Traditional Chinese Medicine and the Menstrual Cycle
Traditional Chinese Medicine (TCM) places great emphasis on a normal menstrual cycle. The menstrual cycle is supposed to be a certain length, approximately 28 days. The time from menstrual period to ovulation is called the follicular phase, which should last 12-15 days. From ovulation to menstruation is called the luteal phase, which should last 14 days. Regularity in length between phases should be present, and irregularities indicate various hormonal issues. Ovulation is accompanied by a spike in basal body temperature. Your period should be non-painful, neither too scant not too heavy, and last 4-5 days. There should not be heavy clots or spotting before or afterwards. Menstruation shouldn’t be associated with back pain, cramping, mood swings and cravings. These are all signs of imbalances in TCM that can be addressed with acupuncture and nutrition.
Normalizing the menstrual cycle is often the only step that is needed to restore fertility.To begin addressing fertility issues, start keeping a basal body temperature chart such as the one available on my website. Not only will your medical doctor recommend that you begin this chart, but your acupuncturist will need to see one as well.
Stress and Fertility
Stress is a known major contributor to fertility issues. I like to think of stress and fertility as being counterintuitive counterparts by using the following exaggerated example. Imagine being chased by a lion. The stress hormones are surging to save you from becoming the lion’s lunch. Your heart is beating wildly, you are able to run faster than you’ve ever imagined, you can even climb a tree although you’ve never climbed one before, you can do whatever it takes to escape. Wouldn’t it seem strange for the same lion-escaping stress hormones to be welcoming to an embryo or newborn baby? Although you are not getting chased by lions on a regular basis, the stress experienced as a result of a job or lack thereof, family life, infertility, or other stressors, creates the same chemical reactions in the body. Stress and fertility do not go hand-in-hand.
In a perfect non-stressed internal environment, chances are the egg and sperm will be healthy. However, in the absence of this state of internal peace and equilibrium, the quality of the egg and sperm will reflect the state of the rest of the body. The inflammatory effects of a poor diet will manifest and hormonal cues will be interrupted; communication between the brain, the hypothalamus, pituitary gland and the ovaries becomes less efficient. Follicles in the ovaries become less sensitive to the effects of follicle stimulating hormone (FSH). And finally, with the passage of time, an inflammatory diet, and lack of adequate exercise, blood flow to the uterus and other reproductive organs becomes compromised.
Proper nutritional choices, acupuncture, exercise and yoga are very effective ways to reduce stress. Exercise, including yoga, is absolutely essential to reduce the levels of inflammatory mediators in the body. Having excessive body fat, a possible indicator of Syndrome X, leads to increased stress hormone levels and causes depression. Body fat, or adipose tissue, used to be thought of as an energy storage organ. Now it is recognized that adipose tissue plays a pivotal role in determining the flavor of our internal chemistry. It contributes inflammatory chemicals to the body and stimulates the immune system in undesirable ways; it may even stimulate autoimmunity. The fat cells actually secrete highly inflammatory chemicals into the body!1
Syndrome X also causes sympathetic overactivation—this is the flight-or-fight response described above in escaping the lion. Syndrome X increases circulating levels of cortisol,2 a stress hormone. Clearly sympathetic activation and high levels of cortisol are not amenable to a fertile state. One of the ways in which acupuncture and yoga help restore fertility is by reducing this sympathetic response and reducing high cortisol levels.
Acupuncture and IVF
Acupuncture has been shown to be very effective in improving the success rates of in vitro fertilization (IVF). It can help by improving the function of the ovaries to produce better quality eggs, regulate the menstrual cycle and its hormones to produce a larger number of follicles by stimulating the hypothalamus, increase blood flow to the uterus, and increase the thickness of the uterine lining. It can also reduce stress levels and relax the mother-to-be by facilitating the release of endorphins in the brain and reducing the sympathetic response.3
The issues that affect female fertility affect male fertility as well. In the 1940s, average sperm counts were 113 million/ml. In the 1990s, average sperm counts dropped to 66 million/ml. That’s a significant drop! Now anything below 20 million/ml is considered low. It seems that inflammatory dietary factors and stress contribute equally to male fertility issues, and they need to be addressed.
Acupuncture has been shown to improve semen quality by increasing the quality and quantity of sperm and strengthening the immune system. In one study, acupuncture administered twice a week for five weeks to men diagnosed with idiopathic infertility improved sperm production, motility, and quality, and reduced structural defects.
Sperm maturation takes about 90 days, and the ideal amount of time to allow for optimal egg development is 90 days as well. Both the future mother and father should therefore consider a TCM assessment and both receive acupuncture and make nutritional modifications 90 days before they try to conceive. This goes for either natural conception or through IVF transfer.
One of the main reasons IVF transfers fail is a lack of receptivity for the embryo in the uterus. Often the uterus contracts, possibly due to stress, in reaction to the embryo transfer. The pregnancy rate of IVF treatment is significantly increased when acupuncture is administered on the day of embryo transfer.4
- Antuna-Puente et al. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab. 2008 Feb;34(1):2-11. Review.
- Axelsson J et al. Adipose tissue and its relation to inflammation: the role of adipokines. J Ren Nutr. 2005; 15(1):131-6
- Chang et al. Role of acupuncture in the treatment of female infertility. Fertil Steril. 2002 Dec;78(6):1149-53
- Ng et al. The role of acupuncture in the management of subfertility. Fertil Steril.2008 Jul;90(1):1-13. Epub 2008 Apr 28.