Fertility

How to Treat Polycystic Ovarian Syndrome (PCOS) With Acupuncture and TCM

By Xiaomei Cai, L.Ac., Ph.D.

abdominal pain PCOS
PCOS causes irregular and painful periods.

Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects 10-20% of women during their reproductive years. PCOS is also one of the most prevalent causes of infertility among women. The primary problems of PCOS are hormonal imbalances and dysfunction of the ovaries. Women with PCOS have irregular or missing periods, anovulatory menstrual cycles, and elevated androgen and/or testosterone levels. 

Medical interventions for PCOS often involve using birth control pills to stimulate regular menses, but this treatment does not address the issue at its source. Additionally, many women struggling with PCOS are actively trying to get pregnant, so contraceptive medications are not useful in these cases. TCM and acupuncture are able to help resolve many women’s health problems, including PCOS and the resulting infertility, restoring normal function to the female reproductive system without the side effects that medications can cause.

What Is PCOS?

PCOS is a syndrome, which means it is a collection of symptoms that occur together and help to define a disease even though its medical causes are not completely understood yet.

Most women with PCOS ovulate infrequently or not at all. Women with PCOS also might experience:

  • Irregular Periods
  • Heavy and/or painful periods
  • Insulin resistance
  • Obesity
  • Excess hair on body and face (hirsutism)
  • Thinning hair on head
  • Acne, oily skin

PCOS is considered a disorder of both the reproductive and endocrine systems. The majority of women with PCOS also exhibit hyperandrogenemia – an excess amount of androgen hormones. In many cases, this condition starts early, when a girl is going through puberty. The problems begin to manifest shortly after a girl gets her first period (menarche).

Androgens are commonly referred to as the “male” sex hormones, although they naturally occur in both men and women, just in differing amounts. The primary androgens are testosterone and androstenedione. In women, androgens are produced by the ovaries and adrenal glands, whereas in men they are produced in the testes, usually in larger quantities. Hyperandrogenemia can be helped by weight loss, because adipose tissue (fat) itself is hormonally active, meaning the fat cells themselves also produce excess androgens.

Insulin resistance is also widespread among women with PCOS; about 85% of women with PCOS are insulin resistant, causing them to be at risk for Type 2 Diabetes. Sometimes women are prescribed Metformin to lower insulin and blood sugar levels.

PCOS Diagnosis

polycystic ovaries
polycystic ovaries

PCOS often goes undiagnosed for years. In many cases, women do not find out they have it until they are trying to get pregnant and then seek help for infertility. For most women, PCOS causes irregular periods. In these cases, women may go months without having a period, and then have a very heavy, painful period. Often, PCOS begins when girls are teens, and this condition causes them to struggle with being overweight, prone to getting pimples, and having extreme period pain (dysmenorrhea) and heavy periods that can cause embarrassing accidents. Girls may not realize that their experience is not normal, and may not talk to anyone about it. When they do seek help, they are usually prescribed birth control pills. 

Birth control pills “regulate” the menstrual hormone cycle, causing a period to predictably start every 28 days. This use of contraceptives to “correct” menstrual problems and help clear acne during the teenage years leads to the masking of PCOS for many years–often until a woman is well into adulthood and ready to conceive. Then, when the birth control is stopped, the PCOS symptoms appear, which generally means that regular periods stop.

At this point, a firm diagnosis of PCOS is often reached after an internal ultrasound reveals the phenomenon which gives the syndrome its name: multiple small cysts forming around the edges of the ovaries. These fluid-filled bubbles, only a few millimeters in diameter, are partially formed eggs that have not been released. These cysts do not in and of themselves cause problems. Blood tests are done to find the high levels of androgens (testosterone) and also to measure the hormones involved in egg production and release. Women with PCOS often have higher levels of luteinizing hormone (LH), which triggers ovulation. The ratio of LH to FSH (follicle stimulation hormone) is higher in women with PCOS.

