Polycystic ovary syndrome(PCOS) is one of the common diseases in young women. In mild cases, symptoms include menstrual disorders, acne or obesity. In severe cases, it can affect pregnancy, even infertility and increase the risk of endometrial cancer.

In the treatment of PCOS, Chinese medicine can provide a new perspective for patients with polycystic ovary syndrome in improving symptoms and improving the quality of life through holistic conditioning and individualized treatment. It can also regulate women’s menstruation through natural therapy of Traditional Chinese Medicine(TCM), and then treat the possibility of infertility caused by polycystic ovary syndrome.

What is polycystic ovary syndrome?

PCOS is a common endocrine disorder in women. PCOS is common in women aged 20-40 years old in their reproductive period, and up to 20% of the infertile population. Typical manifestations of PCOS include polycystic ovarian changes, hyperandrogenism and increased luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio, varying degrees of menstrual abnormalities (sparse menstruation, scanty menstruation, amenorrhea, dysfunctional uterine bleeding), infertility, hirsutism, acne, obesity, etc., and are often accompanied by pancreatic hormone resistance or hyperinsulinemia and hyperlipidemia that become increasingly obvious with age.

Under normal circumstances, about 10 follicles develop in a woman’s ovaries every month, but only one will mature and release an egg, while the other immature follicles will degenerate and atrophy. However, the follicles of patients with PCOS cannot mature and release eggs normally, and more than 10 immature follicles like cysts will form in the ovaries, causing the ovaries to enlarge, leading to menstrual disorders, acne, hirsutism, obesity and infertility.

What causes PCOS?

Currently, the cause of PCOS is not clear. It is generally believed to be related to hyperinsulinemia and insulin resistance, genetics, hormonal changes, etc.:

Genetics: Women with a family history of PCOS have a higher chance of developing the disease.

Excessive androgen secretion: interferes with the development of follicles and ovulation.

Insulin resistance: cells react poorly to insulin, and normal concentrations of insulin cannot control blood sugar, causing the body to secrete too much insulin, which in turn induces excessive androgen secretion.

Obesity or lack of exercise: More than half of PCOS patients are overweight or obese.

How does TCM treat PCOS?

From the perspective of TCM, the treatment of PCOS is mainly based on kidney deficiency and blood stasis. TCM believes that the formation and onset of menstruation are closely related to the kidneys. Insufficient kidney essence will prevent the follicles and eggs from developing normally, and insufficient kidney yang will prevent the eggs from being discharged smoothly. Therefore, kidney deficiency is the root cause of ovulation disorders. If the kidney is deficient and phlegm and dampness occur, it will hinder the circulation of qi and blood, further aggravating PCOS. Therefore, kidney deficiency is the basic pathogenesis of PCOS, and phlegm and blood stasis are the main pathological factors.

Therefore, tonifying the kidney, resolving phlegm, and activating blood circulation are important methods for treating PCOS. The treatment principle is the Chinese medicine artificial cycle method of “tonifying the kidney – activating blood circulation and removing blood stasis – tonifying the kidney – activating blood circulation and regulating menstruation”. Following this idea, acupuncture combined with Chinese medicine is used, so that “PCOS” and “infertility” can be treated at the same time.

In addition, TCM will also use herbal medicine and acupuncture to promote ovulation according to the changes in the menstrual cycle to restore the patient’s normal menstrual cycle. That is, during the menstrual period, the main treatment is to activate blood circulation and regulate menstruation to promote normal menstrual blood discharge; in the late menstrual period (follicular period), the Yin, blood and kidney are nourished to promote follicle development; during the intermenstrual period (ovulation period), Chinese medicine that replenishes kidney yang and activates blood circulation is added to promote smooth egg discharge; and in the premenstrual period (luteal phase), the main treatment is to warm and nourish kidney yang, replenish qi and nourish blood, improve luteal function, and make menstruation normal.

