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Acupuncture and Polycystic Ovarian Syndrome (PCOS)

Updated: Dec 2, 2023

What is polycystic ovarian syndrome (PCOS)?

1 in 10 people are affected by Polycystic ovarian syndrome (PCOS), and yet despite this staggering number it is still not fully understood what causes it and there is no cure.


But that doesn't mean that acupuncture cannot help manage those signs and symptoms.


In PCOS it is the communication between the hypothalamus, pituitary gland and the ovaries

In PCOS the hypothalamus and GnRH preferentially promote luteinising hormone (LH) over follicle-stimulating hormone (FSH).


This causes the anterior pituitary gland to increase the LH/FSH ratio and in turn, the ovaries create hypersecretion of androgen (an example of which is testosterone).


With this increase in androgen, there is an increase in insulin resistance.


The result is high androgen, high insulin and low FSH = follicles continue growing but not maturing and no ovulation.


= PCOS


If like me, you would like more information on the hormones involved in the menstrual cycle, you can find more in my recent blog here.


Signs and symptoms of PCOS

The signs and symptoms of PCOS can include no or irregular periods, acne, hirsutism, increase in weight, greater propensity to insulin resistance and high blood pressure

With these hormonal changes we will expect to see:

  • no or irregular periods/infertility

  • acne

  • increase in bodily hair

  • the polycystic appearance of ovaries on an ultrasound

  • increase in weight

  • risk of developing non-insulin-dependent diabetes

  • high blood pressure

  • cardiovascular disease

The exact cause of PCOS is not well understood but could be an interaction between genetics and environmental factors.

 

How does acupuncture look at PCOS?

In acupuncture, we treat the individual symptom and whilst a diagnosis of PCOS is helpful we will take the whole picture and treat it accordingly.


If we look at the individual signs and symptoms e.g. no or irregular periods there are a number of TCM patterns we can explore including:

  • Qi & Blood deficiency

  • Yin deficiency

  • Qi stagnation or Blood stasis

  • Liver Fire

However, there are four acupuncture 'patterns' that we might look for. These would be:


PCOS and Spleen Yang Deficiency

Spleen & Kidney Yang Deficiency

  • delayed / irregular periods

  • scanty light coloured period blood

  • infertility

  • dizziness & tinnitus

  • aching or weak lower back and knees

  • cold sensation in body and limbs

  • clear and profuse urine

  • loose stools

  • loss of libido

  • obesity


 

PCOS and phlegm dampness in Chinese medicine

Phlegm Dampness

  • scanty, delayed, or no periods

  • infertility

  • vaginal discharge

  • dizziness or muzziness

  • nausea

  • profuse sputum in throat

  • loose stool

  • obesity




 

Acupuncture and PCOS and the Liver Fire diagnosis

Liver Fire

  • no periods or scanty periods

  • irregular periods

  • infertility

  • thick hair

  • acne

  • distending pain in the chest or breasts

  • dry mouth with thirst

  • constipation




 

Qi stagnation, blood stasis and PCOS in acupuncture

Qi Stagnation & Blood Stasis

  • delayed menstruation

  • scanty period with clots

  • abdominal pain during menstruation

  • no periods

  • infertility

  • mental depression

  • fullness in the chest










 

So, what can acupuncture do for PCOS?

In this podcast published in January 2022, Sandro Graca talks about acupuncture for PCOS. The episode is about 1 hour long, however, the show notes themselves are fascinating with lots of excellent guidance.


I have summarised the evidence he talks about below


​Date

Title

Author

Results

​2013

​Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Johansson

repeated acupuncture treatments with manual and electrical stimulation in lean/overweight women with PCOS results in a higher ovulation frequency during the treatment period than in the control group

2000

​Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome

Stener-Victorin

Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS

2013

​Polycystic ovary syndrome: effect and mechanisms of acupuncture for ovulation induction

Johansson

Several clinical and animal experimental studies indicate that acupuncture is beneficial for ovulatory dysfunction in PCOS. This is also related to decreased levels of sex steroids and possibly inhibin B

2007

Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence

Stener-Victorin

Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.

