Serena Norr
Written by Serena Norr

Reviewed by Dr Andre Budihardjo, MM

PCOS Treatment Options to Help Improve Fertility

PCOS is a common yet complicated condition that affects women of childbearing age. Treatment options such as lifestyle changes, medications, surgery, and TCM practices can help with this condition.

yet complicated disease that can be very challenging that affects women of childbearing age.

Polycystic ovary syndrome (PCOS) is one of the most common yet complex health conditions. Caused by an imbalance of reproductive hormones, this condition affects the ovaries. It affects approximately 1 in 10 female patients of childbearing age in the United States. It is commonly diagnosed by the presence of two of these conditions: hyperandrogenism, ovulatory dysfunction, or polycystic ovaries.

As such, it is very important to visit a doctor who can assess your history and provide a diagnosis so you can receive proper PCOS treatment. This article shares more about what PCOS is, PCOS treatment options, and how to aid in recovery from a Traditional Chinese Medicine (TCM) and Western perspective.

What is PCOS?

Typically, women who are diagnosed with PCOS have hormonal imbalance and metabolism problems. This causes missed or irregular periods, leading to cysts in the ovaries and infertility. This is seen in women ages 15 – 44 – with the majority of those diagnosed in their 20s and 30s. PCOS is caused by genetics or low-grade inflammation. However, there are many PCOS treatment options to heal your body that can eventually lead to pregnancy. Diagnosis and awareness are key for your PCOS fertility treatment.

PCOS symptoms

It is important to understand the symptoms of PCOS. Below, are some common symptoms to be aware of. Always, note and discuss any changes in your body with your doctor.

  • irregular periods
  • family history of PCOS
  • having “hirsutism” or too much hair on the face and body
  • persistent acne on the face, back, or chest
  • sudden weight gain
  • excessive flaps of skin on the body
  • thinning hair
  • dark spots or changes in skin tone.

Other risk factors and associated health conditions

First of all, PCOS is often associated with obesity and type 2 diabetes. Having high levels of insulin may increase your risk of PCOS. Meanwhile, obesity by itself, even without insulin resistance, will increase the risk of PCOS. Type 2 diabetes can lead to insulin resistance, causing the body to compensate by over-producing insulin, resulting in excessive androgens, or “male hormones.” Low socioeconomic status, genetics, and ethnicity are other risk factors of PCOS.

In addition, women with a history of type 2 diabetes may also suffer from PCOS. Finally, women with PCOS also experience many health implications, including metabolic complications, high blood pressure, miscarriage, liver inflammation, depression, uterine bleeding, cancer of the uterine lining, and most notably, infertility.

PCOS Treatment Options

The first step to recovery is to visit your doctor for a proper diagnosis and PCOS treatment plan.

A doctor will diagnose you with PCOS after they conduct a full physical and pelvic examination as well as an assessment of your family history. They may also do a sonogram and require blood work to test your hormone levels.

Lifestyle change

Due to the association between PCOS and obesity, weight reduction and lifestyle changes are critical for overweight women with PCOS and anovulatory infertility. Losing weight decreases the over-production of insulin and insulin resistance, whereas increasing physical activity can increase insulin sensitivity, improving hormonal imbalance in the ovaries.

Drugs and surgery

Your doctor may prescribe medications as a course of your PCOS treatment. This may include taking a form of hormonal birth control such as the pill or the patch, anti-androgen medicines, or metformin to help with diabetes.

Additionally, a doctor might prescribe clomiphene citrate (CC), a drug used to induce ovulation (ovulatory stimulants). This works in the same way as estrogen, the female hormone that supports the development of eggs in the ovaries, and their release. According to research, clomiphene may increase the rate of getting pregnant in PCOS patients.

Healthcare providers may conduct a surgical laparoscopic ovarian drilling (LOD). The procedure is minimally invasive and is 84% successful in helping patients with PCOS-related infertility achieve pregnancy. More importantly, it is more cost-effective than other ovulation induction procedures and has long-term benefits in improving insulin resistance and ovarian androgen production.