Herbs medicine 

The treatment of polycystic ovary syndrome with Chinese medicine mainly focuses on adjusting endocrine disorders and promoting ovulation after normalization. Tonifying the kidney and activating blood circulation is the basic method of TCM to treat the disease. Kidney-tonifying Chinese medicine is believed to have endocrine hormone-like effects and can have a bidirectional regulatory effect on the female gonad axis. Adding blood-activating drugs to kidney-tonifying can improve local blood circulation in the ovaries, increase ovarian blood flow, thereby promoting follicular development, inducing ovulation and promoting corpus luteum formation. This has been widely confirmed in clinical and experimental studies of Chinese and Western medicine.

Usually, Chinese medicine starts with regulating menstruation and divides the menstrual cycle into menstrual period, postmenstrual period, ovulation period and premenstrual period. By adjusting the menstrual cycle, Chinese medicine is used rationally for demonstration and treatment.

• Menstrual period: Activate blood circulation and regulate menstruation to promote normal menstruation. Consider salvia miltiorrhiza, red peony root, wormwood leaf, etc.;
• Postmenstrual period: Nourish yin, nourish blood and tonify the kidney to promote follicle development. Consider angelica, yam, cornus officinalis, cooked rehmannia, etc.;
• Ovulation period: tonify the kidney and regulate qi and blood to promote ovulation. Consider dodder seed, radix scutellariae, antler tablets, etc.;
• Premenstrual period: tonify kidney yang and improve corpus luteum function. Angelica sinensis, epimedium, purple quartz, etc. can be considered.

Studies have found that Wenjing Decoction developed using traditional Chinese medicine can increase the ovulation rate of PCOS patients to 50%, treat dysmenorrhea caused by cold stagnation in the meridians, significantly increase the levels of follicle-stimulating hormone (FSH) and estradiol (E2) in patients with amenorrhea, and significantly reduce the level of luteinizing hormone (LH) in patients. Therefore, Wenjing Decoction is often used as one of the main prescriptions for the treatment of PCOS in traditional Chinese medicine.

Acupuncture

The effect of acupuncture in the field of assisted reproduction has been generally recognized by the industry, especially in inducing ovulation, improving endometrial receptivity, and polycystic ovary syndrome. In the treatment of polyovary syndrome, acupuncture mainly focuses on the Taichong, Guanyuan, Zhongwan, Uterus, Zhongji, Sanyinjiao, etc. points of the Ren meridian, liver meridian, spleen meridian, and kidney meridian to soothe the liver and regulate qi, regulate the internal organs, and regulate the body. function to return to normal.

Acupoint health care: Guanyuan, Zhongji, Uterus, Sanyinjiao

Guanyuan point

Location: On the lower abdomen, on the anterior midline, 3 inches below the navel. Efficacy: Replenishing vitality, warming kidneys and replenishing essence

Zhongji point

Location: On the lower abdomen, on the anterior midline, 4 inches below the navel. Efficacy: Replenishing kidney and revitalizing yang, regulating menstruation and stopping vaginal discharge

uterus point

Location: In the lower abdomen, 4 inches below the middle of the umbilical cord, 3 inches from the front midline. Efficacy: Regulates menstruation, regulates qi and blood.

Sanyinjiao point

Location: 3 inches straight above the tip of the medial malleolus, the posterior edge of the tibia is close to the depression on the bone edge. Efficacy: irregular menstruation, amenorrhea

FAQ

• Are patients with polycystic ovary necessarily obese?

Patients with polycystic ovary are not necessarily obese, and thin women may also suffer from this disease. But if a patient with polycystic ovary syndrome is obese, symptoms can improve after losing weight.

Why should we face up to polycystic ovary syndrome as early as possible?

If polycystic ovary syndrome worsens, it can not only cause infertility and endometrial cancer, but also increase the risk of cardiovascular diseases such as diabetes, high blood pressure, and high cholesterol.

• Can more exercise improve polycystic ovary syndrome?

