How does Chinese Medicine view PCOS ?

In Traditional Chinese Medicine (TCM), PCOS is categorised under “Dysmenorrhea (painful period)”, “Amenorrhea (no period)” or “Infertility” depending on individual symptoms. The main 3 organs responsible are Spleen, Liver and Kidney, and usually has an underlying dampness and blood stagnation with patterns of Qi and Yang deficiency.

PCOS in TCM: Spleen, Liver, Kidney and Blood stagnation is the key. Click To Tweet

3 main types of PCOS in TCM

In TCM, PCOS is catagorised under these 3 main types. All of them have a certain level of phlegm dampness (hence the fluid filled cysts or immature follicles) and blood stagnation associated with it. Most of the times in the clinic, the symptoms are not so straight forward and can be a mixture of the different types. The key for TCM physicians is to be like Sherlock Holmes and find the “why” before jumping in to conclusions.

TCM treatment goal is to boost the relevant organs, boost the Yang or unblock the blood so that the body is hormonally balanced, optimised like SEO.  TCM doctor Aimee Raupp thinks that we shouldn’t “force ovulation” as this might cause  “the body to ovulate poor quality egg”. Perhaps that’s true.

Find the WHY in PCOS. Aim to balance and optimise the body; don't force ovulation. Click To Tweet

Kidney Yang deficiency

This is the most common type. Kidney yang, also known as pre-natual true yang is the foundation of the Yang Qi of the whole body. In TCM, Kidney is the organ that is responsible for sexual health and reproductive development. It is the heater that warms and promotes the functions of the organs and tissues. Symptoms include prolonged cycle or no period, cold hands and feet, always cold, dull complextion, acne on face, may or may not be overweight, dull ache at the lower back.

Spleen Qi/ Yang deficiency

Often seen in early stages. Common symptoms include having a longer menstrual cycle, scanty or heavy period, tiredness, digestive issues (insulin resistance) bloating, loose stools, always worrying, long term illness,  or a miscarriage and usually has sallow yellowish complexion with pale tongue with teeth marks on the sides.

Liver Qi Stagnation

Physical and mental stress is the biggest cause of Liver Qi stagnation. Common symptoms include being anxious, easily affected and depressed, sighing often, over thinking, tender breasts before menses, painful crampy period, very irritable, have bitter taste in the mouth especially in the morning, distended feeling around the ribs area.

TCM treatment focus for PCOS

1. Balance & fine tune the body by addressing all the metabolic and mental issues
2. Facilitate the release of healthy eggs and conception

4 phases of menstruation & herbs

In TCM, there are 4 phases of menstruation : Period (bleeding), post-period, ovulation and post-ovulation.  Jane Lyttleton, TCM doctor who specialises in fertility uses a 4 Jade Moon Phases to target each phase with different heral formulas and specific herbs for specific symptoms. These are only for educational purposes and should only be prescribed by your doctor.

[Phase 1] BLOOD- Bleed & Flush

This is from the first day of bleeding (not spotting). We want the old blood and lining to be pushed out of the body.

Tao Hong Si Wu –  Includes 4 blood tonics to replenish lost blood and at the same time move the blood with peach kernel (Tao Ren) and saffron (Hong Hua). During period, the aim is to clear the uterus lining and flush the old linings. If there is severe pain, add Chi Shao that will move the blood more (in TCM, pain mean something is stuck and in this case it’s the stuck blood). Yan Hu Suo can be added to as it has really good analgesic properties to increase pain threshold to ease the crampy pain.

[Phase 2] YIN- Nourish the lining

This is a a crucial nourishing stage for boosting fertile potential and make sure that the egg matures. This phase is closely related to the Kidney too.

Liu Wei Di Huang Wan – This famous formula is viewed as a longevity formula by many specialists and we want to use it to improve the longevity of the ovaries. The aim is to reinforce Kidney Yin to enhance follicular development, nourish blood to promote endometrial growth.

Dang Gui and Shao Yao – Move the Qi gently and make sure blood moves smoothly too.

Tu Si Zi and Bu Gu Zhi – Yang tonics. Yin and Yang work together and small amount of Yang tonics are added to help Yin’s growth.

Xiang Fu and Chai Hu – Qi movers.  Things are constantly moving from one phase to another and these herbs support the LIver to assist in the smooth flow of Qi.

He Huan Pi – This is like Mr. Calm. When everything is moving, things can get messy and the level of anxiety goes up. So here come peacemaker to make sure everything is moving smoothing so operation pre-ovulation goes well.

