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Thursday, 11 June 2015

The Holistic prevention, management and treatment of Polycystic Ovarian Syndrome: TCM Herbal formulas for Kidney Yang deficiency

By Kyle J. Norton
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

           Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome is defined as endocrinologic diseases among reproductive-age women caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries associated with a high risk for metabolic disorder(1) as resulting of enlarged ovaries(2), leading to hormone imbalance(excessive androgen and anti-müllerian hormone (AMH) )(1)(3)(4)(5), induced Hirsutism(6)(7), reproductive disorder(10(12)), risks of type 2 diabetes(9)(10)(11), metabolic syndrome(10)(12) and early cardiovasular disease(8)(13), acne(10)(14), endometrial cancer(18)(19),weight gain and obesity(15)(16)(17). The syndrome effects over 5% of women population or 1 in 20 women. Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasing altered glucose tolerance(20), CVD and hypertension(21).

In Traditional Chinese Perspective

While conventional medicine focus of using synthetic medication to induce ovulation and assisted artificial insemination for infertility couple, if the medicine fail, traditional Chinese medicine views polycystic ovarian syndrome in different approaches. Polycystic ovary syndrome, according to traditional Chinese medicine is a medical condition characterized by accumulative of fluid over a prolonged period of time causes of dampness and phlegms(1247a)(1247b) build up on the ovaries due to the effects of vary differentiations, affecting not only the women’s menstrual cycle, but also ovulation and fertility(1247a)(1247b).

PCOs Treatment according traditional Chinese medicine
Depending to differentiation, most common diagnosis of polycystic ovary syndrome can be classified into

              Kidney yang deficiency

Along with common symptoms mentioned above, women with PCOs diagnosed with kidney yang deficiency may also experience yang vacuity induced cold expressive syndrome, including lumbago, cold limbs, fatigue, cold aversion, feverish sensation in chest, palms and soles(1573), difficulty in urination, enuresis, incontinence, declining libido and edema(1574) as a result of kidneys no longer perform their functions in store fluid to moister and warm the body for healthy function in the body's organs and tissues, inducing adrenal insufficient chronic lower back pain(1575)(1580), depression(1575), hypothyroidism(1579)(1575), nephritis(1578)(1575), ...(1575), failure in transform damp heat expression, promoted accentuation of inflammatory development of phlegm(1583). Kidney yang deficiency has shown to alter carbohydrate and lipid metabolisms (free fatty acids, 1-monolinoleoylglycerol, and cholesterol), gut microbiota metabolism (indole-3-propionic acid), impelled anovulatory infertility( 1581) and hypertension(1582) of which related to symptoms of PCOs(1576)(1577).

Herbal formulas for kidney yang deficiency By TCM


The below formulas of traditional Chinese medicine for treatment kidney yang deficiency induced Polycystic ovary syndrome, contributed by "TREATMENT OF OVARIAN CYSTS WITH CHINESE HERBS" by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland(1833). We recommend readers to read the complete article for more details at the link provided.
1. The formula one 
rehmannia(shoudihuang andshengdihuang)12 grams
aconite(fuzi)6 grams
dioscorea(shanyao)9 grams
epimedium(yinyanghuo)9 grams
psoralea(buguzhi)9 grams
cuscuta(tusizi)9 grams
citrus(chenpi)1.5 grams
Aconite, like cinnamon bark, helps restore warmth to the kidney; epimedium, psoralea, and cuscuta further enhance the kidney yang and produce warmth. Citrus is included here primarily to aid the digestion of the rich tonic herbs, mainly the rehmannia. These amounts are for a one day dosage; the herbs are decocted, dried, and made into tablets; the usual instruction is to take 5 tablets each time, three times daily. To treat polycystic ovaries (or bronchitis in which there is substantial phlegm accumulation), this formulation might be combined with a phlegm-resolving formula such as Tan Yin Wan (pill for phlegm accumulation). Tan Yin Wan contains the many of the same ingredients as Cinnamon and Rehmannia Combination, except that ma-huang and deer antler gelatin are replaced by atractylodes (cangzhu and baizhu), aconite, raphanus (laifuzi), and perilla fruit (zisuzi). This pill treats the combined syndrome of deficiency of spleen and kidney yang(1833).
2. The  formula 2
According to the general doctrine of Chinese medicine, many diseases develop from an excess condition in the early stage to a deficiency syndrome in the later stage of its development. Thus, young women with polycystic ovaries may tend to have an excess syndrome (as described in the above evaluation, in which the average age of the patients was 24.6 years), and older women may tend to reveal the deficiency syndrome (with kidney yang depleted). However, due to genetic, behavioral, and environmental factors, some young women may already have a deficiency syndrome by the time the particular disease (in this case polycystic ovaries) has developed. Therefore age cannot be used as the sole factor in deciding among treatment strategies.
In a clinical trial by Dr. Yu Jin of the Shanghai Medical University Obstetrics and Gynecology Hospital, 133 patients with polycystic ovary syndrome were treated with the following base formula:
rehmannia(shoudihuang)12 grams
dioscorea(shanyao)12 grams
polygonatum(huangjing)12 grams
epimedium(yinyanghuo)12 grams
psoralea(buguzhi)12 grams
gleditsia(zaojiaoci)12 grams
fritillaria(chuanbeimu)12 grams
pangolin scale(chuanshanjia)9 grams
This formula was modified either for signs of cold (adding aconite and cinnamon bark) or for liver qi stagnation (adding moutan, gardenia, bupleurum, tang-kuei, and blue citrus, while removing gleditsia and fritillaria). According to Dr. Yu Jin, 82.7% of the women so treated ovulated and of 76 women that were known to be infertile, 36 became pregnant(1833).



