PCOS (polycystic ovary syndrome)
PCOS (polycystic ovarian syndrome) is a hormonal disorder in which the ovulation and menstrual cycle may be disturbed. Typical include irregular or absent ovulation and an increased amount of androgens, such as testosterone. In addition, many small immature follicles can be visible on an ultrasound.
PCOS can express itself very differently. Some women mainly have irregular menstruation, while others suffer from acne, increased hair growth, hair loss, weight gain or difficulty getting pregnant. Not every woman with PCOS has overweight or insulin resistance and not everyone has polycystic ovaries.
The treatment therefore depends on the complaints, any child desire and personal situation.
Common symptoms
Not every woman with PCOS has the same symptoms. Common symptoms are:
- irregular or long menstrual cycles;
- little or no periods;
- decreased or absent ovulation;
- difficulty getting pregnant;
- acne or oily skin;
- increased hair growth on the face or body;
- hair loss according to a male pattern;
- weight gain or loss of weight;
- fatigue.
Some women have only some of these symptoms, and PCOS can also occur in women with normal body weight.
Possible causes
The exact cause of PCOS is unknown. It probably develops through a combination of genetic, hormonal and metabolic factors.
Factors that can play a role include:
- genetic predisposition;
- increased production or activity of androgens;
- disturbance of normal follicular development and ovulation;
- insulin resistance and elevated insulin levels in some women;
- overweight, which may enhance existing hormonal and metabolic disturbances;
- other lifestyle and environmental factors.
PCOS can therefore have different appearances. For example, one woman has obvious metabolic complaints and overweight, while another is slim but has an irregular cycle and increased androgens.
What can acupuncture do?
Acupuncture can be added to PCOS. The treatment is tailored to your menstrual cycle, complaints, any child desire and the underlying TCM pattern.
In Chinese medicine, not only the diagnosis of PCOS is examined. It examines which combination of symptoms and physical characteristics is present. One woman, for example, recognizes characteristics of Dampness-Phlegm, while another kidney deficiency, Heat or stagnation of Qi and Blood is at the forefront.
Depending on the picture of complaints, treatment may be directed at:
- support the menstrual cycle;
- support ovulation;
- Enhance kidney-yin and/or kidney-yang;
- support Chong Mai and Ren Mai;
- reduce Dampness and Phlegm;
- improve Qi and Blood flow;
- Reduce heat when this pattern is present.
The treatment can be adjusted during the cycle. Within a phase-oriented TCM approach, more emphasis may be placed on supporting the Kidneys at PCOS in the period after menstrual periods and around ovulation. If characteristics of Dampness-Phlegm are present, attention can also be paid to this.
What can Chinese herbal medicine do?
Chinese herbal medicine, like acupuncture, is tailored to the individual TCM pattern. Therefore, there is no single herbal treatment used in every woman with PCOS.
In addition, the treatment can be adjusted during the menstrual cycle. A long or irregular cycle will look at the symptoms and signs that indicate which functions need mainly support at that time.
Depending on the pattern, herbal treatment may focus on:
- Support kidney-yin and kidney-yang;
- Support Jing, within TCM connected with development and reproduction;
- reduce Dampness and Phlegm;
- Supporting the Spleen in moisture processing;
- Free circulation of Qi and Blood;
- Feed blood when characteristics of Blood deficiency are present;
- Reduce heat when appropriate to the complaint image.
Acupuncture and Chinese herbs can be combined from the same TCM diagnosis. Herbs can be used daily between acupuncture treatments.
How does Chinese medicine view PCOS?
In Western medicine, PCOS is described by hormonal changes, disturbed or absent ovulation and possibly the image of polycystic ovaries. In Chinese medicine, the overall pattern of symptoms and physical characteristics present in the individual woman is also examined.
At PCOS, patterns are often recognized within TCM involving the Kidneys, Spleen and Liver. In addition, the special meridians Chong Mai, Ren Mai and Du Mai play an important role in the menstrual cycle.
Within Chinese medicine, the Kidneys and the so-called Jing are closely linked to development, reproduction and menstrual cycle. Therefore, kidney and Jing deficiency are important patterns that can be found at PCOS.
In other women, characteristics of Dampness and Phlegm are more prominent. Dampness and Phlegm are TCM concepts for a pattern in which the processing and distribution of body fluids is less effective. Characteristics that can fit include heavy or bloated feeling, fatigue and vaginal discharge. Overweight or weight loss problems may occur, but is not necessary.
Also Liver-Qi-stagnation, Heat, Blood stasis or Blood deficiency can be part of the overall picture. Thus, the TCM pattern is not determined based on the diagnosis of PCOS or the echo image alone, but on the combination of menstrual symptoms, general symptoms, tongue, pulse and other physical characteristics.
