For those wondering what PCOS is, it's a female reproductive condition which is diagnosed by excluding other diseases, hence known as a syndrome. To be diagnosed with PCOS according to the Rotterdam criteria, a woman needs to have any two of the following:
- Polycystic ovaries: (that's right, ovaries with many cysts on them). The jury is out on how many cysts constitute PCOS, but they may be arranged in a classic black pearl necklace formation identified by ultrasound.
- Androgen excess: Basically, we are talking about too much free testosterone (but other hormones may be out of balance too - including the LH FSH ratio.) This hormonal imbalance can lead to symptoms such as hirsutism (an increase in body hair on the face, chest, nipples and lower belly), hair loss/thinning (again in the male pattern) and acne (although this is controversial as to whether it is definitely a part of the syndrome.
- Anovulatory menstrual cycles/amenorrhoea: This means that either you have stopped having periods altogether (and you are not pregnant or menopausal) or that you are not ovulating during your cycle. Women may also experience longer menstrual cycles. (35-60 day cycles are common in PCOS).
So, what can be done if you are given this diagnosis from your doctor (aside from or complementary to the common drug protocols - OCP, Clomid, Metformin)?
- Acupuncture: Research suggests that acupuncture can be useful in increasing the number of menstrual cycles a woman with PCOS has (that means bringing the length of the cycle down to a healthier range). Two randomised controlled trials have been undertaken on the topic. The first double-blind study showed that both the control group and the sham group (who had pretend acupuncture with a special non-needle) both improved on their before trial results. This suggests that perhaps the sham acupuncture may have worked after all. (Pretend acupuncture is very difficult to do without making a change to the body.) The second trial, used a better acupuncture point prescription (more like what we would use in mour clinic), and showed that acupuncture was superior to exercise for PCOS. The researchers pointed out that doing acupuncture and exercise would be the most beneficial treatment.
- Paeonia and Licorice: These herbs have both been shown to be beneficial in women with PCOS. They have also been studied in Chinese herbal formulas for the condition.
- Vitamin D: Have you had your levels checked? Researchers identified that women with PCOS are often low in Vitamin D. This has a relationship with calcium in your body and can influence ovulation. This makes sense from a Chinese medicine point of view as sunlight (one source of Vitamin D that we have) is a source of Yang (the warming, energetic, functional aspect of our body). A woman needs a peak in Yang to ovulate. (Anyone who has taken Basal Body Temperature charts knows to look for a peak in body temperature prior to ovulation.)
- Spearmint Tea: A month-long study on hirsutism was undertaken with participants drinking 2 cups of spearmint tea each day. The participants experienced a decrease in androgens and a subjective decrease in male pattern body hair.
- Weight loss and Insulin management: Most of the studies specify that the treatment is more likely to work in patients with a lower Body Mass Index (BMI) and without insulin resistance. There are additional dietary, herbal and nutritional interventions that may assist in these areas, so that your PCOS treatment works more efficiently. These areas can not be overlooked. It's suggested that PCOS may be an evolutionary condition allowing a small percentage of women to be able to reproduce in times of starvation (when most other women would experience infertility).
If you have been diagnosed with PCOS, I recommend discussing the condition with not only your doctor but also your acupuncturist or natural medicine practitioner (who has an interest in women's health). PCOS if left untreated, may be a risk factor for other metabolic disorders including diabetes and hypertension, not to mention is a cause of infertility. Every woman is different, and PCOS is notorious for presenting in many different ways so an individualised treatment plan is a must.