Polycystic Ovary Syndrome (PCOS) is well treated with Traditional Chinese Medicine (TCM), but it is not resolved quickly. This is because Internal Dampness is a main contributing factor, and takes some time to address fully. The general pathology of PCOS in TCM is a bit complicated. First one must understand that The Kidney energetic organ system of the body is the basis of all Yang in the body. Therefore, Yang Deficiency of the Kidney affects the Spleen Yang energy as it is not supported by the Kidney Yang. Qi is a Yang substance; therefore Spleen Qi Deficiency develops resulting in Internal Dampness. Chronic dampness combined with Heat due to Liver Qi Stagnation forms phlegm in Lower Jiao of women and affects the reproductive system as the Liver controls menstrual blood. Therefore several formulas are often required for 6-8 months to address this condition.
Kidney Yang Deficiency
Abnormal Menstruation: A girl with a tendency towards Yang Deficiency constitution may have a late onset of her menstrual cycle. Menstrual cycles tend to be shorter than 28 days as these women begin to menstruate. Menstrual blood is light, pinkish in color and a tendency towards clear discharges before menstruation and near ovulation. Other possible symptoms: Sensitivity to cold, cold extremities, sleepiness, lower back pain or discomfort, overweight, facial hair and underdeveloped breasts. Common symptoms include lethargy, a tendency towards easy fatigue with exertion, flaccid skin, weakness in lower back and legs, cold sensation in the lower part of the body, especially in the lower limbs, or edema, no tone in the lower abdomen. Consider our organic Ancestor Treasure Yang tonic formula!
Kidney Yin Deficiency
As our Yin Yang Theory article explains, Yin Deficiency and Yang Deficiency are often seen together. Like Kidney Yang Deficiency type PCOS, Kidney Yin Deficiency also manifest with shortened menstrual cycle, scanty blood, and spotting between periods as this generally indicates an imbalance in the Kidney energetic organ system. Additionally, women with Kidney Yin Deficiency PCOS will be thirsty and often have a dry throat, and experience soreness and weakness of low back and knees periodically. Emotionally they will have a tendency towards anxiety and insomnia. Their bowel movements may be dry leading to constipation. Her tongue body will likely appear red, with red dots on tip or sides, and the coating may be peeled. Pulses tend to be fast and thready. They may also experience dizziness, tinnitus, weak waist, periodic hot flashes and night sweats. Consider our organic Yin Valley tonic formula!
Liver-Kidney Imbalances and PCOS
In Chinese medicine there is not a specific endocrine system; rather, hormonal imbalances are attributed to Liver-Kidney energetic organ system imbalances or insufficiency. The earliest stages of PCOS with irregular menstruation and symptoms of PMS may be attributed to Liver Qi Stagnation, as the Liver stores the menstrual blood and is the basis of energetic Qi circulation; stagnation of Qi would result all types of menstrual irregularities and PCOS with breast tenderness, especially around menstruation. You may also see acne, increased facial hair, or male pattern-type baldness with this pattern of PCOS according to TCM. Consider our organic Free and Easy Wanderer formula!
Spleen Imbalances and PCOS
One type of PCOS is due to Spleen imbalances according to TCM. Improper diet and the Liver overacting on the Spleen are common causes of Spleen imbalances. Fatigue, insulin resistance, unstable blood sugar, a body mass index over 25, or weight gain would be indications of Spleen Qi-type PCOS. Internal Dampness can develop with Spleen Qi Deficiency may be indicated with vaginal discharges, development of large fluid filled cysts, and a heavy feeling in the body. Additionally, PMS pains that are deep, achy, and relieved with pressure or heat would indicate Internal Cold-Damp accumulations. In Chinese medicine this is seen as Phlegm retention in the Lower Jiao. It manifests most commonly with symptoms of obesity, weak muscles, facial hair, phlegmy chronic cough caught in the throat, and nausea. A woman suffering with this pattern of imbalance would often feel sleepy and tired. She would have a poor appetite and loose bowel movements. Her tongue body would have teeth marks on the sides and would have a thin greasy or white greasy coating. Her pulses would feel slippery. Consider our organic Restore the Middle Way Spleen tonic!