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References
(1) Adiposity and metabolic dysfunction in polycystic ovary syndrome by Sam S.(PubMed)
(2) A "kiss" before conception: triggering ovulation with kisspeptin-54 may improve IVF by Young SL.(PubMed)
(3.) Androgen hyperfunction and excessive heterosexual hair growth in women, with special attention to the polycystic ovarian syndrome by Lunde O1.(PubMed)
(4) Expression of anti-Müllerian hormone in letrozole rat model of polycystic ovary syndrome by Du DF1, Li XL, Fang F, Du MR.(PubMed)
(5) [Serum levels of anti-muller hormone in women with polycystic ovary syndrome and healthy women of reproductive age].[Article in Bulgarian] by Parahuleva N, Pehlivanov B, Orbecova M, Deneva T, Uchikova E.(PubMed)
(6) [Current opinions on the etiology and pathophysiology of hirsutism].[Article in Polish] by Krysiak R1, Kedzia A, Okopień B.(PubMed)
(7) The clinical evaluation of hirsutism by Somani N1, Harrison S, Bergfeld WF.(PubMed)
(8) Polycystic ovary syndrome and insulin: our understanding in the past, present and future by Mayer SB1, Evans WS, Nestler JE.(PubMed)
(9) Association of mean platelet volume with androgens and insulin resistance in nonobese patients with polycystic ovary syndrome by Dogan BA1, Arduc A2, Tuna MM1, Karakılıc E1, Dagdelen I1, Tutuncu Y1, Berker D1, Guler S1.(PubMed)
(10) Approach to the patient: contraception in women with polycystic ovary syndrome by Yildiz BO1.(PubMed)
(11) Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women by Talbott EO1, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ.(PubMed)
(12) Prevalence of vitamin D deficiency in Slovak women with polycystic ovary syndrome and its relation to metabolic and reproductive abnormalities by Figurová J1, Dravecká I, Javorský M, Petríková J, Lazúrová I.(PubMed)
(13) Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis by Thethi TK1, Katalenich B2, Nagireddy P3, Chabbra P4, Kuhadiya N5, Fonseca V1.(PubMed)
(14) Acne in hirsute women by Lumezi BG1, Pupovci HL1, Berisha VL1, Goçi AU2, Gerqari A3.(PubMed)
(15) Obesity and polycystic ovary syndrome by Naderpoor N1, Shorakae S, Joham A, Boyle J, De Courten B, Teede HJ.(PubMed)
(16) Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan by Teede H1, Deeks A, Moran L.(PubMed)
(17) Metabolic Evidence of Diminished Lipid Oxidation in Women WithPolycystic Ovary Syndrome. by Whigham LD1, Butz DE2, Dashti H3, Tonelli M3, Johnson LK1, Cook ME2, Porter WP4, Eghbalnia HR5, Markley JL6, Lindheim SR7, Schoeller DA8, Abbott DH9, Assadi-Porter FM10.(PubMed)
(18) Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis by Barry JA1, Azizia MM1, Hardiman PJ2.(PubMed)
(19) Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study by Gottschau M1, Kjaer SK2, Jensen A1, Munk C1, Mellemkjaer L3.(PubMed)
(20) Polycystic ovary syndrome: metabolic consequences and long-term management by Carmina E1.(PubMed)
(21) Arterial stiffness is increased in asymptomatic nondiabetic postmenopausal women with a polycystic ovary syndrome phenotype by Armeni E1, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Kazani A, Kolyviras A, Stellos K, Panoulis K, Alexandrou A, Creatsa M, Papamichael C, Lambrinoudaki I.(PubMed)
(1246) [Clinical study of area of Jiangsu province of polycystic ovarian syndrome correlation distribution of traditional Chinese medicine syndrome type and improper diet]. [Article in Chinese] by Feng Y, Gao YP.(PubMed)
(1247) [Preliminary study on relationship of disease-syndrome-symptom of ovulatory disorder infertility based on factor analysis]. [Article in Chinese] by Li M, Ma K, Shan, J.(PubMed)
(1247a) A Comprehensive Treatment of Polycystic Ovarian Syndrome (PCOS) by Liqin Zhao
References
(1833) "TREATMENT OF OVARIAN CYSTS WITH CHINESE HERBS" by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland