How can Chinese Medicine help you with polycystic ovary syndrome?
This week’s article is about PCO (Polycystic Ovaries) and PCOS (Polycystic Ovary Syndrome).
PCOS is a condition affecting the hormones that regulate the ovaries and therefore often, but not always, causes difficulty conceiving due to the absence of ovulation or irregular ovulation.
The ovaries are regulated by the hormones produced by the pituitary gland in the brain. These hormones are follicle stimulating hormone (FSH) and luteinising hormone (LH).
In a normal cycle these hormones stimulate the growth of a number of ovarian follicles, each containing one egg. One follicle grows at a faster rate to the others and this is called the dominant follicle.
By day 7 of the cycle, oestrogen levels in the blood rise significantly inhibiting the secretion of FSH, causing the smaller follicles to die off. When the level of oestrogen reaches its peak, it initiates the LH surge (sudden release) triggering ovulation. Ovulation occurs 28-36 hours after the start of the LH surge.Â
If your ovaries are polycystic, you would likely have an LH level that is higher than your FSH level indicating that the body is struggling to mature a dominant follicle and release an egg.
With the condition polycystic ovaries (PCO)multiple follicles (classified as cysts) grow each month on one or both ovaries. None of these grow to be the dominant follicle and usually don’t contain an egg.
It is possible to have polycystic ovaries which would be identified on an ultrasound scan, without having the syndrome.
To qualify as having PCOS, the syndrome, as defined by the Rotterdam Criteria in 2003 you would have:
1.   Chronic absence of ovulation that leads to menstrual irregularities
2.   High levels of androgens that do not result from other causes or conditions.
3.   Cysts on one or both ovaries as detected by ultrasound.
You might notice:
-Â Â Â Â Â Â Irregular, prolonged or absent periods
-Â Â Â Â Â Â Excessive hair growth on the face, chest, back or buttocks.
-Â Â Â Â Â Â Thinning hair or hair loss from the head
-Â Â Â Â Â Â Weight gain or difficulty losing weight
-Â Â Â Â Â Â Oily skin or acne
-Â Â Â Â Â Â Difficulty conceiving
-      Anovulation (you don’t ovulate)
-Â Â Â Â Â Â Oligo-ovulation (you ovulate only infrequently or irregularly)
-Â Â Â Â Â Â High levels of androgens. These are referred to as male hormones such as testosterone and androstenedione. However, androgens are present in both females and males but usually in a higher level in males. This contributes to the excessive hair growth and acne and interferes with the development of the follicles.
-      Pre-diabetes, metabolic syndrome or insulin resistance. Excess insulin contributes to the increased production of hormones including testosterone.
-      Thyroid condition – hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid). Thyroid conditions can affect the productive of hormones and contribute to menstrual irregularities.
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If you suspect that you have PCOS or PCO ask your GP or fertility doctor to test for the following:
-      Day 2-4 Blood Test – for FSH, LH, oestrogen, thyroid and insulin levels.  This should be taken on the first few days of your cycle. In the UK this blood test is free and can be requested from your GP.
-Â Â Â Â Â Â Ultrasound scan
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Traditional Chinese Medicine (TCM) and PCOS
Acupuncturists in TCM diagnose in terms of organ patterns of disharmony. This means that we identify by signs, symptoms, pulse and tongue diagnoses what is wrong with particular organs in the body. These organs can either be in excess (stagnation of Qi or Damp or Blood) or deficient (Qi, Yin or Yang deficiency).
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The main organs relating to fertility are:
Liver, Heart, Spleen, Kidney, Uterus (encompassing also the fallopian tubes and ovaries).
Common PCOS patterns that we see in fertility acupuncture are:
1.   Damp (deriving from Spleen Qi deficiency)
2.   Kidney deficiency (Yin or Yang)
3.   Blood deficiency (usually Liver)
Qi is the energy currency of the body. We support it with healthy food and by resting. Qi needs to flow smoothly for blood to build, flow and support the organs with nutrients.
The Kidneys support the reproductive organs and are made up of Kidney Yin and Kidney Yang. See more in the Yin and Yang article here.
The Spleen transports Qi around the body. When the Spleen Qi is weak, Damp (known as fatty deposits or phlegm) accumulates. This can cause problems such as PCOS.
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What can you do to encourage ovulation?
Western Medicine:
1.   Clomid or letrozol may be prescribed by a fertility doctor to increase the chance of ovulation.
2.   Laparoscopic Ovarian Drilling (Ovarian Diathermy or LOD). This involves using heat or a laser to destroy tissue in the ovaries that is producing androgens.
LOD has been found to lower levels of testosterone and LH whilst raising levels of FSH.
3.   Metformin may be prescribed. This is commonly used to treat type 2 diabetes. It makes cells more sensitive to insulin, decreasing the blood level of insulin and therefore counteracting one of the underlying causes of PCOS. It doesn’t improve success rate at IVF and diarrhoea is a side effect.
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Chinese Medicine:
1.   Acupuncture – visit us at Creaion Acupuncture. Acupuncture addresses the hormone imbalance by regulating hormones and improves the ovarian activity, increasing the Qi and blood flow to the fertility organs such as the ovaries and the uterus. It also strengthens the Kidneys to support the reproductive system, strengthens the Spleen to remove Damp, regulates the menstrual cycle and promotes ovulation.
2.   Qi energy healing. Creation Acupuncture patients receive weekly modules including energy clearing meditations which focuses on the main TCM causes of PCOS such as Damp and includes affirmations and lifestyle advice specifically to promote ovulation.
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Additional:
1.   Weight control and a high protein diet can have a possible effect on PCOS and ovulation.