Polycystic Ovarian Syndrome (or Polycystic Ovary Syndrome, PCOS) is an endocrine disorder with increased androgen level (male hormones), insulin, or both. Polycystic, meaning “many cysts”, refers to partially formed, fluid-filled sacs on the ovaries which rarely grows or matures into fertile eggs. Sometimes the ovaries can become enlarged under ultrasound examination. This usually affects girls and women in of reproductive age.
The main symptoms in patients with PCOS typically appears during puberty, such as:
Irregular menstruation, which begins with lessened menstrual flow and gradually develops into amenorrhoea (or no menstruation).
No ovulation, due to increased androgen level and inadequate luteal function. It can develop into difficulty in conceiving and infertility.
Abnormal hair growth (body and facial hair growth), oily-skin and acne-prone.
Obesity, due to insulin resistance.
Other symptoms can be:
Hair loss (scalp)
PCOS can be hereditary, and higher risk for patients who are overweight. It is also a common cause of infertility in women. However, some women may present with polycystic ovaries but if it is not accompanied by the above typical symptoms then it is not diagnosed as PCOS.
Traditional Chinese Medicine (TCM) perspective on PCOS
PCOS belongs to the category of “Zheng Jia” 癥瘕 in Chinese Medicine, meaning abdominal mass. It is a difficult and complicated disease to treat. Chinese Medicine has a long history of treating gynaecological conditions such as “irregular menstruation” and “infertility”, both which are typical manifestations of PCOS. The root cause of PCOS in Chinese Medicine terminology is “kidney qi insufficiency” with "stagnation". This includes qi stagnation, blood stasis, phlegm and damp retention and damp-heat symptoms which are symptoms of zheng jia or mass.
Q. Why is the “kidney” important in reproductive health?
In TCM classical literature there are texts dedicated to explaining the importance of kidney qi and essence in assisting growth, development, puberty and reproduction.
“In a female, at the age of seven, the qi of the kidney abounds. The (first) teeth are substituted and the hair grows long. With two times seven¹, the heaven gui² arrives, the controlling vessel³ is passable and the great thoroughfare vessel⁴ abounds (with qi). The monthly affair⁵ moves down in due time and, hence, (a woman) may have children”.
The kidney is considered as the root of congenital foundation in Chinese Medicine medical theory. “The Kidney stores essence, the essence generates marrow, and the brain is the sea of marrow”. This “congenital kidney essence” is the nourishment and source for acquired constitution which maintains the basis of life. The kidney’s part in the development of the brain also includes the hypothalamic-pituitary-ovary relationship in regulating hormones for normal reproductive functions.
Body fluid metabolism is affected when there is kidney insufficiency as fluid can’t be drained normally in the lower part of the body. In the long term, stagnant fluid becomes phlegm retention, and as a result obesity and enlarged ovaries is apparent. In addition, Chinese Medicine believes that “the liver and kidney shares the same source⁶”. The liver stores blood and requires kidney essence to aid blood production and maintain the quality of blood. Therefore, these stagnations contribute to symptoms such as scanty menstrual flow, fluid-filled follicles, amenorrhoea and may have irritability, dizziness and dry mouth.
PCOS is a chronic condition and it can be stubborn to treat. Regular acupuncture treatment and herbal prescriptions are highly recommended and requires patients to fully cooperate with long-term treatment plans to regulate their ovulation and menstrual cycle.
Lifestyle Adjustments & TCM Health Advice
Maintaining a healthy and balanced diet with regular workout to reduce body weight is important in the long-term management of PCOS. It can also reduce the risk of other health complications such as high cholesterol, high blood sugar and diabetes. It is also ideal to keep track of your BBT (basal body temperature) on a chart to predict ovulation period.
Types of food to choose from:
Low-fat and low-sugar content
Less of rich sauces and spicy food
Aged oolong or black tea (as opposed to green tea) to help reduce cholesterol level
Types of food to avoid:
Chilled beverages and ice-cream
Foods that are cold in property (see picture below).
Q. Why should I avoid cold food and drinks?
Our core body temperature is between 36.5 to 37.5 and this is important for the body to carry out vital functions. From a Chinese Medicine perspective, this body temperature is maintained by the yang energy, and it is the driving force for all visceral and its functions.
Ｗhen there's warmth, qi and blood will flow uninterrupted (stagnation free).
Ice-cream and chilled drinks, for example, is considered cold and damp in property. Cold can further damage the yang energy in the body, with kidney yang in particular. Since PCOS is due to both kidney insufficiency and stagnation syndrome, cold food and drinks should be avoided whenever possible. Although each individual's tolerance to cold foods may vary and your health is not immediately affected, please be mindful of the possible long-term health impact. That goes to say "you are what you eat".
¹Two times seven = at 14 years of age.
²Heaven Gui or Tian Gui is the Chinese Medicine terminology for puberty.
³Controlling vessel: The Ren meridian, the sea of three foot yin meridians and it is important for governing qi and blood flowing through the reproductive organs.
⁴Great thoroughfare vessel: Also known as the Chong meridian, the sea of blood and it is important for normal menstrual flow and nourishment to the uterus and ovaries.
⁵Monthly affairs = menstruation.
⁶Also known as “Yi Gui Tong Yuan”: According to the ten heavenly stems and five elements, the “liver is Yi and Wood” and “kidney is Gui and Water”. In the five elements, water gives rise to wood, therefore kidney essence supports the liver and blood. In other words, the basic meaning of Yi Gui Tong Yuan is “the essence and blood shares the same source”. Both kidney essence and blood stored in the liver requires nutrients collected from food intake for production. Therefore, essence and blood thrive and decline mutually.