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Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility in women. This hormonal disorder affects about 6 percent of pre-menopausal women. It, also, affects 90% of all women with irregular menstrual cycles. This condition is also known as Stein Leventhal syndrome.
What is Polycystic Ovarian Syndrome?
Polycystic ovarian syndrome (PCOS) is a disorder of the endocrine system. It affects the hormones, the ovaries, and the eggs which are developing within the follicle.
What are the possible causes of Polycystic Ovarian Syndrome?
- A genetic component may be involved.
- Excess levels of the luteinizing hormone (LH) interferes with normal ovarian function. High levels of both LH and insulin stimulate the ovary to produce excessive androgens.
- Insulin issues
- Abnormalities in the ovaries and adrenal glands
- Abnormalities in the central nervous system. Cases of both hypothalamic and pituitary gland dysfunction have been reported.
What are risk factors for Polycystic Ovarian Syndrome?
Risk factors are excess adrenal hormone disorders like:
- Cushing syndrome
- Androgen-secreting tumors in the ovaries
- Thyroid problems
If left untreated, PCOS can put women at risk for:
- Heart disease
- Diabetes
- High blood pressure
- High cholesterol
- Infertility
- Obesity
- Increased risk of miscarriage
- Type 2 diabetes and gestational diabetes
- Endometrial or uterine cancer
- Sleep apnea
What are the symptoms of Polycystic Ovarian Syndrome?
Symptoms may first appear around the time of puberty. But for most women, signs do not become noticeable until their early teens.
Symptoms:
- Hirsutism, which a growth of excessive body hair, appears on the chin, upper lip, neck, sideburn area, chest, nipple area and the lower abdomen along the midline.
- Irregular or infrequent periods.
- Abnormal levels of insulin as well as insulin resistance
- Late or absent ovulation
- High prolactin hormone levels (hyperprolactinemia)
- Prolonged premenstrual syndrome (PMS) symptoms, such as bloating, pelvic pain, headaches, mood swings and/or depression.
- Excessive weight gain.
- Acne and/or oily skin.
- Polycystic ovaries or enlarged ovaries containing more than 12 follicular cysts.
- Darkening of the skin around the areas of the neck, arms, breasts, or thighs and is usually indicative of insulin resistance.
- Skin tags which are small pieces of excess skin around the armpit or neck area.
How does Chinese Medicine treat PCOS?
Research shown on women with anovulatory PCOS showed restoration of ovulation in one-third of the test subjects using electro-acupuncture. Endocrine indicators of PCOS were also affected including mean testosterone concentrations, beta-endorphin concentrations, and LH to FSH ratios. Hence, acupuncture works to restore optimal function of the hormonal and sympathetic systems, and helps to rebalance the nerve and blood supply in ovaries. Combining acupuncture, herbs, diet, and Reproductive Organ Massage has lead to many women experiencing less symptoms and pregnancy.
Western Treatment and prevention of PCOS
- Weight management to address obesity or unwanted weight gain. According to the American Society for Reproductive Medicine, losing as little as 5 to 10 percent of total body weight may help women resume normal ovulation. In addition, a healthy diet and regular exercise are the best ways to prevent long-term consequences of PCOS such as cardiovascular disease and diabetes.
- Quit smoking because it increases the risk of complications associated with PCOS like heart disease.
- Get regular gynecological examinations to detect early signs of either ovarian or uterine cancer.
For women with PCOS who are trying to conceive, treatment varies and may include:
- Ovulation drugs are used as the first line of treatment for women with PCOS. The most common drug is Clomiphene Citrate (Clomid). A second, more aggressive therapy which may be used, involves injectable drugs called gonadotropins.
- Antidiabetic agents are medications that increase the body’s sensitivity to insulin. Normally prescribed by your physican is metformin (glucophage).
- Laparoscopic ovarian drilling is a surgery that stimulates ovulation, regulates the menstrual cycle and increases a patient’s chances of becoming pregnant.
- In Vitro Fertilization (IVF) is another option for women with PCOS.
For women not trying to conceive, treatment usually involves restoring a normal menstrual cycle and may include:
- Birth control pills are used to regulate the menstrual cycle and to reduce the risk of endometrial and uterine cancer.
- Corticosteroids are used to suppress androgen production by the adrenals.
- Anti-androgens like spironolactone and flutamide block the effect of androgens and can prevent unwanted hair growth and acne.
- Gonadotrophin-releasing hormone (GnRH) agonists (luprolide) suppress production of sex hormones and induce a temporary menopause in pre-menopausal women. These types of medications also reduce skin problems such as acne, and may cut down on hirsutism for as long as they are taken.
Western Drug Therapy:
- Metformin (Glucophage) improves both glucose tolerance and insulin sensitivity.
- Pioglitazone (Actos) works primarily by improving insulin sensitivity and glucose tolerance.. Periodic liver function tests are recommended for the first year of therapy.
- Rosiglitazone (Avandia) works by improving insulin sensitivity.
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