Polycystic Ovary Syndrome (PCOS) and Infertility

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs similar to blisters. They are common among women during their reproductive years and are located on the two almond-sized ovaries on each side of the uterus. Most types of ovarian cysts are harmless and go away without any treatment. Some cysts come with increased estrogen and disappear when the estrogen level drops during a period. When women go through hormone injections for in-vitro fertilization, they tend to develop many small cysts in their ovaries.

What can cause ovarian cysts?

There are several possible reasons for the increasing prevalence of ovarian cysts:

1. High stress and multitasking can lead to hyperactivity of the sympathetic nervous system. With smart phones and the internet in our lives, our sympathetic nervous system is stimulated for more than 10 hours a day. When scientists transected the sympathetic nerve control over the ovaries in rats with chemically induced PCOS, the rats started ovulating again, and their cyst sizes were reduced. Electro-acupuncture activated certain muscle-nerve fibers to deactivate the sympathetic nervous system. It also changed neuronal activities in the spinal cord and induced the release of a number of chemicals, which are important in balancing the sympathetic and parasympathetic nerves over the uterus and ovaries. For the past 15 years, I have been treating many very fit women with PCOS. They exercise extensively and are very muscular, especially personal trainers. They may not have higher levels of estrogen, but their testosterone level is high and the ratio of LH/FSH is abnormal. They have higher metabolism and never gain weight, but they also have a very strong sympathetic nervous system which reduces the blood flow to the ovaries, therefore they do not ovulate regularly and develop many cysts in their ovaries. For this group of women, even if they do not gain weight, high stress can stimulate their sympathetic nervous system and lead to PCOS.

Our sympathetic nervous system is in charge of the fight or flight reaction for surviving. Our parasympathetic nervous system is in charge of the body’s basic needs: sleeping, relaxing, food absorption, sex and body repair. When we get older, our parasympathetic nervous system becomes weaker; it is hard for us to relax and get a good night’s sleep, especially in this high stress society. Acupuncture can strengthen the relaxing part of nervous system and bring the energy to your ovaries, uterus, adrenal gland, digestive system and your hands. If you are relaxing, you noticed that your heart rate slows down and your hands and feet become warm.

B.Y. Chen at Shanghai Medical University observed the effect of electro-acupuncture on hand temperature, ovulation and ß-endorphin level. Their clinical data showed that, after electro-acupuncture, for patients who resumed ovulation after treatment, their blood ß-endorphin level either declined from its original higher level or stayed within the normal range. On the other hand, for patients who did not resume ovulation, their blood ß-endorphin level was significantly higher than normal. Interestingly, when ß-endorphin is high, hand temperature is low, and the ovulation rate decreases. This may explain why many professional athletes, who have very high levels of ß-endorphin, have irregular periods and ovulation problems. Thus, the feeling-good hormone ß-endorphin should not be too high or too low in order to maintain the normal function of our ovaries.

Nerve growth factor can stimulate the peripheral nerve to regenerate and also can stimulate the ovarian cyst to grow. Dr. Stener-Victorin used nerve growth factor to measure how electro-acupuncture can influence sympathetic nervous system activity. With hyperactivity of the sympathetic nerves, the level of nerve growth factor will increase. Electro-acupuncture can lower the level of nerve growth factor. Another study done by Dr. Stenver-Victorin et al. evaluated the use of electro-acupuncture for ovulation induction on 24 women with PCOS, having symptoms of irregular period and no ovulation. The percentage of ovulatory cycles in all subjects was shown to improve from 15% (in a total of 3 months before treatment) to 66% up to 3 months after treatment. Responsive patients were noted to have significantly lower body mass index (BMI), waist-to-hip circumference ratio, serum testosterone concentration, serum testosterone/sex hormone-binding globulin ratio, and serum basal insulin level. In patients who do not ovulate regularly, especially in PCOS cases, electro-acupuncture can regulate their ovulation.

2. High insulin levels due to high sugar intake: High insulin can stop follicles from producing healthy eggs, and the follicle becomes a cyst. That is why women with PCOS tend to grow more facial and body hair. Each cyst grows bigger with the stimulation of estrogen and every cycle releases testosterone to interrupt ovulation. Polycystic ovarian syndrome is becoming increasingly common even among teenagers with a high sugar diet.

