What is PCOS: Treatment and Post-Surgical Recovery Tips

What is PCOS (polycystic ovary syndrome)? Approximately 6% to 10% of women have this reproductive and endocrinologic disorder, and almost 20% of females with infertility issues were diagnosed with PCOS. This article shares what PCOS is, its treatment methods, and how to aid recovery from Western and Traditional Chinese Medicine (TCM) perspectives.

What is PCOS?

It’s time to find out if you are at risk. Read on to learn the health implications of this condition and how it is usually diagnosed.

Risk factors and associated health conditions

PCOS is often associated with obesity. Being overweight can lead to insulin resistance, causing the body to compensate by over-producing insulin, resulting in excessive androgens, or “male hormones”. Low socioeconomic status, genetics, and ethnicity are other risk factors of PCOS.

Women with PCOS also experience many health implications, including metabolic complications, cardiovascular diseases, poor mental health, endometrial and breast cancer, and most notably, infertility.

Diagnosis

According to the Rotterdam criteria, the three key diagnostic features of PCOS are anovulation, hyperandrogenism, and polycystic ovaries. Women who display two of these conditions are diagnosed as having PCOS. Recent studies have also suggested doctors to diagnose based on the sonographic appearance of the polycystic ovaries and the level of anti-Müllerian hormone (AMH).

Up to 95% of women with PCOS experience some form of anovulation – oligomenorrhea with less than eight periods in a year or amenorrhea with no period for more than three months. If your menstrual cycles are not regular, consult a doctor for a thorough check-up.

How to Treat PCOS-related Infertility

Lifestyle change

Due to the association between PCOS and obesity, weight reduction and lifestyle change are beneficial for overweight women with PCOS and anovulatory infertility. Losing weight decreases the over-production of insulin and insulin resistance, whereas increasing physical activity can increase insulin sensitivity, improving hormonal imbalance in the ovary.

Drugs and surgery

Clomiphene citrate (CC) is arguably the most used drug to induce ovulation (ovulatory stimulants. It works in the same way as oestrogen, the female hormone that supports the development of eggs in the ovaries, and their release. It results in pregnancy 50% of the time after three treatment cycles and 75% after nine cycles. However, the pregnancy rate is 10-fold higher with CC use than with spontaneous conceptions, and CC may also have adverse effects on the development of the endometrium.

Healthcare providers will usually use laparoscopic ovarian drilling (LOD) if CC is unsuccessful in inducing ovulation. The procedure is minimally invasive and is 84% successful in helping patients with PCOS-related infertility achieve pregnancy. More importantly, it is more cost-effective than other ovulation induction procedures. Furthermore, it has long term benefits in improving insulin resistance and ovarian androgen production.

TCM

Physician Anita Pee, a TCM practitioner at Eu Yan Sang, shares that the primary focus of women with PCOS is to treat their infertility. “With TCM, we give medications along with acupuncture, electro-acupuncture, moxibustion, and other treatment methods. We want to promote more regular ovulation and menstruation to increase their chances of becoming pregnant.”

According to Physician Pee, there are three patterns of diagnosis to describe PCOS:

1. Kidney deficiency is the absence of the period. Therefore, the absence of ovulation is a kidney pathology.
2. Spleen deficiency, which has to do with the insulin resistance part of the PCOS diagnosis. This is also the organ that relates to weight gain (obesity).
3. Liver stagnation, which can manifest as blood stasis, causing irregular periods. Liver stagnation can also cause excessive lung heat. This affects the skin and hair, resulting in oily skin and coarse, dark hair on the chest, face or back (hirsutism).

She assures that TCM is generally safe for most women. However, it is not recommended for those who have bleeding disorders or other chronic conditions like cancer. Women who would like to use TCM to treat their infertility should consult a physician to examine their condition thoroughly.

Recovery Tips After Surgery

Post-surgical effects 

After surgery, you may experience discomfort, including a swollen abdomen, sore throat, and nausea. It is common for patients to experience vaginal bleeding up to one month after LOD. Your next menstrual cycle should occur four to six weeks after the surgery. During this time, bleeding will be heavier, and discomfort will be greater than usual.

Seek immediate medical attention if you experience severe side effects such as persistent vomiting or fever for more than 24 hours, breathing difficulties or signs of wound inflammation.

Dietary recommendations

If you feel nauseous after your procedure, you can try to have a light meal comprising soup, toast, gelatin, or crackers.

Physician Pee explains that in TCM, “Surgery is something major and can negatively affect the blood and qi (vital life energy). We normally use generic tonics to boost the body after post-surgery. So, we don’t prescribe specific herbs unless a patient has other health conditions or different kinds of discomfort after the surgery.”

Common tonics include danggui (当归), dangshen (党参) and shudihuang (熟地黄), which can be found in concoctions for women’s well-being.

Not all PCOS cases are related to obesity. Therefore, Physician Pee advises that “it’s better to consume nutritious and bland food that are easier to digest. This will help them lose weight, keep their blood sugar at bay, and promote a more regular ovulation.”.

Dos and don’ts

Doctors recommend abstaining from alcohol for at least 24 hours after the surgery. You may bathe and remove the bandages the following day. You can also return to work after three days, and resume sexual activity after one week.

Physician Pee encourages patients to get sufficient rest and maintain a well-balanced low-sugar diet. She also advises them to avoid stress as well as overly rigorous and strenuous activities. Now you have a better understanding of PCOS and how to treat it. Fortunately, there are many management and treatment options available for this condition in Malaysia. If you’re experiencing some form of anovulation or struggling with infertility problems, consult a doctor or TCM physician for professional help.