Conventional medicine provides the means to pinpoint the manifestations of PCOS in the body, hormonally and physically, but it does not offer much in the way of causal understanding or effective treatment. 

TCM Perspective of PCOS

5 elements of TCM
5 Elements in TCM

Traditional Chinese Medicine is based on the concepts of Qi, life force energy that travels through the body along meridians, and the balanced energies of Yin and Yang. Elemental pathogenic factors such as Wind/Cold, Dampness, Fire/Heat and Dryness come into play.  Disease is created by either external or internal factors and can be discovered through diagnostic techniques of observation, inquiry, and palpation. 

In a sense, TCM looks at all diseases as “syndromes.” In TCM, we do not look for one single cause of the symptom for which the patient is seeking relief. We look for other signs and symptoms that the patient may not have realized were related. We study the whole collection of indications and look for a pattern. An illness can be the result of any one of several different patterns.

When working with a patient who is experiencing reproductive and hormonal problems, a TCM provider will take into consideration the lab results of blood tests showing hormone levels, but will also be looking for clues as to what is happening throughout the organ systems of the body. In TCM,  PCOS is categorized as a “Zheng Jia” diagnosis. Zheng Jia means “masses” (tumors), and includes uterine fibroids, endometriosis, ovarian cysts, and even reproductive cancers.

Internal factors are at the root of PCOS and other Zheng Jia disorders. Most clinical manifestations of PCOS arise from patterns of too much Dampness and Phlegm in the reproductive organs, which is what causes the fluid-filled cysts to form. This excess dampness is also what causes weight gain. Kidney deficiency contributes to the imbalances in hormone production. Blood deficiency causes absent or scanty periods, while blood stasis leads to painful periods.

Acupuncture and TCM for PCOS and Hormonal Imbalance in Women

Standard medical treatment for PCOS and infertility in women involves using medications to alter hormone levels: either OCP to regulate periods, Metformin to lower insulin, or Clomid or Letrozole to stimulate ovulation.

Acupuncture and TCM treatment for PCOS focuses on clearing excess dampness and phlegm from the uterus and other female reproductive organs, tonifying and nourishing the kidneys, invigorating the blood and clearing blood stasis. Electro-acupuncture has been shown to help facilitate natural ovulation.

A TCM provider will also focus on lifestyle and nutrition changes that will help alter the internal factors involved. Tracking basal body temperature can help both doctor and patient understand what is going on during the follicular and luteal phases of the menstrual cycle in each individual. Specially chosen combinations of herbs can be very helpful for making the subtle adjustments needed to normalize the hormones, increasing blood flow, and even balancing the emotions. 

PCOS and Endometriosis

Endometriosis is another common women’s health problem in which uterine lining tissue begins growing outside of the uterus. It is estimated that about 10% of reproductive-age women have endometriosis, although we cannot be sure because, like PCOS, endometriosis is also often undiagnosed. It is not uncommon for women to have both conditions. When women with endometriosis have a menstrual period, there can also be bleeding in other parts of the abdomen. This can cause severe pain and create a lot of scar tissue in the pelvic region. Sometimes surgery is recommended to remove this scar tissue. This can help alleviate pain and increase the chances of conception, but it does not address the root problem, so the bleeding often recurs. Like PCOS, endometriosis can be a cause of infertility, making the use of birth control pills to control the hormones far from ideal. 

According to TCM, endometriosis and PCOS are both Zheng Jia disorders; they are part and parcel of the same root problem. An acupuncturist can help correct both of these disorders, and the related infertility, all at the same time.

Integrative Medicine for PCOS and Infertility in Women

TCM has been using acupuncture and herbs to help women’s reproductive disorders and increase fertility for many centuries. In the past few decades, it has become increasingly common for patients to seek out acupuncture to help address infertility due to PCOS, both on its own and as an adjunct to Assisted Reproductive Technologies (ART). Studies have shown that acupuncture and herbal supplementation used in concert with infertility procedures such as Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) improve outcomes. Acupuncture treatment also helps to reduce the pain and anxiety many women experience while undergoing ART procedures.