Western medicine uses Metformin to regulate blood sugar and menstrual period. There are many factors contributing to PCOS. Metformin can influence the digestive system, and cause indigestion. The following study compares how acupuncture can not only induce ovulation, but also increase the pregnancy rate. D. Chen et al in Guangzhou, China, conducted a clinical study on PCOS in 2007. One hundred and twenty-one cases of PCOS women were divided into an acupuncture group of 61 cases and a medication group of 60 cases with a randomized and controlled method. The needle-pricking therapy group was treated by needling the sacral region stimulating points on both sides of the spine and lateral points of Dazhui (CV 14), right underneath the cervical 7th vertebra, and the medication group by oral administration of domiphen and intramuscular injection of human chorionic gonadotropin (HCG), a pregnancy hormone. Levels of hormones and symptoms in the patients before treatment, at the 3rd menstrual cycle, and at the sixth cycle after treatment were investigated. After treatment for 3 menstrual cycles, the levels of testosterone and estradiol were reduced. Patients had more regular menstrual cycles with regular ovulation, and ultrasound examinations indicated a reduction of ovarian cysts in the two groups. However, at the sixth menstrual cycle after treatment, the conditions of the patients in the medication group had returned to the pre-treatment levels, whereas the conditions in the needle-pricking therapy group remained at the post-therapeutic level: their menstruation and ovulation restored to a normal state. Furthermore, the ovulation mucosa (vaginal discharge during ovulation) and the pregnancy rate were significantly higher in the acupuncture group than in the medication group. Acupuncture had a good long-term therapeutic effect for women with PCOS, helping them lose weight and lower their cholesterol.

3. Too much alcohol or medication compromises liver function. The liver can no longer break down estrogen and deactivate its effects, so estrogen and its metabolites lead to an imbalance of estrogen and progesterone, which prevents the ovaries from releasing healthy eggs.

4. Anti-acid medications especially influence the absorption of B12, causing anemia and malnutrition, so our ovaries cannot produce sufficient progesterone to balance the estrogen. The estrogen dominance condition can contribute to PCOS. Furthermore, the deficiency of B complex can lead to hyperactivity of the sympathetic nerves, contributing to the formation of cysts in the ovaries and other body parts.

5. Birth control pills: Many women take birth control pills to treat acne, menstrual cramps and irregular periods as well as for preventing pregnancy. Long-term use of birth control pills causes an imbalance between estrogen and progesterone. If we follow up with women who have been taking BCP for over 5 years, their menstrual pain usually has been reduced, but their cysts never go away, sometimes they can rupture creating an emergency situation.

What you can do to get rid of PCOS and get pregnant as soon as possible?

1. Strengthen your parasympathetic nervous system with electro-acupuncture once or twice a week, 3 months before you are planning to conceive.

2. Practicing gentle Yoga, meditation or Qi Kong every night before you go to sleep. You can simply take deep breathing when you are lying in your bed before you get up or before you fall asleep when you are doing your acupressure points.

3. Pressing the following points to dilate the blood vessels and bring energy to the ovaries:

Before ovulation:

CV4: From belly button to symphysis pubis, divide this area into 5 parts. The CV4 is located on the midline of the lower abdominal area, at the 3/5 part from belly button down to symphysis pubis.

CV3: From belly button to symphysis pubis, divide this area into 5 parts, located on the midline of the lower abdominal area, at the 4/5 part from belly button down to symphysis pubis.

Kid12: one thumb width lateral to CV3, at the same level.

After ovulation

Kid16: one thumb width lateral to the belly button, at the same level of the belly button.

CV7: located on the midline of the lower abdominal area, at the 1/5 part from belly button down to symphysis pubis.

CV9: located on the midline of abdominal area, the same distance above the belly button as CV7 is below the belly button.

The following points will help reduce blood stagnation and phlegm condition which are related with ovarian cysts and can be pressed before and after ovulation:

SP10: When the knee bends at the 90 degrees, the point is located on the medial aspect of the thigh, three fingers (index, middle and ring) above the medial-superior border of the patella.

SP9: located in the depression of the lower border of the medial condyle of the tibia.

Kid4: first locate Kid3, which is located between the top of the medial ankle bone and Achilles and one thumb directly below the kid3.

4. Stop coffee because it stimulates your sympathetic nervous system and you may grow more cysts. You can drink light green tea or white tea instead to make you happy and alert.