Introduction

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age globally. More than a reproductive disorder, PCOS is a complex symptom with metabolic, cardiovascular, and psychological implications. Awareness and timely diagnosis are paramount for several reasons. They facilitate early intervention, which can mitigate long-term health risks associated with the syndrome, such as infertility, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Moreover, understanding and managing PCOS symptoms can significantly improve a woman’s quality of life and self-esteem, reducing the psychological burden often carried by those affected. 

In a world increasingly focused on women’s health issues, shedding light on conditions like PCOS is essential. By fostering an environment of knowledge and support, we can empower women affected by PCOS to seek the care they need and lead healthier, more fulfilling lives. Recognizing the signs and symptoms of PCOS and advocating for comprehensive healthcare can make a significant difference in the lives of millions of women and their families. At Golden Gate, we understand the importance of PCOS and are here to guide you through the process.

What Are the Key Symptoms of PCOS to Watch For?

Recognizing these symptoms is a critical step toward seeking help and receiving a diagnosis. It’s essential for women experiencing these signs to consult with a healthcare provider for a comprehensive evaluation and personalized management plan.

1. Irregular Menstrual Cycles: 

A hallmark symptom of PCOS is menstrual cycle disruption. Women may experience  irregular periods, commonly fewer than nine cycles in a year, (oligomenorrhea), absence of periods for three or more consecutive months (amenorrhea), impacting fertility.

2. Excessive Androgen Levels: 

Elevated levels of male hormones, aka hyperandrogenism,  can lead to physical signs such as excessive facial and body hair (hirsutism), severe acne, and male-pattern baldness (androgenic alopecia). These symptoms stem from the ovaries overproducing androgens. Most women with PCOS have both clinical and biochemical evidence of hyperandrogenism. Asian women with PCOS, have lesser degree of hirsutism than do non-Hispanic White or Black women. Serum total testosterone is the best way to assess androgen level, more accurately by liquid chromatography-tandem mass spectroscopy (LC-MS/MS). The upper limit of normal for serum testosterone in women is in the 45 to 60 ng/dL range (1.6 to 2.1 nmol/L) depending on laboratory calibration. 

3. Polycystic Ovaries: 

Many women with PCOS have enlarged ovaries containing numerous small, fluid-filled sacs known as follicles, detectable via ultrasound, typically transvaginal ultrasound. Note that having polycystic ovaries alone does not confirm PCOS; symptoms must also be present.

4. Weight Gain and Obesity: 

A significant proportion of women with PCOS struggle with weight gain and obesity, especially around the waist, exacerbating insulin resistance and leading to further health complications. Approximately 40-85% of women with PCOS are overweight or obese., 

5. Insulin Resistance: 

A condition where the body’s cells do not respond effectively to insulin, leading to elevated blood sugar levels and subsequently increased risk of diabetes. Though an underlying issue, it significantly contributes to PCOS symptoms.  Insulin resistance is present in both lean and obese women with PCOS (30% and 70%, respectively)

6. Infertility: 

A common issue face by women with PCOS, this is due to the absence of ovulation, anovulation nature of PCOS. For women who wants to get pregnant, TVS (transvaginal scan) is used in those anovulatory infertility to monitor follicular growth and number, as well as to document occurrence of ovulation.

7. Skin Changes: 

Besides acne, women may notice darkening of the skin (acanthosis nigricans) in body creases and small skin tags in these areas.

8. Fatigue: 

Increased fatigue and low energy levels may be linked to poor sleep, sleep apnea and metabolic disturbances.

9. Mood Disorders: 

Hormonal imbalances can contribute to mood swings, depression, and anxiety, affecting mental health and quality of life.

Why Does PCOS Affect Women Differently?

1. Genetic Diversity

• Genetic Factors: The genetic makeup of an individual plays a significant role in how PCOS manifests. Specific gene variations associated with PCOS can influence the severity of symptoms. Since these genetic predispositions vary widely among individuals, the expression of PCOS symptoms can also vary significantly.
• Family History: Women with a family history of PCOS are at a higher risk of developing the condition. The interplay of multiple genes inherited from parents can affect the risk and presentation of PCOS, leading to variations in symptoms among family members.

