Menstrual periods coming only once every few months? Uncontrollable weight gain? Acne constantly flaring up on your face? Longing for pregnancy after marriage without success? These troubles may all point to the same "culprit" behind the scenes—Polycystic Ovary Syndrome (PCOS). What Chinese medicine can effectively treat it?
What are the main causes of the high incidence of PCOS?
Dr. Que Poh Yuen Albert, a TCM gynecology specialist at Gong Fang Tang TCM Singapore, stated that the etiology of PCOS is complex, resulting from the combined effects of genetic factors and acquired environment and lifestyle. Its high incidence is closely related to changes in modern living patterns:
Metabolic Burden from "Diet":
High-Sugar, High-Fat Diet: Excessive intake of refined carbohydrates, sugary drinks, and fried foods drastically increases the risk of insulin resistance (IR). IR is a core pathological link in PCOS, stimulating the ovaries to produce excess androgens and disrupting ovulation.
Nutritional Imbalance: Lack of dietary fiber, vitamin D, antioxidants, etc., affects endocrine balance.
Energy Imbalance from "Sedentary Lifestyle":
Lack of Exercise: A sedentary lifestyle with insufficient energy expenditure exacerbates obesity and insulin resistance, creating a vicious cycle. Even without obesity, lack of exercise itself impacts metabolic health.
Endocrine Disruption from "Staying Up Late":
Chronic Late Nights & Sleep Deprivation: Disrupts the normal rhythm of the hypothalamic-pituitary-ovarian (HPO) axis, affecting the secretion of sex hormones (such as luteinizing hormone, LH), leading to ovulation disorders and infrequent/absent periods (oligomenorrhea/amenorrhea).
Disrupted Circadian Rhythm: Particularly impacts the endocrine system.
Liver Qi Stagnation from "Stress":
Intense Mental Pressure: Multiple pressures from work, life, and emotions lead to chronic tension and anxiety. TCM believes "the liver system is particularly vital for women’s physiology," and emotional frustration most easily causes liver qi stagnation. Liver stagnation leads to qi stagnation; qi stagnation leads to blood stasis; liver stagnation overacting on the spleen leads to spleen deficiency generating phlegm-dampness. Qi stagnation, blood stasis, and phlegm-dampness are precisely the common pathological products in PCOS, obstructing the uterus and uterine collaterals, affecting follicle development and release.
Interaction of "Genetics and Environment":
Those with a family history of PCOS, diabetes, or hypertension have a higher risk. However, genetic susceptibility requires "triggering" by environmental factors like poor lifestyle habits to manifest.
Physician Que Poh Yuen Albert emphasized: "The high incidence of PCOS faced by modern women is largely a 'disease of the times' brewed by the combination of a fast-paced, high-stress life and unhealthy diet and lifestyle habits. Regulation cannot focus solely on the ovaries; it must start from the whole body, improving metabolism, relieving emotions, and restoring the balance of the internal organs.
What to Do About PCOS? Gong Fang Tang TCM Singapore's Que Poh Yuen Albert's Pattern-Based Regulation is Highly Effective!
How can TCM regulate and treat PCOS effectively?
Facing the complexity of PCOS, Physician Que Poh Yuen Albert deeply integrates classical TCM theory in practice, particularly advocating and excelling in the application of "Menstrual Cycle Phased Therapy". This therapy is not a fixed formula but involves dynamic and precise regulation using corresponding classical ancient formulas based on the physiological characteristics of different stages of a woman's menstrual cycle and the patient's specific pattern (Kidney Deficiency, Spleen Deficiency, Phlegm-Dampness, Blood Stasis, Liver Stagnation, etc.).
Essence of the Therapy:
Phased Treatment, Following Natural Timing:
Post-Menstrual Phase (Follicular Phase): From the end of menstruation to before ovulation. During this phase, the "Sea of Blood" is empty. Focus is on nourishing the Kidneys, replenishing essence, nourishing blood, and enriching Yin, laying the material foundation for follicle development. Common formulas: Modified Gui Shen Wan (Kidney-Returning Pill), Zuo Gui Wan (Left-Restoring Pill), or combined with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill). Sufficient Kidney essence nourishes the follicles.
