A balanced menstrual cycle is a harmonious flow of energy between yin and yang, at the most fundamental level.  Imbalances of this cycle can manifest as symptoms like: fatigue, pain, breast tenderness, excessive or diminished appetite, nausea, bloating, mood swings, irritability , and water retention. For tips on how to naturally alleviate some common PMS complaints, check here.   Other gynecological manifestations that can occur include endometriosis, PCOS, amenorrhea, infertility, uterine fibroid, adenomyosis, and irregular menstruation.

Although menstrual discomforts often arise a few days prior to or during a woman’s period, the root imbalance can be occurring anywhere in the cycle.  The nature of the complaint and a detailed understanding of a woman’s cycle are the best ways to get a clear idea of the “first domino” causing the problem. Once a woman understands her cycle, she simultaneously understands her fertility and can therefore easily prevent or promote pregnancy. The following is a brief guideline of what is physiologically happening during the various phases of the menstrual cycle, from both western and eastern medicine perspectives.

Four Phases of Menstruation: A General Guideline

1)  Menstrual Phase (4-6 Days)

BIO: Sharp fall in Estrogen & Progesterone, Necrosis & Shedding of Endometrial Lining

TCM: Blood is moving = Free Flow of Liver Qi and Liver Blood

RX:  Facilitate Flow of Liver Qi and Liver Blood, Unblock the Channels

•Incorporate Mild Exercise, Relaxation, Meditation, Healthy Foods

•Avoid Stress or Frustration, Heavy/Greasy Foods, Alcohol & Overeating

2)  Post-Menstrual/Follicular Phase (about 7 days)

BIO:  Follicle(s) growing within ovary, under the influence of Follicle Stimulating Hormone (FSH)

TCM: Blood & Yin in the Chong and Ren Meridians are Relatively Depleted from Blood Loss

RX:  Nourish the Yin & Blood

•Rest, Eliminate Stimulants (caffeine,energy drinks)

•Eat Eggs, Fruit, Wheat Germ, Spirulina, Good Quality Meats, Stews

3)  Mid Cycle/Ovulation Phase (about 7 days)

BIO: Lutenizing Hormone (LH) surges causing Ovulation and forms the Corpus Luteum

TCM: Yin & Blood/Ren & Chong fill up with vital energy and overflow (yin becomes yang)

RX: Tonify Kidney Essence and Kidney Yang

•Meditate, Yoga, Moderate Exercise, Easily Digestible Foods

•Begin to Avoid Dairy, Heavy Foods, Refined Carbs & Sugar

•Incorporate EFA’s (Essential Fatty Acids: Fish Oil, Eggs, Flaxseeds, Raw Nuts)

4)  Pre-Menstrual Phase (About 7 days)

BIO: Progesterone levels increase, sustains Corpus Luteum & Thickens Uterine Lining in preparation for conception or menstruation

TCM:  Yang Qi moves and Liver Qi courses in preparation for Menstruation

RX: Tonify the Yang and Course the liver Qi

•Moderate Exercise, Meditation, Yoga

Eat Cruciferous Vegetables like broccoli, cauliflower and brussel sprouts

Avoid Dairy, Caffeine

If you have ever had difficulty trying to conceive and involved the aid of a Reproductive Endocrinologist (RE), then most likely one of the first tests they ran was a hormone panel on Day 3 of your menstrual cycle.  Specifically looking at:  Follicle Stimulating Hormone (FSH), LutenizingHormone (LH), Estrodial (E2), and Prolactin.  The levels of the aforementioned hormones (among others) and their ratio to each other can give insight into the general quantity of eggs a woman has left to ovulate.  However, hormones are finicky creatures, and can change drastically month-to-month due to other illness (like thyroid disease or poly cystic ovarian syndrome, for example) or just from plain old-fashioned stress.

