Polycystic ovary syndrome in chinese medicine

Polycystic ovary syndrome affects 6%-7% of reproductive-aged women, it is estimated that up to 5 million women are affected in USA. In 1935, Stein and Leventhal described masculinized women with amenorrhea, sterility, and enlarged ovaries containing multiple cysts. The syndrome was placed in the gynecologic realm for control of chronic anovulation, abnormal menstrual bleeding, and infertility. By the early 1980s, this symptom complex had been linked to hyperinsulinemia and impaired glucose tolerance. The connection to an insulin post-receptor defect was isolated in women with PCOS in the early 1990s.
Experts at a 1990 National Institute of health conference proposed the following diagnostic criteria: oligo- or anovulation, and biochemical or clinical signs of hyperandrogenism, such as hirsutism, acne, or male pattern hair loss, the third diagnosis criteria is the presence of polycystic ovaries; patients who exhibit 2 out the 3 criteria are diagnosed with polycystic ovarian syndrome. It is important to exclude other disorders such as adrenal hyperplasia or hyperprolactinemnia.
In Chinese Medicine enlarged ovaries are seen as a consequence of water accumulating in the pelvic cavity where it is transformed into phlegm, as the result of chronic Kidney Yang deficiency. It is this dampness and phlegm which causes ovarian cysts to form and Kidney yang deficiency in turn causes infertility. In some cases blood stagnation also play a role in PCOS.
Chinese Medicine including Acupuncture and chinese herbs have been used to restore fertility and regular menstrual cycle in patients with Polycystic ovary syndrome.
In one study after using chinese herbs, patient’s estrogen levels increased and in some cases patients had biphasic estrogen production. These herbs act by regulating the LH receptors, therefore affecting the ovarian function. It has been shown that Chuan Shan Jia, Zao Jiao Ci, and Chuam Bei mu can resolve the phlegm and reverse the thickening of the ovarian capsule and the follicular atresia by antagonizing androgens.
It has been shown that Acupuncture and Chinese herbal medicine will increase FSH and E2 levels and in turn will reduce the LH/FSH and T/E2 ratios. Increase E2 level act as appositive feedback causing ovulation. This formula is proven to work on hypothalamus-pituitary system as well as ovaries. In 20% of cases breast enlargement and high prolactin levels were found, in those cases the formula worked in its modified form for liver qi stagnation.