Infertility is a growing concern for many couples especially in Western societies. We live in a very fast paced world these days, with many couples delaying pregnancy and child rearing until their mid to late 30s.
Often when couples feel that emotionally and financially the time is right to conceive, their bodies have different plans. Pregnancy is such an amazing and delicate phenomena, that even slight imbalance in the body can lead to an inability to conceive.
Many couples who suffer from fertility issues feel isolated, as though they are the only ones in their group of friends who can not conceive. Believe me, you are not alone.
Many people suffer from an inability to conceive and it appears that globally fertility is on decline. It was estimated several years ago that 1 in 6 couples would have trouble conceiving, with projected rates being closer to 1 in 3 within 10 years. It is scary to think that we could be at or over that 10 year mark now.
From a Chinese Medical perspective, there are many different pathological conditions that can lead to infertility or issues relating to the inability to “hold” a pregnancy. An individuals signs and symptoms’, along with pulse and tongue diagnosis can lead to an accurate depiction of why an embryo is unable to implant into the womb, remain in the womb or even lead to an indication of why ovulation fails to occur at all. Based on the underlying “root” causes of the condition, a Acupuncture and Chinese Herbal Medicine formula may be implemented.
-GYNECOLOGICAL DISORDERS & SUB FERTILITY OR INFERTILITY-
From a Chinese Medicine perspective, the menstrual cycle that governs Fertility requires the free flow of blood and qi (energy) and the appropriate amounts of yin (cool & moist) and yang (warm & dry). When yin and yang are imbalanced, or if blood or qi becomes stagnant, pain can ensure along with several other menstrual disorders that can even lead to infertility.
Over the years, Western and Chinese Medicine have seen an increase in the presentation of menstrual disorders such as PCOS (Poly Cystic Ovarian Syndrome), Fibroids, Amenorrhea , Dysmenorrhea, Endometeriosis, Luteal Phase Defect, low Anti Mullarian Hormone (AMH) and high Estrogen or Androgen levels in women. These conditions can be explained in Chinese medical terms as follows:
PCOS: Phlegm obstruction, Dampness, Stagnation of Qi and Blood, Spleen and Kidney yang deficiency.
FIBROID’S: Liver qi Stagnation, blood stasis, and underlying Spleen and Kidney deficiency.
AMENORRHEA: Blood and qi deficiency, blood stasis, underlying kidney and spleen deficiency.
DYSMENORRHEA: Stasis of blood or qi, dampness and cold in the uterus.
ENDOMETRIOSIS: Reckless blood, blood and qi stagnation.
LUTEAL PHASE DEFECT: Yang deficiency, based on Spleen, Kidney,and Liver deficiency.
LOW AMH: This is often due to a combination of Kidney, blood and yin deficiency.
Gynaecological Issues can be attributed to several factors that can affect our hormone balance, these include: stress, medication, long time use of the Contraceptive Pill, Insppropriate diet or Life style choices, eating foods high in Soy fillers and overwork to name a few.
The menstrual cycle relies on the appropriate function of several hormones to create a normal cycle length, normal menstrual flow, absence of pain, masses and ovarian and uterine cysts to allow for natural fertility. Many of these hormones can be tested in the Lab and often give the practitioner a deeper insight into menstrual issues and reason for apparent infertility.
Lets introduce you to some of these hormones. Estrogen (E2) and progesterone (P4) are very important at different stages of the menstrual cycle. The follicular phase controlled by the Follicular Stimulating Hormone (FSH) is dominated by Estrogen (The yin part of the cycle), whilst the luteal phase (The yang part of the cycle) is dominated by Progesterone that is relased form the corpus luteam after ovulation.
The transformative hormone that pushes the cycle from the follicular (yin) to luteal (yang) phase is the Lutenizing Hormone (LH). This transformation between the yin and yang phase of the cycle and the length of each phase is very important when trying to maintain regular cycles and enhance fertility. Other hormones that greatly affect fertility and menstruation are the Thyroid Hormones. The Thyroid is largely regulated by the Kidney yin and Yang from a Chinese perspective.
It is understood than an Ideal cycle length should be approximately 28 days. Although in saying that, it is often normal for women to vary in cycle lengths, some having shorter, some having longer cycles without issues. However, if cycles are too short or too long, this can greatly impact a woman’s fertility and even cause distress in those who aren’t actively trying to conceive.