Imagine a thick and soft bedding with lots of moisture and nourishment + good ventilation of Qi  + calming vibes for the baby to sleep in for 9 months. #bliss

[Phase 3] YANG – Promote ovulation

As the Yin becomes full and turns into Yang, we want the egg to mature and pop out of the follicle (ovulation) for fertilization.

Bu Shen Cu Pai Luan as the base formula to support the Kidney Yang.

Nu Zhen Zi – Support Kidney Yin.

Ji Xue Teng – Moves the blood and relaxes muscles so as to maintain fluidity in the movement of the fallopian tubes.

Xiang Fu (fried with vinegar) – A well known Qi regulator in gyneacology to ensure smooth movement. Frying in vinegar will boost the pain relieving properties and address any uncomfortable ovulation pain.

Hong Hua, Chi Shao and Zao Jiao Ci – Blood mover to ensure no stasis. Make sure the function”Sea of Blood” or the endometrium is at its peak performance.

[Phase 4] QI – Support implantation/ Get ready for next cycle

If ovulation and conception has happened, the cycle will stay at Phase 3. However at the same time, we need to make sure the baby has its premium king size bed with the plushiest cushions and its favourite nutritious food (Qi and Blood) on demand. Yes, babies are picky and only comes when all conditions are met. So how now? Support the Kidney Yang and keep the bed (uterus) warm too.

If there is no pregnancy, Qi will be boosted to make sure the body has enough energy to push the blood out for the next new cycle.

You Gui Wan – Support Kidney Yang. It has Yin tonics too because Yin generates Yang too.

Yu Lin Zhu – Using Ba Zhen Tang as base which is made of 4 blood tonics + 4 Qi tonics+ Kidney Yang tonics.

Other herbs to consider for PCOS:

• Da Huang is a strong & cold purgative and lower jiao (include uterus areas) blood mover. Good for severe blood stagnation. Good for constipation too.
• Rou Gui is cinnamon, a warm herb that helps to open up the lower jiao. When used with Da Huang, it can counter the cold properties = Da Huang & Rou Gui combo.
• Yi Mu Cao not only clears out stasis, but also cool and promotes urination by clearing out all
  the waste metabolites that likely accumulate in and around stasis/dampness which may be responsible for PCOS.

Acupoints used for PCOS

Studies shown by researchers in several countries that acupuncture can improve ovary function, as well as increase ovulation frequency. Some of these studies have found that the elevated levels of LH, testosterone and insulin in PCOS patients were reduced by a course of acupuncture.  The frequency of the treatments is important, acupuncture at least 2 times a week for 3 to 4 months is needed to return ovary function and regular ovulation.

• Spleen: SP 3, SP 6, SP 9, SP 10.  To strengthen the Spleen. SP 10 is the “Sea of Blood” to boost blood.
• Kidney: KI 3, KI 6, KI 7, KI 14. To strengthen and warm Kidney. For KI 14 careful not to needle Ren 5 (may cause infertility).
• Liver: LI 4, LR 3.  To open the 4 gates for smooth flow of Liver Qi if there are signs of stress.
• Ren: Ren 3. Front Mu point of the Urinary Bladder to clear heat via pee.
• Dai Mai: SJ 5 & GB 41. To open Dai Mai, clear encapsulated heat from Shao Yang meridian.
• Zi Gong acupoint – Zi Gong means “Palace of Child”. Its a local acupoint for direct stimulation of the uterus.

TCM food therapy for PCOS

In TCM food therapy, we like to do the Colour Plate. We believe that the 5 tastes (sour, sweet, bitter, spicy and salty)  and colour of food is related to the organs. When consumed in moderation, it can benefit the related organs.

Liver 

Go for Sour & Green food. Dark green vegetables such as kangkong, spinach, kale, rockets, watercress, mustard greens. High quality vinegar, apple cider, perppermint tea, sour plum, citrus fruits (grapefruit, lime, kiwi, green apple).

Spleen

Go for Sweet & Yellow food. No, not the milk chocolate or glazed donut! Caramelised onion, sweet potato (purple or yellow), dates or jujube, brown rice, oats (cook softer or as a porridge), warm garnishes such as ginger, spring onions, garlic. 

Kidney

Go for Salty & Black food. Miso, kelp,seaweeds, kidney beans, seafood such as oysters, shellfish. Black is the colour associated with the Kidney, so try black beans, black lentils, black garlic (limit if you’re very heaty), black sesame.

Blood moving food

Qi and Blood are best buddies. If one is stuck then the other is stuck too. Move them together with pungent and aromatic food such as  radish, basil, coriander seed, fennel, turmeric, cayenne, black pepper, cardamom, saffron and ginger.