Inter-Menstrual Phase (Ovulatory Phase): Around ovulation days. This is the critical moment of transition from predominant Yin to Yang. Treatment focuses on warming the Kidneys and supporting Yang, activating blood circulation to unblock collaterals, and soothing the Liver to regulate qi to promote ovulation. Common formulas: Modified Wen Jing Tang (Channel-Warming Decoction), Shao Fu Zhu Yu Tang (Lower Abdomen Stasis-Expelling Decoction) combined with Chai Hu Shu Gan San (Bupleurum Liver-Soothing Powder), or adding ovulation-promoting herbs like Dan Shen (Salvia), Hong Hua (Carthamus), Zao Jiao Ci (Gleditsia Spine). The goal is to invigorate Yang Qi, unblock uterine collaterals, and assist the smooth release of the egg.
Pre-Menstrual Phase (Luteal Phase): From ovulation to the onset of menstruation. During this phase, Yin is full and Yang grows. Treatment should warm and tonify Kidney Yang, soothe the Liver and fortify the Spleen to maintain luteal function and prepare for conception or menstruation. Common formulas: Modified You Gui Wan (Right-Restoring Pill), Xiao Yao San (Free Wanderer Powder), or Shou Tai Wan (Fetus Longevity Pill). Focus is on maintaining Yin-Yang balance and supporting the corpus luteum.
Menstrual Phase: During menstruation. Treatment focuses on activating blood to regulate menstruation and guiding blood back to its channels, ensuring smooth discharge of menstrual blood. Common formulas: Modified Tao Hong Si Wu Tang (Peach Kernel & Carthamus Four Substances Decoction) or Sheng Hua Tang (Generation and Transformation Decoction). Unblocking prevents pain, ensuring smooth menstrual flow.
Pattern Differentiation Integration, Precise Prescription:
Based on the phase, Physician Dr. Que precisely differentiates the patient's constitution and core pathogenesis (e.g., predominant Kidney Deficiency, Phlegm-Dampness, Blood Stasis, Liver Stagnation with Fire) and makes personalized modifications to the base ancient formulas.
Example 1: Obese PCOS with Profuse Phlegm-Dampness: Strengthen modifications based on Cang Fu Dao Tan Wan (Atractylodes & Cyperus Phlegm-Guiding Pill), emphasizing Cang Zhu (Atractylodes), Ban Xia (Pinellia), Fu Ling (Poria), Chen Pi (Citrus Peel) to fortify the Spleen and transform phlegm-dampness.
Example 2: Liver Stagnation Transforming into Fire with Severe Acne: While soothing Liver and regulating qi, incorporate principles from Dan Zhi Xiao Yao San (Moutan & Gardenia Free Wanderer Powder) or Long Dan Xie Gan Tang (Gentiana Liver-Draining Decoction) to clear Liver and drain fire.
Example 3: Kidney Deficiency with Blood Stasis causing Infrequent/Absent Periods: While tonifying Kidneys, strengthen the blood-activating and collateral-unblocking power of Ge Xia Zhu Yu Tang (Beneath the Diaphragm Stasis-Expelling Decoction) or Xue Fu Zhu Yu Tang (Blood Mansion Stasis-Expelling Decoction).
Holistic Regulation, Addressing Root and Manifestation:
This therapy not only focuses on restoring the menstrual cycle and ovulation but also emphasizes improving overall constitution: regulating metabolism (improving insulin resistance), balancing endocrine function (lowering androgens), improving acne/hirsutism, controlling weight, relieving anxiety, etc., creating an internal environment unfavorable for PCOS development from the root.
Physician Que Poh Yuen Albert stated: "The advantage of Menstrual Cycle Phased Therapy lies in its 'dynamic precision.' It simulates and follows the body's natural physiological rhythm, leveraging the characteristics of Qi, Blood, Yin, and Yang changes at different stages, utilizing the power of classical formulas to guide according to the situation, helping the disordered cycle return to the right track. This is a vivid embodiment of TCM's holistic view and pattern differentiation/syndrome treatment in gynecological menstrual regulation and fertility promotion."