This explains why two women with the same Western diagnosis within TCM can get different treatment.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to exist. Thus, the pattern is not a Western diagnosis and is determined on the basis of the overall picture of complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns in PCOS
Kidney-Yang-deficiency
In this pattern, irregular or absent menstrual periods are combined with characteristics of insufficient heat and activity. Kidney-Yang deficiency is an important underlying imbalance that can be found at PCOS.
Common symptoms
- long or irregular menstrual cycles;
- absence of menstruation;
- impaired fertility;
- fatigue;
- cold hands and feet;
- low back pain;
- frequent urination;
- decreased libido.
Examples of Western disorders
PCOS, amenorrhea, irregular ovulation and impaired fertility.
Kidney-Yin- and Jing-deficiency
This pattern has features of insufficient Yin and Jing of the Kidneys in the foreground. Within TCM they are closely linked to the menstrual cycle, development and reproduction. Among other things, the pattern can be recognized by a very scarce or absent period in combination with signs of Yin or Jing deficiency.
Common symptoms
- low or absent periods;
- impaired fertility;
- low back pain;
- dizziness;
- dry mouth or throat;
- night sweats or warmth;
- little fertile cervical mucus.
Examples of Western disorders
PCOS, amenorrhea, ovulation problems and impaired fertility.
Dampness-Phlegm
In many women with PCOS, characteristics of Dampness-Phlegm are recognized. Within TCM this refers to a disturbance in the processing and distribution of body fluids. Complaints such as heavy or bloated sensation, fatigue and vaginal discharge can fit. Also, the ultrasound image of multiple unripe follicles is seen within some TCM approaches as appropriate for Dampness-Phlegm. This is a traditional TCM interpretation of the picture of complaints and no explanation for the biological cause of these follicles.
Common symptoms
- long or absent periods;
- a heavy or full feeling in the abdomen;
- bloating;
- fatigue;
- vaginal discharge;
- a heavy feeling in the body;
- weight gain or difficulty in losing weight in some women.
Examples of Western disorders
PCOS and other menstrual or ovulation problems involving characteristics of Dampness-Phlegm.
Dampness-Phlegm with Heat
This pattern combines characteristics of Dampness-Phlegm with signs of Heat. As a result, acne, oily skin or other heat phenomena can be present in addition to a disturbed menstrual cycle.
Common symptoms
- irregular or absent periods;
- acne or oily skin;
- vaginal secretion that may be yellower or stronger smelling;
- feeling heavy or bloated;
- feeling thirsty or warm;
- sometimes irritability.
Examples of Western disorders
PCOS with clear acne or other characteristics of Dampness-Heat in addition to cycle problems.
Liver-Qi-stagnation
In some women with PCOS, characteristics of Liver-Qi-stagnation are recognized. For example, menstrual symptoms go hand in hand with obvious tension, PMS and emotional complaints. Stress and emotional stress within TCM can contribute to the emergence or worsening of Liver-Qi-stagnation.
Common symptoms
- irregular menstrual periods;
- PMS;
- irritability;
- mood changes;
- tense or sensitive breasts;
- a bloated or tense feeling;
- symptoms that increase during periods of stress.
Examples of Western disorders
PCOS, PMS and other menstrual symptoms with clear features of Qi-stagnation.
Blood stasis
Blood stasis is not at the forefront of every woman with PCOS. This pattern is especially recognized when menstrual problems are associated with obvious pain, dark menstrual blood and blood clots.
Common symptoms
- painful menstruation;
- sharp or stabbing menstrual pain;
- pain in a fixed place;
- dark menstrual blood;
- blood clots;
- sometimes brown secretion before or after menstruation.
Examples of Western disorders
PCOS with menstrual pain and other gynaecological symptoms where signs of Blood stasis are present.
Outlook
PCOS is usually a long-term condition. The course of treatment depends, among other things, on the regularity of menstrual periods and ovulation, the duration and severity of symptoms, the presence of insulin resistance or other metabolic factors, the underlying TCM pattern and any child desire.
Because changes in the menstrual cycle require time, the effect of treatment is usually assessed over several cycles. When menstrual periods occur only several times a year, it may take longer for changes in the cycle pattern to be properly assessed.
In the initial phase, one acupuncture treatment per week is a common guideline. When it is necessary to treat more intensively around a particular stage of the cycle, it can be treated temporarily two or three times a week. As the cycle and other symptoms become more stable, the frequency can be reduced. Chinese herbs can be used, if appropriate, daily between treatments.
In the case of a child's wish, treatment is specifically tailored to the cycle and can be combined with regular fertility guidance.
Contact
Do you have PCOS and do you want to know whether acupuncture and/or Chinese herbal medicine can be used in addition to your complaints?
During a first consultation, we will discuss your menstrual cycle, complaints, medical history, any child's wish and other relevant symptoms. Based on the overall picture of complaints, we will examine which TCM pattern is likely to be at the forefront and which treatment fits in with it.
You can make an appointment directly online or contact us for more information.