Ideally both phases should last 14 days each, a long follicular cycle, followed by a short luteal phase can in some instances be an indicator for PCOS. Blood tests performed on day 2 of a women’s menstrual cycle that test for E2, FSH, LH and Androgen levels along with an internal ultrasound can offer a diagnosis of PCOS. Women with this condition are often referred on to a fertility specialist or undergo IVF treatment.
Many women become concerned not only by blood results showing high Estrogen or Androgen’s and Low Progesterone, but also by low Anti Mullerian Hormone (AMH) which has been described as being a factor for declining egg quality and advanced egg age. Low AMH levels can cause a great deal of stress for a woman who is trying to conceive.
Many women will turn to In Vitro Fertilisation (IVF) if they suffer from hormone imbalances leading to infertility or will try alternative medicine such as Acupuncture or Chinese herbal medicine either before trying to conceive or whilst they are preparing for IVF.
Chinese Medicine is hard to quantify and test via a scientific medical framework due to it being an entirely different paradigm. In spite of the lack of funding for Chinese Medicine trials or scientific methods not being able to fully understand or test Chinese Medicine appropriately. There have been some studies that give evidence to support the benefits Chinese Medicine and Acupuncture has in those suffering from infertility. One such peer reviewed article is provided in the link below.
Women can track the lengths and temperatures of both stages of their cycle by Basil Body Temperature Charting (BBT). It is important that the temperatures are taken at the same time each morning before getting out of bed. The first day of the cycle is considered to be the first day of the bleed. Charting correctly along with tracking your fertile mucous can enhance your strike rate by ensuring you are having intercourse at the optimum time for conception to occur. An blank BBT chart for you to download and print off is available in the link below.
-PREGNANCY AND POSTPARTUM-
Pregnancy can be an amazing time for most expectant mothers. Some however can be worried about miscarriage if they have suffered from one in the past, or they may be concerned about past birth trauma that has resulted from prolonged or overdue labour, breech or posterior birth. Below is a study that was conducted to show the efficiency of therapy at BL 67 in turning a breech baby with Acupuncture.
Some new mothers find that issues arise postpartum after their baby is born. Many find breast feeding is not as easy as they thought it would be with some suffering from insufficient breast milk. From a Chinese Medicine perspective, this can be a result of blood, kidney and Spleen Qi deficiency.
Whilst pregnant, the baby takes so much from the mother in the way of qi and blood. Once the baby is born, the breast milk which is a substrate of blood can also become insufficient if the blood is depleted. Lack of sleep along with deficiency of the qi and blood can also lead to postpartum depression.
-CHINESE TERMINOLOGY RELATING TO GYNECOLOGICAL ISSUES-
Kidney Deficiency: This condition has a major affect on the follicular phase of a woman’s cycle (the yin phase).
Signs and symptoms may include: hot flushes, night sweats, thirst, dry mucous membranes, scanty periods, dry skin, hair and nails and irritability.
Kidney Yang Deficiency: This condition mainly affects the luteal phase of the cycle.
Signs and symptoms include: Frequent urination, edema, lethargy, weight issues, feeling the cold and desire for warm food and drinks.
Heart & Liver Qi Stagnation:</ conception and holding a pregnancy requires that the mind and spirit be calm and free from stress.
Signs and symptoms: Anxiety, fear, Depression, sadness, tender breasts around period time and Period pain
Blood Stagnation: It’s important that blood and qi are able to flow freely throughout the body without becoming impeded.
Signs and symptoms: Sharp stabbing period pain, Endometriosis and clotted menstrual blood.
Damp Phlegm Accumulation: Can lead to blockages in the body, i.e. Blocked Fallopian tubes or a womb that is too slick and therefore does not encourage Embryo implantation. Fertile mucous may also be absent with the presence of copious damp type mucous which can actually impede sperm travel towards the reproductive tract.
Signs and symptoms: Weight issues, excessive vaginal discharge, edema, digestive disorders, PCOS (can occur in yin deficient types also), chronic phlegm disorders such as nasal congestion, sinusitis etc.
Spleen Qi or Blood Deficiency: The spleen in Chinese Medicine is responsible for holding the blood and organs in their place, and has a fundamental role in blood production.
Signs and symptoms: Heavy periods, prolapses, weak digestion, diarrhoea or constipation, lethargy, dizziness, miscarriage or anemia.
Any problems within the menstrual cycle can indicate issues relating to blood and qi movement. Obstructions to either of these mechanisms can have implications for fertility. Painful menstrual periods, passing of Clots, Breast or nipple pain and ditention, scanty or heavy menstrual flow, excessively long or short cycles, break through bleeding, periods that stop and start. All these factors can indicate a dysfunction of the movement of qi and blood.