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For PCOS women, a holistic treatment plan involving acupuncture, herbal and dietary therapy, as well as exercise may be necessary to help regulate the menstrual cycle and optimize fertility (for full info see 'Treatment' section below).
Generally, one course of treatment is the administration of 12 acupuncture treatments within a 3 month time period.
Polycystic Ovary Syndrome (PCOS) is a condition that is very treatable through natural therapy such as diet, exercise, acupuncture, and Chinese herbal medicine. These treatments restore hormonal balance and ovulation while improving the environment for proper egg growth resulting in increased egg quality and likelihood of pregnancy and live birth. If you are considering getting pregnant or attempting In Vitro Fertilization (IVF) it is important to consider the value of regulating your reproductive system and whole-being before this occurs.
PCOS is an ovulatory disorder that tends to involve many aspects of the endocrine glands including the pancreas, ovaries, adrenals, thyroid, hypothalamus, and pituitary. These glands are responsible for optimal functioning and balance of a woman’s reproductive hormones.
This is why a holistic approach to overcoming PCOS is necessary. Strong commitment to lifestyle changes, regular exercise, recommended dietary guidelines and supplements, electro acupuncture, Chinese herbal medicine, avoiding toxins, administering self-treatment and cycle monitoring at home, removing obstacles in life that may sabotage success, and nourishing the spiritual side of life drastically increases a PCO woman’s chances of restoring health and balance to her reproductive system and overall well-being, which significantly increases the rates of regular ovulation, pregnancy, and live birth. 6-12 months of treatment is often required. Ideally after 3 normal cycles, hormones are balanced, ovarian environment is improved, and healthy eggs and pregnancy is much more likely.
Women with PCOS often present with vascular disorders, glucose intolerance, insulin resistance (when cells get resistant to insulin the pancreas reacts by making more, therefore more insulin is in the blood. More insulin in the blood causes the ovary to manufacture androgens. Follicles shrink due to lack of hormone balance and proper nourishment. The insulin resistance contributes to obesity and increases chances of developing diabetes), anovulation (no ovulation) resulting in erratic long or absent menstrual cycles with either heavy or light bleeding, excess androgens (male hormones), thick skin (esp behind the neck), increased hair growth (esp facial and below umbilicus), centralized obesity or increased fat stores around lower abdomen, loss of head hair, acne, have difficulty losing weight, and some women are actually very thin and lack secondary sex characteristics and live a very ‘type A’ lifestyle. The ovaries can display multiple small follicles which is where the syndrome’s name came from (these are actually cysts, not functioning follicles). These cysts never grow to regular size or produce mature eggs that will ovulate. This is caused by an excess production of androgens by the cysts and connective tissues on the ovary. These androgens (male hormones) enter the bloodstream and disturb normal reproductive hormone function. Estrogens also tend to increase out of proportion to other reproductive hormones. This causes an increase in Luteinizing hormone (why ovulation strips always test positive) and again compounds the production and excess of androgens such as DHEA and testosterone. These ovaries are often larger in physical size than usual and have a shiny white coating covering the surface. The quality of the egg, the follicular fluid (fluid that surrounds the egg), and the endometrium is also affected. The uterine lining will thicken in response to the high estrogen levels, becoming too thick and not being properly offset by adequate amounts of progesterone, which make conditions for implantation poor. This poor ovarian environment which produces poor quality eggs contributes to unhealthy pregnancies (i.e. gestational diabetes) and increased rates of miscarriage. When ovulation does occur, it is usually later in the menstrual cycle.
Western biomedicine will usually diagnose PCOS via ultrasound of the ovaries, measurement of waist to hip ratio when centralized obesity is observed, anovulation or long erratic cycles are reported, hair growth on the face and below umbilicus is present, and acne with oils skin is part of a woman’s medical history. Lab tests may include; prolactin, androgens, insulin, and estrogen. Treatment is comprised of clomid with or without metformin, hcg, and IUI. Progesterone may be given periodically to induce bleeding. Drugs like spirolactone is sometime administered for unwanted hair growth. More aggressive treatments include stimulation with gonadotropic medications and In Vitro Fertilization (IVF). Women with PCOS often react well to the gonadotropic injection therapy but pregnancies and term birth rates are not as high.
For those that desire evidence based medicine, clinical trials in Europe and Australia have shown that acupuncture can lower elevated levels of testosterone and luteinizing hormone which inhibit ripening of eggs and ovulation in PCOS patients. Acupuncture also decreases insulin resistance and reduces sympathetic nervous system activity both of which are often abnormally high in PCOS. Working at all these levels, acupuncture can improve ovary function and increase ovulation frequency restoring more regular menstrual cycles. Furthermore, better quality eggs are produced because the damaging effects of high testosterone and LH are ameliorated. One of the problems for PCOS patients doing IVF is poor egg quality. From this point of view creating a better ovarian and follicular environment (ie one lower in testosterone and LH) for the eggs in the few months before an IVF cycle will allow for the possibility of recruitment of better quality eggs when the stimulating drugs are used. Another problem that PCOS patients face when doing IVF is a higher than normal risk of hyperstimulation. Some researchers in China have found that acupuncture during the IVF stimulation reduced this risk.
Set out specific 1. goals, so we can monitor progress. These would always relate to the Chief Complaint and the top 3-5 changes in lifestyle or key signs and symptoms that when balanced/augmented will facilitate the manifestation of regulated cycles, reduced associated symptoms, or pregnancy and family. Ideally, our main goal is to see three healthy regular menstrual cycles before trying to conceive. When the recommended plan and lifestyle changes are deeply committed to, three healthy regular menstrual cycles and pregnancy are often achieved within a 6-12 month treatment period. Additional & more specific treatment goals are most often to get more quality sleep, reduce stress, lose weight, regulate blood sugar/insulin levels, reduce levels of circulating androgens, estrogens, & luteinizing hormone, manage acne, eliminate excess hair growth, promote regular ovulation & cycles, optimize overall reproductive health, reduce chances of miscarriage and aid in carrying pregnancy to term. Continued evaluation of treatment efficacy is achieved via observation and improvement of these goals and specific signs & symptoms associated to each individual case.
The remaining 9 steps (the 'how');
2. Electro-Acupuncture is administered once per week until the 12th week of pregnancy. According to current research on PCOS, electro-acupuncture helps induce regular ovulation in more than one third of women with PCOS. The patient population within this demographic which acupuncture has the greatest effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance. For these women, electro-acupuncture offers an alternative to pharmacological ovulation induction. Because chances of miscarriage are higher in women with PCOS, it is also recommended that your husband receive acupuncture and/or herbal treatment to help optimize his sperm and reduce its role in the possibility of pregnancy loss.
3. Chinese herbal medicine will commence immediately and continue in conjunction with acupuncture until the 12th week of pregnancy, or, begin post mediclear dietary cleanse and continue in conjunction with acupuncture until the 12th week of pregnancy.
4. Supplements recommended are various combinations of the following;