Top 5 Self-Care Tips for PCOS

icy drink and cold foods
icy cold drinks and foods are not beneficial

One of the main internal factors causing the excess dampness and stasis of PCOS is too much cold in the body. Maintaining your warm energy is key. Habits like drinking ice cold beverages and eating ice cream, especially around the menstrual period, can really have a negative impact. It may seem old-fashioned, but a lot of the advice we associate with our grandmothers’ time still applies today. 

  1. Dress appropriately for potentially chilly weather. Always bring your jacket with you.
  2. Avoid exercising to the point of sweating and then allowing yourself to get chilled. Change into dry clothes right after your workout.
  3. Keep the abdomen covered and warm. 
  4. Don’t wear sandals or go barefoot when it is cold outside.
  5. Don’t go to bed with wet hair. 

Acupuncture Near Me for PCOS

At Art of Wellness, our doctors have over 30 years of experience in the successful management of women’s health issues, including PCOS and infertility. In China, Dr. Cai practiced and taught at Chengdu University’s TCM Hospital as a gynecologist. During a two-year period of specialty training, she had the opportunity to study and work with some of China’s foremost experts, pioneers in integrative medicine for reproductive health.

Since 1997, Drs. Cai and Tan have brought their unique experience to Santa Monica and Los Angeles. Their knowledge of both Western medicine and Traditional Chinese Medicine allows them to recommend, when necessary, a mixture of medical modalities and to advise whatever course of treatment is most beneficial for each patient.

 

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.

How to Treat Infertility in Women with Acupuncture and TCM

by Xiaomei Cai, L.Ac., Ph.D.

Heart Hands on Belly
TCM for Infertility

About one in ten women who are ready to conceive find that they have trouble doing so naturally. Infertility in women is thus a very common condition, one that has a profound impact on women and their partners. Acupuncture and TCM is proven to be extremely beneficial to women who are trying to get pregnant, both as primary and complementary care. 

Dr. Cai at Art of Wellness has thirty years of experience, both in China and in the U.S., as a specialist in women’s healthcare and infertility in women. She has studied and worked with some of the most influential doctors in the field in both countries, and has helped hundreds of women achieve healthy pregnancies.

Traditional Chinese Medicine (TCM)  is a system of health care that goes back thousands of years. Women’s health care has been a key part of this system all of that time. Conditions such as irregular or painful menstrual periods, ovarian cysts, endometriosis, and infertility have all been recognized, studied and effectively addressed by TCM for many centuries. Women who are having difficulty solving these problems with their medical doctor may find not only relief from pain, but a true solution that addresses their whole being–body, mind, and spirit.

Diagnosis of Infertility in Women in 8 Exact Steps

Any time a woman of childbearing age has a partner with healthy sperm, and they’ve been trying for two years without conceiving, we define this as infertility. But age makes a difference. If the woman is over 35, and it has been one year, we will diagnose infertility.

There can be many factors or causes involved in the infertility diagnosis, some chemical, some mechanical: 

Fertilization
Fertilization
  1. Hormonal imbalances can cause irregular cycles, which means shorter or longer than the usual number of days (28-30), sometimes with no sign of ovulation, sometimes with high FSH (follicle stimulating hormone). 
  2. Fallopian tubes may not be open due to scarring or previous PID (pelvic inflammatory disease). 
  3. Endometriosis or an STD (sexually transmitted disease) can also cause blockage. 
  4. Sometimes the uterus can be congenitally misshapen, or inside there may be fibroids, polyps, lining issues, twisting, chronic inflammation, etc. 
  5. Occasionally, antibodies can get into the cervix and block the sperm.
  6. In rare cases, the uterus may be tilted to the front or back, positioning the cervix so that it is either very high or very low or over to the side, making it difficult to receive sperm. These patients must rely on IUI (intrauterine insemination) to get the sperm where they need to go.
  7. Autoimmune issues can cause a woman’s immune system to produce antibodies that reject the sperm. 
  8. Blood incompatibility between the parents–for example, if the woman is RH (Rhesus factor) negative with a RH positive man–can happen sometimes after a first pregnancy or miscarriage. This is more common in older women.

