Polycystic Ovarian Syndrome (PCOS) is the most common occurrence for female infertility. It affects nearly 1 in 10 to 15 women and can typically start in childhood. This endocrine condition expands beyond the childbearing years, though.  With more research and care practices, physicians are recognizing it as metabolic and hormonal dysfunction in the body. 

In East Asian Medicine, we want to get to the root cause of the imbalance to reduce inflammation, regulate the hormonal cycle and help support insulin sensitivity. PCOS can be easily managed to reduce inflammation and insulin sensitivity and restore cycle regulation for fertility.

The Processes of PCOS in the Body?

We often focus on how this is going to affect fertility due to cycle irregularity or failed pregnancies. The inflammation cycle in PCOS impacts egg quality, ovulation and implantation.

 But we need to look at metabolic dysfunction, which is often influenced by environmental factors, insulin resistance and this low grade inflammation. The long term effects of this systemic inflammation is cardiovascular diseases and diabetes predisposes women to conditions such as diabetes. 

Inflammation is typically welcomed. It supports our immune system and kicks in for a great reason. It helps fight off infections and with cellular repair in injuries. Unfortunately inflammation can happen at the wrong time. This leads to oxidative stress and damage to surrounding cells and tissues.

In PCOS there is an excess of inflammation due to the dysfunction of the fat cells. The fat cells are larger in women with PCOS. The enlarged cells release free fatty acids in the bloodstream and fat necrosis occurs in the fatty cells. 

The immune system is triggered to clean up the inflammation. In doing so, a chronic low-grade inflammation occurs continuously. This can cause damage to the vascular system; the ovaries and it triggers the insulin resistance of the surrounding tissues.

Nutrition and Exercise

When insulin stays elevated throughout the day, the body starts to store this excess energy into the fat cells.  Nutrition is powerful in regulating insulin. 

Avoiding overstimulation of the insulin secretion is key. When insulin is high, the body is in an energy storage phase leading to weight gain.

Understanding the foods that cause this insulin speaks is one way to help PCOS. This is a great resource on insulin counting.

If there are food sensitivities or signs of digestive issues, it is highly recommended to eliminate that exposure and reduce GI inflammation. This process takes patience as a general food elimination diet may take up to 6 weeks to start seeing improvements.

PCOS Dietary Support:

• Eating a variety of fruits and vegetables and low fat protein such as chicken, fish and beans is great. Limit your refined carb intake (carbs can impact your insulin levels too), dairy and red meats

• Seek out a dietician that specializes in PCOS and insulin sensitivities

• Walking 15 minutes after a meal can help reduce insulin spikes

• Glucometers are a great tool to measure your blood sugars to see what causes a spike 

• Weight loss: Research shows that losing 10 % of body weight can result in normal ovulation

Exercise is also very effective in improving metabolic function and reducing inflammation in PCOS. Research shows 75 minutes a week of moderate to HIIT training is effective. **

https://www.fertstert.org/article/S0015-0282(14)00764-X/fulltext

Symptoms of PCOS

The Rotterdam Criteria points to 3 factors of PCOS 

1. Oligo‐anovulation (irregular or infrequent periods)
2. Hyperandrogenism  (excess of male sex hormones)
3. Polycystic ovaries 

Not all of these factors need to be present and often symptoms of PCOS are effective indicators of insulin sensitivity. Lab testing can be tricky with Testosterone levels as the reference range in fertility includes women with PCOS and various age ranges outside of the reproductive years. This skews what “normal” looks like.

Other things to look for

The beauty is that our bodies can typically show early signs. 

• Obesity
• Insulin resistance
• Mood swings
• Hirsutism – hair growth typically on the chin which looks like a few stubble coarse hairs on chin 
• Hair loss – diffuse, thinning hair, scalp is visible instead of patchy hair loss
• Skin tags neck and axilla and red bumps keratosis pillari on upper arms
• Acne on the jawline, chest, buttocks, moderate to severe (may have been on Acutane in their teens and early twenties)
• Infertility 
• Irregular and Long cycles

Labs to Request

Full thyroid panel (TSH, Free T3, Free T4, Antithyroidglobulin, AntiTPO, reverse T3)

DHEAs

A1C 

Fasting Insulin

Total Testosterone and Free testosterone

AMH

Supplements – these can be purchased on Fullscript link below under Favorites > PCOS

1. NAC (N-acetylcysteine) antioxidant and anti-inflammatory, regulates menstrual regularity
2. Vitamin D – if low is associated with symptom severity. Improves ovarian reserves, AMH levels and fertility 
3. Inositol – reduces insulin resistance, testosterone and AMG levels, restores ovulation and improves fertility, egg quality and pregnancy rates. It also helps with anxiety. D-chiro-inostol and myo-inositol blends are best
4. Adaptogen complexes with holy basil, ashwaganda, reishi mushroom, can reduce cortisol, improve blood sugar metabolism, and reduce insulin resistance. 
5. White Peony and Licorice formula also known as Shao Yao Gan Cao Tang – Chinese herbal formula that supports cycle regulation if androgen excess is inhibiting the ovulatory process.

Acupuncture’s Role in PCOS Care

Acupuncture can help with PCOS by working on the HPO Axis (hypothalamic – Pituitary – Ovarian Axis) and can help regulate:

• Reducing testosterone
• Increasing circulation on to the reproductive organs
• Lower insulin levels and BMI
• Improve menstrual cycle irregularities
• Normalize hormone levels through the cycle

https://pubmed.ncbi.nlm.nih.gov/29381988/

https://pubmed.ncbi.nlm.nih.gov/20230329/

https://pubmed.ncbi.nlm.nih.gov/29071945/

https://pubmed.ncbi.nlm.nih.gov/29354933/

If you’re interested in incorporating East Asian Medicine in your care, you can book your free phone consultation or call our office at (480) 426-9251.