Effective Traditional Chinese Medicine (TCM) Strategies for Managing PCOS: Insights on Acupuncture and Herbal Treatments

Exploring Polycystic Ovarian Syndrome (PCOS) in Traditional Chinese Medicine

Traditional Chinese Medicine has been used for thousands of years to treat menstrual and reproductive system problems. TCM has a particularly robust focus on the female reproductive system that we in the west are coming to appreciate and value more and more! Polycystic ovarian syndrome (PCOS) is an unfortunately common reproductive system problem.  In this article we will talk about using Chinese medicine treatments, nutrition and lifestyle to help treat PCOS, but first let’s look at what PCOS is. 

PCOS is a condition where a person’s ovaries get filled up with follicles that don’t mature properly , thus preventing or delaying ovulation. Women with PCOS can have months between periods. If you are trying to get pregnant, having less periods in a year gives you less chances at conceiving in a year,  not to mention that a regularly functioning menstrual period is important to overall general health. The underlying pattern in PCOS is one of inflammation. There is a large amount of western research showing acupuncture having benefit in numerous types of inflammatory conditions like Crohn’s disease, asthma and Rheumatoid Arthritis. As I mentioned early, in a person with PCOS , their ovaries respond to this inflammation by clogging up with immature follicles. This inflammation can come from a few different sources, but first let’s take a look at the root of PCOS from a TCM perspective. 

TCM and Western Medicine: Diverse Perspectives on PCOS

In TCM we recognize two basic patterns in PCOS. Western medicine has been slower to see these two types. However recent research in western medicine is acknowledging that there are different phenotypes involved in PCOS and you have to treat them differently to be successful. 

The first pattern is one where blood sugar and therefore insulin levels are high. In these people the higher blood sugar/insulin is the source of the inflammation that their ovaries respond negatively to. In the other PCOS group, their blood sugar and insulin levels are normal and often even good. Here the source of the inflammation is not always clear, but often comes from constipation. The bowels are one of the body’s favourite ways to get rid of inflammatory substances, e.g. the regular waste products of metabolism. If the stool hangs around longer in the intestines, then all these inflammatory substances that the body wants to eliminate end up getting reabsorbed back into the bloodstream. The other possibility is that these women’s ovaries are just more sensitive and over-respond to a “normal” amount of inflammation. Obviously, not everyone reacts to this extra inflammation caused by constipation by having PCOS. We each have our own constitutional/genetic strengths and weaknesses.  For those women with PCOS, it’s their ovaries that react. Now let’s look at how we treat PCOS in TCM. 

The Role of Acupuncture in PCOS Treatment

As most of you know, Acupuncture is one of the main treatment modalities of TCM. There are a few different studies that show that using acupuncture helps PCOS, including one that looks at the metabolic pathways behind the benefits of TCM  Acupuncture for  PCOS. (https://pubmed.ncbi.nlm.nih.gov/34539997/)  Acupuncture can do many things to help. Increase blood flow to the uterus and ovaries , help our digestive system function better to help make better blood, help our immune systems function better and last but not least help counter the effects of stress on our bodies by helping us relax more. Acupuncture can also be very effective for treating the mental and emotional strain that having any chronic condition causes us. However acupuncture is only 1 way to treat PCOS. To be successful you need not only acupuncture but also to incorporate at least nutritional and lifestyle changes not to mention herbal treatments/supplements. 

Nutritional and Lifestyle Strategies for PCOS Management

Again depending on the type of PCOS you have,  diet and activity changes will be crucial. If you have the higher blood sugar type of PCOS you need to regulate your blood sugar to have lasting changes in your menstrual cycle. Acupuncture and herbs can only go so far. Crash diets and strict exercise regimes also don’t work in the long run. Patients who get the best results with having regular menstrual cycles  are able to change their eating and activity habits in a sustainable way that also helps their overall health. Those women who have the regular blood sugar PCOS, even though their diet and exercise levels are usually very good, they usually have to add more raw veggies and fruit to help regulate their bowels. You would be aiming to have 2 bowel movements /day. If that seems daunting and unachievable , just work on increase the # of BM’s you have now by eating more raw veggies and fruit. You would want to hit at least 5 servings of veggies/fruit each day. . Some “bad” news is that smoothies don’t work as well for creating more BM’s as eating whole veggies and fruit do. Not unsurprisingly, breaking up all that fibre in a blender isn’t as effective as eating it whole. Saying that, better to get veggies and fruits in a smoothie than to not get any at all. Activity levels also directly impact the amount of BM’s you have. Our bowels depend on regular activity to function properly. 

 Like with food changes, changing your  activity level is something you want to do steadily and slowly. Walk to a bathroom farther away at work , get off the bus a stop early, park your car farther away. Any little bit of extra movement helps to regulate your blood sugar and also helps create more and better bowel movements. Our bowels need movement to function properly. We did not evolve sitting in chairs or cars!

Herbal Treatments for PCOS: A Customized Approach

As for herbal remedies that help with PCOS , I am reluctant to talk about specific herbs for PCOS  because there are different phenotypes and even individual differences in women within the same  PCOS phenotypes. Everyone’s individual bio-chemistry is so different that you really should see a regulated health professional to get advice on which herbs would be good for you. The exception to this would be, if you have the higher blood sugar-type PCOS , then a supplement that has a large percentage of inositol in it would safely help regulate your blood sugar. (Elan’s Ovofolic is a good one)

Conclusion: Integrative Approach to Managing PCOS

In conclusion, PCOS is a reproductive system problem that unfortunately many people suffer from. Even though there are different types of PCOS , inflammation is at the heart of all of it.  Changing your nutrition and lifestyle habits, especially to match the different-type of PCOS, is key to long term sustainable health, and for people with PCOS, well functioning menses. Besides a supplement with a large amount of inositol in it , you need to consult with a trained and experienced practitioner, here in Canada it would be a TCM practitioner or ND, to get acupuncture and herbs to match your PCOS pattern and individual health condition.