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Healing the Conception Vessel - PCOS and POF: blog series part 6 of 8
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"The little seed cracks, and the spirit of heaven emerges."
~ Scandinavian Proverb
The ripening of eggs within the follicles of our ovaries is a miracle. From birth women are filled with all the eggs they will ever have - one to two million, and for most of us, the eggs we possess at birth, and the 400,000 or so we still have when we begin menstruating, are more than enough to ensure the possibility of pregnancy before we enter menopause.
If our hormones are out of whack, the ovaries can become afflicted with disease or fail altogether. There can be many causes for the hormonal interference that saps vitality from our ovaries; polycystic ovarian syndrome (PCOS) and premature ovarian failure (POF) are common manifestations of this hormonal imbalance.
Polycystic Ovarian Syndrome
Also known as Stein-Leventhal syndrome, a disorder of ovulation which can affect the skin, hair, body weight, reproductive system, and endocrine system - including the pancreas, hypothalamus, pituitary gland, and adrenal glands.
- The most common indication of PCOS is irregular or absent periods, often dating back to menarche. Other symptoms include excess weight, acne, excess facial hair and increased body hair, or thinning of the hair on the head.
- In polycystic ovarian syndrome, multiple small cysts or tiny follicles, develop inside the ovaries. These cysts are not the same as active follicles but instead have been arrested in their development, never growing to full size or releasing healthy eggs. The cysts and the connective tissue surrounding them produce male hormones called androgens. Androgens block follicular development and cause the follicles to degenerate, preventing the release of mature eggs. In addition, the amount of estrogen circulating in the bloodstream increases in relation to other hormones like progesterone, causing an increase in LH and testosterone. Because of this hormonal cascade, ovulation is prevented.
- Western medical doctors and scientists have been unable to pinpoint the actual cause of PCOS and thus have been unable to treat it effectively. One of the contributing factors appears to be abnormal insulin and glucose (sugar) interaction. Excess insulin circulating in the bloodstream stimulates enzymes that help manufacture androgens in the ovaries. High insulin levels may also overstimulate leading to follicular atresia ("starving" the follicles of the correct hormonal food for the developing eggs).
- Women who are diagnosed are often prescribed a series of drugs such as clomiphene, hCG, and gonadotropin. If these drugs fail, IVF and other ART are recommended. However, most women with PCOS don't respond well to any hormonal manipulation. Follicular development is a process that takes many months. Eggs are meant to develop in an estrogen- and progestrone-rich environment, not in an androgenic setting. Therefore if a woman's body is forced to ovulate with ovulation-stimulating drugs, the quality of her eggs may be poor.
The Eastern View
Traditional Chinese medicine seeks to redress the entire hormonal millieu that produces these changes in a woman's ovaries. The most common manifestation of PCOS is dampness or phlegm (fat cells storing estrogen), and treatment is based upon different patterns as well as the different ways these patterns show up as symptoms.
TCM insulin-managing diet:
- Cut out all forms of refined sugar.
- Cut out all forms of refined carbohydrates, as the body immediately turns them into sugar. Refined carbohydrates include white bread, pasta, white rice, most breakfast cereals, rice cakes or any starchy, low-fiber food.
- Do not follow fertility diets advocating massive yam consumption. The high starch and sugar content in yams exacerbates the impaired glucose metabolism and can actually delay or prevent ovulation.
- Avoid soda, fruit juice, and any drink that rapidly raises the blood sugar level.
- Consume adequate amounts of protein, either in vegetarian form or in the form of lean meat that has not been treated hormonally.
- Eat as many fresh vegetables as you wish.
- Eat only complex, whole grains like oatmeal, brown rice, and whole wheat.
- Eat fruits like berries, which are not too sweet.
- Avoid milk and dairy products, which tend to exacerbate the condition of internal dampness.
- Eliminate alcohol and caffeine.
- Increase your dietary fiber intake.
- Get adequate amounts of exercise.
- Addition of chlorophyll - Spirulina & broccogen.
- Chromium, B vitamins, magnesium, ALA, CLA will improve insulin resistance.
- NAC (N-acetylcysteine) decreases testosterone. In TCM, NAC would be categorized as a liver cleanser.
Premature Ovarian Failure
POF is essentially very early menopause, occurring before a woman reaches the age of forty. By the time we hit full-blown menopause, our supply of eggs has dwindled. This gradual loss of eggs during our fertile years is normal, but in POF, for some reason, either the loss of eggs is accelerated or the follicles themselves become less responsive to hormonal stimulation. One in every thousand women between the ages thirty and thirty-nine is diagnosed with POF. Women with POF will have stopped menstruating altogether, or will have short cycles. Sometimes periods do not occur at all.
- As ovulation occurs increasingly early in women with POF, the cycle is often accompanied by elevations in FSH, indicating the ovaries are not responding to clues from the brain. The lack of communication causes hormonal "confusion." Estrogen production is reduced, the uterine lining is often too thin for implantation, and the follicles have not had time for their residing egg to fully mature, leaving no chance for conception.
- Premature ovarian failure is an extremely frustrating diagnosis, as Western medicine cannot pinpoint its cause with any degree of accuracy. Some theories include chromosomal defects; damage from pelvic surgery, chemotherapy, or radiation therapy; or pelvic inflammatory disease (PID). Often a woman diagnosed with with POF will have a concurrent diagnosis of conditions like autoimmune thyroiditis, Grave's disease, or Addison's disease (involving the adrenal glands).
- The treatment options are are usually estrogen replacement therapy. However, this is not an option for women who are attempting to conceive because the estrogen tells the hypothalamus that it doesn't need to prompt the pituitary to stimulate the ovaries to produce estrogen. The whole hormonal system then goes to sleep. Usually POF diagnosis is left with one option: IVF with donor eggs.
The Chinese Medical View
Although the treatment of POF is challenging for practitioners, it is also rewarding because Chinese medicine offers one of the most effective ways to address POF. Traditional Chinese medicine views most cases of POF as a combination of excess and deficiency patterns cuasing the Penetrating and Conception meridians to become "empty," or a deficiency in Blood.
A typical treatment will consist of the following recommendations:
- Avoid wheat, refined carbohydrates, sugars, dairy, and most animal products.
- It's also wise to avoid hot, spicy foods. We want to calm the body down to make it less reactive.
- Take herbs like Astragalus (Huang Qi) to fortify the Spleen; herbs to nourish the Yin and Blood like Six Flavor Pill with Rehmannia (Liu Wei Di Huang Wan), and herbs to resolve the Blood stasis and obstruction, such as peach kernel (Tao Ren), moutan (Mu Dan Pi), and red peony (Chi Shao).
- Stimulate the acupressure points (shown by your acupuncturist) to regulate the Penetrating and Conception meridians and to supplement Yin and Blood.
With all treatments, however, it's important to remember the hundred-day time line for the production of a healthy egg. Please allow three cycles before you start trying to get pregnant and give your body (and your future child) the chance for the healthiest conception and pregnancy possible.
Please join me next week as we discuss part 7 of this series:
Mechanical Infertility: Clearing the Path to Conception
References
This article was written using the following sources:
1. The Infertility Cure : the ancient Chinese wellness program for getting pregnant and having healthy babies / Randine Lewis, Ph.D. ISBN 0-316-15921-2, pgs. 227 - 241
2. http://www.thefertilesoul.com
Categories: TCM (Traditional Chinese Medicine), Fertility, Pregnancy