Polycystic ovary syndrome (PCOS), affects 5-10% of women in North America and is the leading cause of ovulatory based infertility.
Women with PCOS are known to have high levels of male hormones (androgens), which interfere with the normal production of female hormones like estrogen and progesterone.
Many women with pcos will experience some or all of the following symptoms: irregular periods or no menstruation (amenorrhea), weight gain or obesity, excessive hair growth (hirsutism) and/or abnormal hair growth, enlarged ovaries covered with cysts, acne, glucose intolerance, or impaired glucose metabolism, insulin resistance, mood swings and irritability. But you do not have to experience these symptoms to have pcos, as some women have no symptoms at all.
How does this affect your fertility?
Insulin is a hormone that regulates the transformation of sugars and starches into energy for the body or into storage for future use. If there is too much insulin in the blood, a rise in male hormones can occur. Excessive insulin also blocks the liver from regulating these male hormone levels. As a result of these excessive androgens (male hormones), follicles develop too quickly and then shut down prematurely before they are able to produce an egg. As a result, the ovaries fill with cysts or create immature follicles that are unable to produce eggs.
TCM (Traditional Chinese Medicine) and PCOS
In Chinese Medicine this condition can have a number of linked patterns of deficiency and excess that have an impact on the way the body ovulates. TCM always looks to the individual and seeks to find the underlying pattern and bring the body back to balance from there. Women may fall into one of the following patterns or exhibit symptoms from a combination of them. Working with a qualified TCM Doctor is the ideal way to diagnosis but the following will give you and idea of where you might fit.
The first patterns result from a deficiency in the body and an imbalance in the kidney system (think of the kidneys as your bank of energy or your reserved energy/adrenal glands). Imbalance can show up in either yin (female energy) or qi/yang kidney energy (male energy). When the yang is off-balance you will have signs like: lethargy, cold limbs, frequent urination, heavy sensation in the abdomen, excessive vaginal discharge, a pale, swollen tongue with a sticky white coating, low sex drive. When the yin is off-balance you will have symptoms such as: night sweats, flushes of heat, a short follicular phase, dizziness, low backache, constipation, slight anxiety, scanty and dark urine.
The other patterns are more excess patterns and present as damp-phlegm accumulation (think of how phlegm accumulates when you have a cold – a similar pattern can exist internally leading to accumulations or cysts) or blood stasis (when energy and blood isn’t moving, it accumulates and stagnates unable to move the old out or bring in the new fresh blood leading to accumulations or cysts). Symptoms of damp-phlegm conditions would look like foggy headedness or fatigue and feeling heavy limbed, bloating after meals, chronic nasal congestion or phlegm, looser bowel movements. Stasis symptoms would show up in painful periods, headaches, irritability or pms, rib pains or tightness, sighing a lot, irregular periods, clotted menstrual blood, a purplish tinge to the lips or tongue.
As PCOS is strongly influenced by insulin levels and glucose metabolism, diet and lifestyle modifications can have a significant impact on balancing your hormones and regulating your blood sugar levels and PCOS.
Working with a TCM Doctor for your particular diagnosis and incorporating acupuncture and herbs into your regime is also important and helpful in rebalancing your body. But, by incorporating the following dietary and lifestyle modifications, you can help make a significant change at home. The little things you do daily can make a BIG difference in the long-term! You can also learn more here
- Eat foods low on the Glycemic Index (GI) such as vegetables and whole grains. It is very important for women with PCOS to completely avoid refined carbohydrates which include: sugar (pop and candy), white flour, whole wheat flour and products made from them (pasta, breads, desserts, etc.)
- Keep your blood sugar stable by eating regularly – every three to five hours is ideal and making sure that you include some protein and good fats (for example some nuts or seeds and their butters, eggs, humus etc.) at each meal. Protein foods take up to 5 hours to digest while carbohydrate foods digest within 30 minutes and can spike your blood sugar.
- Eat at least five servings a day of vegetables including at least two of leafy greens (kale, broccoli, collard greens, bok choy, cabbage, rapini, etc..) Leafy greens contain indole-3 carbinol, which helps to regulate liver function which is key in glucose and hormone metabolism.
- Have a regular servings of legumes like black beans, adzuki beans, mung beans, black-eyed peas etc.. Adzuki beans are beneficial in draining ‘dampness’ from the body.
- Eat organic meats only. You can have red meat up to 3 times/week but make sure it is organic and grass-fed (when meat has been grain fed it changes the fats from healthy omega 3 fats to omega 6’s)
- Eat at least three daily servings of fruits like berries –which are lower on the glycemic index and high in anti-oxidants
- Include cinnamon into your diet daily as it helps to reduce insulin resistance
- Include bitter Melon and fenugreek – help to regulate blood glucose
- Include complex carbohydrate such as whole grain cereals, quinoa, brown rice, etc.
