Many women have problems with their period: period delays, light periods without ovulation, no periods without medication. Inexplicably, some women are overweight while others are exceedingly thin. Some might have excessive body hair, acne, or thinning hair. In many of these cases, these symptoms are a result of a multitude of small cysts in the ovaries, commonly referred to as symptoms of “pore-cysts ovarian”—PCOS. These cysts result from follicles that stop growing in the middle of the follicular phase. It might be that hormones like estrogen, LH, FSH and their receptors, insulin, IGH-II, aromatics and androgen etc. are out of balance. Others believe that it might be related to the performance of hypothalamus and pituitary gland. Even though previous research suggests that PCOS can be inherited, the causes of PCOS are still unknown. But like most other inherited diseases, unless it is stimulated by the environment, the disease does not manifest itself in the body. Especially for women with PCOS who have no family history of PCOS, diet and lifestyle are major contributors to the development and the alleviation of the disease.

When I first started seeing patients in the US many years ago, I discovered that there were many more patients with PCOS in America than in China. I wasn’t surprised for long—there were obvious differences between my patients in China and my current patients that seemed to contribute. For one, different long term diets affected the prevalence of PCOS. Patients’ diets in the Western world are generally imbalanced with a high intake of fats and carbohydrates and undersized portions of vegetables. In China, along with better standards of living and newfound open-mindedness to the world, the number of PCOS patients has also increased rapidly in Chinese population in last two decade—primarily because the Western lifestyle and diet  have also spread quickly. Overeating carbohydrates and refined sugar are conducive to weight gain. Overeating animal meat that contain hormones, antibiotics and their by-products that stay in our body will also impact women’s overall health, especially the functioning of the ovaries.  The original hormone balance in the ovaries has been disturbed because of these environmental changes within the body. The result of these changes makes women more susceptible to PCOS.

The manifestations of PCOS are complicated and vary from person to person. No two patients have the same exact condition. A patient with PCOS may have a blood test that presents an abnormal LH/FSH ratio, or high levels of androgen, or high levels of insulin resistance. It could also show that all these hormones are in the normal range or are slightly imbalanced. Medication has not always adequately treated all these different cases because PCOS is complicated. Some patients don’t respond well to any of the medication their doctors gave them or cannot get healthy eggs from a larger quantity of the mature follicles after stimulation. Medication for PCOS is often chemical, specifically targeted to one part of the body with side effects. But PCOS is very complicated with multiple imbalances in the entire body. It has not only problem in endocrine system but also circulation system, nerve system and metabolic system. Each case is very individualized, which means that PCOS can manifest itself in different ways in each individual. Simple medication cannot target all the factors that contribute to the disease.

Chinese herbal medicine is made from multiple herbs in different combinations to satisfy the need of individual PCOS patients. These personalized formulae are made from different herbs according to different conditions that a patient has.  The formula not only balances patients’ hormones and build up the receptors for those hormones  but also change the pelvic environment. Healing the pelvic environment allows the ovaries to more readily respond to the signals released from the hypothalamus-pituitary axis.   Just as we do not completely understand the causes of PCOS, we do not understand the pathology of the herbs used to heal—although perhaps science will fully explore these pathways one day.  Chinese medicine has developed from thousands years of accumulated experience. And in my practice, after treatment with Chinese medicine, many of my patients either have a healthy ovulation or conceive. In some cases, the patient conceived without having period while western medicine requires a period before stimulation. This treatment and its methods and technology are very different compared with western medicine. It is why even patients who had failed multiple IUI or IVF treatments were still able to conceive naturally with the help of Chinese medicine or were able to conceive through IVF or IUI treatments that they had previously failed.

For an example, my patient Anna, 30 years old, had just failed an IVF when she was referred to our clinic by her doctor. Anna never had her period without medication.. She was over weight (around 200 pounds) and had high levels of testosterone. Her hair was thinning on her head but she had extra hair growing on her abdomen and nipples. She tried to conceive after she married  4 years ago but she never got pregnant. She tried different medication such as metformin, clomiphin, follistim, letrozole and menopur etc.  but she still did not ovulate most of the time. When she did ovulate, she went through IUI but still never got pregnant. With her doctor’s suggestion she tried IVF. She produced 30 eggs in the IVF cycle but only transferred two embryo. She failed her first IVF. She visited our clinic in order to prepare the next IVF cycle.

When I first saw her, Anna hadn’t had a period in over two months since her last IVF cycle. With her condition, we decided that her egg quality was the main problem behind her failed IVF cycle because she only had two embryos that could be viably transferred in day-five-fertilization. I suggested that she change her diet to lose weight and improve the environment of her body, receive acupuncture once a week to improve her pelvic circulation to absorb the inflammation and the cysts, and take Chinese herb formula to balance her hormone levels to be ready for next IVF. Less than a  month treatment, she was able to successfully conceive her son—naturally, without going through a previous period.

I have seen many young women with PCOS who came to my clinic after they failed an IVF cycle. They were only in their twenties—and at that age, egg quality should not be a problem.  But they always produced low quality eggs and had great difficulty conceiving even with IUI and IVF. What caused these problems? I realized that most growing follicles during IVF might have been the old follicles (cysts) that had stopped growing in the middle of the follicular phase due to the PCOS. Once the medication stimulated the ovaries, the follicles grew from these “low-quality” follicles. In addition, PCOS patients easily overacted to the medication that hyper-stimulated the ovaries, further affecting egg quality.  Furthermore, studies show that PCOS patients tend to have swelling ovaries which lead to inflammation between the follicles. This inflammation possibly affects egg quality, which also prevents a successful IVF cycle.

PCOS is a complicated disease and medical treatment cannot solve all cases.  Patients must take steps to adopt a healthy lifestyle with a balanced diet which will increase the chance of pregnancy.  Chinese medicine offers another option to patients with difficult cases of PCOS by improving their body’s general condition, allowing patients greater chances to conceive naturally and readying them for IVF or IUI procedures.