Formula One for Polycystic Ovary Syndrome – Yu’s Warming and Tonifying Prescription
Name of Formula: Yu’s Warming and Tonifying Prescription
【Function and Indications】
Function: Warm and tonify kidney yang, while also resolving phlegm and softening hard masses. Indicated for polycystic ovary syndrome.
【Prescription Composition】
Rehmannia glutinosa (prepared) 12g, Polygonatum sibiricum 12g, Epimedium sagittatum 12g, Psoralea corylifolia 12g, Manis pentadactyla 9g, Gleditsia sinensis 12g, Sargentodoxa cuneata 12g, Fritillaria thunbergii 12g. Decoct and take orally.
【Differential Diagnosis and Modifications】
If cold sensitivity, add Aconite root 9g, Cinnamon bark 3g; if liver qi stagnation, add Cortex Moutan 9g, Toosendan fruit (stir-fried) 12g, Bupleurum chinense 6g, Angelica sinensis 12g, Green tangerine peel 6g, remove Gleditsia sinensis, Sargentodoxa cuneata, and Fritillaria thunbergii.
【Source of Prescription】
Yu Jin, Department of Gynecology and Obstetrics, Shanghai Medical University.
【Comment】This formula emphasizes warming tonification of the kidneys. Among them, Rehmannia glutinosa (prepared), Epimedium sagittatum, and Psoralea corylifolia have been shown to promote ovulation in adolescent dysfunctional uterine bleeding. Adding Rehmannia glutinosa (prepared) and Polygonatum sibiricum, which tonify kidney yin, reflects the principle “without yin, yang cannot transform.” After treatment, patients’ estrogen levels increased, and in some cases, bidirectional regulation of estrogen was observed. Combined with kidney-tonifying herbs, this formula may regulate gonadotropin receptor levels on ovarian tissue. The regulatory effect on ovaries by this formula is evident. The inclusion of Manis pentadactyla, Gleditsia sinensis, Sargentodoxa cuneata, and Fritillaria thunbergii aims to soften hardness and resolve phlegm, possibly treating thickened ovarian capsule and follicular closure caused by local testosterone. Hormonal dynamics showed decreased serum FSH, increased E2 levels after treatment, leading to reduced LH/FSH and T/S ratios. Increased E2 triggers positive feedback, resulting in ovulation and pregnancy. This indicates that besides direct ovarian regulation via estrogen-like effects, this formula also promotes ovulation by regulating hypothalamic-pituitary function.
In some patients with polycystic ovary syndrome, hyperprolactinemia occurs. The above kidney-tonifying and phlegm-resolving therapy proved ineffective in such cases, occasionally accompanied by breast distension. When liver-clearing herbs were added to the treatment regimen, prolactin levels dropped and ovulation occurred. This suggests that when kidney-tonifying and phlegm-resolving therapy fails, measuring serum prolactin is advisable. If elevated, treatment should focus on clearing liver fire while tonifying the kidneys—this represents an integrative approach combining macroscopic and microscopic differentiation, and also provides scientific evidence for the traditional Chinese medicine theory of “Yi Gui Tong Yuan” (the liver and kidney share the same origin).<Ovary>