TCM Perspective

Physician Anita Pee, a TCM practitioner at Eu Yan Sang, shares a different look at the PCOS in the body. She stated, “with TCM, we give medications along with acupuncture, electro-acupuncture, moxibustion, and other treatment methods. We want to promote more regular ovulation and menstruation to increase their chances of becoming pregnant.”

According to Physician Pee, there are three patterns of diagnosis to describe PCOS:

  1. Kidney deficiency is the absence of the period. Therefore, the absence of ovulation is a kidney pathology.
  2. Spleen deficiency, which has to do with the insulin resistance part of the PCOS diagnosis. This is also the organ that relates to weight gain (obesity).
  3. Liver stagnation, which can manifest as blood stasis, causing irregular periods. Liver stagnation can also cause excessive lung heat which affects the skin and hair, resulting in oily skin and coarse, dark hair on the chest, face or back (hirsutism).

She assures that TCM is generally safe for most women, except for those who have bleeding disorders or other chronic conditions like cancer. Women who would like to use TCM to treat their infertility should consult a physician to examine their condition thoroughly.

Recovery Tips After Surgery

Rest is a vital part of your PCOS recovery plan.

Typically, laparoscopic ovarian drilling is a one-day surgical procedure and patients rarely need to be hospitalized overnight. Follow-up appointments are two to eight weeks from the surgery, so patients should take additional care when recovering at home.

Post-surgical effects

After surgery, you may experience physical discomfort, including a swollen abdomen, sore throat, and nausea. It is common for patients to experience vaginal bleeding up to one month after LOD. Your next menstrual cycle should occur four to six weeks after the surgery. During this time bleeding will be heavier, and discomfort will be greater than usual.

Seek immediate medical attention if you experience severe side effects. Commonly, this includes persistent vomiting or fever for more than 24 hours, issues breathing, or wound inflammation.

Dietary recommendations

If you feel nauseous after your procedure, try to have a light meal consisting of a nourishing soup, toast, gelatin, or crackers.

Physician Pee explains that in TCM, “surgery is something major and can negatively affect the blood and qi (vital life energy). We normally use generic tonics to boost the body after post-surgery. We don’t prescribe specific herbs unless a patient has other health conditions or different kinds of discomfort after the surgery.”

Common tonics include Chinese angelica (danggui, 当归), codonopsis root (dangshen, 党参) and rehmannia root (shudihuang, 熟地黄), which can be found in concoctions for women’s well-being.

Although not all PCOS cases are related to obesity, Physician Pee advises that “it’s better to consume nutritious and bland food that are easier to digest. This will help them lose weight, keep their blood sugar at bay, and promote a more regular ovulation.”.

Dos and donts post-surgery

As a general rule, stay away from alcohol for at least 24 hours after your surgery. Additionally, take a bath, remove your bandages the following day, return to work after three days, and resume sexual activity after one week.

Physician Pee encourages patients to get sufficient rest and maintain a well-balanced low-sugar diet. She also advises avoiding stress as well as overly rigorous and strenuous activities.

Fortunately, there are many management and treatment options available for those suffering from PCOS. If you’re experiencing anovulation or struggling with infertility problems, consult a doctor or TCM physician who can help you with a personal plan.

References

  1. American Family Physician. 2021. Diagnosis and Treatment of Polycystic Ovary Syndrome. [Accessed on January 27, 2022]
  2. Office on Women’s Health. 2019. Polycystic ovary syndrome. [Accessed on January 27, 2022]
  3. Medline Plus. 2021. Clomiphene. [Accessed on January 27, 2022]
  4. University of Michigan Health. 2020. Laparoscopic Ovarian Drilling (Ovarian Diathermy) for PCOS. [Accessed on January 27, 2022]
  5. Cleveland Clinic. 2020. Laparoscopy. [Accessed on January 27, 2022]
  6. Frontiers in Bioscience. 2014. Polycystic ovary syndrome: current status and future perspective. [Accessed on January 27, 2022]
  7. Mayo Clinic. 2020. Polycystic ovary syndrome (PCOS). [Accessed on January 27, 2022]

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