PCOS (Polycystic Ovary Syndrome)

What is PCOS?

PCOS is one of the most common endocrine disorders suffered by women of childbearing age. It's condition where the ovaries produce an excessive amount of androgens (male hormone) and this can manifest into various symptoms.

There are 4 types of PCOS, by understanding which category type(s) that you fall into, this can help to identify which support and lifestyle changes will help your presentation of PCOS. It's important to note that there can be some overlap amongst these types.

Insulin-resistant PCOS

(the most common)

This condition occurs when elevated insulin levels disrupt ovulation and prompt the ovaries to produce testosterone instead of estrogen. Additionally, levels of LH (Luteinising hormone) may increase while SHGB (sex hormone-binding globulin) levels decrease, leading to an excess of testosterone.

Post-pill PCOS,

Post-pill PCOS is where a woman’s periods were normal before the contraceptive pill and they became irregular after, normally these women will not have insulin resistance.

Inflammatory PCOS

Inflammatory PCOS can cause irregular menstrual cycles and increased levels of androgens. This condition is also associated with various inflammatory symptoms, including digestive problems, chronic fatigue, headaches, joint pain, and skin issues.

Adrenal PCOS

Typically, this form doesn't show signs of inflammation or insulin resistance and maintains normal androgen levels, but has elevated adrenal androgens (DHEAS). It is primarily driven by an abnormal stress response.

Common signs of PCOS include

Irregular and infrequent periods over 34 days (oligomenorrhea) or no periods at all (amenorrhea).
Symptoms of androgen excess - Acne, hirsutism
Insulin resistance
Weight gain/ difficulty losing weight
Polycystic ovaries on ultrasound
Anxiety/depression

Are they cysts?

In PCOS, the ovaries often develop multiple small follicles, which can sometimes give the appearance of cysts. PCOS are not actually cysts, it’s a historic name that was given to describe the condition pre ultrasound era, the language hasn’t evolved since. These tiny follicles, contribute to the characteristic features of PCOS. They disrupt normal ovulation and hormonal balance, leading to irregular menstrual cycles, anovulatory cycles and other symptoms associated with the condition.

Can PCOS be ruled out by an ultrasound scan?

It’s important to note that PCOS cannot be entirely confirmed or ruled out by an ultrasound, but it can provide supportive information. PCOS is a complex condition where a diagnosis can be based on combined symptoms of androgen excess and infrequent irregular cycles. If the ultrasound does not show PCOS, it doesn’t necessarily mean that you do not have polycystic ovaries.

Can acupuncture help?

Living with PCOS can be challenging, whilst the condition doesn't go away, its symptoms can be managed. As the leading cause of infertility, PCOS affects countless women. That's why many turn to acupuncture for relief and improvements of the symptoms PCOS can cause. I've worked with many women on their journey, helping them regulate their cycles, conceive, and alleviate PCOS symptoms.

Research has demonstrated that acupuncture may be helpful to those diagnosed with PCOS by

Increasing of blood flow to the ovaries
Improve the recovery of menstrual cycles
Increases beta-endorphin levels
May have regulatory effect on FSH, LH and androgens.
Reducing of ovarian volume and the number of ovarian cysts,
Controlling hyperglycaemia through increasing insulin sensitivity
Decreasing blood glucose and insulin levels
Reducing cortisol levels and assisting in weight loss
Modulating the parasympathetic nervous system
Deactivating the analytical brain responsible for anxiety

How often should I have acupuncture for PCOS?

I recommend a minimum of weekly sessions for 12 weeks, after this point, if cycles have improved then it’s a great time to space sessions to every two weeks. Acupuncture’s effectiveness is dose dependant and accumulative, a bit like a course of antibiotics, taking just one or two would be in effective.

Why do I recommend 3 months?

Primordial follicles are recruited from the resting supply several months to over a year before ovulation.

In the final three months before ovulation, during the antral phase, the follicle matures with the help of Follicle Stimulating Hormones (FSH) and Luteinising Hormone (LH)

This is when I recommend acupuncture, (whether or not you're using IVF) During this time, the follicle becomes highly responsive to hormonal signals, and its development can be influenced by various factors, including overall health and lifestyle. If your goal is to conceive, these three to four months are crucial to prioritise optimisation for the maturation of the follicle.

Resources

https://www.sciencedirect.com/science/article/abs/pii/S1876382016300087

https://pubmed.ncbi.nlm.nih.gov/20230329/#:~:text=Acupuncture therapy may have a,and assisting in weight loss

https://www.larabriden.com/you-might-not-have-pcos/

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