2. Environmental and Lifestyle Influences

• Diet and Nutrition: Dietary habits can influence the severity of PCOS symptoms. High intake of processed foods, sugars, and unhealthy fats may exacerbate symptoms, while a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage them.
• Physical Activity: The level of physical activity significantly affects insulin resistance, weight management, and hormonal balance in women with PCOS. Those who are more active may experience milder symptoms compared to those with a sedentary lifestyle.
• Exposure to Environmental Toxins: Emerging research suggests that exposure to certain environmental toxins may play a role in the development and severity of PCOS symptoms. These toxins can interfere with hormonal balance and metabolism.

3. Hormonal Variations

• Androgen Levels: The degree of androgen excess can vary greatly among women with PCOS. Those with higher androgen levels may experience more severe symptoms such as hirsutism, acne, and androgenic alopecia.
• Insulin Sensitivity: Variations in insulin sensitivity and the degree of insulin resistance can affect the severity of PCOS symptoms. Women with higher insulin resistance may struggle more with weight gain, metabolic issues, and anovulation.

4. Obesity and Weight

• Impact of Obesity: Obesity exacerbates many PCOS symptoms, especially insulin resistance, hormonal imbalances, and menstrual irregularities. The distribution of body fat, particularly increased abdominal fat, is closely linked to the severity of PCOS symptoms.
• Weight Fluctuations: Changes in weight over time can also influence the manifestation of PCOS symptoms. Weight loss can improve symptoms for many, while weight gain may worsen them.

5. Age and Life Stages

• Variability Over Time: The impact of PCOS on a woman’s health and reproductive system can change with age. For instance, menstrual irregularities may become more pronounced during adolescence and perimenopause.
• Post-Menopausal Changes: The risk factors and symptoms of PCOS can evolve as women age, especially after reaching menopause. While the risk of endometrial cancer may increase, other symptoms such as menstrual irregularity and acne may subside.

Treatment Options for PCOS

The management of PCOS is highly individualised, with treatment plans tailored to address the specific symptoms and goals of each woman. Successful management of PCOS often requires a combination of lifestyle changes, medication, and sometimes alternative therapies. Regular follow-ups with your doctors are essential to monitor progress and adjust treatments as necessary. Women with PCOS should be encouraged to adopt a proactive approach to their health, seeking support from a multidisciplinary team of healthcare professionals, including gynecologists, endocrinologists, dietitians,mental health providers and TCM fertility practitioners .

1. Lifestyle Modifications

• Diet and Nutrition: Adopting a healthy diet that emphasizes whole foods, lean proteins, and vegetables can help manage weight and reduce insulin resistance. Low glycemic index (GI) foods are particularly beneficial in stabilizing blood sugar levels.
• Physical Activity: Regular exercise, including both aerobic and resistance training, can help lose weight, improve insulin sensitivity, and reduce cardiovascular risk factors. Even a modest weight loss of 5-10% can significantly improve PCOS symptoms.
• Weight Management: For overweight or obese women, weight loss is often the first line of treatment recommended. Reducing body weight can help decrease insulin levels, lower androgen levels, and improve ovulation and menstrual regularity.

2. Medications

• Hormonal Contraceptives: Birth control pills, patches, or vaginal rings that contain oestrogen and progestin can help regulate menstrual cycles, reduce androgen levels, and manage acne and excess hair growth.
• Metformin: This medication is primarily used to treat type 2 diabetes but can also be prescribed for PCOS to improve insulin resistance, regulate menstrual cycles, and assist with weight loss.
• Clomiphene (Clomid): For women with PCOS who wish to become pregnant, Clomiphene can stimulate ovulation. Letrozole (Femara) might also be used for this purpose.
• Spironolactone: This anti-androgen medication can help reduce hirsutism and acne by blocking the effects of androgens on the skin. Due to its potential effects on a developing fetus, it’s crucial to use effective contraception while on this medication if sexually active.
• Hair Removal Treatments: Options such as laser hair removal and electrolysis can be used to manage unwanted hair growth, although they may require multiple sessions and can be costly.