Top 5 Different Causes of Infertility in Women

Infertility can feel isolating
Infertility can feel isolating

According to TCM, there are several differentiations of an infertility diagnosis. TCM practitioners differentiate between various causes and treatment plans for dysmenorrhea based on when the pain occurs (before the onset/during the period), the quality and location of the pain, associated symptoms like bloating, the appearance and volume of flow and accompanying emotions and sensations such as dizziness or fatigue. Some types are due to an excess, either of cold, or of stagnation of qi or blood. Others are due to a deficiency of qi or blood.  

  1. Kidney Deficiency – If a woman’s menarche occurred later than usual (typical is age 12-14), that might indicate some weakness of the reproductive system. To perform its normal functions, the uterus needs a rich and plentiful blood supply. Constriction of the capillaries that supply blood to the uterus occurs when there is too much cold in this area. Certain lifestyle behaviors can cause diminishment of ovarian health, sometimes leading to premature ovarian failure. Naturally over the age of 35, many women can begin to show signs of kidney deficiency.
  2. Blood deficiency – Poor digestion or a diet with insufficient nutrition can create a situation in which blood is not providing enough nourishment to support the ovaries and uterus.
  3. Liver qi stagnationLong periods of emotional stress and irritability can cause qi/blood flow to become stagnated, interrupting the flow of energy through the system.This can cause irregular periods or a lack of ovulation. Blockage in the flow of qi restricts the supply of necessary energy to developing eggs, fertilized egg or embryo.
  4. Dampness – Insufficient nutrition from diet, poor digestion, and/or being overweight can cause dampness and water retention to accumulate in the reproductive system. This condition can lead to pelvic inflammation, PCOS (polycystic ovarian syndrome), painful periods and blockage of qi.
  5. Blood stasis – Can be caused by physical trauma to the uterus due to surgery or injury. It can also stem from a Cold uterus condition (too much cold exposure or icy-cold drinks/raw food during periods). Lack of proper blood circulation relates to painful conditions such as the formation of clots, ovarian cysts, tumors or fibroids that create a physical blockage. Blood stasis can also lead to thin lining or even absence of periods.

Both kidney and blood deficiency can cause irregular periods, anovulation, short cycles, light flow, poor uterine lining, and the type of pain during periods that is helped by massage or heat.

Blood stasis and dampness can cause endometriosis, severe menstrual pain (not helped by heat or massage), ovarian cysts, strong hormone suppression, and lack of ovulation.

Top 5 Infertility Treatments with TCM

moxibustion
moxibustion

TCM treatments for the different kinds of infertility in women include: 

  1. Acupuncture: In TCM, the objective is always to use the stimulation of specific points to clear blockages in the systems in order to keep qi and blood moving fluidly, clearing the way for harmonious cooperation between the organs involved in the system. Weak areas are tonified, or strengthened, while areas bloated with excess are relieved of pressure. 
  2. Cupping: This is a method of acupressure that uses glass cups to create a vacuum effect in specific points. It is used to dispel stagnation and excess heat and stimulate circulation of blood and qi.
  3. Moxibustion: burning a stick made of mugwort near a specific acupuncture point is something patients can do at home to help a cold uterus condition.
  4. Herbal supplements: Herbs can really help to support the woman’s cycle and even re-activate ovaries until average menopause at age 45-55.
  5. Nutrition and Lifestyle Guidance: An acupuncturist will recommend an appropriate diet for nourishing the whole body as well as correcting any Yin/Yang imbalances. In addition, certain behaviors related to bathing, exercise and even clothing choices may be affecting a cold uterus condition and need attention and adjustment.

