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Polycystic Ovarian Syndrome
Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasingaltered glucose tolerance(20), CVD and hypertension(21).
Management and Treatment according to Traditional Chinese Medicine 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).
Depending to differentiation, most common diagnosis of polycystic ovary syndrome can be classified into
Spleen yang deficiency
Spleen yang deficiency is a serve form of spleen qi deficiency, characterized by a condition of inability of spleen in distribution of fluid and nutrient to the body organs, in removal and descend the turbids(2072), causing malfunctions functions of the organs and fluid retention. Prolong period of spleen yang deficiency may induce the development of phlegm, including women with PCOs.
Women with PCOs diagnosed by spleen yang deficiency may also experience yang vacuity impelled cold expression of additional symptoms of abdominal pain(2074), lack of appetite(2076), fatigue(2075), lightheadedness(2075) and headache(2075), weakness of the four limbs(2077), diarrhea(2073)(2076), chilliness(2077), edema(2074), pale, swollen, wet tongue(2076) and weak, slow, deep pulse(2072),....
In the review of the Data base provided by PubMed, spleen qi deficiency may alter certain metabolic pathways, such as the energy, protein, and glycolytic metabolisms(2078), body weight and motor behavior(2079), skeletal muscle function(3080), blood glucose, lipid metabolism and fat-islet axie.(2081),.....
Herbal Medicine recommended for Treatment of PCOs induced by spleen yang deficiency
1. Licorice (gancao)
(See stress management in herbal medicine for more information)
[Gan Cao is also known as Licorice root. The sweet and neutral herb has been used in TCM as anti allergy(856), anti inflammation(855), anti ulcer(857), anti convulsion(858) agent and to treat stomach weakness, tired and lack of strength, cough with abundance of phlegm, stomach and solar plexus pain, and improve cardiac function(855), etc., as it tonifies the Spleen, benefits the Qi, moistens the Lungs, calms cough, deaf or acute pain, by enhancing all 12 channels(859).In treatment of PCOs(862), combination of licorice and 100 mg spironolactone showed the activation of the renin-aldosterone system in lowering blood pressure and water (fluid) balance(860). reducing the prevalence of side effects related to the diuretic activity of spironolactone(860). In model rats experiment, Ganshao Paste (CGP), showed the decrease of serum levels of LH, T, and FSH and increase of serum estradiol (E2), and progesterone (P)(861)(865)].
(See The Insulin resistance improvement and/or anti metabolic syndrome herbs: Licorice for more information)
[ Licorice, in a review of 33 studies of herbal medicine for the management of polycystic ovary syndrome (PCOS), showed a strong evidence in improved metabolic hormone profile and improved fertility outcomes and regulation of ovulation and inhibition of hyperandrogenism in PCOS(860). In model rats experiment, Ganshao Paste (CGP), also decreased serum levels of LH, T, and FSH and increased of serum estradiol (E2), and progesterone (P)(861)(860)(865). According to University of Natural Resources and Life Sciences Vienna, licorice may have a potential effect on metabolic syndrome(862) in women with PCOs.
2. Blow flow
Licorice improves the blood flow in the body by exerting its anti thrombosis(983) and inhibiting the levels of bad cholesterol(984)(985) and triglyceride levels(985) and increasing HDL-cholesterol content(984) in reduced risk of cardiovascular disease(985) and blood stagnation(897) in the abdominal region induced induced infertility(986).
Glycyrrhizin, one of main ingredient from licorice, exhibited anti inflammatory effect pharmacologically in treatment of inflammatory diseases(988)(989)(990), lowered high serum testosterone levels in oligomenorrheic or amenorrheic women, and induced conception in some women(991). As antioxidant, the phytochemical also inhibit irregular cell growth(992)(993) and microbial invasion(994)(995) causes of cancers(992)(993) and infection and inflammation(994)(995) respectively. in adrenocortical function and behavour, it also regulated the levels of cortisol(996), induced by over production of serotonin cause of hormone imbalance(997).