3. Traditional Chinese Medicine (TCM) Treatments

• Herbal Therapies: TCM utilizes various herbal formulas to target different aspects of PCOS, aiming to restore balance and improve ovarian function. Spearmint tea, for instance, has been studied for its potential to reduce androgen levels in women with PCOS.
• Acupuncture: Some studies suggest that acupuncture can help improve menstrual frequency, manage symptoms of PCOS, and could be beneficial for fertility by improving blood flow to the ovaries and reducing stress levels.
• Dietary Modifications in TCM: TCM emphasizes dietary adjustments that align with an individual’s specific constitutional needs, potentially aiding in managing PCOS symptoms. Foods that are believed to nourish the body, support the spleen, and regulate Qi are often recommended.

When to Seek Medical Advice for PCOS Symptoms

Seeking early medical intervention is crucial if you’re experiencing symptoms suggestive of PCOS, particularly if they interfere with your daily life or you’re trying to conceive. Early diagnosis and treatment can reduce the risk of long-term complications.

Introduction

Polycystic Ovary Syndrome (PCOS) stands as a significant endocrine disorder that casts a wide net over women in their reproductive years, presenting a complex array of symptoms that extend beyond fertility concerns to encompass broader health implications. Despite its considerable prevalence, the dialogue surrounding PCOS is often mired in misconceptions and myths, clouding the public’s understanding and potentially hindering timely and effective management of the condition. This article endeavours to address and debunk five of the most pervasive myths surrounding PCOS, aiming to illuminate the realities of the syndrome and foster a more nuanced comprehension of its multifaceted nature.

Myth 1: PCOS Only Affects Overweight Women

PCOS does not discriminate based on body type. While a significant number of individuals with PCOS experience weight gain or have difficulty losing weight due to insulin resistance, PCOS can affect women of all sizes, including those who are underweight or have a “normal” BMI. The diversity in PCOS presentations underscores the importance of looking beyond body weight when considering a diagnosis.

Myth 2: Irregular Menstrual Cycles Directly Equate to PCOS

Though irregular menstrual cycles are a key indicator of PCOS, they are not solely indicative of this condition. Various factors, including stress, excessive exercise, and other hormonal disorders like thyroid dysfunction, can also disrupt menstrual regularity. A comprehensive evaluation, often including blood tests, hormone tests, ultrasounds, and a review of symptoms, is necessary to accurately diagnose PCOS.

Myth 3: All PCOS Symptoms Are Visible and Obvious

The manifestations of PCOS vary widely among individuals, with some experiencing overt symptoms like hirsutism (excessive hair growth in areas where men typically grow hair), severe acne, and obesity, while others may have less visible signs such as irregular periods, anovulation (lack of ovulation), and insulin resistance. Many PCOS-related symptoms, particularly metabolic issues, can go unnoticed without proper testing and evaluation.

Myth 4: PCOS Completely Precludes Pregnancy

While PCOS is a leading cause of infertility due to its impact on ovulation, it does not render pregnancy impossible. Many individuals with PCOS conceive naturally or with minimal assistance, and others achieve successful pregnancies through treatments like ovulation induction, in vitro fertilisation (IVF), or lifestyle interventions aimed at improving metabolic health. Fertility treatment outcomes in PCOS can vary, emphasising the need for personalised medical guidance.

Myth 5: There is No Effective Treatment for PCO

While PCOS is indeed a chronic condition with no definitive cure, numerous effective management strategies can mitigate symptoms and reduce associated health risks. Treatment plans often include lifestyle interventions, such as diet and exercise modifications, pharmaceutical options to regulate menstrual cycles and manage metabolic issues, and targeted therapies for specific symptoms like fertility treatments for those desiring pregnancy.

Comprehensive Management of PCOS

A successful approach to managing PCOS extends beyond mere symptom treatment, aiming to enhance overall health and quality of life for those affected. By integrating lifestyle changes, medical interventions, and mental health support, individuals can take proactive steps toward mitigating the impact of PCOS on their daily lives and long-term well-being.

