During my time as a chiropractor and nurse practitioner, I have worked with many women with PCOS (Polycystic Ovary Syndrome), especially women with PCOS that are dealing with fertility issues. PCOS is a complex disorder, and there are different aspects of PCOS that need to be addressed from dietary changes to hormone imbalances. Many times one of the components that is not adequately addressed are the structural concerns.
This blog is based mainly on my clinical experience that I have seen through years and patterns of working with a large amount of women. These will not necessarily correlate with every woman with PCOS or infertility, but I highly recommend finding a practitioner that can assess and treat you holistically. Some of the aspects of care that are mentioned in this blog are to share some of the forgotten aspects of PCOS.
Where to Begin
One of the critical steps in treating anyone is to get a comprehensive history. Even sometimes events that might seem to be isolated or trivial play a significant role in your history. Here are a few concerns that I find most important to evaluate:
- Have you ever had a major fall on your low back or your tailbone?
- Do you have a history of any significant traumas?
- Do you have scoliosis or other major structural problems?
- Do you have TMJ, headaches, or chronic upper neck pain?
- Do you have a history of any major emotional concerns?
It is important to remember that our bodies hold on to patterns, even if they are suboptimal. Therefore, it is important to change these patterns. This should be done through the proper care and at-home exercises.
There are three structural concerns that I regularly see in women with menstrual problems:
- Upper neck and cranial (head) region
- Sacral or tailbone
- Low back
These three areas should be thoroughly assessed and treated. Hands-on care is so important. Since the body holds onto patterns and muscle memory works against us, it is important to both treat regularly with a practitioner and do exercises in between. This care can come from chiropractic, acupuncture, massage therapy, Reiki, or craniosacral practitioners.
Additionally, I stress the need to do physical work and exercises to reconnect with your body. My favorite recommendation for PCOS women is yoga. This helps to decrease cortisol (stress hormones) while reconnecting the mind and body. Yoga is also amazing for opening up the hips and sacral chakra. Other types of activity that I recommend are Pilates, Barre, Zumba, and dance. These also help to open up the sacral chakra while providing a healthy connection to the body.
I also find that it is important to do cranial and sacral work. Two of the major areas I find with PCOS women are at the base of the skull and the sacral region. Therefore, working with a practitioner that specifically works on “unwinding” these tensions can have a significant impact on these women.
Acupuncture can be beneficial for many different concerns. One that I see amazing results with is menstrual concerns, fertility, and PCOS. Finding a practitioner that focuses on women issues can be extremely beneficial. It can help to restore balance both for the metabolic concerns of PCOS and hormones. There are also many Chinese herbs that can be extremely useful depending on what is found. However, it is best to work with an herbalist to decide specifically what you need.
Massage itself can be vital, especially if it is focused on the low back and sacral region. It is also important to do abdominal massage to help with lymphatic flow, circulation, and stimulate the reproductive organs. If you can find a practitioner that does Arvigo Maya Abdominal Massage, then I highly recommend this healing art.
If you are working with a chiropractor, have them assess for some of the following structural concerns that I have seen numerous times with women with menstrual concerns:
- Tailbone injury. There is an adjustment that can be done to help alleviate concerns with the coccyx (tailbone). This can be beneficial if there was a tailbone injury in the past or if it is stuck for any reason. One easy way to assess for this structural abnormality is to press on the bone you sit on. If it is extremely tender, then this is something that should be evaluated by someone that does coccyx and sacral releases. The pubic symphysis (the bone in the front of the body where the pelvis comes together) should also be assessed.
- Sacral blockage. The two-way highway of nerve input to the organs, skin, and muscles from the spinal cord and brain is dependent on the nerves, organs, skin, muscles, and spine to be working properly for best communication. If there are “blockages” along this highway either due to spinal misalignments, tight muscles, or lymphatic congestion, then this needs to be addressed. Also, there are two ligaments that I always evaluate in individuals with menstrual concerns. The two ligaments are the iliolumbar ligament and the sacrotuberous ligament. By stimulating and releasing these ligaments, it is easier to release the pelvis and sacrum region. These are usually very tender in women with PCOS.
- Pelvic floor dysfunction. Many times the pelvic floor needs to be assessed and treated. The pelvic floor is composed of a group of muscles that hold up the bladder and uterus. There are chiropractors and physical therapists that can evaluate and treat these concerns through various treatments.
At-home exercises that I recommend for many of my patients:
This is an applied kinesiology approach that I give many of my women to do at home. There are videos online that show the “uterine lift” if you need a visual. Many times the uterus shifts in the cavity. This can be a major contributor to pelvic floor dysfunction and leads to cramping, incontinence, or painful sex. This technique is done by contacting the abdomen right above the pubic bone (pubic symphysis) and lifting it up towards your head while doing a small pelvic tilt and head lift.
Psoas stretching and hip opening exercises
The psoas and iliacus muscles, known as the hip flexors, are directly connected to the reproductive organs. In many patients, they are tight with multiple trigger points. This is one of the reasons that I highly recommend yoga for women with PCOS. Many of the best hip opening exercises, such as the warrior poses, are part of yoga sequences. Yoga also helps to improve lymphatic and blood flow to organs in the abdominal cavity because certain poses compress the organs to alleviate stagnation.
I find that myofascial rolling of the sacral region has so many benefits for women. It helps to open up this region and decreases both muscle and fascial tightness that is present. It is good to get a myofascial roll and do it 3-5 times a week. This can be done after working out, immediately upon getting up, right before bed, or even during commercial breaks when watching television.
I hope this information opens up a few more options in your dealing with PCOS. I understand that this condition is extremely comprehensive. I find that it is important to empower yourself with great education and a health care team that can help to guide you.
Dr. Meaghan Kirschling has both an allopathic and alternative medical background, receiving a Doctor of Chiropractic from Northwestern Health Sciences University, a B.S. in Nursing and Exercise Science from Valparaiso University, a Masters of Nutrition from the University of Connecticut Bridgeport, and a Masters of Nursing in Women’s Health from University of Cincinnati. Before coming to Synapse is 2006, she worked as a floor nurse for six years in the Organ Transplant Unit at the University of Minnesota Fairview Hospital. In 2010, she moved to Germany to be one of the first doctors to provide chiropractic services to military personnel overseas. At Baumholder Health Clinic, she helped create an integrative environment & worked closely with MDs, DOs, PTs, & others. She also was a faculty member for the University of Maryland during this time, & taught health science classes. Dr. Meaghan works in Minnesota at Synapse: Center for Health and Healing. She focuses a lot of her practice on women’s health issues. She also is the creator of a website called Beyond the Basics Health Academy. The site is focused on promoting health and wellness through blogs, podcasts, and courses.