- Insure adequate fiber intake (should be 30g/day), by eating a lots of fresh vegetables and whole grains
- It is very important that women with PCOS avoid all refined sugars (white and brown sugars, fructose, sucrose, corn syrup) and simple sugars (maple syrup, honey etc). (Lower sugar intake by avoiding intake of simple sugar that helps to prevent further impaired glucose metabolism)
- No refined carbohydrate (white bread, pasta, potatoes, white rice, most breakfast cereals, rice cakes, popcorn, or any starchy, low fiber food)
- Avoid artificial sweeteners (which are shown to affect the insulin levels the same way sugar does)
- Pay careful attention to portion sizes in order to moderate glucose load and minimize insulin resistance. Opt for smaller and more regular meals than bigger and more spaced out ones.
- Avoid sodas, fruit juice and drinks that raise the blood glucose rapidly (i.e. Energy drinks, Gatorade or any drink with refined sugar)
- Avoid milk and dairy products (cheese and yogurt), which are considered as ‘damp’ foods and will exacerbate the problem. Try substituting unsweetened almond milk as an alternative to cow’s milk.
- Include some form of moderate exercise (yoga, pilates, walking etc) for at least 30 min/day. Studies have shown that exercise can reverse diabetes and improve insulin sensitivity as well as help with weight control.
- Lose some weight (Fat cells store estrogen which can have a direct influence on pcos and fertility. Losing even a moderate amount of weight if you are overweight can have a significant improvement)
- Love your liver (Your liver is important in insulin metabolism, so it is important to keep your liver functioning well. Adding vitamin B complex to your daily routine will help to restore liver normal function in insulin balancing. Also be sure to include leafy green vegetables daily and be sure to watch your stress level and moods. If you’re agitated easily and find yourself frustrated regularly, include some stress management tools into your daily life: meditation, visualization and regular exercise all help.
- Get regular acupuncture. A study at Goteborg University in Sweden showed that electro-acupuncture may help 38% of women with PCOS women ovulate. Acupuncture can help to restore the ratio of LH and FSH, reduce the level of testosterone and beta-endorphin. Some studies show that acupuncture also helps to shrink of the weight of polycystic ovaries, which can enhance ovulation and egg implantation. Weekly acupuncture is ideal.
- Chlorophyll -reduces symptoms of hypoglycaemia without raising blood glucose level. You can buy liquid chlorophyll at the health food store and add it to your water and sip it throughout the day
- Probiotics (the healthy bacteria found in your intestinal tract). Foods which promote the growth of beneficial bacteria in the intestinal tract include whole grains, onions, bananas, garlic, honey, leeks, artichokes and some fortified foods. Probiotic can be taken in supplement/capsule form (although dairy/yogurt does include probiotics, it is not in a therapeutic dose and it is best to avoid dairy products foods for women with pcos).
- B Vitamin
- Fish oil
- Alpha lipoic acid
Learn more about your PCOS body type according to Chinese medicine here
23 responses to “PCOS – A Chinese Medicine Diet and Lifestyle Approach”
Great article! Thank you! 🙂
Great Website and Articles…
I will pass your site onto my family, friends and patients…
I have PCOS and now being treated by local TCM Specialist. Thank you for the article
I’m so glad to hear that and hope the article helped! All the best
Hi Thank you so much for your insightful article. I have PCOS and have experienced an early miscarriage this year. Since then I’ve become vegan in hopes that this will help. In yoru article you say that wholewheat should be avoided… so should I just stick to brown rice and beans for carbs?
Also, I wonder if you have any referrals for TCM’s in HK that specialise in this
Thanks for your message – I’m glad you found the article useful. Generally wheat can be a congesting grain so over-consumption of it can lead to ‘dampness’ or one of the contributors to pcos. If it’s not something you have often I wouldn’t worry too much about it, but if it’s a staple, I would cut it out and stick to other grains like brown rice or quinoa. If you tend to be on the thinner side with pcos I would also look at reducing stress as much as possible in your life as that can be a contributor as well. I hope that helps. And as far as a TCM practitioner in HK, I’m sorry but I don’t know anyone specifically. I’m sure there are a lot of amazing TCM’s there but I will ask some of my colleagues and see if I can find someone for you. All the best to you!
Thank you so much for your reply! 🙂
I am still actively trying to find a TCM in HK, I think my main issue is that I need one that speaks fluent English.
