Report of Findings: PCOS
In this blog post, I will explain how Polycystic Ovary Syndrome (PCOS) looks like through the lens of both current biomedical research and Chinese Medicine, as well as treatment outcomes.
PCOS is a complex reproductive disorder that involves many body systems. As one of the leading causes of female infertility, more and more women that suffer from PCOS are learning about and seeking treatment for this disease. Not only does PCOS pose issues for reproductive reasons, but it is a lifelong disease that can increase serious health problems such as diabetes, heart disease, high blood pressure, and stroke. Chinese medicine provides a remarkably different outlook and approach to looking at the causes and providing management for this condition.
Current Research
Women diagnosed with PCOS have been shown to have increased insulin resistance and metabolic disorders. It was found that women in this population have significantly higher levels of adipose insulin resistance than compared to women without PCOS. Also, this group overall have a higher BMI and higher blood glucose levels (He, 2020).
When two groups of infertile women, one with PCOS and one without, were assessed on their quality of life in a form of a questionnaire, the women with PCOS rated significantly lower quality of life. Although both PCOS and infertility individually play a big role in negative emotions (Angin, 2019).
Acupuncture has been found to be relatively effective and safe in decreasing BMI, improving waist-to-hip ratio, improving fasting plasma glucose levels, insulin sensitivity, and triglycerides in women with PCOS (Zheng, 2021).
According to a metanalysis looking at data from June 1970 to June 2009, acupuncture has been found to benefit those suffering with PCOS. Acupuncture may have a role in increasing blood flow to the ovaries, reducing the size and number of ovarian cysts, increasing insulin sensitivity, decreasing blood glucose, reducing cortisol levels, and assisting in achieving a healthy weight (Lim, 2010).
Chinese Medical Theory
Traditional Chinese Medicine (TCM), including acupuncture and herbs, is an ancient medicine spanning over 3,000 years and used on a vast number of different ailments. It works by implementing traditional Chinese medicine theory, qi (life force) flows though energetic channels called meridians to cover the body, similar to nerves, veins, and arteries in western medicine. According to theory, acupuncture allows qi to flow to areas of deficiency and out of areas that are excess. In this way, it can regulate and restore the body into balance. For centuries, it has been very effective in treating various gynecological issues and menstrual cycle irregularities.
For many PCOS cases, the patient can tend to be overweight and store more fat, or in Chinese medicine, “dampness” in the body. The spleen is in charge of receiving products of digestion from the stomach (transportation) and then turns it into qi and fluids that can be used by the body (transformation). Dampness in the body arises from the spleen’s dysfunction. Its ability to transport and transform becomes compromised and dampness begins to accumulate (Kim, 2015).
In Chinese medicine, dampness is considered to be a cause to many illnesses that we see associated with PCOS such as high cholesterol, metabolic disorders, and increased weight. Not only do damp conditions stem from PCOS, but PCOS in as itself can be explained by dampness as well. Just in the name “polycystic ovarian syndrome” comes from the appearance of the ovaries, seen through ultrasound, where the ovaries appear to be covered with many small pearl-like cysts. These cysts could be translated to damp, or phlegm, in Chinese medicine (Lyttleton, 2013).
Another major component, jing, plays a big role in all individuals. Jing, or pre-heaven qi, most closely resembles genetics, as we are given jing by our parents and maintain this for the rest of our lives. Chinese medicine recognizes that jing corresponds strongly with PCOS and may set the stage for the rest of life. A deficiency of pre-heaven qi plus other factors that occur during development in the womb in the form of post-heaven qi influence the development of the ovaries before it can be seen after the onset of puberty (Lyttleton, 2013).
Jing is stored in the kidneys, so treatment involves reinforcing the kidneys. A portion of kidney jing transforms into tian gui, which is responsible for starting and maintaining reproductive function for both men and women. Although it is quite normal for the cycle to be irregular in the beginning, as the tian gui is still awakening and stabilizing. However, for some women, the symptoms of PCOS do not appear until years later. In this case, there may be other factors at play here (Lyttleton, 2013).
In Chinese medicine, the spleen is the origin of post birth and development, and the root of post-heaven, or acquired, qi. As it has been mentioned earlier, the spleen is in charge of transforming and transporting fluids acquired from food for the stomach to use. In cases of PCOS, the spleen could be damaged in different points in life. It can be become damaged during the time of conception if the mother’s spleen function is also compromised by receiving inadequate nourishment. It can also become damaged during the time of puberty. Not only does the tian gui need to be supported by the kidneys, but there must be sufficient nourishment of the blood that is provided by the proper working function of the spleen. Poor nourishment can come in many forms: not enough food, too much food, and not the right types of food. This can occur later in life during the reproductive years, during the 20s and 30s, as well (Lyttleton, 2013).
Another body organ that is very closely linked to menstruation is the liver. As the kidneys provides the essence, or the egg, the spleen needs to nourish the reproductive system, and the liver stores the blood. Liver blood is actually menstrual blood. Because of this, the liver regulates menstruation. It is a regulating, balancing, and harmonizing organ. It is very easily affected by strong emotions such as frustration, resentment, repressed anger, depression, irritability, and rage. Many of the PMS (pre-menstrual syndrome) symptoms can be associated to a stagnation of liver qi. If there are too many strong emotions or stressful situations, the free flow of liver qi becomes stuck and symptoms such as irritability, moodiness, breast distention, and painful periods can occur (Kim, 2015).
Treatment Outcomes
In the case of PCOS, Chinese medical treatment protocols are recommended to be done frequently and regularly. Preferably, these patients will come into treatment once or twice a week for a period of at least three months, or until ovulation has occurred. The patient should be reevaluated after this period. The frequency of acupuncture treatments is very important for providing the best outcome. Some research has shown that having 2-5 acupuncture treatments per week over a period of four months is needed for patients with PCOS to return to adequate ovary function and ovulation (Lyttleton, 2013, p. 228).
I would like to stress that this research has only taken acupuncture into consideration, which is only one modality in Chinese Medicine. In addition, applying herbal medicine formulas plus nutrition and lifestyle adjustments may help to provide better treatment outcomes for those with PCOS.
To read the complete “Report of Findings,” click here.
References
Angin, P., Yoldemir, T., & Atasayan, K. (2019). Quality of life among infertile PCOS patients.
Archives of Gynecology and Obstetrics, 300(2), 461-467. doi:10.1007/s00404-019-05202-z
He, Y., Hu, W., Yang, G., Guo, H., Liu, H., & Li, L. (2020). Adipose Insulin Resistance and
Circulating Betatrophin Levels in Women with PCOS. BioMed Research International, 2020, 1-9. doi:10.1155/2020/1253164
Kim, H. (2015). Handbook of Oriental Medicine (5th ed.). Anaheim, CA
AcupunctureMedia.com
Lim, C. E., & Wong, W. S. (2010). Current evidence of acupuncture on polycystic ovarian
syndrome. Gynecological Endocrinology, 26(6), 473-478. doi:10.3109/09513591003686304
Watson, K. (2019, March 7). 30 Natural Ways to Help Treat Polycystic Ovary Syndrome
(PCOS). Retrieved July 7, 2021, from https://www.healthline.com/health/womens-health/natural-treatment-pcos#endocrine-disruptors
Zheng, R., Qing, P., Han, M., Song, J., Hu, M., Ma, H., & Li, J. (2021). The Effect of
Acupuncture on Glucose Metabolism and Lipid Profiles in Patients with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine, 2021, 1-11. doi:10.1155/2021/5555028
