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PCOS


PCOS

Poly Cystic Ovarian Disease

Poly cystic ovarian disease is characterized by the biochemical findings of hyperandrogenism (too much androgen), an occasional insulin resistance as well as the physical findings of polycystic ovaries and occasional hirsutism (excess hair on the face or other areas of the body like the abdomen or chest). Fifty-percent of PCOS women are obese.

PCOS can lead to many diseases including type 2 diabetes, heart disease and osteoporosis.

Another major problem caused by PCOS is infertility. The inability to conceive in the PCOS patient stems from several factors: 1) the follicles typically don’t mature and only develop to between 10 and 12 mm. A mature follicle grows to approximately 20mm; 2) the eggs contained within the follicles are not of the best quality. This is why, even when women with PCOS use medication and IUI or IVF to conceive there is a greater rate of miscarriage than experienced by women in the general population; 3) there is an inappropriate hormonal milieu: the FSH, LH, Estrogen, Androgen and Progesterone levels are typically at either inappropriate levels or have inappropriate quantitative relationships between them.

One of the mainstays of acupuncture and herbal medicine is to improve hemodynamics or blood flow to the ovaries and uterine lining. This is important because blood carries hormones, electrolytes, oxygen and nutrients to target tissue and upon its return, takes debris or dead cells away from the target tissue. Thus, an increase in the patency of blood flow to any tissue means a healthier tissue and a better performing organ system.

From the perspective of traditional Chinese medicine, PCOS represents a disease that is caused by what we call ‘phlegm’. This phlegm is not the typical phlegm that you think of, but represents rather a sticky, viscous substance that is inert, still, clogging and blocking. This type of presentation as you can imagine is not very amenable to being nurtured by blood and enjoying the benefits that blood has to offer. One may think of a polycystic ovary in traditional Chinese medicine terms as a big bruise that won’t go away.

Imagine if you will, strongly improving blood flow to and through that bruise: it is then that the healing process begins. This is exactly the case with the polycystic ovary. Acupuncture and herbal medicine cannot cure PCOS, but when combined, they can help to improve follicle quality and egg quality. This is why the East meets West approach to infertility makes sense. When a patient undergoes an IUI or IVF procedure, the reproductive endocrinologist fertilizes an egg with sperm and transfers the embryo back to the uterus. Or, as in the case with an IUI, the doctor will facilitate the growth and development of more than one follicle and have those follicles meet with more sperm than that which occurs with sexual intercourse thereby improving the chances of a fertilized ovum.

The problem with these methods is that the treating physician can only work with the eggs and sperm that the patient presents with. If either egg or sperm is qualitatively deficient, either a pregnancy will not occur, or a miscarriage will prevail.

By including acupuncture and herbal medicine in the mix, there is a good chance, based upon 3000 years of clinical history, and volumes of classical literature on gynecology and infertility, and modern day clinical experience, that pregnancy rates will increase and miscarriage rates will decrease. This is because egg quality and lining is improved.

Lining quality is an often overlooked problem in the PCOS patient. The health of the endometrium is dependent upon the proper circulating amounts of estrogen and progesterone. In the PCOS patient the estrogen levels are abnormal as are the progesterone levels. So, even when a doctor states that “you have a beautiful 10mm lining” this is not necessarily so. The shape or morphology of the uterine lining is no more an indication of its health that the shape of a person’s body. For example, you can look at a male model who is tan, handsome and muscled up and appears to be at the height of health but in fact, is HIV +.

Again, as acupuncture and herbal medicine can stimulate blood flow to the lining of the uterus; it too will improve in quality, thereby increasing the chances of a successful implantation.

When seeking the care of an acupuncturist and herbalist, look for two things: 1) experience in the field of reproductive disorders and 2) licensure and board certification.

A great place to find a qualified practitioner is www.aborm.org.

Mike Berkley, Licensed Acupuncturist and Board Certified Herbalist has been treating infertility cases for 23 years. He is the first acupuncturist in the United States to specialize in this field. For more on traditional Chinese medicine and infertility, please see www.berkleycenter.com.