PCOS and Cortisol: Why a Relaxation Regimen Is Not Optional

Most doctors agree that the most effective first-line treatment for Polycystic Ovarian Syndrome is diet and exercise.  Eating a low-glycemic diet that helps regulate blood sugar levels and exercising regularly to improve glucose metabolism can help re-start ovulation in many PCOS patients.  However, at the Moon we think this “prescription” is missing something – and that something is stress reduction.

Interestingly, both overweight and normal weight patients with PCOS show altered cortisol metabolism, with PCOS patients showing an increase in circulating stress hormones likes cortisol.   Higher levels of cortisol are not optimal for either overall health or for fertility.  Cortisol can disrupt our menstrual cycle, increase appetite (particularly for sugary foods), promote weight gain, especially around our middle where it is more harmful to our health and impair our immune function.  While experts cannot yet agree why cortisol is higher in PCOS patients, they should agree that taking steps to lower cortisol is likely to improve overall health of women with PCOS as well as their fertility.

Techniques that have been shown to lower stress include:

Acupuncture:  Recent studies have found that the increased muscle sympathetic nerve activity (a sign of increased stress hormone activity) in PCOS patients can be significantly lowered with acupuncture treatment.

Exercise:  We all recognize the stress reduction component of  fertility-friendly workouts.   Exercising regularly controls stress and makes us feel better about ourselves.

Yoga/Relaxation Training:  Yoga has been shown to be as effective as cognitive-behavioural therapy at improving psychological and physiological measures of stress. 

Bottom line:  if you have PCOS, by all means continue with your healthy eating and exercise program but consider adding acupuncture to your regimen and taking at least 15 minutes a day to practice yoga stretches and breathing.

iRest – Sleeping Your Way to Fertility (the Yoga Way)

What do U.S. soldiers returning from Iraq and infertility patients have in common?  They both might benefit from a form of yoga called Integrative Restoration or iRest.  A feasibility study conducted at Walter Reed Army Medical Center in Washington, D.C., indicated that a particular approach to yoga called Yoga Nidra is having a positive effect on military personnel suffering from post-traumatic stress disorder (PTSD).  Participants in the program have reported that through the use of progressive relaxation, deep breathing and meditation, symptoms of anxiety, depression, insomnia and pain have lessened. 

Meanwhile, on the infertility battlefield, PTSD takes a different yet familiar form: anxiety, depression, loss, isolation from friends, marital stress, financial burdens, spiritual crisis and feelings of being broken.  Is it possible this same technique of Yoga Nidra could help fertility patients relieve their symptoms of distress just as it has helped our soldiers? Richard Miller, PhD. Psychologist, who developed the protocol of iRest used in the Walter Reed study says, “yes.”  Dr. Miller adds, “The ultimate design of iREST/Yoga Nidra is to help people live contented lives, free of conflict, anxiety, fear and suffering.  iREST accomplishes its goal through two basic steps: (1) the embodiment of pure awareness and (2) the release of negative body sensations, emotions, beliefs and stress that give rise to self-destructive patterns.”

Embodiment of Pure Awareness

Yoga Nidra, a Sanskrit phrase which means “sleep of the yogi’s,” has been practiced by yogis and sages for thousands of years.  It is based on the idea that we have three states of consciousness: the wakeful state, dream state, and the deep dreamless sleep state.  It is thought that the dreamless sleep state is the purest form of consciousness and a connection with it ultimately leads to a greater knowledge of God or Spirit. This concept of the dreamless sleep state maybe difficult to grasp but when you are asked in the morning how you slept the night before, you usually have a deep knowledge of the answer.  You say, “I slept great” or “I tossed and turned all night.”  How do you know if you are asleep?  There is awareness within this deep, dreamless state of consciousness which the yogis contend offers the greatest opportunity for a student to experience an understanding of her innate nature.  This consciousness is pure awareness that never sleeps and welcomes every moment as it is, without analysis, judgment or conclusion.  By welcoming things as they are, a student begins to see that they are not separate, finite beings, rather infinite and eternal.  Connecting with this state of consciousness offers an opportunity to resolve mental, physical and spiritual confusion, conflict and suffering. It’s like having an internal disarmament mechanism built right into your psyche and that’s not a bad thing to have in your fertility tool belt, particularly if you find yourself among those who experience stress and self-destructive patterns while trying to conceive.