TCM Doctors Offer Solutions for Infertility in Women

Welcoming a new baby
Helping women have healthy babies

Advances in technology in recent years have been a boon to couples who are struggling, especially for women who have physical barriers to achieving conception and carrying a pregnancy, such as blocked tubes. IVF (in vitro fertilization) allows us to move past these roadblocks with surgery.

However, a woman still needs good hormone levels for better outcomes for conception, pregnancy and birth. For those with elevated FSH or low AMH (anti-müllerian hormone) who require IVF, adjunctive acupuncture and TCM will help to address these problems and increase the chances of success. One German study showed that success with IVF cycle was 15% higher than without acupuncture.

Each woman’s situation is unique and personal to her. Scientific study and medical research are only in recent decades beginning to acknowledge the connections between a person’s thoughts and emotions and her physical well-being, but women intuitively know that their less visible, harder-to-describe feelings are inextricably linked to their reproductive processes. Finding an acupuncturist who really listens and understands this might be the key to reaching a new level of quality of life, as well as realizing a dream of having a child.

For additional resources, visit our Fertility FAQs page. For more examples, visit our success stories of women who found solutions from Dr. Cai’s treatment. 

If your family suffers from infertility and  you are looking for infertility clinics, visit Art of Wellness at Santa Monica, Los Angeles, one of top 19 picks among 825 clinics in the great LA area.

Acupuncture and Cervical Health

Women’s health is a big part of the healthcare industry. And acupuncture can be very beneficial in caring for the overall health of women. Acupuncture has been especially effective in helping with things like infertility, turning breech babies, inducing labor and clearing up infections. The cervix is just one small part of the uterus. Specifically it is the lower part of the uterus that opens to allow passage between the uterus and the vagina. The cervix widens during childbirth to allow the baby to pass, it also allows the passage of menstrual fluids from the uterus out of the body and it is vital for sperm to pass through the cervix to reach the uterus when trying to procreate.

The cervix is very vulnerable to several health conditions, such as chronic inflammation, polyps, dysplasia and even cancer. Cervical conditions rarely present symptoms in the early stages, which makes it extremely important for women to get regular pap smears. If an abnormality is detected, there are several ways to address it, depending on the severity. In the early stages of any of the aforementioned conditions, acupuncture can be a positive addition to Western medical treatments. Acupuncture is very good at decreasing inflammation and helping to dissolve polyps and tumors. Acupuncture can also balance hormones, which allows the body to correct any imbalances.

One of the most studied areas of acupuncture is in treating fertility issues. When invitro fertilization by itself does not get the job done, adding acupuncture may be the last piece of the puzzle. Acupuncture does much more than just balance the hormones. When a woman is trying to get pregnant and struggling with it due to fertility issues, the stress levels are extremely high. And high stress levels have been proven to disrupt the body’s ability to conceive. One of the things that acupuncture is really successful at is decreasing stress levels. This can make it easier for the fertility treatments to work. Acupuncture has also been shown to increase blood flow to areas of the body, including the uterus. This can help to make a very hospitable place for a baby to grow.

Acupuncture and traditional Chinese medicine are also widely used for treating infections and sexually transmitted diseases. In traditional Chinese medicine, most infections have some sort of heat or discharge associated with them. This medicine uses principles, herbs and acupressure points that have specific properties that can drain heat and expel toxins from the body. This can lead to an overall improvement in both uterine and cervical health.

Another area where acupuncture can help with cervical health is at the time of birth. About four percent of babies are presented in the breech position prior to birth. An accessory modality known as moxibustion, has proven time and time again, that it can actually turn the baby to the proper birthing position. Moxibustion involves the burning of an herb, dried mugwort, very near the skin on a specific acupressure point that is located on the outer edge of the pinky toe. By performing moxibustion several times a day, the baby and the body somehow know that there needs to be a repositioning and the baby tends to turn during the night.

When it comes to women’s health, acupuncture is an amazing resource. Contact us to schedule your appointment today.