Managing PCOS: A Holistic Approach With TCM
In Traditional Chinese Medicine (TCM), late summer, spanning mid-August through September, is recognized as a transitional period between the peak of yang energy and the nurturing yin energy. During this time, the body naturally seeks rest, balance, and nourishment. It's fitting that September is also PCOS Awareness Month, as this season often brings hormonal changes for many women. For those with an imbalanced Spleen organ system, this time can trigger stress, worry, and pensiveness, making it an ideal moment to explore the connection between stress and Polycystic Ovary Syndrome (PCOS).
What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects up to 10% of women of reproductive age. It is characterized by hormonal imbalances, irregular menstrual cycles, and the presence of multiple cysts in the ovaries. PCOS is a complex condition with a wide range of symptoms that can include infertility, weight gain, acne, and excessive hair growth.
From a biomedicine perspective, PCOS is primarily viewed as a reproductive and metabolic disorder. One of the key features of PCOS is insulin resistance, where the body's cells do not respond effectively to insulin, leading to elevated blood sugar levels. This can increase the risk of developing Type 2 diabetes and other metabolic complications. Elevated androgen levels (male hormones) are another hallmark of PCOS, contributing to symptoms like hirsutism (excess hair growth) and acne.
While the exact cause of PCOS is not fully understood, factors such as genetics, inflammation, and environmental triggers are believed to play a role in its development. The biomedical approach to managing PCOS often includes a combination of lifestyle changes, medications to regulate blood sugar or hormone levels, and fertility treatments when necessary.
TCM View of PCOS
Although TCM does not specifically define PCOS, the symptoms align with various menstrual disorders such as excessive menstruation, delayed cycles, amenorrhea, and infertility. From a TCM perspective, PCOS often involves patterns like blood stasis and phlegm-damp accumulation, creating "nests" in the ovaries. These patterns, unique to each individual, reflect hormonal and organ system imbalances that contribute to the development of PCOS.
Spleen Qi Deficiency, Phlegm-Dampness, & Liver Qi Stagnation
The Spleen organ system is vital for digestion and the production of Qi (vital energy) and Blood, while the Liver ensures the smooth flow of both throughout the body. When stress causes Liver Qi to stagnate, it disrupts the flow of energy and blood, burdening the Spleen, which leads to weakened digestion. As digestion falters, food turns into phlegm-dampness, a type of internal congestion that can accumulate in the uterine network, further complicating PCOS symptoms. Hormonal weight gain and digestive issues, often seen in PCOS, can be traced back to this combination of Spleen Qi deficiency and Liver Qi stagnation.
Common Symptoms of Spleen Qi Deficiency and Liver Qi Stagnation:
Digestive issues (bloating, gas, loose stools, etc.)
Sluggish metabolism and insulin resistance
Low energy and fatigue
Water retention and bloating
Weight gain
Brittle hair and nails
Dry skin and acne
Mood changes (irritability, anxiety, depression)
Irregular menstruation
The Impact of Stress on PCOS
Stress plays a significant role in the progression of PCOS, triggering symptoms like anxiety, depression, and irregular cycles. When stress is chronic, it activates the body’s sympathetic nervous system, leading to the release of stress hormones like cortisol and adrenaline. Over time, this disrupts hormonal balance, worsening PCOS symptoms and affecting overall health. Chronic stress can also elevate insulin levels, further aggravating insulin resistance, a key component of PCOS.
Biomedicine Perspective on PCOS Treatment
From a biomedical standpoint, managing PCOS often requires addressing both hormonal imbalances and metabolic issues. Treatments may include:
Medications: Hormonal birth control pills are commonly prescribed to suppress the natural menstrual cycle and reduce androgen levels, rather than regulating the cycle. Metformin, a diabetes medication, is often used to improve insulin sensitivity and manage blood sugar levels. In some cases, fertility treatments such as ovulation-inducing medications are needed for women trying to conceive.
Lifestyle Modifications: A healthy diet and regular exercise are essential for managing weight, improving insulin sensitivity, and reducing the severity of symptoms. Weight loss in some situations, even in small amounts, can significantly improve menstrual regularity and reduce the risk of complications like Type 2 diabetes.
Fertility Support: For women struggling with infertility due to PCOS, fertility treatments like Clomid (a medication that induces ovulation) or assisted reproductive technologies (such as IVF) may be recommended.
Managing Stress for PCOS
Stress management is a crucial aspect of PCOS care. As I’ve seen in many of my patients, chronic stress can exacerbate hormonal imbalances, negatively impact insulin levels, and lead to more severe symptoms. Incorporating stress-reducing techniques, such as acupuncture, meditation, and low-intensity exercise, can help alleviate some of the burdens caused by both PCOS and stress.
Self-Care Tips for Managing Stress-Induced PCOS
Nourish Your Body: Focus on an anti-inflammatory and blood sugar balancing diet rich in whole foods, particularly leafy greens that support Liver Qi flow.
Movement: Engage in gentle, low-impact exercises like yoga and walking to reduce stress and support physical health.
Prioritize Rest: Adequate sleep and relaxation are essential for hormone balance and stress management.
Herbal Medicine: TCM Formulas like Xiao Yao San (Free & Easy Wanderer) can help women with PCOS by regulating Liver Qi, reducing stress, and supporting hormonal balance to improve menstrual regularity. Be sure to get guidance from a licensed Chinese medicine practitioner for the correct herbal formulas for your particular case.
Self-Care Rituals: Practices like meditation, breathwork, and acupuncture can help lower stress levels and enhance well-being.
Targeted Supplementation: Some supplements known to help manage PCOS include: inositol, N-Acetyl Cysteine (NAC), omega-3 fatty acids, vitamin D, magnesium, zinc, berberine, chromium, cinnamon, ashwagandha, and probiotics. Be sure to get guidance from a trained professional on the correct supplementation and dosages for you.
Seek Support: Consider therapy or counseling to manage the emotional impact of a PCOS diagnosis and support mental health.
By following a holistic approach, you can better manage the complexities of PCOS, reduce stress, and find pathways toward healing. If you're experiencing any of the imbalances mentioned, I’m here to help you restore balance and well-being. Please reach out to discuss how we can work together on your healing journey > Book a free 15 minute consult.