New findings are showing that the typical Day 3 FSH testing gives inaccurate values of a woman’s ovarian reserve one out of every six tests.  This is to say that every sixth woman to undergo traditional fertility testing may have  false lab results – offering an unnecessarily grim outlook on their hopes of ever conceiving.  How disturbing. (And probably part of the reason that one of the next steps in fertility treatments – IVF – has only a 30% success rate).  Women who are lumped into the “never will get pregnant” category regularly prove that wrong, and others who are in good health are for some reason never are able to fulfill their dream of having children.  A possible reason for this discrepancy is the inability to accurately asses ovarian reserve or egg quality.  At the very least, it is clear that the diagnosis and treatment of infertility must continue to develop in order to understand what is happening at the clinical level.

ReproSource is a lab dedicated to fertility testing and they work with patients and RE’s around the world.  Dr. Ben Leader, a scientist who works for ReproSource, presented in last night’s lecture on their newest test that indexes three specific hormone levels on Day 3: FSH, AMH (anti-mullarian hormone), and Inhibin B.  The index of the three, according to Dr. Leader, will give a much more accurate assessment of a woman’s ovarian reserve.  The results come up on a sliding graph as well, rather than the typical ‘within normal limits’ or ‘out of normal limits’ / ‘you’ll conceive’ or ‘you won’t’ – which is much easier to understand and interpret.  Other experts in the field are finding that AMH can be tested on its own at any point in a woman’s menstrual cycle and will give more accurate and consistent insight to ovarian reserve than even the day-3 FSH test.

The results of all of the aforementioned tests indicate what potential a woman has to work with while trying to conceive – of vital importance to any health care provider helping her on this journey.  We can do all the acupuncture or fertility medicine in the world, but if there simply aren’t any eggs left for a woman to ovulate, that is one thing we cannot create (in this case, donor egg is often offered as a viable option).  A woman is born with all the eggs she will ever have in her lifetime, and depending on the delicate nature of the menstrual cycle, genetics, hormonal balance and other factors will determine at what point she will run out – essentially beginning menopause (with normal onset somewhere in the neighborhood of age 50).

The fact that such testing is more specific for detecting egg quantity, it cannot be used to determine egg quality – the part that we as acupuncturists have the potential to improve.  The best way to consistently determine egg quality is still by a woman’s age: the younger the woman, the better the egg quality -regardless of ovarian reserve (although this is often debated).  It is quite interesting to me that with all the new developments in fertility therapy that they have yet to determine a quantifiable way to detect poor or high egg quality.

This is where we come in.  Acupuncture and herbal medicine have been used for thousands of years to help couples conceive.  By invigorating blood flow to the pelvic area, regulating a woman’s menstrual cycle, and alleviating stress we are able to accomplish the task in question: improve egg quality. If the issue is male-factor, acupuncture and herbs can also help improve sperm quality in addition to sperm quantity due to the simple fact that males regenerate new sperm avery three months (please note that success depends on the etiology of low sperm count, motility, or morphology issues). Depending on a couple’s history, age, lab work and diagnosis, acupuncture and herbs can help couples to safely and effectively conceive – either naturally, or alongside western fertility treatments.

In order for Chinese medicine to have an effect on improving egg/sperm quality, it does take time. To regulate a woman’s cycle can take anywhere from three-six months, and the same goes for impacting a change on male sperm production.  Therefore, I recommend beginning to work with an acupuncturist/herbalist either when you are just beginning to try and conceive or beforehand.  I have personally studied under renowned fertility acupuncturist and herbalist, Dr. Mike Berkley, and seen the amazing power of Chinese medicine in conjunction with modern developments.  Tests like the FSH/AMH/Inhibin B Index are useful to patients, RE’s and acupuncturists alike.  With more accurate clinical findings and continued research, we can all be better internists in this challenging field.

This post is proudly a part of Prevention Not Prescriptions Tuesday @ The Kathleen Show.  For more information and to check out some other great health blogs, check this site.

If you have ever had difficulty trying to conceive and involved the aid of a Reproductive Endocrinologist (RE), then most likely one of the first tests they ran was a hormone panel on Day 3 of your menstrual cycle.  Specifically looking at:  Follicle Stimulating Hormone (FSH), LutenizingHormone (LH), Estrodial (E2), and Prolactin.  The levels of the aforementioned hormones (among others) and their ratio to each other can give insight into the general quantity of eggs a woman has left to ovulate.  However, hormones are finicky creatures, and can change drastically month-to-month due to other illness (like thyroid disease or poly cystic ovarian syndrome, for example) or just from plain old-fashioned stress.

