Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, is a disorder characterised by enlarged, smooth ovaries that contain multiple small follicle cysts. The condition mostly affects teenagers and young women. Symptoms, which typically develop during puberty, include male-pattern body-hair growth on the chest and face, obesity, acne, infertility, and absent or retarded menstruation (amenorrhea). Alternatively, profuse, irregular vaginal bleeding may occur, without any increase in body hair or weight.

With PCOS, the pituitary gland secretes large amounts of leuteinising hormone (LH), which increases the production of male hormones, or androgens. High levels of androgens are the reason women with PCOS develop those masculine characteristics of coarse body hair and acne; they also prevent normal ovulation and normal follicular development, resulting in the formation of cystic follicles instead of mature follicles with the ability to ovulate. If the condition is not treated, some of the androgens may be converted to oestrogens, resulting in a constant level of oestrogen instead of a cyclic, regulating level. Chronically high levels of oestrogens may increase the risk of endometrial cancer (cancer of the uterine lining).

The causes of PCOS are multiple. Until recently, abnormal ovarian function was seen as the main culprit, but today it is known that excess weight gain, blood-sugar abnormality, thyroid dysfunction, abnormal adrenal function, hypothalamic and pituitary hormonal dysfunction and poor liver detoxification contribute to this disease in varying degrees. Overweight women are prone to PCOS because adipose tissue has the capacity to convert androgens into oestrogen. Many obese women also suffer insulin resistance, which further contributes to PCOS.

Ultrasound scanning can detect PCOS, while serum blood tests determine whether levels of leuteinising hormone (LH) and androgens are elevated, and follicle-stimulating hormone (FSH) low. A range of procedures is used to rule out the possibility of the male hormones being produced by a tumour.

The medical approach is to use hormones such as oral contraceptives or progestin (synthetic progesterone) to regulate the cycle. The natural therapist’s approach focuses primarily on liver-pathway detoxification, using herbs to normalise ovulation, reduce excess androgen and normalise other hormones such as LH and FSH. Diet therapy corrects blood-sugar abnormalities and helps normalise weight.

Traditional Chinese medicine (TCM) sees PCOS as a form of abdominal mass, which is contributed to by a deficiency of kidney yang and the formation of phlegm and dampness with blood stagnation. Deficiency of kidney yang fails to transform evaporate and transport fluids in the lower heater, which causes accumulation of dampness and phlegm in the lower abdominal area. Dampness and phlegm form the cysts, and kidney yang deficiency contributes to the irregular menstruation and infertility.

Treatment for PCOS from the TCM point of view is rather complex because we focus very much on differentiation of signs and symptoms. To tonify the kidney yang, we use kidney-tonifying herbs such as cooked Rehmannia, Polygonati (Huang Jing), Epimedii (Xian Ling Pi), and Bu Gu Zhi, and prescribe different combinations of herbs, or herbal compounds, in different phases of the menstrual cycle. Some of the major herbs are Dang Gui, Hong Ha, Tao Ren, Dan Shen and Yi Yi Ren.

Acupuncture in conjunction with herbal and nutritional therapy is very effective for treating PCOS, especially for women who are obese and infertile. It tonifies the kidney, resolves dampness and encourages the elimination of phlegm, thereby reducing the mass.
Treatment of PCOS involves a biochemical approach as well as energetic, nutritional and dietary support. Self-treatment by reading books or searching the Internet is not recommended, as treatment needs to be monitored by a practitioner with experience in gynaecological disorders.

SIDEBAR: NUTRITIONAL THERAPY
Nutritional therapy includes:
Zinc, as a lack of this mineral has been shown to increase the production of male hormones. Studies have shown zinc supplementation exerts a beneficial effect on low female fertility. Zinc can be very effective for treating hormone-related acne.
Vitamin A is important for the maintenance of healthy skin: research shows that people with severe acne typically have low blood levels of vitamin A.

Essential fatty acids (EFAs) can help hormonal imbalances as well as related symptoms such as acne: people with hormone-related acne, including women with PCOS, have demonstrated EFA deficiencies.

This article was first published in the magazine “Nature and Health”

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