Release of Negativity

The practice of Yoga Nidra is not auto suggestion, hypnosis or a series of postures.  It is a guided process of relaxation, self-inquiry and sensory withdrawal which leads to profound contemplation and healing.  The great news is, anyone can do it.  You don’t need to have Gumby-like flexibility, a fit physique or a calm mind to practice the technique.  In fact, if you like sleeping, you will love iRest because the practice is done while lying down in a savasana style (dead man’s corpse) position.  Those who are new to the practice often fall asleep and have no conscious recollection of what might have happened during iRest.  When they wake, they feel rested and relaxed.  Interestingly, it is believed that 30 minutes of Yoga Nidra is like having three hours of regular sleep.  Take that to the sleep bank during your two-week wait! 

Yoga Nidra is a little bit of body awareness, a little bit of breathing and a whole lot of guided meditation which is meant to help the student process all of the negative emotions and situations which constantly bombard the physical world.  You can hop on the treadmill and feel a sense of stress reduction when you are finished, but just like any given point on the conveyer belt of your running machine, your problems and their associated emotions will keep popping up from time to time.  Yoga Nidra teaches us to get off the treadmill by acknowledging our stresses, emotions and problems rather than reacting to them.  In so doing, we will experience a more lasting type of healing.

Infertility and Trauma

            Yoga, military veterans and holistic fertility are three phrases one would not expect to find in the same article.  While some may find it a stretch to connect the stresses of battle with the stress of infertility, the fact is that studies have shown that women undergoing IVF have depression and anxiety rates similar to women with cancer and AIDS (Domar AD et al.  The psychological impact of infertility:  a comparison with patients with other medical conditions.  J Psychosom Obstet Gynaecol 1993;14 Suppl:45-52).  For those that haven’t experienced difficulties getting pregnant, it’s difficult to truly recognize the trauma that can occur.  At Pulling Down the Moon, we find that many women actually seek out holistic treatment following a particular trauma – a miscarriage, failed cycle or devastating piece of news.  Take Eleanor, for instance, who finally conceived after years of fertility treatment only to have her baby die in utero from a cord incident.  Or Steve, who learned after a routine sperm analysis that he has no viable sperm and no chance of fathering a biological child. Or Amy, whose gynecologist diagnosed her with early menopause at the age of 27.   Such events, while not life threatening, are deeply shocking and challenge one of our most primal drives – the drive to procreate.  In addition, they assail deeply held beliefs of marriage, partnership and family.

            Time and again in our classes we hear traumatic stories of miscarriages, phone calls from the nurses with “devastating” news, and the overpowering fear of having to try again only to experience another failure or loss.  These memories are often denied or pushed below the surface without sufficient time for grieving and/or processing because infertility is largely a private experience that occurs simultaneously with daily life, work and relationship experiences.  Unlike death in the family or major illness, there is no established societal framework for honoring and working through the losses and challenges associated with infertility.  Many former fertility patients report that routine ultrasounds, a television commercial that features a swimming sperm or even a phone call from a newly pregnant friend can evoke feelings of panic and helplessness well beyond the resolution of their fertility treatment. 

Are you Sleeping?

Since research has shown that women who are depressed or anxious have significant declines in IVF success rates (Chen TH, Chang SP, Juang KD. Human Reprod. 2004; 19:2313-2318), it is easy to see the value of a practice like Yoga Nidra which reduces stress and helps a woman feel more empowered while trying to conceive.  At Pulling Down the Moon we incorporate Yoga Nidra into our Tools for Healing Yoga Class and are offering a new class called WeRest for couples in September of 2007.  Beyond the practical value of stress reduction, our students state that one of the most profound experiences of the practice is using deep relaxation for setting a private intention or Sankalpa.  This allows them the opportunity to ask for their heart’s desire in a way in which they, themselves, suspend judgment on the nature of the intention and its outcome. The teacher then instructs them to believe that this intention has already manifested.  This puts motivation and energy behind the intention so the student feels as though they are actively working toward, and have the ability to attract those things they want in their life.  Similarly, they are getting rid of those things that are not conducive for achieving their intention. 