Medical Case
Patient: Ms. Li, 28 years old.
Chief Complaint: Infrequent periods (every 3-6 months) for 3 years, failure to conceive without contraception for 2 years after marriage. Recurrent facial acne, overweight (BMI 26.8), fatigue, soreness and weakness in lower back and knees, aversion to cold.
Examination: Ultrasound showed polycystic changes in both ovaries; Hormones: LH/FSH > 3, elevated testosterone.
First Consultation: Tongue pale, swollen with teeth marks, coating white and greasy; pulse deep and thready.
Diagnosis: Polycystic Ovary Syndrome (PCOS).
TCM Pattern Differentiation: Spleen and Kidney Yang Deficiency with Internal Obstruction of Phlegm-Dampness.
Treatment Course:
Holistic Regulation Phase: Focus on fortifying Spleen, tonifying Kidneys, warming Yang, and transforming phlegm-dampness, emphasizing improving constitutional foundation. Formula: Modified You Gui Wan (Right-Restoring Pill) combined with Cang Fu Dao Tan Wan (Atractylodes & Cyperus Phlegm-Guiding Pill) (Shu Di/Rehmanniae Radix Praeparata, Shan Yao/Dioscoreae Rhizoma, Shan Zhu Yu/Corni Fructus, Gou Qi Zi/Lycii Fructus, Du Zhong/Eucommiae Cortex, Rou Gui/Cinnamomi Cortex, Zhi Fu Zi/Aconiti Lateralis Radix Praeparata, Cang Zhu/Atractylodis Rhizoma, Xiang Fu/Cyperi Rhizoma, Fu Ling/Poria, Ban Xia/Pinelliae Rhizoma, Chen Pi/Citri Reticulatae Pericarpium, etc.). Combined with dietary and exercise guidance.
Menstrual Cycle Phased Treatment Phase (Subsequent):
Post-Menstrual Phase: Primarily Gui Shen Wan (Kidney-Returning Pill), adding Dang Shen (Codonopsis), Bai Zhu (Atractylodes Macrocephala) to fortify Spleen, small amounts of Dan Shen (Salvia), Ji Xue Teng (Spatholobi Caulis) to nourish blood and activate circulation.
Inter-Menstrual Phase (Ovulation Monitoring): Modified Wen Jing Tang (Channel-Warming Decoction) combined with Shao Fu Zhu Yu Tang (Lower Abdomen Stasis-Expelling Decoction) (Wu Zhu Yu/Evodiae Fructus, Dang Gui/Angelicae Sinensis Radix, Chuan Xiong/Chuanxiong Rhizoma, Chi Shao Yao/Paeoniae Radix Rubra, Gui Zhi/Cinnamomi Ramulus, Dan Pi/Moutan Cortex, Sheng Jiang/Zingiberis Rhizoma Recens, Ban Xia/Pinelliae Rhizoma, Mai Dong/Ophiopogonis Radix, Xiao Hui Xiang/Foeniculi Fructus, Yan Hu Suo/Corydalis Rhizoma, Wu Ling Zhi/Trogopterori Faeces), plus Zao Jiao Ci (Gleditsiae Spina), Lu Lu Tong (Liquidambaris Fructus) to promote ovulation.
Pre-Menstrual Phase: Modified You Gui Wan (Right-Restoring Pill) combined with Xiao Yao San (Free Wanderer Powder) to warm and tonify Kidney Yang, soothe Liver and regulate Spleen.
Menstrual Phase: Modified Tao Hong Si Wu Tang (Peach Kernel & Carthamus Four Substances Decoction) to activate blood and regulate menstruation.
Result: After 2 months of treatment, menstrual cycle shortened to 40-50 days, energy and physical strength improved, aversion to cold reduced; In the 3rd month, entered phased cycle regulation, successfully monitored a dominant follicle and ovulation; In the 4th month, Ms. Li successfully conceived naturally!
