PCOS? Acupuncture Can Help: A Guide to Supporting Your Diagnosis

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a condition where your brain mistakenly creates more LH (lutenising hormone) and not enough FSH (follicular stimulating hormone). This unbalanced ratio creates a surge of androgens and insulin creating a maelstrom of perfect conditions for PCOS.

Symptoms of PCOS can include:

Absent or irregular periods
Acne
Increase in body and facial hair, typically called hirsutism
An increase in weight
A greater risk of developing non-insulin depending diabetes
High blood pressure and an increase in the possibility of cardiovascular disease

Whilst not a sign of PCOS, understandably there is also a mental-emotional element to PCOS because of the symptoms that people are displaying.

It can be very lonely, depressing, and scary to be told you have PCOS. The fear of possibly not having children, or having to live with an excess of hair, weight gain, and/or acne can be detrimental to some people's mental health.

Diagnosing PCOS

If you suspect you have PCOS, based on your signs and symptoms, then the NICE guidelines for a diagnosis include:

Signs and symptoms mentioned above including (but are not necessarily all)
- hirsutism
- acne
- absent or irregular periods
- weight gain
Blood tests for:
- FSH
- E2
- LH
- Testosterone (will be normal to high with PCOS)
- Androgens (will be normal to high with PCOS)
- SHBG (sex hormone binding globulin, will be normal to low in PCOS)
- Prolactin (will be normal to high with PCOS)
- TSH
- Fasting insulin test
- Ultrasound scan (although please note that the absence of cysts on the ovaries does not preclude a diagnosis of PCOS if all other signs and symptoms demonstrate it)

What "type" of PCOS do I have?

Understanding the "type" of PCOS you are experiencing can give you a range of different tools and holistic methods that you can correctly incorporate to help support you.

Insulin resistant PCOS

Insulin-resistant PCOS is a common endocrine disorder that affects up to 20% of women of reproductive age. It is characterized by chronic ovulation dysfunction, an overabundance of androgens, and insulin resistance. Insulin resistance is a condition in which the body's cells do not respond normally to insulin, a hormone that helps regulate blood sugar levels. In women with PCOS, insulin resistance can lead to high blood sugar levels, which can increase the risk of type 2 diabetes.

To see if you have insulin-resistant PCOS, you will need a "fasting insulin" blood test. You might also be able to have a HOMA-IR index which measures your ratio of glucose to insulin.

Inflammatory PCOS

If your PCOS is not insulin-resistant or post-pill then we might consider inflammatory PCOS. If you have all the typical signs and symptoms of PCOS plus:

digestive problems
unexplained fatigue
headaches
joint pain
skin conditions such as eczema and psoriasis

then this might be inflammatory PCOS.

Post-pill PCOS

Post-pill PCOS is a condition that can occur in some women after they stop taking hormonal birth control pills. The exact cause of post-pill PCOS is not fully understood, but it is thought to be related to changes in the body's hormones after stopping birth control pills.

In most cases, post-pill PCOS is a temporary condition that will resolve on its own within a few months. However, in some cases, the symptoms may persist for longer.

To diagnose post-pill PCOS, you will have the normal symptoms of PCOS, plus you DO NOT have insulin resistance, and your periods were normal before the pill.

The only other result might be an high LH to FSH.

Adrenal PCOS

Adrenal PCOS is when you have elevated DHEAS (dehydroepiandrosterone) from the adrenal glands. You will have normal ovarian androgens (testosterone and androstenedione) but you will have all the other signs and symptoms of PCOS.

With adrenal PCOS you maybe able to ovulate regularly.

You will be able to diagnose adrenal PCOS by having only elevated DHEAS.

Acupuncture for PCOS

Acupuncture might be able to support you with your symptoms of PCOS; both physical and mental.

I have written a comprehensive blog post here about how acupuncture might support you. This blog post (it is a 4-minute read) looks at:

What PCOS is in acupuncture and Chinese medicine
The evidence for using acupuncture in supporting your PCOS diagnosis
Free lifestyle advice based on your Chinese medicine diagnosis that you can start incorporating today.

Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews (December 2022)

"combining acupuncture with other medicines can effectively improve the clinical pregnancy rate (CPR) and ovulation rate, and reduce luteinizing hormone/follicle-stimulating hormone ratio, homeostasis model assessment of insulin resistance, and body mass index (BMI).

Further, when compared with no intervention, acupuncture had a better effect in promoting the recovery of menstrual cycle.

Acupuncture was reported to cause no adverse events or some adverse events without serious harm"

Taking the P

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