What we see in our classes is that women going through fertility are often “sleeping” or at war with themselves.  The series of tests, treatments and disappointing outcomes take them further away from their purest form of consciousness and throws them into a state of confusion and separation.  They are not truly “awake” to their true potential.  When they start welcoming life as it is rather than how they imagine it should be, they awaken from their own symbolic “sleep” and experience the genie in the bottle that exists in each and every one of us.  

If you are interested in practicing Yoga Nidra/iRest make sure you seek out a yoga instructor who has been specifically trained and certified to teach its methods.  As an alternative to private or group instruction, there are several CD’s which offer exceptional value in taking a student through the process such as Richard Miller’s, “Infinite Awakening: The Principles and Practice of Yoga Nidra,” and Rod Stryker’s “Relax into Greatness.”  For more information about iRest or Yoga Nidra, or to find Yoga Nidra CDs for practice, you can visit www.pullingdownthemoon.com or www.nondual.com .  We also offer iRest for Fertility workshops at our Rockville location.  Click here for details .

Acupuncture, Depression and Pregnancy

A new study was published this week in the Journal of Obstetrics and Gynecology which showed that acupuncture can help treat symptoms of depression in pregnant women.  In the study, depressed women were placed into three groups:

  • 52 women received acupuncture for the specific purpose of relieving depression
  • 49 women received acupuncture without a stated purpose and served as a control group
  • 49 women received massage therapy and served as a second control group
  • Groups underwent 12 treatments over an eight-week period of time and were then asked to take the Hamilton Rating Scale for Depression.  Results showed the severity of depression in the acupuncture specific group to be significantly lower than that in both of the control groups.   

    This was encouraging news since we are often asked at Pulling Down the Moon what holistic therapies might be available to patients who become depressed during pregnancy or what patients can do if they do not want to take their anti-depressants while TTC or pregnant.  Understandably, many women are concerned about taking or starting medications during their pregnancy due to potential risk to their babies.  Interestingly, research has shown that women with depression tend to have a greater liklihood of developing postpartum depression and they are more likely to have babies with lower birth weights.  For these reasons, it is important to talk with both your doctor and your acupuncturist about integrating their care to make your treatment plan as seemless as possible. 

    For information about the study, check out this Wall Street Journal Article:

    http://online.wsj.com/article/SB10001424052748704454304575081753471294546.html

    Vitamin “Sea” for Fertility: A Primer

    Sea vegetables are nutrient powerhouses, especially for fertility.  These humble ocean plants (well, technically they’re algae which is neither plant nor animal – but that may be T.M.I.) are full of antioxidant vitamins like carotenoids (A), and C, the B-vitamin folate and minerals that are essential for reproduction like iron, calcium and iodine.   Iodine is particularly important for fertility, since iodine is a key component the thyroid hormones T3 and T4.  Thyroid hormones play a role in almost every body function, from metabolism and weight management to the proper function of our reproductive system .  Many foods in our diet (like soy , caffeine, raw peanuts) can suppress thyroid function so having a good source of dietary iodine on the plate is a good idea.   Sea veggies also contain lignins, which are a fave food of the beneficial bacteria that live in our gut and support digestion and immunity.

