Do you experience menstrual irregularities, uncontrollable weight gain, and persistent acne? Does facial hair and hair loss in the mirror cause anxiety? This may be polycystic ovary syndrome (PCOS) at play! This condition affects nearly 10% of women of reproductive age. How does Traditional Chinese Medicine (TCM) treat it?
What Causes PCOS?
Dr. Que Poh Yuen Albert, a TCM Gynecology Specialist at Singapore Gong Fang Tang TCM, explains that Singaporean patients predominantly exhibit "Spleen Deficiency with Phlegm-Dampness"—spleen dysfunction leading to phlegm-stasis blocking the uterus, causing amenorrhea and infertility.
The core reasons for this pattern in Singaporean PCOS patients can be summarized as "Three Overlapping Factors":
Hot-Humid Climate
Singapore’s rainy, humid climate allows dampness to trap the spleen, impairing its transport function → Fluid retention transforms into phlegm.
Heat boils bodily fluids → Sticky phlegm-dampness congeals in the uterus, blocking follicular development.
Dampness-Aggravating Diet
Sweet cravings (desserts/fruits) → Sweetness obstructs the spleen, worsening damp-turbidity.
Overconsumption of cold drinks/herbal teas → Damages spleen yang, preventing fluid metabolism.
Constitutional Predisposition
High prevalence of phlegm-damp constitution in Singaporeans (genetic metabolic slowdown).
Spleen deficiency → Phlegm-stasis binding → Directly causes polycystic ovarian morphology.
What Are the Symptoms of PCOS?
Menstrual disorders: Cycles >35 days, <8 periods/year, or amenorrhea
Hyperandrogenism: Upper lip/areola hirsutism, stubborn acne, androgenic alopecia
Metabolic abnormalities: Central obesity (waist >80cm), acanthosis nigricans (dark neck/armpits)
Ultrasound findings: ≥12 follicles (2–9mm) per ovary
Reproductive issues: Anovulatory infertility, recurrent miscarriage
Emotional problems: Anxiety, depression, sleep disorders
How Does TCM Treat PCOS?
For phlegm-dampness type PCOS, Dr. Que applies the century-old formula Cangfu Daotan Tang (苍附导痰汤) with tailored modifications, offering recovery hope to numerous patients.
Formula Composition:
Atractylodes (苍术), Cyperus (香附), Tangerine Peel (陈皮), Arisaema (南星), Citrus Aurantium (枳壳), Pinellia (半夏), Chuanxiong (川芎), Poria (白茯), Medicated Leaven (神曲).
Formula Actions:
Monarch Herbs:
Atractylodes (苍术) – Dries dampness, resolves phlegm-turbidity, strengthens the spleen (targets root cause).
Cyperus (香附) – Soothes liver qi, alleviates stagnation from phlegm-damp obstruction.
Minister Herbs:
Poria (茯苓) – Fortifies spleen, drains dampness, enhances Atractylodes.
Tangerine Peel (陈皮) – Moves qi, transforms phlegm; synergizes with Cyperus to disperse dampness.
Assistant Herbs:
Pinellia (半夏) – Dries dampness, resolves phlegm, harmonizes stomach (reduces nausea/abdominal fullness).
Arisaema (胆南星) – Clears heat, dissolves phlegm (prevents damp-heat transformation).
Medicated Leaven (神曲) – Promotes digestion, supports spleen function.
Guide Herb:
Ginger (生姜) – Warms middle jiao, counters Pinellia/Arisaema side effects, aids phlegm resolution.
Licorice (甘草) – Harmonizes formula, tonifies qi.
Formula Characteristics:
Phlegm-Damp Synergy: Atractylodes and Pinellia dry dampness; Cyperus and Tangerine Peel move qi ("Qi movement dispels dampness").
Root-Branch Integration: Resolves phlegm-damp (branch) while using Poria/Medicated Leaven to fortify spleen (root), preventing recurrence.
Temperature Balance: Cool Arisaema offsets warm herbs (Atractylodes, Ginger), avoiding yin damage.
Medical Case
Patient: Ms. Li, 26 years old.
Chief Complaint: Amenorrhea for 6 months; weight gain of 15 lbs.
Initial Consultation: Oily complexion, thick greasy tongue coating, deep-slippery pulse.
Tests:
Ultrasound: Bilateral polycystic ovaries
Elevated testosterone
Abnormal insulin release test
TCM Diagnosis: Spleen deficiency with phlegm-dampness; blocked thoroughfare and conception vessels.
Treatment:
Modified Cangfu Daotan Tang (enhanced damp-dispelling and blood-activating)
Sugar-free, high-fiber diet
Outcome:
Week 2: Scant, dark menses resumed
Cycle 3: Regular 28–32 day cycles; acne resolved
6 months: 18 lbs weight loss; normalized hormones; dominant follicle on ultrasound