Lifestyle Modifications

Lifestyle changes are foundational in the management of PCOS, with diet and exercise at the forefront of this transformative journey:

• Nutritional Wellness: Adopting a balanced diet rich in whole foods, lean proteins, and fibre, while limiting processed foods and sugars, can help in managing insulin levels and support weight management — two critical aspects in PCOS care. Incorporating foods with anti-inflammatory properties may also alleviate some PCOS symptoms.
• Physical Activity: Regular exercise, tailored to individual preferences and capabilities, can significantly improve insulin resistance, aid in weight management, and reduce the risk of cardiovascular disease. Activities may range from brisk walking and cycling to strength training and yoga, each contributing to overall health and symptom relief.

Medical Treatments

The medical management of PCOS is highly individualized, reflecting the diverse needs and health objectives of each person:

• Hormonal Contraceptives: Often used to regulate menstrual cycles, reduce androgen levels, and alleviate symptoms like acne and excessive hair growth.
• Insulin-Sensitizing Medications: Drugs such as metformin can improve insulin sensitivity, aiding in weight management and potentially improving ovulation frequency.
• Fertility Treatments: For those seeking pregnancy, options like clomiphene citrate (Clomid) or letrozole may be used to induce ovulation, with assisted reproductive technologies (ART) such as IVF considered in more complex cases.

Mental Health Support

The psychological impact of PCOS, from coping with symptoms to navigating fertility challenges, can be profound. Accessing mental health support is a vital component of comprehensive PCOS care:

• Professional Counseling: Engaging with therapists who specialize in chronic health conditions or fertility issues can offer valuable coping strategies and emotional relief.
• Support Groups: Connecting with others who share similar experiences can foster a sense of community, reduce feelings of isolation, and provide a platform for sharing resources and encouragement.

Polycystic Ovary Syndrome (PCOS) has emerged as a significant health concern affecting women worldwide, with its prevalence steadily increasing. As conventional Western medicine grapples with defining and treating PCOS, an alternative perspective arises from the realm of Traditional Chinese Medicine (TCM). Golden Gate Fertility Centre recognizes the need for a holistic approach to women’s health, addressing the root causes of PCOS beyond symptomatic relief.

PCOS often presents as a complex hormonal disorder with characteristics such as irregular menstrual cycles, ovarian cysts, and hormonal imbalances. Recent statistics indicate that PCOS affects approximately 1 in 10 women of childbearing age, positioning it as one of the most common endocrine disorders. The conventional approach to PCOS involves diagnostic criteria such as irregular menstruation, elevated androgen levels, and polycystic ovaries on ultrasound. However, the symptoms and experiences of PCOS extend beyond these Western medical parameters.

Understanding PCOS Symptoms

A. Traditional Western Medicine Perspective

Polycystic Ovary Syndrome (PCOS) is a multifaceted challenge that demands a comprehensive approach, integrating both Western medicine and traditional perspectives. In Western medicine, PCOS is recognized as a complex endocrine and metabolic disorder influenced by genetic and environmental factors. Key aspects include:

• Intricate endocrine and metabolic disorder
• Influence of genetic and environmental factors
• Links to mood disorders and epigenetic factors

Traditional Viewpoint

From a traditional standpoint, emotional factors significantly impact the hypothalamic–pituitary–ovarian axis, contributing to irregular ovarian ovulation and PCOS manifestation. Insights into PCOS development include:

• Emotional factors’ impact on the hypothalamic–pituitary–ovarian axis
• Role of anti-Müllerian hormone (AMH) concentration
• Influence of intestinal flora alterations on insulin resistance and androgen metabolism

Diagnosis and Treatment Perspectives

The diagnosis of PCOS from a Western medicine perspective involves specific criteria, including irregular periods, elevated androgens, and ovarian cysts. PCOS poses various challenges, such as infertility, weight gain, and a higher risk of type 2 diabetes. The conventional treatment approach includes:

• Combination of oral medications, lifestyle adjustments, and surgical interventions
• Limitations of pharmacological approaches (60% effectiveness)
• Emphasis on the need for a comprehensive strategy integrating both perspectives

Holistic Understanding for Effective Interventions

A holistic understanding of PCOS symptoms is crucial for personalized and effective interventions. Whether considering emotional well-being, epigenetic factors, or the impact on hormonal balance, a combined approach ensures a nuanced and thorough exploration of this complex syndrome. By integrating the strengths of Western medicine and traditional perspectives, a more holistic and tailored approach to PCOS symptom management is achievable.