    Admittedly there can be a bit of a “fear factor” that comes into play when we first begin to explore sea vegetables.  For that reason we suggest baby steps.  Here are two ways to “dip your toe into sea veggies:”

    1.  Make dashi.  Dashi is a flavorful broth that can be sipped alone or used as a base for clear or thicker soups.    This recipe from Whole Foods Market will help you get started.  Please note that this recipe includes bonito flakes.  Because bonito is a type of tuna we investigated the mercury content of bonito and were pleased to learn that this quick growing fish is not a high mercury risk.   Some other ways to use dashi:

    • Season with fresh ginger and mirin and pour over cooked brown rice for a more hearty soup
    • Add cooked protein (chicken, free-range beef strips, shrimp or fish) and some lightly steamed veggies and you’ve got a great one-bowl meal

    2.  Try nori (flat sheets of pressed sea vegetable that you’ve probably seen on the outside of sushi rolls) as a condiment.  Toast it over the flame of your gas range until it turns from emerald green to blackish green (but not burnt) and then cut into strips or crush into flakes.  This will add crunch and savory flavor to salads, grains and casseroles.

    As with anything related to fertility nutrition, do not overdo.  Several servings of sea vegetables per week is a great start.  Regardless of whether you’re adding sea veggies to your diet, if you’re trying to conceive and not sure about your thyroid function (women can have both overactive and underactive thyroid) you should speak to your doctor about having it tested.

    Be Present, Be Positive…Be Adventurous in the Kitchen, Paige

    Don’t Just Do Something…Sit There!

    As part of our free patient education series sponsored by Fertility Centers of Illinois , we offer a fun class called The Relaxation Response designed for women (and partners) who are stressed, struggling with the ups and downs of fertility challenges and willing to explore meditation as a way to calm body and mind.

    To understand why meditation helps, it’s useful to understand a bit more about stress. One of our favorite holistic teachers, Deepak Chopra, defines stress as what happens when our needs are not met. For instance, if we perceive that we need to get to work by 9 and we’re stuck in traffic at 8:55 we get stressed. If our monthly bills are greater than the money we have to pay them with we get stressed. If we need a baby and we’re not getting pregnant that, too, generates a tremendous amount of stress.

    To deal with stress skillfully, it’s important to recognize its rightful place in our biology. What we call “stress” – that stomach-churning, heart pounding reaction to an irritating boss or a negative beta-HCG result- is actually a valuable evolutionary mechanism that has allowed for the survival of our species. The biological stress response is called the “fight or flight” mechanism. Long ago, human survival depended on the ability to fight or run from bigger, meaner predators. The secretion of “stress hormones” like cortisol and adrenaline facilitate physiological conditions that would allow escape from a hungry saber tooth. During the stress response, blood is shunted from internal organs to the skeletal muscles, the heart and respiratory rate increase, glucose is released from muscles and liver to fuel our muscles, platelets in the blood become “stickier” to reduce blood loss in the case of injury and non-essential activities such as digestion, physical repair and reproduction are dialed back. All fine and good when we’re talking about a tussle with a tiger but in that scenario there’s resolution -either we kill the beast, escape or get eaten. But in this age of 24/7 communication, we can see that a sustained, unrelenting stress response can severely impact our physical wellbeing.

    Any fertility patient who hears the words “just relax and you’ll get pregnant,” is apt to eye-roll or worse. However, increasing clinical evidence suggests that stress may impair a woman’s ability to conceive both “naturally” and with Assisted Reproductive Technology (ART). Cortisol down-regulates our reproductive system. Women who do not ovulate have been shown to have higher levels of cortisol in their blood, and a similar correlation has been noted in IVF patients, with higher levels of cortisol associated with poor outcomes. It also seems that cortisol effects fertility directly, as recent studies show that stress actually damages uterine receptivity (how prepared the uterus is to hold and nourish an embryo) in mice.

    So what’s the solution? If we’re serious about improving our overall health and fertility, we must address our immediate response to stressful situations. Here are several tips for identifying and eliminating excess stress in our lives.

