PCOS Through an Acupuncturist’s Lens
PCOS is the most common endocrine disturbance. Many women have no idea they have PCOS until the endocrine disturbance becomes so big that their periods become non-existent.
To qualify for a diagnosis of PCOS, a patient must only exhibit two of the following: Anovulation, hyperandrogenism or polycystic ovaries (an ovary with 12 or more follicles measuring 2-9mm).
Other signs/symptoms, weight gain, menstrual cycle disturbances, hirsuitism, hyperinsulinemia (or other insulin issues), acne, alopecia or thinning hair, skin tags, acanthosis nigricans.
A word about weight gain– research shows about 60% of women that have PCOS are overweight, in my personal experience and clinician at Tao to Wellness for 20 years, that’s not true. I would actually say that 60% of women who have come to our clinic in Berkeley that have PCOS are lean and of an average body weight. So when looking at signs and symptoms know it can really go either way.
Labs to watch:
Labs can be extremely valuable. Commonly at Tao to Wellness we have a patient come in with labs from their OBGYN and one thing always stands out, a high LH with a normal FSH in a 2:1 ratio. For me, I call this a freebie when I see this, I start investigating other areas to see if the patient has PCOS. Even if a patient is having regular periods, I would still have a discussion around the possibility of PCOS starting and things that we can do to stop it in its tracks now.
High LH, low or low/normal levels of FSH, 2:1
High testosterone (especially Free T)
DHEA, high in ½ of women
SHBG low (this stands for Sex Hormone Binding Globulin and is controlled by hormones. Testosterone inhibits SHBG and estrogen and thyroxine stimulate SHBG. Women with PCOS have a 50% reduction in circulating SHBG, a response to the increased testosterone.)
Prolactin, 20% of women have high levels, because of increase pulsatility in gonadotropins.
Possible high estrogen (E2)
TSH is usually high
Two most consistent elements are high androgens and no ovulation. Excess androgen produced by the cyst enters the bloodstream and alters the HPO axis. Estrogen is also high in the bloodstream in relation to progesterone, causing increase in LH and testosterone. The hormonal cascade causes no ovulation, although a woman thinks they are ovulating because the OPK indicates it, but it’s just picking up the LH surge, which results in a false positive. Women with PCOS ovulate late if at all and when they do the egg quality goes down; think about baking eggs in the oven for 2 hours instead of 30 min.
Basal Body Temps
BBT charts will show long follicular phases and short luteal phases.
The Chinese perspective
Chinese medicine looks at things in a different way, but in the event of PCOS there is almost always an issue of excessive damp even if they are lean or thin. Dampness can wreak havoc in the body and throw the hormone system off which results in no ovulations and lowered egg quality.
Acupuncture: Acupuncture is wonderful for PCOS, it can ‘move’ the damp, it can talk directly to the hypothalamus and reset the communication between the brain and the ovaries so that hormone regulation happens again, it brings inflammation down throughout the whole body, it de-stresses the body, it enhances digestion, it assists in better sleep so that healing can occur faster.
Chinese herbal medicine: Herbs are like magic and should be only taken under the guidance of an experienced herbalist. At Tao to Wellness we would build a custom formula for you, maybe even two depending on your own individual situation. We create or mimic the normal cycle or how we want the cycle to be, for example if you are in the follicular phase for four weeks and the luteal phase for one week, we want to change that and herbs are a great way to do that because it helps the body make subtle changes daily. There are amazing herbs just for dissolving the waxy capsule around the ovary, there are herbs to increase blood flow to the uterus for enhancing the lining, herbs to regulate the hormones, herbs to relax the emotions around the journey itself.
Nutritional guidelines: What you eat is important here, there are lots of foods that boost fertility but with the case of PCOS we need to limit foods that are causing the hormonal chaos and bring in other foods to help regulate hormones, bring down inflammation, support blood flow and so on.