B. Traditional Chinese Medicine Perspective

In ancient Chinese medicine texts, Polycystic Ovary Syndrome (PCOS) lacks a specific term. It is classified based on clinical manifestations as ‘irregular menstruation,’ ‘amenorrhea,’ or ‘infertility.’ Treatment primarily revolves around rebalancing the kidney, Tiangui, Chongren, and uterus. Tiangui, a vital factor for women’s reproductive health, plays a role akin to neuroendocrine hormones regulating reproduction. 

Disruptions in Tiangui, manifested as irregularities in timing, state, and rhythm, can lead to female reproductive issues. PCOS patients often exhibit Tiangui disorders, and Traditional Chinese Medicine (TCM) has shown effectiveness and safety in PCOS treatment, garnering increasing attention. Despite the lack of clear biological mechanisms and ongoing treatment controversies, this review explores TCM’s impact on PCOS and introduces potential cellular endocrine mechanisms. The aim is to offer insights for clinicians and researchers in the ongoing exploration of PCOS treatment methodologies.

Success stories of Golden Gate Fertility Centre helps in PCOS patient. Illustrate how personalized TCM treatments can restore balance, regulate menstrual cycles, and alleviate symptoms, offering hope to those seeking alternatives to conventional Western approaches.

TCM Methods for Diagnosis and Treatment

A. Diagnosis in TCM Methods

In Traditional Chinese Medicine (TCM), the diagnosis process for treating Polycystic Ovary Syndrome (PCOS) involves a thorough evaluation of various factors contributing to the condition. Professor Shi adopts TCM diagnostic methods to pinpoint key issues in the patient’s spleen and kidney functions, considering them as primary pathogenic factors. Additionally, TCM recognizes secondary factors like phlegm-dampness and collaterals obstruction. The diagnosis includes clinical syndrome differentiation, where the practitioner analyzes symptoms for categorization. Meridian selection is crucial, with specific attention to the kidney, spleen, pregnancy, and stomach meridians. Professor Shi tailors acupuncture techniques and acupoint prescriptions based on this diagnosis, creating a personalized approach to restore balance and promote overall well-being. This holistic TCM diagnostic process ensures a nuanced understanding of the patient’s condition, guiding effective acupuncture treatments for PCOS.

B. TCM Treatment Approaches

In tackling Polycystic Ovary Syndrome (PCOS), Traditional Chinese Medicine (TCM) offers a holistic and diverse range of therapeutic methods. A key TCM approach involves acupuncture, using thin needles to stimulate energy flow, regulating hormones and addressing PCOS symptoms like irregular menstruation and infertility. Chinese herbal medicine, with specific herb combinations, aims to balance organs and enhance reproductive health in PCOS. TCM places significant emphasis on dietary therapy, crafting nutritional recommendations to rectify specific imbalances and bolster digestive health. Cupping therapy and moxibustion come into play to enhance blood circulation, diminish inflammation, and alleviate PCOS-related pain. 

Mind-body practices such as Qi Gong and Tai Chi, centering on movement and meditation, contribute to overall well-being and stress management. TCM extends to lifestyle recommendations covering exercise, sleep, and stress management tailored for effective PCOS support. These personalized TCM strategies take into account unique disharmony patterns, offering a comprehensive and tailored approach to managing PCOS symptoms and restoring balance.

Golden Gate Fertility Centre’s Approach to PCOS

Golden Gate Fertility Centre stands at the forefront of integrating TCM with modern healthcare. By combining advanced diagnostics and technology with traditional healing methods, Golden Gate Fertility Centre offers a unique and effective approach to PCOS treatment. Testimonials from satisfied patients underscore the success of this integrated approach, showcasing the transformative impact on women’s lives.