New findings are showing that the typical Day 3 FSH testing gives inaccurate values of a woman’s ovarian reserve one out of every six tests.  This is to say that every sixth woman to undergo traditional fertility testing may have  false lab results – offering an unnecessarily grim outlook on their hopes of ever conceiving.  How disturbing. (And probably part of the reason that one of the next steps in fertility treatments – IVF – has only a 30% success rate).  Women who are lumped into the “never will get pregnant” category regularly prove that wrong, and others who are in good health are for some reason never are able to fulfill their dream of having children.  A possible reason for this discrepancy is the inability to accurately asses ovarian reserve or egg quality.  At the very least, it is clear that the diagnosis and treatment of infertility must continue to develop in order to understand what is happening at the clinical level.

ReproSource is a lab dedicated to fertility testing and they work with patients and RE’s around the world.  Dr. Ben Leader, a scientist who works for ReproSource, presented in last night’s lecture on their newest test that indexes three specific hormone levels on Day 3: FSH, AMH (anti-mullarian hormone), and Inhibin B.  The index of the three, according to Dr. Leader, will give a much more accurate assessment of a woman’s ovarian reserve.  The results come up on a sliding graph as well, rather than the typical ‘within normal limits’ or ‘out of normal limits’ / ‘you’ll conceive’ or ‘you won’t’ – which is much easier to understand and interpret.  Other experts in the field are finding that AMH can be tested on its own at any point in a woman’s menstrual cycle and will give more accurate and consistent insight to ovarian reserve than even the day-3 FSH test.

The results of all of the aforementioned tests indicate what potential a woman has to work with while trying to conceive – of vital importance to any health care provider helping her on this journey.  We can do all the acupuncture or fertility medicine in the world, but if there simply aren’t any eggs left for a woman to ovulate, that is one thing we cannot create (in this case, donor egg is often offered as a viable option).  A woman is born with all the eggs she will ever have in her lifetime, and depending on the delicate nature of the menstrual cycle, genetics, hormonal balance and other factors will determine at what point she will run out – essentially beginning menopause (with normal onset somewhere in the neighborhood of age 50).

The fact that such testing is more specific for detecting egg quantity, it cannot be used to determine egg quality – the part that we as acupuncturists have the potential to improve.  The best way to consistently determine egg quality is still by a woman’s age: the younger the woman, the better the egg quality -regardless of ovarian reserve (although this is often debated).  It is quite interesting to me that with all the new developments in fertility therapy that they have yet to determine a quantifiable way to detect poor or high egg quality.

This is where we come in.  Acupuncture and herbal medicine have been used for thousands of years to help couples conceive.  By invigorating blood flow to the pelvic area, regulating a woman’s menstrual cycle, and alleviating stress we are able to accomplish the task in question: improve egg quality. If the issue is male-factor, acupuncture and herbs can also help improve sperm quality in addition to sperm quantity due to the simple fact that males regenerate new sperm avery three months (please note that success depends on the etiology of low sperm count, motility, or morphology issues). Depending on a couple’s history, age, lab work and diagnosis, acupuncture and herbs can help couples to safely and effectively conceive – either naturally, or alongside western fertility treatments.

In order for Chinese medicine to have an effect on improving egg/sperm quality, it does take time. To regulate a woman’s cycle can take anywhere from three-six months, and the same goes for impacting a change on male sperm production.  Therefore, I recommend beginning to work with an acupuncturist/herbalist either when you are just beginning to try and conceive or beforehand.  I have personally studied under renowned fertility acupuncturist and herbalist, Dr. Mike Berkley, and seen the amazing power of Chinese medicine in conjunction with modern developments.  Tests like the FSH/AMH/Inhibin B Index are useful to patients, RE’s and acupuncturists alike.  With more accurate clinical findings and continued research, we can all be better internists in this challenging field.

This post is proudly a part of Prevention Not Prescriptions Tuesday @ The Kathleen Show.  For more information and to check out some other great health blogs, check this site.