Polycystic Ovary Syndrome is a leading cause of infertility in women and the most common endocrine pathology in reproductive-aged females worldwide, but often evades proper diagnosis and treatment. Indeed, the World Health Organization estimates that up to 70 percent of affected women remain undiagnosed globally. Because this disorder encompasses a wide variety of clinical presentations, indicating an array of individual-specific root causes ranging from genetic and hormonal to environmental factors, it is also challenging to treat, and is in fact deemed “incurable” by Western medicine. Thankfully, TCM offers many valuable insights for PCOS.
As the most common metabolic disorder of reproductive-aged American women, PCOS is best understood as a complex disorder that’s not purely gynecological, but systemic. That is, it affects many different bodily systems, especially glucose metabolism, hormones, lipids, blood vessels, and Liver function. Its clinical manifestations include amenorrhea or scanty periods, irregular cycles, hirsutism, obesity, infertility, ovarian cysts, and hormonal imbalances—namely, elevated testosterone levels and LH (luteinizing hormone). Anovulation, meaning an egg does not release, is a common issue; unfortunately, if ovulation does occur, the risk of early miscarriage is nearly triple for women who have PCOS.
The aforementioned symptoms are utilized as clues in TCM to denote patterns of deficiency and excess, supported by incredible wisdom regarding the body’s interconnections. According to late TCM expert Giovanni Maciocia in his book Obstetrics and Gynecology in Chinese Medicine, scanty periods or amenorrhea point to Blood deficiency in the Penetrating Vessel as well as Kidney deficiency (which leads to hormonal imbalances). Obesity, meanwhile, is always an indication of Damp-Phlegm in the Penetrating and Directing Vessels, and it is the exact same pattern for ovarian cysts. Hirsutism is caused by a dysfunction of the Penetrating Vessel with an imbalance between Qi and Blood. Maciocia explains, “A deficiency of Blood in the Uterus leads to amenorrhea, but this would mean that there is more Blood available in the Penetrating Vessel at the skin level in the chin to promote the growth of hair.” Though we can dive much deeper, the interconnected patterns that ripple out to further imbalances are already evident.
Iris Lee, LAc, offers another way of looking at the patterns of PCOS through the lens of the elements:
I often use a metaphor of the Water and Fire imbalance to explain PCOS to
my patients. The water overflows due to Spleen Qi deficiency and accumulates
in the pelvic cavity due to the lack of Fire (Ming Men Fire), resulting in the
reproductive organ becoming a swamp that cannot reproduce any life.
Therefore, the treatment should aim to stop the production of excessive
dampness by strengthening [Spleen] Qi and drying up the dampness by adding
Kidney Yang (Ming Men fire). When a fire ignites and water stops flowing in,
the swamp dries and becomes fertile ground for seeds to sprout.
Acupuncture has been quite effective in treating PCOS, though it takes time, and a practitioner trained in TCM herbology can prescribe potent, targeted formulas to further support and enhance treatment. This is the recommended course of action because symptoms and underlying causes can differ on a bio-individual basis. However, looking at both the TCM root causes and manifestations, we can explore tonic herbs that may offer helpful at-home support for those experiencing PCOS symptoms. As Maciocia states, the two most important patterns in PCOS are Kidney Deficiency—indicated by the deep hormonal disharmony that characterizes PCOS, and Damp-Phlegm in the Uterus. The latter manifests as: ovarian cysts, obesity, excess vaginal discharge, abdominal fullness and heaviness, and swollen tongue with sticky coating (among other practitioner-assessed symptoms).
Remember: tonic herbs are essentially food medicines best suited for daily, long-term use in order to deeply nourish and regulate, thus helping to prevent discord while fortifying our innate capacity for vibrant health. Other TCM herbs are more curative, enlisted to cause a rapid and powerful biological shift. The following supportive tonic herbs can help promote balance at the root cause level (Kidney deficiency—usually Yang, Spleen deficiency, and Liver-Qi stagnation), and bring support to the expressions of these imbalances (Damp-Phlegm in the Uterus, Blood Stasis, Dampness, Damp-Heat in the Liver channel, and Liver-Fire).
Potentially Supportive Tonic Herbs:
Cordyceps – supports Kidney Yang, additionally showing promise for improving insulin resistance and regulating blood sugar. As a Qi tonic, it promotes the abundant and unobstructed flow of vital energy in the body can help mitigate the fatigue common with PCOS.
Deer Antler Velvet – a renowned fertility tonic indicated for those with Kidney Yang deficiency, nourishing to Jing or essence (crucial for fertility), while also supporting optimal Liver function.
Eucommia – a primary fertility herb for tonifying the Yang Jing functions of the Kidneys. It has been found supportive for those at risk of miscarriage, and additionally tonifies the Liver.
Rose – tonifies the Liver and Spleen, thus supporting detoxification, the movement of Qi, and the harmonization of the Blood for menstrual regulation. It helps prevent the accumulation of Dampness in the body, dries Dampness, and clears Liver heat.
Eleuthero – indicated for those with Phlegm-Dampness, tonifying to the Spleen and Kidneys, and supports fertility by promoting hormonal balance. It also regulates Qi and Blood.
Schizandra – tonifies the Kidneys and modulates estrogen production, therefore supporting those with estrogen dominance (common in PCOS) or deficiency. It works on both Phase I and Phase II liver metabolism, promoting detoxification and the clearance of sex hormones from the body.