    • Make stress reduction a part of your fitness regimen. Taking 20 minutes a day to practice stress reduction techniques will make a serious dent in your stress levels.
    • Learn to breathe mindfully. The breath is a key way to “stop the bleeding” in the midst of a stressful situation. Deep, slow breathing in a stressful situation reduces the severity of the stress response.
    • Practice hatha yoga . This ancient system teaches gentle stretches, breath awareness and mindfulness techniques that release tension and dis-ease in the body. Rather than “fight or flight,” yoga promotes the “rest, digest and nest” hormonal response.
    • Learn to meditate. Meditation is a chance to cultivate a non-reactive mind. Often, stressful events will “re-play” during meditation, evoking their panic messages. As we learn to observe these repeat performances in stillness we short circuit their power.
    • Live more simply. If stress arises when our perceived needs are not being met, have an honest conversation about yourself about what it is you really need to be happy. Try to let go of the things that aren’t so important. Recognize that all of our modern gadgets make our needs seem more immediate than ever before and try to lessen the pressure you put on yourself to respond to work and life situations in light-speed.
    • Take time for deep relaxation. Practices like yoga nidra (deep guided relaxation), listening to beautiful music and spending time in nature can restore our body and mind to balance.

    There’s a great saying in the yoga world, “don’t just do something, sit there!” While this advice may fly in the face of our go-go worldview, it contains deep wisdom. Stress is a reality in our lives that we cannot run away from. It’s hard-wired into our biology. Thankfully, instead of razor-sharp teeth human kind was gifted with big brains and the ability to study our own behavior. When we become aware to the negative impact of stress on our body and mind and begin to set aside time to address it, we may finally have the tiger by the tail.

    Now, the thing about relaxing is that you actually have to do it. We suggest you join a yoga class or get into a community that shares the intention of reducing stress and increasing relaxation. The next Relaxation Response class will be offered at our Chicago center in March (click here to sign up) and we are also offering a yoga nidra workshop at our Rockville center this Sunday, February 28 ( click here for info ). We hope to see you there!

    Be present, be positive…be peaceful! Paige

    Mastery, Flow and Fertility

    My brother Ted Bilich, a D.C.-area attorney and Associate Professor of Law at Georgetown, writes and teaches about the importance of goals, how to set them and how to achieve them.  He has a ton of great info on his blog ( www.tedbilich.com ), but being the P.I.T.A. little sister, I thought I’d try and stump him with a question:  what advice would he give to goal-oriented people who are up against something that is out of their control (ie. getting pregnant)?  It’s a relevent question since many of the women in the Pulling Down the Moon community (including Tami and myself) are very goal-oriented.  In fact, for many of us, getting pregnant is the first goal we haven’t been able to achieve despite all efforts. 

    Within a few hours Ted came up with a response that I found thoughtful and inspiring ( read the whole piece here ).  What interested me the most was his inclusion of the concept of flow, which resonates deeply with yoga and holistic medicine.  Ted writes:

    “…S eek the benefits of flow by finding ways to appreciate the value of the process itself.  As Malcolm Gladwell’s book Outliers points out, outsized success ordinarily requires substantial practice.  Mastery tends to require thousands of hours of study, and someone will not devote hours and hours if they don’t find some way to love the process.  The concept of flow captures that notion.  Our favorite experiences tend to be those that challenge us sufficiently that we lose ourselves in the moment.”

    So from a Pulling Down the Moon perspective, flow is what happens when we begin to embrace the journey of trying to conceive.  Not because it’s fun or because we want to struggle with infertility, but because that is what life is putting on our plate in this moment.   Flow is what our fertility  acupuncturists try to achieve when they place needles on the body to direct the movement of life energy in our bodies.  When we begin to eat right, excercise right, address areas of dis-ease our life (stress, anger, emotionality) we enter a flow that is greater than trying to get pregnant.   The benefit of these practices is that they do, as Ted writes, “bring one’s vital statistics into target zones,” that may improve our odds of getting pregnant.  

    But if we’re lucky, we find these practices challenge us in a way that allows us to lose ourselves in the present moment, amazed and enchanted by the process of living life at a deeper, more mindful level.  In PDtM, our six week yoga class we study breathing, meditation and even philosophy to help us experience the concept of flow.   On a very basic level, our bodies can also help to unlock the door to the present.  Check out the video below, a sequence of postures that we call our Moon Salute.  This practice stretches the hips and groin, makes the low back more supple, opens the heart and calms the body and mind with rythmic breathing.  One one level it fits the criteria of “bringing our vital stats into the fertility zone,” yet it’s also beautiful experience in and of itself.   When we focus on the breath and the movement, letting the outside world fall away, we find entry into flow.  Asana (yoga posture) practice isn’t the only way to get there…there’s journaling, painting, gardening, cooking, singing…the list goes on.  

