Health Resources

Syndrome Differentiation and Constitutional Regulation: TCM Approaches to PCOS

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders among modern women, characterized primarily by ovulatory dysfunction, hyperandrogenism (high male hormones), and polycystic ovarian morphology. Western diagnosis relies on hormonal blood tests and ultrasound scans. While conventional treatments often involve oral contraceptives or ovulation-inducing drugs to alleviate symptoms, the condition may recur once medication stops, and some patients experience hormonal side effects. In Singapore, PCOS is a prevalent gynecological endocrine issue frequently linked to irregular menstruation, amenorrhea (absence of periods), abnormal ovulation, and infertility. Women with a higher Body Mass Index (BMI) are statistically more prone to developing PCOS.

Common Clinical Symptoms:

  1. Menstrual Irregularities: Infrequent periods (cycles exceeding 35 days or lasting several months), scanty menstrual flow, or even amenorrhea.
  2. Ovulatory Dysfunction: Difficulty or failure to ovulate, which is a leading cause of female infertility.
  3. Hyperandrogenism: Manifestations such as hirsutism (excessive hair on the face, lower abdomen, or chest), acne, and androgenetic alopecia (thinning hair).
  4. Obesity or Metabolic Syndrome:
    • Abdominal obesity (BMI > 25 or excessive waist circumference).
    • Insulin resistance (increased risk of hyperinsulinemia, pre-diabetes, or Type 2 diabetes).
  5. Polycystic Ovarian Changes: Ultrasound findings of enlarged ovaries with small follicles (≥12 follicles, 2–9mm in diameter) arranged in a "necklace" pattern.

TCM Understanding of PCOS

TCM categorizes PCOS under "Delayed Menstruation," "Amenorrhea," or "Infertility." The root cause often lies in congenital Kidney Qi deficiency combined with acquired Spleen and Stomach dysfunction, emotional distress, or Liver stagnation turning into "fire."

The specific mechanisms include:
1. Kidney Deficiency and Blood Stasis: Insufficient congenital essence leads to Kidney Qi weakness and lack of nourishment for the Chong and Ren meridians, resulting in ovulatory failure.
2. Phlegm-Dampness Obstruction: Overconsumption of greasy/sweet foods or Spleen dysfunction leads to internal dampness that congeals around the ovaries, obstructing the meridians.
3. Liver Stagnation and Fire: Chronic stress or anxiety causes Liver Qi to stagnate and turn into heat, disrupting the balance of Qi and Blood and leading to relative androgen excess.
4. Disharmony of Qi and Blood: Qi deficiency causes poor circulation, while blood deficiency leads to poor storage; both interfere with healthy ovulation.

TCM Syndrome Differentiation and Treatment

TCM treatment for PCOS emphasizes personalized care. Common patterns include:

  • Kidney Deficiency and Blood Stasis: Delayed periods, stabbing pain in the lower abdomen, dark purple tongue. Treatment: Tonify the Kidneys and activate blood (e.g., Rehmannia, Angelica, Sanling).
  • Spleen Deficiency and Phlegm-Dampness: Scanty menses, fatigue, greasy tongue coating. Treatment: Strengthen the Spleen and transform dampness (e.g., Erchen Decoction).
  • Liver Stagnation and Fire: Irritability, pre-menstrual breast tenderness, red tongue. Treatment: Soothe the Liver and clear fire (e.g., Xiaoyao San).
  • Deficiency of Qi and Blood: Infrequent periods, sallow complexion, fatigue. Treatment: Replenish Qi and nourish blood (e.g., Bazhen Tang).

Advantages of TCM Treatment

  • Treating Both Branch and Root: Oral herbs regulate the organs while acupuncture clears the meridians to improve ovulatory function.
  • Personalized Plans: Prescriptions are adjusted based on the patient's specific constitution and disease stage.
  • Low Side Effects: Natural ingredients are suitable for long-term conditioning.
  • Enhancing Fertility: Balances hormones naturally to increase the chances of spontaneous conception.

Daily Prevention and Care

  • Diet: Avoid greasy and cold foods. Incorporate Spleen-strengthening ingredients like Chinese Yam, Barley, and Red Dates.
  • Exercise: Maintain regular activities like brisk walking, Yoga, or Ba Duan Jin to promote circulation.
  • Emotions: Manage stress to prevent Liver Qi stagnation.
  • Sleep: Maintain a regular sleep schedule to stabilize the endocrine system.

Dr Li Rui: Over 30 Years of Clinical Experience in Women's Health

Dr Li Rui graduated from the China Academy of Chinese Medical Sciences, holding a Master's degree in TCM and a Bachelor's degree in Western Medicine. With over thirty years of experience, she studied under the renowned gynecological expert Professor Li Guangrong. Dr Li Rui specializes in using a combination of herbal medicine, acupuncture, and dietary therapy to regulate PCOS, menstrual disorders, infertility, and insomnia. She emphasizes a constitutional approach to restore Yin-Yang balance and improve reproductive health.

If you have been struggling with PCOS, you are welcome to book an appointment with Dr Li Rui at our Yishun TCM clinic for a professional assessment and a personalized regulation plan.