PCOS

"Acupuncture alone can help improve the communication between the brain and ovaries, promote ovulation, and regulate the menstrual cycle." **
Check out this latest video! In a virtual panel discussion of Reproductive Endocrinologists, Nutritionists and myself, I break down PCOS and a holistic approach for the NYC Nutrition Education Network.

PCOS

What it is, symptoms and diagnosing, what acupuncture and Chinese herbal medicine can offer, holistic and integrative support, and links to current research.

    What is PCOS?

    Polycystic ovarian syndrome is the name given to the gynecological and endocrine disorder involving multiple cysts on the ovaries, making the ovaries “polycystic.” A main feature of PCOS is that eggs are not being released from the ovaries, rather fluid builds up around the eggs forming sacs (cysts). Since PCOS can have so many varying presentations, many women don’t know if they have this condition. Here are some Common Symptoms of PCOS:

    • Irregular or absent menstrual cycles
    • Excess facial or body hair
    • Cystic acne
    • Weight gain
    • Hair thinning or loss
    • Enlarged ovaries with multiple cysts
    • Skin tags on the neck or armpits
    • Insulin resistance
    • Elevated androgens, LH, DHEA, or AMH levels 
    • Type 2 Diabetes Mellitus
    • Sleep apnea
    • Infertility

    However, it’s important to know that in most cases, many of these factors are absent, which is why PCOS can be tricky to identify and diagnose. Medical diagnostic criteria require 2 out of 3 of the following for a true PCOS diagnosis; 1.) presence of cysts, 2.) elevated androgens, 3.) insulin resistance. 

    Unfortunately, PCOS is one of the leading causes of infertility due to ovulatory dysfunction (incomplete egg development that may result in irregular ovulation or a complete lack of ovulation) and poor egg quality (due to immature eggs).

    Longstanding western medical treatment options include Metformin to treat insulin resistance, oral contraceptives to regulate periods, and medications to induce ovulation for increasing fertility. 

    What does Acupuncture and Chinese medicine offer?

    Hormonal issues and even the manifestation of PCOS has been treated for thousands of years using a combination of herbs and acupuncture. As early as the 12th century, Chinese medicine recognized PCOS, describing it as a “Tian Gui” disorder, of which the term refers to female essence comprising our hormonal network and menstruation itself.

    "Acupuncture could improve BMI, reduce luteinizing hormone (LH), estradiol (E2), and testosterone levels, increase ovulation reaction and effectively shorten cycles." *

    Hormonal balance is an incredibly complex, delicate interplay of what should be high and what should be low at any given time. These normal ebbs and flows are what help perpetuate healthy endocrine, metabolic, and reproductive functioning. It’s when those mechanisms become faulty, whether from predisposition (genetics) or lifestyle factors such as environment, diet, stress load, medication use, exercise habits, and trauma or illness, that disorder can develop. 

    With PCOS and other hormone imbalances, the natural shifts are not occurring because of disruptions to functioning of the body's homeostasis, and more specifically to what we in TCM look at in the functioning of the organ systems. One of the main ways we can diagnose and treat the root cause of hormone imbalance is by identifying in what organ system(s) the problem originates. 

    Why Acupuncture?

    Acupuncture has been shown to profoundly effect the reproductive organs through mechanisms in the endocrine system and sympathetic nervous system. When needles are inserted into certain points and stimulated, it produces a neurological reflex transmitted to the organ correlated with that nerve pathway.

    "Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system." ***

    Acupuncture is also powerful for reducing inflammation and improving blood flow into the reproductive organs. In treating women with PCOS, one of the main goals of acupuncture, in addition to endocrine support, is to improve hemodynamics, or blood flow, to the ovaries and uterus. This can help improve egg quality by nourishing the environment in which those eggs do all of their development and maturation. With healthy circulation and hormone signaling reestablished, an irregular or absent menstrual cycle can be corrected, ovulation regulated, and pregnancy more likely achieved where intended.

    How about Herbs? 

    Chinese herbal formulas are a specific combination of plant and mineral compounds, selected specifically to restore organ imbalance unique to each patient work best when customized. This is one of the reasons it’s best not to take herbs unless you have been advised by a skilled practitioner, as it may not only be less than beneficial but potentially harmful.

    "Current research demonstrates that the compounds isolated from herbs have shown beneficial effects for PCOS and when combined in an herbal formula can target both reproductive and metabolic defects simultaneously." ****

    In clinical practice, I have seen profound benefits and changes in women’s cycles with the incorporation of Chinese herbs to the treatment plan. Deep hormone imbalances such as PCOS, endometriosis, fibroids, peri menopause, dysmenorrhea, and PMDD have responded well - in the regulation of menstrual cycles and ovulation, reduced heavy bleeding, reduced pelvic pain, emotional balance, and healthy pregnancies, and improved quality of life!

    Herbal medicine can work synergistically along with regular acupuncture as well as on it’s own. I work with many women remotely for herbal consulting and ongoing lifestyle support, which offers a great option for care when you’re not in physical reach of acupuncture.   

    Holistic & Integrative Support

    Holistic care means addressing the root cause by treating the whole person to help restore you to your ideal state of health. During our initial consultation, we dig deep with a complete detailed health history, looking for the underlying causes that may currently be contributing to hormonal issues. 

    Holistic also means utilizing all the tools available that impact a person’s “whole” system, and because PCOS is affected by so many factors, I work with my patients to create a customized and dynamic plan that incorporates all relevant and important aspects including stress management, appropriate diet, the right amount of exercise, targeted supplements, Chinese herbal support and regular acupuncture. Depending on the severity of your unique presentation, significant improvement can take place within 3-6 months for irregular ovulation and 3-12 months for anovulation (no ovulation).

    In many cases, if you have not done so already, I will refer a patient for further testing and diagnostics, such as blood work and ultrasound, to have a clearer picture of what lies underneath. This is especially helpful in the case of women trying to conceive.

    Though it is not absolutely necessary - because Chinese medicine has been treating complex gynecological disorders for thousands of years without any labs - we are evolving as an ancient medicine in the modern world and adapting our healing toolkit to be as mindful and comprehensive as it can be. It’s here that integrating the best of east and west can propel all our efforts forward.

     

    Research Links

    * Xu, J., & Zuo, Y. (2018). Zhongguo zhen jiu. Chinese acupuncture & moxibustion, 38(4), 358–361. https://doi.org/10.13703/j.0255-2930.2018.04.004
    ** Johansson, J., & Stener-Victorin, E. (2013). Polycystic ovary syndrome: effect and mechanisms of acupuncture for ovulation induction. Evidence-based complementary and alternative medicine : eCAM, 2013, 762615. https://doi.org/10.1155/2013/762615
    *** Stener-Victorin, E., Jedel, E., & Mannerås, L. (2008). Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence. Journal of neuroendocrinology, 20(3), 290–298. https://doi.org/10.1111/j.1365-2826.2007.01634.x
    **** Ong, M., Peng, J., Jin, X., & Qu, X. (2017). Chinese Herbal Medicine for the Optimal Management of Polycystic Ovary Syndrome. The American journal of Chinese medicine, 45(3), 405–422. https://doi.org/10.1142/S0192415X17500252