How do you know if the symptoms of PCOS have gone without having an ultrasound? Is ther any way to tell?
I only ask because I want to know how soon my husband and I should try again for a baby….
Thank youuuuuuuu 🙂
HI Angela.. I have PCOS and have been under the impression that it was getting better. Lately, I feel a major shift again with my lady cycle, moods, and hair growth. Also, my husband and I have been trying for almost 1 year to get pregnant, and nothing. I found your article amazing and wish to follow your suggestions regarding the diet, since I am active 3-4 days a week of yoga, cycling and pilates, I will continue this regiment. I was thinking of doing a detox prior to my change of diet. Any suggestions?
I also have PCOS and after reading Angela’s article I went through Chinese medicine and also went vegan for a few months…and got pregnant….once I got pregnant couldnt stay vegan cuz baby wanted meat. Now have a healthy 1 yr old. I found it helped me to detox my body and get sugar levels under control….hope this helps 🙂
Hi Jiwon, that’s amazing that you have managed to control your PCOS. Can I please ask which TCM did you consult in HK?
I wanted to give an update on my status. After reading Angela’s article, I changed my lifestyle accordingly and then found my menstrual cycle becoming more regular. After 10 months of this lifestyle change, including active exercise, I got pregnant and we are expecting our 1st child this March 2014. We are so grateful and happy we found Angela’s article and how it gave us this beautiful growing child in my belly and our dreams answered.
i too suffer with pcos but i had no idea dairy affects this condition. I,ve been on metformin 500mg but still suffer. I will change my diet to a more strict regimen.hope this helps and much to success to you all.
Diet can really make a huge difference! I’m working on a book right now that will go into more detail and offer a lot more help as to things you can do. I’ve seen a huge difference in my patients who embrace the food changes as well as the acupuncture and herbs. Good luck and all the best to you
I have PCOS confirmed by ultrasound and am just beginning to do acupuncture weekly – I am not overweight, and exercise regularly, but cannot get pregnant. I am having trouble understanding exactly which foods i need to cut out (and which to add in) to my diet to “reduce dampness” – My current diet consists of high-fiber, high protein (often organic turkey and chicken), lots of organic vegetables and brown rice. I usually cook spicy food – i am lactose intolerant so I use lactose free milk and goat cheese. I enjoy beer and liquor – do these affect dampness? As far as grains go – it is so hard to tell from ingredients on carb products which ones are the right ones – whole wheat? whole grain? different types of flour? I find it all very confusing. thanks for your help!
Sorry for the delayed response. We say there are a few different patterns for pcos and dampness is a big culprit. Dairy (lactose free or not) is actually considered a very damp (and also cold) food. And as far as alcohol goes, beer can be a bit ‘damp’ forming as well (and cold particularly as it’s served right out of the fridge!). Unfortunately stress is another thing that is detrimental to fertility and pcos (basically it restricts adequate blood flow to reproductive organs as your body will naturally try to restrict or conserve where the energy goes under stress). Stress reducing techniques can be hugely helpful. Unfortunately I can’t offer too much specific without knowing more about your case. As for grains, generally the grains in their most whole form are best and I’ll often recommend ones from the gluten free family when possible (quinoa, rice, amaranth etc.are great options). Limiting wheat based products, particularly the refined ones is something that is also helpful/important. I hope this helps a bit! Good luck!
Any chance for an updated article?
