LOD), which uses either a hot needle or laser to cauterize the ovary in several places. This procedure can stimulate ovulation and increase your chances of conceiving.

The problem with hormonal manipulation is that it does not address the actual quality of the eggs, or the ovary’s endocrine balance over the previous three or more months of development (follicular development within the ovary is a process that takes about 100 days). In addition, these kinds of treatment, as well as other drug therapies, often bring many undesirable side effects. Surgery is generally considered a last resort, because scar tissue can form on the ovaries as a result, which may in fact reduce your ability to get pregnant.

What is the TCM perspective of PCOS?

pcos

In Traditional Chinese Medicine, PCOS can be seen as an excess condition, a deficient condition, or a combination of both an excess and deficient condition.

Excess conditions:

  • Phlegm and/or dampness accumulation
  • Liver Qi stagnation
  • Blood stasis

Deficient conditions:

  • Kidney Yang deficiency
  • Kidney Yin deficiency
  • Spleen Qi deficiency

The most common patterns of PCOS are phlegm and/or dampness accumulation (fluid filled cysts), and kidney Yang deficiency (poor metabolism). However, PCOS is often complicated with both excess and deficient conditions as their root cause.

Generally, PCOS is derived from a deficiency of Kidney Yang, in its inability to transform, transport and evaporate fluids in the lower body. The accumulation of fluid in the pelvic cavity enlarges the ovaries, leading to phlegm and/or damp accumulation.

Most women with PCOS will ovulate later in the cycle, if ovulation is to occur at all. The BBT graph for phlegm and/or dampness, combined with Yang and/or Qi deficiency, is not bi-phased, but rather more erratic and flat-lined. It may also reveal a long follicular phase (indicated by lower temperatures) with a shortened luteal phase (indicated by high temperatures). Yang Qi deficiency may produce phlegm because it doesn’t get the fluids to move, but rather to condense into dampness.

How can TCM help treat PCOS?

Your TCM doctor will ask many questions about your medical history and check your tongue and pulse on the first visit. From that, they will differentiate your pattern and treat the root cause of the PCOS.

Acupuncture and Chinese herbal medicine provide a safe, effective, drug-free and natural whole body approach. These treatments can bring following benefits for patients with PCOS:

  • Acting on the hypothalamus-pituitary-ovarian (HPO) axis to help balance the hormonal systems of the body
  • Dissolving the waxy coat around the ovarian cysts
  • Regulating menstrual cycle and promoting ovulation
  • Encouraging conception and a healthy pregnancy
  • Calming over activity of the sympathetic nervous system
  • Helping regulate metabolic disorders and reducing insulin resistance
    exercise

Together, with changes in diet and exercise, acupuncture treatments and Chinese herbs are empowering women with PCOS to lead healthier and more satisfying lives. For women trying to become pregnant, either naturally or through IUI/IVF treatments, treating PCOS will help with fertility and overall balance through harmonizing hormones and regulating the menstrual cycle.

In our clinic, Dr. Jim Xing has treated this condition with excellent results in his long clinical career. Patients with PCOS not only had their symptoms relieved effectively, but many also conceived naturally after his treatment. He often combines weekly acupuncture sessions and concentrated powdered extracts of Chinese herbs for PCOS patients. He will also provide dietary and lifestyle advice to his patients, according to their individual circumstances. He stresses that exercise and weight loss are very important for women with PCOS who wish to become pregnant. Exercise and diet are also the key factors in reducing their risk of endocrinal and metabolic conditions, such as diabetes and heart disease.

He devises an individualized program for each patient based on the root cause of the excesses or deficiencies of the person’s conditions. Treatment may involve acupuncture and Chinese herbal medicine for nourishing kidney Yin and warming kidney Yang in order to help follicular development, clearing the stagnation of liver Qi, dispelling of phlegm/dampness and dredging the meridian in order to promote ovulation. Anovulatory women should begin to notice signs of ovulation after a few months of treatment. Women with belated ovulation will often notice that their ovulation comes earlier and the menstrual cycle becomes more regular.

If you suffer from PCOS, please don’t hesitate to contact Dr. Jim Xing. He has a great deal of experience in treating this condition and will be able to treat the illness successfully according to your circumstances.

Helped at the centre:
Using methods which have proven effective in treating this condition, Dr. Xing is experienced in treating PCOS, having already helped many people with this condition become healthy again. Numerous women who had been suffering from PCOS and had tried other methods, but to no avail, have successfully been treated at our clinic.

One woman who visited our clinic had been diagnosed with PCOS, and was also suffering from endometriosis. With these, she suffered from many symptoms, including obesity, late period, mood swings, and fatigue. She had tried to conceive for over three years, without success. By this time, she had already been planning to undergo IVF treatment, but a friend suggested that she visit Dr. Xing for treatment. Here, she was treated using acupuncture and Chinese herbal medicine. After 8 months of treatment, her symptoms had improved dramatically, her periods had returned to normal, and she found herself to be pregnant.