By Breea Johnson, MS RD LDN

September is PCOS Awareness Month which helps bring attention to women with Polycystic Ovarian Syndrome (PCOS).  Did you know about 7 million women in the U.S. have PCOS? PCOS is one of the leading causes of infertility and afflicts nearly 5-10% of women of childbearing age.  Common symptoms of PCOS include irregular or missing periods, anovulation, an inability to lose weight and facial hair growth, however, PCOS is a collection of symptoms and can look very different in different women. Many of the women I see at Pulling Down the Moon are actually within their ideal weight range and have few of the classic symptoms of PCOS. Check out this past blog I wrote titled The Many Faces of PCOS.

Nutrition can greatly impact and help to manage PCOS – even the atypical case of PCOS can benefit from a diet which helps with blood sugar regulation and nutrients that help with insulin sensitivity. While there is no known cause of PCOS, there are some identified factors which may be contributing to PCOS. In my next post, I’ll look at some of these factors that have been connected to PCOS such as thyroid disease, insulin resistance, hormonal imbalances and genetic causes – and discuss in more detail. Stay tuned.

 By Anna Pyne, L.Ac.A TCM

Polycystic ovarian syndrome (PCOS) is a common reproductive endocrine disorder and something we frequently treat at Pulling Down the Moon. Up to 75% of women with this diagnosis do not ovulate, which is hardly ideal when trying to conceive.   In fact, it’s not until they have trouble conceiving that many women learn they have PCOS, which in addition to causing infertility can also have negative long-term health consequences including heart disease and diabetes.

In Traditional Chinese Medicine, PCOS is considered an anovulation disorder related to ovarian insulin resistance.*  Chinese medicine initially acknowledged PCOS in the 1200′s describing it as a “Tian Gui” disorder, meaning a genetic disorder with the main symptoms being cycle irregularity and infertility due to anovulation.  There are a number of TCM patterns of diagnosis to describe PCOS, the main one being a (Chinese) Kidney Deficiency. The kidney in TCM is the organ system that is regarded with any genetic disorder and considered the root cause in PCOS.  The absence of the period, and therefore the absence of ovulation is a kidney pathology.  Interestingly, modern science has just recently identified a genetic component to PCOS and now think of PCOS as a hereditary problem in which symptoms often do not present until later in life.

A secondary pattern in TCM is Spleen Deficiency, which has to do with the insulin resistance part of the PCOS diagnosis. The Chinese spleen is responsible for the metabolism of nutrients from foods, as well as the transformation and transportation of fluids in the body. In patients with actual cysts in the ovaries, TCM considers the spleen to be dysfunctional. This is also the organ that relates to weight gain. Obesity is seen in 30%-60% of patients with PCOS. By improving the function of the spleen we help regulate blood sugar and resolve the excess fluid accumulation from ovarian cysts and/or fat from weight gain.  A third, related TCM pattern is Liver Stagnation, which can manifest as blood stasis or excess heat in the channels. Blood Stasis in the channels causes hair follicles to be nourished excessively creating coarse unwanted hair. This represents the hirsutism symptom, of which 70% of patients with PCOS have. Excess heat in the channels also promotes the acne component of PCOS.

When trying to improve fertility in patients with PCOS the primary focus is to induce ovulation.  According to TCM pattern diagnosis, the main organs treated for this condition are the kidney, spleen, and liver.  Treatment using TCM pattern diagnosis is greatly successful in inducing ovulation and a skilled TCM practitioner can use a combination of acupuncture, electro-acupuncture, moxabustion and herbal therapy to treat Polycystic Ovarian Syndrome. 

*Different phenotypes of polycystic ovary syndrome by Rotterdam criteria are differently steroidogenic but similarly insulin resistant. Fertil Steril. 2010 Mar 1;93(4):1362-5. Epub 2009 Sep 26.

Book an initial consultation with Anna Pyne in Chicago here.

Here’s a good new/bad news situation.  The bad news is that more women are likely to receive a diagnosis of  Gestational Diabetes Mellitus (GDM) in the coming months.   The good news is that if you’re in the trying to conceive process and eating a fertility-friendly diet like the one we use at Pulling Down the Moon you are well on your way to preventing this condition which can be dangerous to mother and baby. 

Previously, a diagnosis of GDM was based on blood sugar measurements that identified women at higher risk for developing diabetes later in life.  The new standards take into consideration risks to the mother and baby, including overweight babies, early delivery, c-section delivery and pre-eclampsia (a life threatening rise in blood pressure that endagers health of mom and baby).  When these outcomes were added to the equation, experts found they needed to make the diagnostic criteria more stringent.  With the new guidelines, it’s estimated 16% of pregnant women will be found to have GDM instead of the 4-6% who currently get diagnosed.

Just in case you needed a bit more motivation to either get started or keep going with your fertility-friendly diet, do it for diabetes prevention and the health of your future child!