    We challenge you now to practice this Moon Salute video every day for a week and come back with your comments and questions.   The flow is a wonderful place to be, and that’s what our community at Pulling Down the Moon is all about.   The babies are just a really big bonus!  Be present, be positive…be part of the flow.  Beth

    Male Infertility and Risk of Testicular Cancer

    This recent study examining the link between male infertility and increased risk of testicular cancer caught the eye of our nutrition department.  When questioned about the reasons why the infertile men in this study were 2.8 times more likely to develop testicular cancer than fertile men, the researchers ruled out fertility treatment as a contributing factor,  largely because men are not likely to undergo surgery or take fertility drugs.  One potential hypothesis suggested by this group is that infertile men may have impaired DNA repair-capacity.  Another suggestion is that environmental exposure to toxins may contribute to the development of testicular cancer.

    From a nutrition standpoint, when we see impaired DNA repair capacity and environmental exposure we immediately think oxidative stress.  Oxidative stress is when our bodies’ defense systems against cell damage and environmental toxicity become overwhelmed.  Oxidative stress is associated with male infertility ( Agarwal 2008 ) and for this reason we counsel our male infertility patients to make changes to support their body’s antioxidant capacity to improve their sperm quality.

    Here are some tips for the “fertile guy” who wants to help his sperm be all they can be…and now, potentially prevent testicular cancer:

    • Quit smoking and avoid exposure to second-hand smoke.
    • Limit alcohol consumption to < 3 servings per week.  Choose red wine for its antioxidant benefits.
    • Oxidative stress may also be higher where inflammation is present, so ensuring good digestion and gut health may reduce circulating levels of ROS.  If you’re experiencing diarrhea, bloating, constipation, cramping or other digestive symptoms, it may be worthwhile to meet with a nutrition specialist to determine if food sensitivity or other digestive disorder is present.
    • Where possible, use organic cleaning products.
    • Increase your dietary antioxidant consumption.  A diet that is wholesome and rich in fruits, vegetables, tea, and healthy fats will improve our body’s defenses against oxidative stress. Be aware that many sources of healthy fats in the diet (fatty fish, flax seed) should be consumed intelligently to avoid excess intake of environmental toxins (fish) and phytoestrogens (flax).
    • Consider an antioxidant supplement and high quality fish oil supplement that provides about 1000 to 1500 mg of EPA per day.
    • Avoid high intensity/high impact exercise without adequate time for body tissues to rest and restore.  The huge aerobic and mechanical demands of strenuous exercise can actually increase oxidative damage to cells in the body.  On the flip side, regular moderate intensity/low impact exercise increases our body’s defenses against oxidative stress.
    • Learn to relax, practice yoga or meditate.  Life stresses may elevate levels of ROS in the body and learning to relax can support our body’s antioxidant defenses and actually promote healing.

    So guys, you have one more reason to take charge of your nutritional status while you and your partner are trying to conceive.  Healthy sperm and good antioxidant defenses may literally save your life!

    How Creativity Supports Fertility

    Let It Be Written…or painted…or cooked…or danced….

    Hmm… can I really start this blog by talking about life energy and chakras?  What the heck.   I’ll give it a try.

    In yoga, we talk a lot about life energy, or prana.  Prana is life force that illuminates us.  When we’re happy and peaceful, we bring more prana in to our body, when we’re stressed we “leak” prana through obsessive thought and negative emotion.  When we die, prana leaves the body completely.  It’s a pretty simple concept.

    Yoga also comes with a full system of energy anatomy.  There are nadis , or channels, through which prana flows, that are analogous to nerves in our Western anatomical systems, and chakras , or wheels, that are analogous to nerve plexuses.  Chakras regulate and direct the flow of life energy in our body.  In the yoga energy system, the flow of energy can be affected by physical, emotional and spiritual conditions.  Seven main chakras are located along the spine, each associated with specific physical functions and psycho/emotional life lessons.   In this system, as we evolve physically, emotionally and spiritually our bodies are able to work more effectively with life energy.