See phytoestrogen in black cohosh
[Phytoestrogen found it balck cohosh showed to occupy the estrogen receptor sites in women body(908), through it antiestrogenic and extrogenic effects(909), to induce hormone balancing may result in improving the chance of ovulation and fertility(910)(911)].
Lecithin is a fat like substance called a phospholipid improved lipid transfer, cholesterol efflux, HDL genesis and and remodeling at the blood-brain barrier (BBB)(998). against cells from oxidation surrounding the brain(999), in reducing psychotic symptoms(1002) such as stress(1000)(1001), and depression(1002).
1. It may raise blood pressure(1003)(1004(1006)
2. Long term usage of large dosage can also cause edema(1004)(1006) and hypokalemia(1004)(1005)(1006).
3. Overdose can be toxic(106), in inducing rhabdomyolysis or myoglobinuria(1006).
1. Glycyrrhizic acid
2. Licochalcone A
3. Licochalcone B
10. Glycyrrhetinic acid
11. 11-deoxyglycyrrhetinic acid
Licorice's phytochemicals, especially glycyrrhizin, have shown efffectively in ameliorated insulin resistance(1059)(1061)(1063)(1064), hyperglycemia(1059)(1060), dyslipidemia(1059)(1063) and oxidative stress(1064) in fructose-induced metabolic syndrome(1059)(1061)(1063) in animal(1059)(1060)(1061)models, probably through its interference of the development of visceral obesity(1064) and cellular derailments that are responsible for the development of metabolic syndrome(1062), anti inflammatory(1062), antioxidant(1062) and an associated with a decrease in tissue lipid deposition(1063) effects].
In chronic unpredictable stress rat model, total flavonoids extract(1153) (licorice flavonoids, LF) and liquiritin(1154), a phyochemical found in locorice exerted anti-depressive(1153)(1154)(1155) and anti-cognitive impairment(1156) property through total flavonoids extract neurogenesis protective effect(1153) and defense of liquiritin and flavonoids extract against oxidative stress(1154)(1156).
Yokukansan, a traditional Japanese formula, containing licorice showed effectively in amelioration of behavioral symptoms, such as aggressiveness, excitability, and hallucination, through reduced stress increased the serotonin 2A (5-HT2A) receptors density on the plasma membrane of the prefrontal cortex (PFC)(1158).
In high-glucose stress, Glabridin(1159)(1160), an isoflavan from licorice root reduced high-glucose stress(1159)(1160) through its anti inflammatory activity(1159), up-regulates manganese superoxide dismutase, catalase and paraoxonase 2(1160).
In anti oxidative stress, licorice showed to contribute to their overall health promoting pharmacological effects against free radicals(1161)(1162)(1163)(1164) induced diseases such as cancer(1161), cardiac dysfunction(1162) liver disease(1164), etc., through its anti-inflammatory(1161)(1163)(1164), anti-oxidant activities(1161)(1162)(1163)(1164).
According to University of Western Sydney, Glycyrrhiza glabra, one of Chinese herbs, exhibited strong evidences of neuroprotective activity for promotion of healthy ageing and longevity(1157).]
According to studies, licorice also is effective in preventing and ameliorating diabetes(2122)(2124), abdominal obesity(2122)(2123) in rat model study.
On metabolic syndrome's complication of cardiovascular disease, licorice and its phytochemicals exerted cardioprotective effect(2127) in prevention of incidence of fatal ventricular arrhythmia from ischemia/reperfusion injury(2125), myocardial infarction(2126) by amelioration of oxidative stress and modulation of cardiac function(2126).
