On the calendar, September is PCOS awareness month. But in our practice, every month is PCOS awareness month. Why? Because 1 in 10 women are diagnosed with this disorder.
Polycystic ovarian syndrome is an increasingly common metabolic condition that causes a hormonal imbalance. It is also disease of insulin resistance. This means that your body’s cells are less sensitive to insulin, which makes you more predisposed to develop diabetes.
Excessive insulin can stimulate the production of testosterone, and this interferes with ovulation. Many women with PCOS experience excessive hair growth, irregular periods, acne, and weight gain.
Often, women are diagnosed simply by their presentation, but an ultrasound of the ovaries will usually show a “string of pearls.” These are the (poly) cysts that don’t develop well. Testosterone levels may or may not be elevated, but A1C levels (which measures insulin resistance are usually elevated. Based on this, Metformin is now a key medical treatment for PCOS.
In my experience, many women with PCOS don’t fit this typical physical body type. I’ve treated numerous women with PCOS who are thin. In 2019 I presented a paper at a professional symposium detailing my diagnostic and treatment strategies for three different body presentations. I forwarded my “off-label” strategies that I have found to be most effective in my clinical practice. By off-label, I mean, I deconstructed and repurposed formulas that might be used to treat, say, a common cold, and applied these principles to help stimulate ovulation with very satisfying clinical results.
PCOS is a triangulated condition: insulin resistance, hormone imbalance, diabetes. At Six Fishes, we take a triangulated approach using diet and lifestyle, acupuncture, and herbs, and it is remarkably effective.
Chinese medicine has roadmaps for understanding and treating you. Since many women are overweight, PCOS is considered a disease caused by phlegm and dampness. As mentioned above, I generally encounter three general presentations:
- Stereotypically robust, overweight, acne, excessive hair, irregular or no periods, and possibly constipated.
- Women who are overweight, but more just plump and a tendency to retain water. They might have weak digestion and loose stool.
- Thin women who may feel cold, have dry skin and hair.
Here’s Six Fishes 3-step method:
Diet and lifestyle: Insulin resistance is hard to change, but it can be done. It takes a commitment to change your lifestyle, exercising 30 minutes daily. Even a simple brisk walk will do this trick. For overweight women, a low-carb diet is essential. The fewer carbohydrates one eats, the lower your blood sugar will be, reducing insulin in your body. It’s critical to eliminate white sugar, white flour, and all processed foods.
Insulin resistance makes it really hard for women with PCOS to lose weight. One of the most effective methods that can quickly change your constitution is intermittent fasting. The purpose here is to switch your body from being a fat storer to a fat burner. There are numerous models for this, and for many of my patients, it’s easy to implement. Some of the variations include: Fasting for 16 hours and eating within an 8-hour window. Some eat normally for several days and then only eat 500 calories a couple of days weekly. Some eat only one meal daily. But even a 12/12 model can help. It’s not for everyone, especially if you are pregnant or nursing or taking certain medications.
Acupuncture and Chinese Herbal Formulas are so effective for helping stimulate ovulation that it is sometimes jaw-dropping. Normally it can take a few months and the ongoing intermittent support, but did I tell you about the woman I treated who ovulated within hours after not having a period for months, conceived within a day, and went on to have twins? I only treated her that one time! Acupuncture has the potential to balance reproductive hormones to restore reproductive health. We also find it helpful for managing the quality of menses. Often when women finally do get a period, it’s heavy, clotty, and painful. Correcting this is key for all women trying to conceive.
Chinese Herbal Medicine is, in my experience, honestly is where our medicine shines. Your PCOS presentation is unique to you. It’s not the same for everyone.
Supplements that we recommend frequently recommend include:
- Myo-inositol. 2000 mgs of it with 200 mgs folic acid twice daily is a safe and effective treatment insulin resistance and, therefore, for PCOS[i]. It’s also been shown to increase egg quality. Many women use myo-inositol instead of Metformin safely and succeed in helping them conceive and reduce insulin resistance.
- Zinc. Please read my blog on seed cycling for recommendations of foods that contain this vital nutrient. It also can help support your immune system, which is vitally important this year. See our list of recommended supplements for more on this topic.
- Berberine: this has been proven to lower blood sugar, making it essential to manage adult-onset diabetes. Note: it’s completely contraindicated to take if you are pregnant or nursing.
- Avoid DHEA, which can act as a precursor to testosterone. That’s the opposite of what you want.
Based on our assessment, each woman would gets a unique herbal formula, and supplements tailored for their specific health concerns. It usually takes 3-6 months to get women on track. And then a life-time commitment to a healthy lifestyle.
[i] Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011528/
Cara Frank, L.OM., was raised in a health food store in Brooklyn, NY. When she was 8, she cartwheeled 5 miles from Greenwich Village through Soho and Chinatown and across the Brooklyn Bridge. For nearly 40 years, Cara has had the same crazy passion for Chinese medicine. At 17, she had her first acupuncture treatment. At 20, she enrolled in acupuncture school. In 1998 she went to China to study where she fell deeply in love with Chinese herbs. Since then, she has devoted her life to studying and teaching the topic.
Cara is the founder of Six Fishes Healing Arts in Philadelphia, where she maintains a busy acupuncture practice and acts as the head fish of a warm and lively office. She is the president of China Herb Company. Cara is the author of TCM Case Studies: Eye Ear Nose and Throat Disorders. You can read her full bio or schedule an appointment.