Damp-Heat and PCOS
If Liver Qi Stagnation is allowed to worsen without proper treatment, the Liver will heat up and combine with the Internal Dampness creating Damp-Heat. PCOS with vaginal discharges that are yellow to orange, marked with blood, or have a strong odor would be indications of Damp-Heat. The goal is to clearing away the Liver stagnation and quench Liver fire while eliminating dampness. One may experience facial acnes and a feeling of breast distendion and tenderness, especially the week before menstruation. Headaches, red eyes, and hypochondriac tenderness under the rib cage would be common. Her Tongue body would be red or have a reddish tip and sides with a thin and dry coating or thin and yellow coating The pulse would feel tense, thin and fast. Consider our organic Peaceful Warrior formula!
Qi and Blood Stagnation and PCOS
Because the Liver controls the free flow of Qi throughout the body, Liver Qi Stagnation can lead to Qi Stagnation in the Lower Jiao. Where Qi goes Blood goes, so long standing Qi Stagnation can form in to Blood Stagnation. Additionally, accumulating Internal Dampness will block the free flow of Qi and is common with PCOS. Blood Stagnation is indicated with sharp, fixed pain and intense abdominal pain , or even progressively intensifying dull and achy pain moving toward menstruation is an indication of Blood Stasis involved with PCOS. The volume of blood during a period is varies from light to heavy, but tends to be dark red or purple in color. Menstrual blood clots would be common with the pain being reduced after clots are discharged. Sometimes the period is long with or blood drips continuing past main menstruation. Another telling sign of Blood Stagnation with PCOS is a heavy pushing discomfort around anus. Additionally sexual intercourse can be uncomfortable, especially before, during, or immediately following menstruation. The tongue body will likely look purple with a tight, wiry pulse that is uneven and choppy.Her face may also appear red or purple. Upon palpitation, the lower abdomen, especially on the left side, may feel tender. Dizziness, poor sleep, startling easily and palpitations are also possible indications forming a diagnosis of Blood Stagnation. Consider our organic Stasis in the Lower Palace formula!
Essence-Jing Deficiency and PCOS
The Kidneys store the Ancestral Essence, or Jing, according to Chinese medicine. Essence is also the origin of menstrual Blood in TCM, and allows for reproduction. Weak Kidney Qi or Jing can lead to scanty periods, watery menstrual blood, and tiredness. A genetic predisposition to reproductive issues would also point to Essence Deficiency; Essence imbalances often suggest a familial component to PCOS which would be seen with women who's mothers had insulin resistance or blood sugar problems when she was pregnant.
Infertility and PCOS and Chinese Medicine
The Conception Vessel is an Extraordinary acupuncture channel that runs mid-line along the front of the body. Internal Dampness can cause blockages of this meridian leading to reproductive imbalances.
Using herbs based on different phases of menstrual cycle is a common treatment strategy in Chinese medicine:
- Invigorate blood circulation to regulate menstruation (Menstrual: 1st -5th days)
- Tonify kidney Yin to promote ovarium development （Postmenstrual / Follicular phase: 6th -11th day )
- Invigorate blood circulation, resolve stagnation to promoting ovulation and tonifying kidney Yang (Intermenstrual / ovulation phase: 12th -16th days)
- Tonify kidney and warm kidney Yang to promoting the development of corpus luteum ( Premenstrual/Postovulatory phase/Luteal Phase: 17th-28th days)
Those actively trying to conceive would only be able to take the appropriate formulas during the first half of their cycle; this course of treatment would be unrealistic because it would take so long. Taking a break from trying to conceive, while taking the herbs full time makes much more sense.