    So, what does all this have to do with creativity…or fertility for that matter?  Well, creativity happens to be the life lesson associated with the second chakra – and the second chakra is associated with the function of our uterus and ovaries (and the testes in men).   While the best strategy for fertility is to balance overall chakra function, we can deeply stimulate and open our second chakra with creative persuits – dancing, painting, cooking…and writing.  There!  Now I’ve gotten to the point…or at least closer.

    If you’re struggling with infertility, this does not necessarily mean that your second chakra is blocked.  However, the process of infertility does take the wind out of the creative sails pretty quickly.  At Pulling Down the Moon, we recommend that women find a creative outlet during this process to prevent the second chakra from becoming stagnant.  There’s something about the fertility process that makes us want to pour every last drop of our energy into the act of creating a baby.  When success doesn’t come easily, we continue to pour.

    Here’s a yoga secret.  Life energy flows better when me make space for it.  In our hatha yoga classes, we stretch tight muscles in order to allow for prana to fully saturate our tissues.   The more space we make, the more energy we hold which in turn makes us healthier, happier and more whole.  For the second chakra to glow and shine, it needs an outlet for creation.  When begin to pour the energy of infertility into new creations we become alive with creative energy.

    I’ve written about my own experiences of grief and healing through creation elsewhere.   I (and the other readers of this blog) would love to hear yours.  Have you started a new hobby, taking a creative outlet in your life to another level, or found out something new about yourself because of the fertility journey?  If so, leave a comment and share your story.   If you haven’t found your creative outlet yet we invite you to attend our upcoming Journaling Your Fertility Journey workshop at our DC Metre/Shady Gove location with Jenny Rough , freelance writer and writing teacher, about journaling the fertility journey.   Jenny has written extensively about her own fertility journey for magazines including Mothering.com, Yoga Journal and her work has been featured on NPR.

    Be Present, Be Positive…Create!  Beth

    Soy and Fertility: The Controversy

    To soy or not to soy is a common question in the world of fertility nutrition and the answer to receive depends on which nutritionist you consult. Don’t laugh…the question of soy is polarizing in the nutrition world and most nutritionists have a “soy philosophy.” On the one hand, there are holistic advocates like Christiane Northrup ( read about the Oprah/Soy/Thyroid story ), who recommend soy for general health and menopausal symptoms. On the other hand, any internet search will turn up scads of articles which attest to the negative impact soy can have on health . So, what’s a fertile gal to do?

    Well, it’s important to start by understanding why soy is so controversial. First, soy contains isoflavones, chemicals that are structurally similar enough to the hormone estrogen to be called “phytoestrogens” which can bind to estrogen receptors in our body. Isoflavones, however, are much weaker (about a thousand times weaker) than our body’s estrogen molecules. Isoflavones do not accumulate in the body and are metabolized quickly. For this reason the proponents of soy recommend soy as a remedy for the hot flashes, night sweats and mood swings that accompany lowered estrogen levels in menopause. It is also the reason why soy opponents believe soy may be driving up rates of estrogen related cancers and infertility. So what’s the real scoop?

    As far as fertility is concerned, soy is a food we approach cautiously at Pulling Down the Moon.

    First of all, soy is a common food allergen and can the cause of digestive upset (they didn’t invent the anti-gas medicine Bean-o for nothing!). At the Moon, we take a “gut first” view of fertility nutrition. If a woman’s digestive tract is upset or inflamed, the result can be disasterous for fertility. Gut trouble can disrupt the absorption of nutrients and chronic inflammation in the gut area can impact the uterus and ovaries. Thus, soy is one of the foods we eliminate in our ART Recovery/Prep Program, in order to ensure that it is not causing digestive problems or allergic response.

