September is PCOS awareness month. Because we do so much work with women and fertility, we see patients with PCOS almost daily in our clinic. These are some of our most rewarding cases, as we often meet these women after they have been trying unsuccessfully to conceive and without ever being told they had PCOS. We find a natural approach works wonders for many of these women.
What is PCOS?
Polycystic Ovarian Syndrome is one of the most common endocrine and reproductive disorders in the US. It is estimated that up to 12% of women have PCOS and yet 50% of patients do not know they have it. PCOS affects fertility because it can delay ovulation but it also can cause diabetes and cardiovascular disease, so early detection is crucial. PCOS is challenging to diagnose because it can present very differently among patients. Common symptoms may include weight gain, acne, hirsutism or excess hair growth on the face or lower belly and loss of scalp hair. Delayed ovulation occurs as a result of high testosterone due to multiple follicles or “cysts” in the ovaries which is what gives PCOS its name. Consequently, women may experience long cycles of 35-60 days or more between periods.
According to the Rotterdam Consensus, two of three criteria must be met to make a positive diagnosis of PCOS.
Presence of multiple small follicles seen with ultrasound.
Either clinical or biochemical signs of androgen excess.
Comprehensive testing for PCOS
Because PCOS elevates the risk of chronic disease, screening for PCOS is important beyond promoting timely ovulation and optimized fertility.
Besides an ultrasound of your ovaries, I would recommend having serum testosterone tested as well as AMH (anti-mullerian hormone) on any day of your cycle. On cycle day 3, test FSH (follicular stimulating hormone) and LH (luteinizing hormone) ratio; an elevated LH is seen in women with irregular cycles and points to PCOS.. Rule out insulin resistance with high homeostatic model assessment insulin resistance (HOMA-IR), which is a calculation involving the ratio of insulin to basal (fasting) glucose.
Treatment of PCOS
Most MD’s will put women on birth control to address irregular cycles. When experiencing fertility challenges, women with PCOS are commonly offered the drug Clomid (often without a trigger shot) to assist in inducing ovulation. The drug Metformin is offered to help with insulin resistance. These medications do come with side effects and do not always work. More importantly, they do not help address the underlying cause of the disease, nor do they diminish the associated health risks that come with PCOS . An effective natural approach to PCOS that addresses root causes would include a lower-carb, plant-based diet, regular exercise and acupuncture.
How does acupuncture help PCOS? Glad you asked;-)
May decrease hyperinsulinemia and increase insulin clearance- YES PLEASE.
May decrease testosterone-
May induce ovulation in PCOS.
Increase skeletal muscle glucose uptake- YAY.
Increase release of your feel-good chemical messengers; neuropeptides, serotonin, dopamine, endogenous opioids, and oxytocin.
Inhibit central sympathetic nerve activity
If you suspect that you have PCOS, ask your GYN or MD to do appropriate testing to rule it out. To read the latest on PCOS, check out FIona McCulloch’s brilliant book called 8 Steps to Reverse Your PCOS. Fiona breaks down the subtypes of PCOS and how to work with each one. Come in to Double Happiness Health for an evaluation, customized treatment plan and some wonderful acupuncture to help get you balanced and feeling great.
Acupuncture and exercise for PCOS
Acupuncture helps insulin sensitivity
Acupuncture treatment for insulin sensitivity of women with polycystic ovary syndrome and insulin resistance:
Acupuncture and women’s health: an overview of the role of acupuncture and its clinical management in women’s reproductive health