PCOS: Tackled by Acupuncture and herbal medicine
The health implications of Polycystic Ovary Syndrome (PCOS) stretch far beyond fertility and conception. Indeed, the third ESHRE/ASRM consensus, following agreements on diagnosis in 2004 and treatment in 2008, considered the wide-ranging ‘health aspects’ of PCOS, notably insulin resistance and other metabolic disorders, type 2 diabetes, cardiovascular diseases and cancers. Among the ‘pregnancy complications’ were gestational diabetes, pre-eclampsia and the birth of small-for-gestational age babies.
Just last year the largest study in the literature to date in assessing PCOS as a risk factor for the metabolic complications of pregnancy confirmed that women with PCOS are indeed at a two-fold higher risk of developing gestational diabetes than women without PCOS, at a 50% increased risk of developing gestational hypertension, and a 30% increased risk of pre-eclampsia.
Acupuncture and herbal medicine, via their regulatory functions on the endocrine and metabolic pathways may be helpful in reducing the possibility or the severity of gestational diabetes, pre-eclampsia and gestational diabetes.
The results come from an analysis of the largest inpatient cohort in the USA (the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database) in which deliveries to women with diagnosed PCOS between 2004 and 2014 (14,882 patients) were compared with a non-PCOS reference group of more than 9 million deliveries. While the results appear to echo those of earlier, and smaller studies, the authors state that this study avoids much of the formers’ heterogeneity and confounding from inadequate statistical power. Thus, in their opinion these earlier studies (even a large meta-analysis from 2019) were unable to isolate PCOS as an independent risk factor for all metabolic complications of pregnancy.
First, in terms of metabolic characteristics, the study showed that pregnant women with PCOS were at baseline more obese than controls (22.3% vs. 3.5%), had greater prevalence of chronic hypertension (8.4% vs. 1.8%) and had more pregestational diabetes (4.1% vs. 0.9%). All these differences were statistically significant. There was also a higher rate if IVF conception in the PCOS women (2.4% vs. 0.1%) and more multiple pregnancies (5.9% vs. 1.5%), which seemed largely explained by IVF.
Acupuncture and herbal medicine, via their regulatory functions on the endocrine and metabolic pathways are often helpful in assisting in weight-loss.
However, in all pregnancies the women with PCOS were more likely to develop gestational diabetes, pregnancy-associated hypertension, and pre-eclampsia than controls. The adjustments controlled for age, income level, obesity, smoking and chronic disease. The study also controlled for ‘insurance type’, which was significantly different between the two groups and may explain a possibility of underdiagnosis in women belonging to lower socioeconomic groups and receiving their care through Medicaid.
Acupuncture and herbal medicine, via their regulatory functions on the endocrine and metabolic pathways are often helpful in reducing the possibility, or the severity of gestational diabetes, pre-eclampsia and pregnancy-associated hypertension.
The adjustments proved important in the findings, indicating, for example, that the two-fold added risk of gestational diabetes was independently associated with PCOS and not confounded by obesity (or other confounding factors). The author’s conclude,
“Most studies and meta-analyses suggest between a 2.5- to 4-fold increased risk of GDM in the PCOS population, with significant uncertainty about whether or not the attributable risk is from PCOS alone, or if it is related to obesity.’
Acupuncture and herbal medicine are valuable interventions when trying to reduce what is in excess and support that which is deficient.
For example, excess may be viewed as gestational diabetes, pre-eclampsia and gestational diabetes, whereas deficiency may be seen as having reduced or stunted-activity of estrogen in the follicles due to excess androgens. By increasing that which is deficient (estrogen, or estrogen activity), this will then create a more balanced ratio between estrogen and follicular androgen. This can translate into better egg quality in the PCOS patient.
Mike Berkley, is Founder and Director at The Berkley Center for Reproductive Wellness in New York.