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A substantial number of our patients seem to be suffering from what Western medicine calls PCOS, which is short for polycystic ovary syndrome. The NHS estimates that 10% of women have PCOS, but many sufferers have not been formally diagnosed, surprisingly. It is clear, from scientific literature, that PCOS is very much under diagnosed. There seems to be a number of reasons for this.
1. The diagnostic protocol is not always followed
The formal protocol for PCOS diagnosis employs the following 3 criteria:
If 2 out of these 3 criteria are met, a diagnosis of PCOS is given.
However, patients tell us that their doctors sometimes only order the follicle scan, and then say they don’t have PCOS when the scans don’t show enough follicles to justify a diagnosis.
2. AMH and testosterone are not tested
The common practice is that doctors don’t seem to routinely check AMH and testosterone levels. But even if they are, the reference ranges for AMH and testosterone are inflated, so the results may not be interpreted correctly.
The reference ranges for AMH were constructed by randomly selecting women from different age groups and then measuring their AMH. Women with PCOS — whether diagnosed or not — were included in the sample, and this skewed the measured average ranges up; a true AMH reference range shouldn’t include women with PCOS. The reference range for testosterone was constructed in a similar way, but didn’t need to take age into account.
As the AMH and testosterone levels are inflated, many women are given false negatives, even when their hormone levels are actually high.
On the other hand, it seems that some doctors do recognise this: We have had some patients who were correctly diagnosed with PCOS before coming to us, where their AMH and testosterone are within the “normal” reference ranges.
3. IVF, the “solution” that’s always offered
When patients are having fertility issues, they are routinely suggested to do IVF by GPs, gynaecologists and IVF doctors. From what our patients have told us, there seems to be little interest in finding out or treating causes of infertility, such as PCOS.
In fact, with IVF, the stress is on collecting as many eggs as possible. As the reference ranges for AMH are so inflated, many patients who have high AMH (which may point to PCOS) end up being told their AMH is too low for IVF.
We understand that patients who are diagnosed with PCOS are either prescribed metformin or not given any treatment at all by their doctors. It should be noted that metformin is a diabetic medication. The reason why metformin may be prescribed is because some doctors believe PCOS patients are insulin resistant. However, it is increasingly clear that metformin does not work for a vast majority of PCOS patients — it has been estimated that metformin only works for about 5% of PCOS patients. This implies that the insulin-resistance hypothesis is not substantiated, at least, in clinical settings. As a result, the NHS is slowly withdrawing prescribing metformin for PCOS.
As there really isn’t an effective Western treatment, most PCOS patients are not treated at all. The lead-on from this is that some Western doctors may also not bothering diagnosing it either — if there’s no treatment they can offer, then why bother?
For women, egg quality is the single most important deciding factor for a successful pregnancy.
Egg quality is highly dependent on hormones: When your hormones are at the right levels and balanced, your egg quality is likely to be good. When they are not, your egg quality is likely to be compromised. When you have imbalanced hormones, you are more likely to experience difficulty in natural conception or IVF, and can have a high probability of miscarrying.
As PCOS is caused by hormonal imbalance, and hormonal imbalance is the cause for poor egg quality, PCOS is thus a problem for fertility.
Since PCOS is seriously under diagnosed, you may wish to look out for it by conducting your own observations, if not investigation. You may wish to check the following:
If the answers to the above are mostly “yes”, you may wish to get AMH and testosterone tested to see if they are on the high side (note the references ranges must be interpreted properly). We can help arrange and interpret the results of these tests.
IVF has the advantage of making sure that an egg meets a sperm. However, the reason why PCOS patients find natural pregnancy difficult is mainly because their egg quality is poor. As the IVF procedure will not, and is unable to, improve egg quality, it will simply collect poor-quality eggs. The original issue — poor quality eggs — remains.
Some patients come to us and say that they’ve made substantial changes to diet and lifestyle, and this seemed to have brought some benefits. However, when we look at their hormone levels, they still suffer from hormonal imbalance — high AMH and testosterone results. This is consistent with our clinical experience, where diet and lifestyle changes can help somewhat — but changing lifestyle and diet alone is not enough to bring hormones to normal levels.
Many patients use supplements before they come to us. They tend to be taking them by faith without pre and post treatment testing of hormone levels. We may be wrong, but we are not aware of effective supplements that can reliably reduce AMH and testosterone levels.
At TCM Healthcare, we use natural herbal remedies to strengthen and regulate the entire reproductive system, as conceived by traditional Chinese medical theory and practice. When the reproductive system functions better, hormones also improve. We have an 80% success rate in lowering AMH and testosterone — we comparing results before and after treatment for all our patients.
You may wish to check out our testimonials and Google reviews.
We have also included relevant scientific papers on the resources page.
For PCOS test, please click test.TT
