What is PCOS?

Polycystic ovarian syndrome, also known as polycystic ovary disease (PCOD) affects five to ten percent of women in North America and is the leading cause of ovulatory based infertility. PCOS occurs in women who have high levels of male hormones (androgens) that  interfere with the normal production of the female hormone, estrogen. This results in multiple cysts n the ovaries and can create  immature follicles that are unable to generate eggs.

There is no known exact cause of PCOS. Women with PCOS frequently have a mother or sister with the condition but there is still not enough evidence to confirm a genetic link to the disorder. Because many women with PCOS have problems maintaining a healthy weight, most research is concerned with  the relationship between PCOS and the body’s ability to use insulin.

PCOS manifests in  increased insulin resistance, limiting the body’s capacity to metabolize insulin and glucose. The results can include: glucose intolerance, impaired glucose metabolism, elevated lipid profile, high blood pressure, mood swings and irritability.

The pancreas is exerted to produce insulin, but the insulin is not able to transport glucose (sugar) into the cells because of a hormonal imbalance or because of too many fat cells. The excess insulin in the blood leads to excess glucose in the blood, creating conditions for prediabetes and weight gain. If untreated, PCOS can lead to obesity, heart disease, diabetes and some cancers.

WHAT ARE THE SYMPTOMS?

Though some women with PCOS have no symptoms, most will have one or more of the following:

1. Weight gain or obesity
2. Excessive and/or abnormal hair growth
3. Irregular periods or complete absence of menstruation (amenorrhea)
4. Acne
5. Enlarged ovaries covered with cysts
6. Insulin resistance/hyperinsulinemia

HOW IS PCOS DIAGNOSED?

In Traditional Chinese Medicine (TCM), practitioners examine each individual for patterns that reveal a specific diagnosis. Your acupuncturist will complete a thorough evaluation of physical and emotional signs and symptoms, your diet and lifestyle and check your tongue and pulse.

If your medical doctor suspects you have PCOS, she may recommend testing a blood sample for elevated luteinizing hormone (LH) and serum testosterone. She may also request an ultrasound of the ovaries to determine if cysts are present (because 20% of all women likely have ovarian cysts visible on an ultrasound, the presence ovarian cysts does not necessarily indicate PCOS).

HOW DOES INSULIN AFFECT FERTILITY?

Insulin is a hormone that regulates the change of sugar, starches, and other food into energy for the body’s use or for storage. Excess insulin causes a rise in male hormones and blocks the liver from producing sex hormone-binding globulin, which restricts which cells are affected by testosterone.

By increasing the amount of male hormones circulating in the blood, high insulin amplifies the effects of these hormones on cells, thereby stimulating the ovaries to overproduce androgens. Excess androgens cause follicles to develop too quickly and shut down prematurely before producing an egg. In addition, the effects of insulin sensitivity contribute to gain weight and difficulties with weight loss, especially in the lower abdomen. Excess fat caused by reactions from high insulin initiate a negative feed back system where the fat-derived hormone litpton, adipocite, inhibits the stimulatory effect of FSH.

In both Chinese and Western medicine, this process of reactions has a direct impact on the way the body ovulates. From a TCM perspective, symptoms described above reveal patterns of excess yang and deficient yin which can be treated with acupuncture, Chinese herbs and diet and nutrition counseling.

HOW IS PCOS TREATED?

For both Western and Chinese medicine the first line of treatment is diet and weight control. The goal is to regulate the blood sugar, decrease insulin resistance and improve glucose metabolism to stabilize mood and weight. With some women, reducing insulin levels and improving insulin sensitivity through weight loss, a low glycemic diet and exercise may restore normal ovulation.

The TCM approach treats underlying imbalances causing hormonal irregularities to correct the problem and the symptoms together. Thorough evaluations, specialized acupuncture treatments and nutritional guidelines are used to regulate the menstrual cycle. Chinese herbs are also extremely effective in stimulating ovulation and can be discussed with your acupuncturist.

After a few months of treatment you may begin to notice signs of ovulation, such as increased mid-month vaginal discharge and elevated basal body temperature. If you have very long cycles, ovulation will begin earlier indicating healthier egg production. Skin will eventually clear and excess hair will diminish.

Tips for Women With PCOS

1. Increase your heart rate with at least 30 minutes of vigorous exercise every day. If you are overweight, losing five to ten percent of your body weight can restore your cycle and reduce distressing symptoms like facial hair and acne. This does not mean begin marathon training. Balance is key!
2. Eat  at least 5 servings of vegetables daily, including leafy greens.
3. Eat low-glycemic carbohydrates, like whole grains and vegetables.
4. Keep blood sugar stable with meals and snacks scheduled every 3-5 hours. Include proteins and healthy fats, such as hummus, nuts, seeds and hard-boiled eggs.
5. Limit or eliminate dairy to avoid aggravating internal dampness. If you do have dairy, enjoy non-homogenized, full-fat milk.
6. Add one or two tablespoons of cinnamon to cereal or oatmeal in the morning to help decrease insulin resistance.
7. Include probiotic and prebiotic foods in your diet to promote the growth of good bacteria in your intestinal tract.
8. Pay attention to portion sizes. This will moderate glucose load and minimize insulin resistance.