By Dr. Angela Warburton TCM
Polycystic ovary syndrome (PCOS), affects 5-10% of women in North America and is the leading cause of ovulatory based infertility.
Women with PCOS are known to have high levels of male hormones (androgens), which interfere with the normal production of female hormones like estrogen and progesterone.
Many women with pcos will experience some or all of the following symptoms: irregular periods or no menstruation (amenorrhea), weight gain or obesity, excessive hair growth (hirsutism) and/or abnormal hair growth, enlarged ovaries covered with cysts, acne, glucose intolerance, or impaired glucose metabolism, insulin resistance, mood swings and irritability. But you do not have to experience these symptoms to have pcos, as some women have no symptoms at all.
How does this affect your fertility?
Insulin is a hormone that regulates the transformation of sugars and starches into energy for the body or into storage for future use. If there is too much insulin in the blood, a rise in male hormones can occur. Excessive insulin also blocks the liver from regulating these male hormone levels. As a result of these excessive androgens (male hormones), follicles develop too quickly and then shut down prematurely before they are able to produce an egg. As a result, the ovaries fill with cysts or create immature follicles that are unable to produce eggs.
TCM (Traditional Chinese Medicine) and PCOS
In Chinese Medicine this condition can have a number of linked patterns of deficiency and excess that have an impact on the way the body ovulates. TCM always looks to the individual and seeks to find the underlying pattern and bring the body back to balance from there. Women may fall into one of the following patterns or exhibit symptoms from a combination of them. Working with a qualified TCM Doctor is the ideal way to diagnosis but the following will give you and idea of where you might fit.
The first patterns result from a deficiency in the body and an imbalance in the kidney system (think of the kidneys as your bank of energy or your reserved energy/adrenal glands). Imbalance can show up in either yin (female energy) or qi/yang kidney energy (male energy). When the yang is off balance you will have signs like: lethargy, cold limbs, frequent urination, heavy sensation in the abdomen, excessive vaginal discharge, a pale, swollen tongue with a sticky white coating, low sex drive. When the yin is off balance you will have symptoms such as: night sweats, flushes of heat, a short follicular phase, dizziness, low backache, constipation, slight anxiety, scanty and dark urine.
The other patterns are more excess patterns and present as damp-phlegm accumulation (think of how phlegm accumulates when you have a cold – a similar pattern can exist internally leading to accumulations or cysts) or blood stasis (when energy and blood isn’t moving, it accumulates and stagnates unable to move the old out or bring in the new fresh blood leading to accumulations or cysts). Symptoms of damp-phlegm conditions would look like foggy headedness or fatigue and feeling heavy limbed, bloating after meals, chronic nasal congestion or phlegm, looser bowel movements. Stasis symptoms would show up in painful periods, headaches, irritability or pms, rib pains or tightness, sighing a lot, irregular periods, clotted menstrual blood, a purplish tinge to the lips or tongue.
As PCOS is strongly influenced by insulin levels and glucose metabolism, diet and lifestyle modifications can have a significant impact on balancing your hormones and regulating your blood sugar levels and PCOS.
Working with a TCM Doctor for your particular diagnosis and incorporating acupuncture and herbs into your regime is also important and helpful in rebalancing your body. But, by incorporating the following dietary and lifestyle modifications, you can help make a significant change at home. The little things you do daily can make a BIG difference in the long term!
Dietary suggestions:
- Eat foods low on the Glycemic Index (GI) such as vegetables and whole grains. It is very important for women with PCOS to completely avoid refined carbohydrates which include: sugar (pop and candy), white flour, whole wheat flour and products made from them (pasta, breads, desserts, etc.)
- Keep your blood sugar stable by eating regularly – every three to five hours is ideal and making sure that you include some protein and good fats (for example some nuts or seeds and their butters, eggs, hummus etc.) at each meal. Protein foods take up to 5 hours to digest while carbohydrate foods digest within 30 minutes and can spike your blood sugar.