Can. Patients with polycystic ovary syndrome are closely related to obesity. Exercising more and losing weight can effectively improve their physical condition and reduce symptoms.

• Can polycystic ovary syndrome be cured?

Currently, there is no method that can completely cure PCOS, but if treated early and good living habits are maintained, the condition can be better controlled, menstruation can occur normally, and the impact on the body can be reduced. On the contrary, if left untreated, the condition may worsen and lead to infertility. If there is no menstruation for a long time, the endometrium will be too thick and it will increase the risk of endometrial cancer.

4 ways to improve and prevent polycystic ovary syndrome

• Keep exercising. If you are obese, you need to actively lose weight;
• Avoid eating high-sugar, high-fat, fried, and frozen foods;
• Get enough sleep and avoid staying up late;
• Keep your mood relaxed and avoid excessive stress.

CASE:

A 30-year-old woman was diagnosed with polycystic ovary syndrome combined with infertility a year ago. An ultrasound examination showed multiple cysts (commonly known as “water tumors”) on the left ovary, with the largest cyst measuring 3.0 cm in diameter. She had been married for five years but had not had a child (and had never been pregnant before), and she had never used any contraceptives. During the last ultrasound examination this year, multiple cysts on the left ovary had fused, with the largest cyst growing to 4.4 cm in diameter. She also had irregular menstruation, which was irregular before and after, sometimes coming every 23 days, and sometimes coming every 35-40 days. She also had lower abdominal pain during menstruation, which was more severe on the left side. After being introduced by a friend, she came to the doctor’s clinic for treatment. Further examination revealed that her luteinizing hormone (LH) was 19.1 mIU/mL and her follicle stimulating hormone (FSH) was 3.8 mIU/mL, forming a high ratio of LH/FSH, which was caused by endocrine hormone secretion disorders. At the same time, it was found that her basal body temperature was a single-phase curve, and the urine ovulation test for 20 days was negative, which proved that the patient had anovulatory menstruation, which is the key to infertility. The patient’s Western medicine obstetrician and gynecologist had suggested that the cyst should be removed surgically first, and then the drug clomiphene (CC) should be used to stimulate ovulation. According to the feedback, it was decided that artificial insemination (IVF) might be used. But she refused this treatment method and was ready to try the treatment of traditional Chinese medicine before deciding.

The doctor in our clinic combined the diagnosis of TCM: the patient had cold limbs, sallow complexion, chest tightness, nausea, sore waist and knees, depression, breast swelling, fatigue, insomnia, forgetfulness, clear and long urine, loose stools, pale tongue with white fur, and deep and slippery pulse. The diagnosis was “spleen and kidney yang deficiency, qi stagnation and phlegm obstruction”. Spleen yang deficiency means that qi cannot transform into fluid, water and moisture stagnate inside, and gather into a stream. Kidney yang deficiency cannot warm the uterus, and the Chong and Ren meridians are out of balance, so the uterus is cold and infertile. In fact, the “polycystic ovary syndrome” and “infertility” of the patient are caused by the same pathological factors and can be treated at the same time. Acupuncture and Chinese medicine are used for combined treatment. Chinese medicine is prepared with different prescriptions according to the menstrual period and ovulation period. After 1 month of treatment, on the 3rd day of menstruation, LH: 4.2 mIU/mL and FSH: 7.8 mIU/mL were measured. After 2 months of treatment, her basal body temperature was a biphasic curve, and on the 17th day of menstruation, the urine ovulation test was positive. In the 3rd month of treatment, on the 15th day of menstruation, the urine ovulation test was positive. On the 32nd day of menstruation, the urine pregnancy test was positive. One week later, the patient’s blood report showed: positive pregnancy, and the ultrasound report: no “ovarian cyst” was found. Because the patient had “ovarian cysts”, miscarriage is usually prone to occur in early pregnancy, so the patient was given 3 months of Chinese medicine to preserve the pregnancy. Now she is 15 weeks pregnant and everything is normal.