2020

Electroacupuncture Mimics Exercise-Induced Changes in Skeletal Muscle Gene Expression in Women With Polycystic Ovary Syndrome

Benrick

electroacupuncture normalizes gene expression in skeletal muscle in a manner similar to acute exercise. Electroacupuncture might therefore be a useful way of assisting those who have difficulties performing exercise.

2013

Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial

Stener-Victorin

There was a modest improvement in depression and anxiety scores in women treated with acupuncture, and improved HRQoL scores were noted in both intervention groups. While not a primary focus of the trial, these data suggest continued investigation of mental health outcomes in women treated for PCOS.



The British Acupuncture Council website and the research that they have on PCOS say that acupuncture treatment may specifically help with symptoms by:

  • impacting on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion (Lim 2010; Stener-Victorin 2009; Feng 2009; Manneras 2009);

  • a regulatory effect on follicle stimulation hormone (FSH), luteinising hormone ( LH) and androgens (Lim 2010; Feng 2009);

  • modulating the activity of the sympathetic nervous system and improving blood flow to the ovaries (Stener-Victorin 2006, 2009);

  • regulating steroid hormone/peptide receptors (Feng 2012);

  • downregulating the expressions of serum levels of testosterone and oestradiol (Zang 2009);

  • controlling hyperglycaemia by increasing insulin sensitivity and decreasing blood glucose and insulin levels (Lim 2010);

  • acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);

  • increasing the release of adenosine, which has antinociceptive properties (Goldman 2010), and;

  • reducing inflammation, by promoting the release of vascular and immunomodulatory factors (Kavoussi 2007).

The Stener-Victorin protocol can also be used for people who suffer from PCOS but who have a low BMI (see picture below). Their study found that electro-acupuncture may be beneficial for people with PCOS.


Chinese Medicine nutritional advice would also advise you, depending on your pattern, on lifestyle changes you could incorporate between treatments.

 

Other things to consider and by the wonder that is Dr Anita Mitra (@gynaegeek on IG) the following will also be helpful in managing the signs and symptoms of your PCOS.


Foods to eat

  • Fruits and vegetables for more fibre

  • Protein is essential for hormone production and helps with blood sugar regulation. eg. fish, chicken, tofu, soybeans, lentils

  • Low GI carbohydrates maintain blood sugar control – eg. porridge oat, wholegrain bread or pasta, brown rice.

  • Good quality fats are a building block for hormone production eg. nuts, avocado, salmon

Foods/drinks to avoid

  • High glycemic index foods e.g. fruit juice, cakes, white bread, pasta, starchy vegetables

  • Excess caffeine

  • Excess alcohol

  • Prolonged periods of starvation

Other things to consider


1. Exercise

Build and maintain lean muscle, which helps to reduce insulin resistance. Exercise can also increase sex-hormone binding globulin (SHBG) levels, a hormone that can bind testosterone, making it less potent. Yoga can also combine exercise and mindfulness.


2. Stress

This can drive the adrenal glands to make more testosterone


3. Sleep

Ensure adequate sleep quantity and quality, the lack of which can further disrupt hormone function.


4. Smoking

Given the increased risk of heart disease with PCOS then quitting smoking would be recommended.


In Doctor Anita Mitra's words


"It’s important to point out that even with the best intentions, some people will not be able to manage their symptoms entirely in this way, and if that’s you, it’s not your fault. There are lots of medical treatments that we can also offer to manage symptoms, and it’s also helpful to ensure that you see a doctor discuss these, and also to ensure that PCOS is in fact the correct diagnosis in your case"

If you have any questions at all, about how acupuncture might help with PCOS, please get in touch. I would love to chat with you.


Love your fave acupuncturist


Andrea


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