Thank you for the enlightening article. I recently was diagnosed with PCOS a few days ago. I am not quite sure how long I’ve had the condition however I noticed symptoms of excessive weight gain the past 3 years along with irregular periods, facial hair, skin tags, and pelvic pain. I have always been active and lived a healthy lifestyle. Although the past three years I have had no success in losing weight. During my childhood years I was considered a normal weight, then in my adolescent years I gained some weight, then when I turned 18 I became a strict vegetarian and throughout college I lost about 60 lbs and became underweight about 105 lbs unintentionally. When I was about 21 I started to eat fish so then I was at a normal weight about 125 lbs . When I got pregnant at 27 I was 150 lbs and started to eat lean meat like poultry and still ate fish, vegetables, whole grains and fruits. I also worked out during my entire pregnancy. After I had my daughter I immediately lost 25 lbs with in weeks. During that year after I had her I was almost down to my weight I was when I got pregnant about 160 lbs. When I was about 29 is when I noticed I was gaining excessive weight. I was going back and forth on different birth controls and then I was sick a few times and was given steriods. After this time I would gain 10-15 pounds every year after. I would switch back to my vegetarian diet for 6 months or more and I could not lose any weight. I had personal trainers, did a doctor’s boot camp, switched up my workouts, and more. In May-June 2013 followed the doctor’s diet during my boot camp program which was more lean meat protein 30% of my diet, 20% healthy carbs and 50% veggies and fruits and they did blood work and this was the first time I found out my hormones were imbalanced. I also took daily metabolic shots, medicine to help balance my hormones, B12 shots, and more. I did not lose any weight. I had high testosterone, low human growth hormone and more. So since then now at 31, I went back to being a pescatarian (fish, veggies, whole grains, fruits and cheese). A few weeks ago I had a physical at my primary doctor which does allopathic medicine, TCM, and there is a ND as well there. However they want to refer me to an endocrinologist and nephrologist. They said my testosterone has doubled, insulin has gone up, my cholestorol levels are off, platelets are high, and that I was at risk for things I never was before. Then they confirmed with an ultrasound it was PCOS. They also did one on my kidney because my renal labs came back at risk. Which I knew I had a kidney stone in my left kidney. So now after reading this article and others what do you recommend is the best diet for me to stick to? Right now I weigh more than I’ve ever weighed before at 195 lbs and I’m only 5’5. I still workout 4-5 times a week such as running, hiking, lifting light weights, doing yoga, pilates, incline, stair master, walking, and more. I am still a pescatarian but I’m considering to do a low glycemic diet or the ketonic diet. I may incorporate organic poultry but I’m not sure. I definelty want to cut out cheese, wheat, and carbohydrates. I drink almond milk, eat egg whites as well. Please let me know what you think may be best for me. I really appreciate it and apologize for the long message. I prefer doing things the natural way. Thanks!
Thank you for your note – I will go over it in more detail but it might be easiest to correspond via email. You can write me at firstname.lastname@example.org and we can chat more that way if it works for you. Thank you again for reaching out and I look forward to talking more soon. Angela
Last year I went to my gyno. My symptoms were acne and excess hair growth. I also battled modrate depression and anciety. It turned out I had slightly elevated Shea and testosterone. She told me I was borderline pcos. I’m 5’8″ and 135 lbs. My diet was awful. I used to crave sugar and eat candy and chocolate in excess everyday. Since then, I have cut out gluten, artificial sugars, dairy andrefined carbs. I also work out 20 mins cardio and about an hour of resistance training 4x a week. I drink super food smoothies and protein mostly. I don’t drink coffee anymore. I also take saw palmetto. Even with all this, my physical symptoms are gone but my premenstrual depression is still pretty bad some months.I was wondering if there is anything else I can do that you would recommend for someone in my case?
Thanks for your comment. They all sound like great changes that you’ve made, and the fact that most of your physical symptoms are better shows your body agrees! I would say for the PMS, I would try to seek out at local Chinese Medicine practitioner to do acupuncture with you pre-menstrually. They may also suggest some herbs. I find with my patients, a few months of regular acupuncture can help get things back on tract fast. I hope that’s helpful. If you let me know what areas are around you I can try to recommend someone for you. Otherwise, keep up the amazing work!
all the best,
Hi Angela, great article! I don’t fit the standard PCOS profile of being overweight and having insulin resistance. I am healthy, young (23), and active, but my hormones are just so out of whack! I have chronic low estrogen that contributes to my irregular periods, migraines, moodiness, vaginal dryness (so frustrating!) and PCOS like symptoms. Anyway, I would like to treat myself in naturopathic or TCM way, but I’m not sure if some women simply need some hormone supplementation to keep things stable…….(I hate birth control because usually makes my headaches/symptoms worse! I tried Metformin and felt a bit better, but I simply don’t like the idea of taking something indefinitely?…)
Have you seen a patient like myself? Irregular periods and low estrogen/migraines? Vaginal dryness at 23? Help ! 🙂
If anyone else has similar experiences- I would love to chat! email@example.com
Also—recommendations to see naturopathic/TCM in NYC?
Thanks for your message – yes I have had patients presenting in similar ways to you. There are a few ‘patterns’ in TCM that can contribute to PCOS like symptoms. One is the ‘damp/phlegm’ pattern which gets talked about a lot. The other pattern is more of a ‘stuck’ pattern and often shows up in women who are thin and have more pms like symptoms or pain. There are absolutely things that you can do to help! Food and diet is big, stress reduction and moderate exercise can help (but it’s important not to OVER exercise!!) and then in my experience herbs and acupuncture are tremendously helpful as well. I will try to get some contact people for you in the NYC area! I can also do long distance (Skype) consults for people to get them started while looking for someone else which can be helpful with the foods and lifestyle components. I’ll be in touch soon with other information! All the very best, Angela