- Eat at least five servings a day of vegetables including at least two of leafy greens (kale, broccoli, collard greens, bok choy, cabbage, rapini, etc..) Leafy greens contain indole-3 carbinol, which helps to regulate liver function which is key in glucose and hormone metabolism.
- Have a regular servings of legumes like black beans, adzuki beans, mung beans, black eyed peas etc.. Adzuki beans are beneficial in draining ‘dampness’ from the body.
- Eat organic meats only. You can have red meat up to 3 times/week but make sure it is organic and grass fed (when meat has been grain fed it changes the fats from healthy omega 3 fats to omega 6’s)
- Eat at least three daily servings of fruits like berries –which are lower on the glycemic index and high in anti-oxidants
- Include cinnamon into your diet daily as it helps to reduce insulin resistance
- Include bitter Melon and fenugreek – help to regulate blood glucose
- Include complex carbohydrate such as whole grain cereals, quinoa, brown rice, etc.
- Insure adequate fiber intake (should be 30g/day), by eating a lots of fresh vegetables and whole grains
Avoid:
- It is very important that women with PCOS avoid all refined sugars (white and brown sugars, fructose, sucrose, corn syrup) and simple sugars (maple syrup, honey etc). (Lower sugar intake by avoiding intake of simple sugar that helps to prevent further impaired glucose metabolism)
- No refined carbohydrate (white bread, pasta, potatoes, white rice, most breakfast cereals, rice cakes, popcorn, or any starchy, low fiber food)
- Avoid artificial sweeteners (which are shown to affect the insulin levels the same way sugar does)
- Pay careful attention to portion sizes in order to moderate glucose load and minimize insulin resistance. Opt for smaller and more regular meals than bigger and more spaced out ones.
- Avoid sodas, fruit juice and drinks that raise the blood glucose rapidly (i.e. Energy drinks, Gatorade or any drink with refined sugar)
- Avoid milk and dairy products (cheese and yogurt), which are considered as ‘damp’ foods and will exacerbate the problem. Try substituting unsweetened almond milk as an alternative to cow’s milk.
Other tips:
- Include some form of moderate exercise (yoga, pilates, walking etc) for at least 30 min/day. Studies have shown that exercise can reverse diabetes and improve insulin sensitivity as well as help with weight control.
- Lose some weight (Fat cells store estrogen which can have a direct influence on pcos and fertility. Losing even a moderate amount of weight if you are overweight can have a significant improvement)
- Love your liver (Your liver is important in insulin metabolism, so it is important to keep your liver functioning well. Adding vitamin B complex to your daily routine will help to restore liver normal function in insulin balancing. Also be sure to include leafy green vegetables daily and be sure to watch your stress level and moods. If you’re agitated easily and find yourself frustrated regularly, include some stress management tools into your daily life -meditation, visualization and regular exercise all help.
- Get regular acupuncture. A study at Goteborg University in Sweden showed that electro-acupuncture may help 38% of women with PCOS women ovulate. Acupuncture can help to restore the ratio of LH and FSH, reduce the level of testosterone and beta-endorphin. Some studies show that acupuncture also helps to shrink of the weight of polycystic ovaries, which can enhance ovulation and egg implantation. Weekly acupuncture is ideal.
Supplements:
- Chlorophyll -reduces symptoms of hypoglycaemia without raising blood glucose level. You can buy liquid chlorophyll at the health food store and add it to your water and sip it throughout the day
- Probiotics (the healthy bacteria found in your intestinal tract). Foods which promote the growth of beneficial bacteria in the intestinal tract include whole grains, onions, bananas, garlic, honey, leeks, artichokes and some fortified foods. Probiotic can be taken in supplement/capsule form (although dairy/yogurt does include probiotics, it is not in a therapeutic dose and it is best to avoid dairy products foods for women with pcos).
- B Vitamin
- Magnesium
- Chromium
- Fish oil
- Alpha lipoic acid