    Second, soy has been shown to negatively impact thyroid function. This is a major problem for women who are trying to conceive, since hypo-thyroidism is associated with infertility. Additionally, it is our experience at the Moon that thyroid conditions can be overlooked in the infertility work-up. Gals with low thyroid should avoid soy products and other thyroid-lowering foods.

    Third, while the action of soy isoflavones is weaker than our endogenous estrogens, women who have a low body weight/and or low levels of body fat metabolize estrogen differently that normal weight women. In lean women, the body up-regulates production of its weaker forms of estrogen (estriol) and down-regulates the production of the stronger form of estrogen, estrodiol. As a result, the estrogen circulating in thin women may be a “weaker” kind, resulting in menstural disruption or anovulatory cycles. It follows that a diet rich in phytoestrogens may further increase the competition for estrogen receptors. This is also why, under specific therapeutic conditions, our nutritionists will use non-soy phytoestrogens to help regulate conditions of estrogen dominance.

    Finally, soy contains high levels of phytates, chemicals that can block the absorption of minerals including iron, calcium and zinc. The amount of soy that would need to be eaten to compromise mineral absorption is well beyond two servings per day. However, many vegetarians easily consume this much soy and more.

    To boil all this down, here are the general guidelines we use at PDtM:

    1. If a woman has digestive issues we recommend an elimination diet that removes soy and then reintroduce soy to see if there is any sensitivity. If sensitivity exists, soy is eliminated permanantly.

    2. In women with symptoms of hypothyroidism and/or unexplained infertility, we recommend they get their thyroid tested and eliminate soy if their hormone levels prove to be low.

    3. If the thyroid is fine, and there are no digestive issues, our recommendation is to use soy sparingly in the diet, keeping soy consumption to no more than one 8 oz serving of fermented soy per day and to consume soy in a fermented form.

    4. In men with poor sperm quality we limit soy consumption to < 3 servings a week and recommend that any soy in the diet be consumed in a fermented form. Because zinc is essential sperm formation, and because the phytates in soy interfere with zinc absorption, we take a cautious apporach. At least one study has shown a correlation between soy consumption and low sperm count in sub-fertile men. The same correlation was not found in normal, healthy young men.

    So, there you have it. Smart soy consumption is possible when you’re trying to conceive as long as you tend to your gut, make sure your thyroid is in good working order and don’t overdo. Be aware that soy is often hidden in the foods you eat – frozen dinners, baked goods, energy bars and “veggie” meats – so be smart and read your lables.

    Have you made a change to your soy consumption since you tried to conceive? Has a doctor or nutritionist shared their perspective with you? Please join the conversation with us.

    Why Yoga for Fertility

    You’re busy, you’re stressed out and you think there’s not another single thing you can fit into your schedule…but you keep hearing people talk about yoga for fertility and you’re curious. Is this something worth your precious time and energy? Obviously we’re a bit biased, but we feel the answer is a resounding “YES!” Here are the top five reasons why yoga is the perfect exercise for fertility:

    1. Yoga has been clinically shown to reduce the chemical by-products of stress. Yoga has been shown to reduce levels of the stress hormone cortisol. High cortisol levels can interfere with optimal reproductive function, as well as cause other chronic health problems.

    2. Yoga helps to improve blood flow. Tight muscles and connective tissue can impede blood flow into the pelvis. The gentle stretching we teach in Puilling Down the Moon’s fertility yoga classes targets the hips, groin and lower back with the aim of increasing blood flow.

    3. Yoga improves brain chemistry. Researchers at Boston University have show that yoga practice elevates levels of GABA, an important brain neurotransmitter. Low levels of GABA are associated with depression and anxiety levels.

    4. Yoga is low impact/low intensity exercise. When trying to conceive, high intensity exercise is not recommended. Yoga stretches and strengthens the body, creating fitness and tone without the excessive physiological strain of high-intensity movement.

    5. Yoga improves digestion/metabolism. Yoga has been used by traditional practioners for thousands of years to relieve constipation and gas, regulate appetite and metabolism and re-acquaint practitioners with their innate hunger/satiety signals. Good nutrition and a healthy body weight are important for optimal fertility.

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