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27yr With PCOS
Dr. Hsiang Ping Lee
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27-year-old C is a former student of mine from a lactation course. Since her youth, she has had irregular menstrual cycles, occurring every 2 to 3 months, or even longer. After getting married last year, she went to a clinic for a check-up, and the doctor informed her that blood tests and ultrasounds showed no issues, recommending medication to induce menstruation.
Could I have Polycystic Ovary Syndrome (PCOS)?
C found it strange that if there were no problems, why was her menstruation so irregular? She traveled from Yunlin to Taichung to seek my help in regulating her cycle. During the consultation, I discovered that C often stayed up very late for work (until 3 AM), which contributed to her high-stress levels, causing issues like mouth sores and acne.
I suggested checking her ovarian function, and the results showed her ovarian function index was too high (AMH: 11 ng/ml), confirming that C likely has PCOS. She was surprised, thinking, “I’m not overweight (BMI: 22). How could I have PCOS?”
How is Polycystic Ovary Syndrome Diagnosed?
According to the commonly used 2003 Rotterdam criteria, two of the following three criteria must be met:
- Irregular menstruation.
- Elevated androgen levels (e.g., hirsutism, acne, male pattern baldness).
- Ultrasound showing polycystic ovaries.
- AMH has recently become another useful tool for accurately diagnosing PCOS. Normal values are approximately 2-6; values greater than 6 along with clinical symptoms can also indicate PCOS.
Common Questions about Polycystic Ovary Syndrome
Q: Do all PCOS patients need to lose weight?
Not necessarily. Only those with a high BMI or waist circumference need to focus on weight loss. Studies show that, unlike the overweight patients in Europe and America, half of the PCOS patients in Taiwan are of normal weight or even underweight. For thin patients with PCOS, weight loss has little effect on improving menstruation. However, not needing to lose weight doesn’t mean they shouldn’t exercise!
Doctor’s Summary: Exercise helps regulate hormones and improve menstrual cycles for both overweight and underweight PCOS patients.
Q: How long does it take to regulate menstruation with Traditional Chinese Medicine (TCM)?
Typically, 3-6 months. For PCOS patients, the lack of menstruation is due to not ovulating, not because menstrual blood is trapped in the uterus.
Doctor’s Summary: TCM aims to improve the body's constitution to help establish regular ovulation. Once regular ovulation is achieved, menstruation will also regulate itself after stopping medication (this differs from the concept of using Western medications to induce menstruation or ovulation).
Q: What lifestyle and dietary changes should be considered?
❌ Control intake of starches and sugars. ⭕️ Increase consumption of vegetables and fruits.
Focus on aerobic exercises like jogging, and swimming, and gradually increasing exercise intensity.
Doctor’s Summary: Dietary adjustments combined with aerobic exercise can improve endocrine disorders in patients, aiding in the regulation of ovulation!