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(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) bny by Liqin Zhao
(2072) Spleen, Earth
(2073) [Research on building method of spleen kidney Yang deficiency diarrhea rats model]. [Article in Chinese] by Pan X, Hu CJ, Geng YY, Zhao L, Wu WH, Wu XQ, Zhong ZD.(PubMed)
(2074) Treatment of an elderly patient with acute abdominal pain with traditional Korean medicine by Son CG1.(PubMed)
(2075) Shenzhu Tiaopi granule combined with lifestyle intervention therapy for impaired glucose tolerance: a randomized controlled trial by Fang Z1, Zhao J2, Shi G3, Shu Y3, Ni Y3, Wang H3, Ding L3, Lu R3, Li J3, Zhu X3, Cheng S4, Zhang X3, Liu Y5, Wang J6, Luo Y3, Fan Q3, Guo C3, Jiang T3, Wu Q3, Fan L3, Ling H3, Cui L3, Luo Y3, Yang H3, Anderson RM7.(PubMed)
(2075) Direct moxibustion to treat spleen qi and yang deficiency fatigue: a pilot study by Thorne TL1, Hanes DA2, Wild H3, Colbert A4.(PubMed)
(2076) [Clinical observation on fuzhong (supporting the middle-jiao) manipulation of tuina for infantile anorexia]. [Article in Chinese] by Wang YY, Liu XY.(PubMed)
(2077) [Effect of umbilicus moxibustion therapy on physical conditions of yang-deficiency volunteers]. [Article in Chinese] by Zhang YY1.(PubMed)
(2078) Analysis of the restorative effect of Bu-zhong-yi-qi-tang in the spleen-qi deficiency rat model using (1)H-NMR-based metabonomics by Zheng XF1, Tian JS2, Liu P3, Xing J1, Qin XM1.(PubMed)
(2079) [1H NMR based metabolomics study of bu-zhong-yi-qi-tang in the spleen-qi deficiency rat model]. [Article in Chinese] by Chen L, Xiang H, Xing J, Tian JS, Qin XM, Du GH.(PubMed)
(2080) Bufei Jianpi granules improve skeletal muscle and mitochondrial dysfunction in rats with chronic obstructive pulmonary disease by Dong Y1,2, Li Y3,4,5, Sun Y6, Mao J7, Yao F8, Tian Y9, Wang L10, Li L11, Li S12,13,14, Li J15,16,17(PubMed)
(2081) [Clinical observation on obesity and hyperlipidemia of liver qi stagnation and spleen deficiency pattern in female patients treated with combined therapy of acupuncture and tapping method]. [Article in Chinese] by Wu B, Liu ZC, Xu B.(PubMed)
(2122) A licorice ethanolic extract with peroxisome proliferator-activated receptor-gamma ligand-binding activity affects diabetes in KK-Ay mice, abdominal obesity in diet-induced obese C57BL mice and hypertension in spontaneously hypertensive rats by Mae T1, Kishida H, Nishiyama T, Tsukagawa M, Konishi E, Kuroda M, Mimaki Y, Sashida Y, Takahashi K, Kawada T, Nakagawa K, Kitahara M.(PubMed)
(2123) 18β-glycyrrhetinic acid attenuates anandamide-induced adiposity and high-fat diet induced obesity by Park M1, Lee JH, Choi JK, Hong YD, Bae IH, Lim KM, Park YH, Ha H.(PubMed)
(2124) Effect of licorice extract on the complications of diabetes nephropathy in rats by Kataya HH1, Hamza AA, Ramadan GA, Khasawneh MA.(PubMed)
(2125) Glycyrrhetinic Acid protects the heart from ischemia/reperfusion injury by attenuating the susceptibility and incidence of fatal ventricular arrhythmia during the reperfusion period in the rat hearts by Wu HJ1, Yang JY, Jin M, Wang SQ, Wu DL, Liu YN, Yan X, Yang C, Zhang G, He J.(PubMed)
(2126) Glycyrrhiza glabra protects from myocardial ischemia-reperfusion injury by improving hemodynamic, biochemical, histopathological and ventricular function by Ojha S1, Golechha M, Kumari S, Bhatia J, Arya DS.(PubMed)
(2127) A Review: The Pharmacology of Isoliquiritigenin by Peng F1, Du Q, Peng C, Wang N, Tang H, Xie X, Shen J, Chen J.(PubMed)