Question : When I came to Pulling Down the Moon my acupuncturist recommended acupuncture and herbs to treat blood and qi deficiency. When I went to my RE’s office they ran a Doppler test on my uterine arteries and said my blood flow is fine. Do I even need acupuncture?
Answer : This is one of those great questions that help us illustrate the difference in approach between Traditional Chinese Medicine (TCM) and Western medicine.
Blood, called “xue” in TCM is in some ways the same as blood in Western Medicine. In both systems blood is the red fluid in our veins and arteries. However, TCM takes the function of blood further to include the nourishment it provides to the body. Blood in TCM is what keeps our skin and hair moistened and it is imperative for optimal fertility because it nourishes the uterine lining, creating a thick plush surface where the embryo can attach. When a pregnancy occurs the embryo also receives its nourishment from blood aiding its growth and development into a fetus.
Women lose blood each month during their menses and TCM states that if the body is deficient and unable to replenish and nourish the body adequately women may experience things like amenorrhea, scanty menses, a thin uterine lining, or recurrent miscarriage. Conditions including physical and emotional stress, poor diet and lack of sleep are all things TCM teaches deplete blood. It is also possible for a woman (or man) to have blood stagnation or stasis which can manifest as painful periods (cramps); heat in the blood may cause rashes or red acne on the skin.
So, for your TCM practitioner, a Doppler test showing adequate uterine blood flow is just part of the equation. The quality of the blood is the rest of the story. Remember, from the TCM perspective blood nourishes all body tissues, including uterine lining, developing eggs and sperm. Put another way, if you are trying to grow grapes you could fill a garden bed with sand instead of soil and still provide a thick layer of dirt for your seeds. The sand, though, would not have the necessary nutrition to nourish the crops into ripe, juicy grapes. This is why your practitioner would still recommend acupuncture and herbal treatment to a woman presenting with blood deficiency EVEN IF she had great uterine blood flow and a good uterine lining. It’s the old adage of quality not just quantity.
Blood deficiency in TCM responds well with acupuncture, herbs and a diet higher in protein and iron. If you are experiencing any of the fertility blood deficiency symptoms listed above (scanty menses, amenorrhea, thin uterine lining, and recurrent miscarriage) or other non-gynecological symptoms (dry skin, dry hair, brittle nails, dry eyes) you might want to explore acupuncture with an experienced practitioner to support your medical fertility treatment.
One of the biggest challenges of promoting holistic medicine is the lack of available research on the benefits of practices like yoga, massage and even acupuncture when compared to the research available for mainstream medicine. This month we are excited to share that a new study, conducted by Fertility Centers of Illinois and Pulling Down the Moon found that our six week Yoga for Fertility program significantly lowered anxiety rates in fertility patients. The study, which is one of the largest controlled studies to date looking at yoga’s impact on fertility, found a 20% reduction in anxiety in the yoga group versus just a 2% reduction in controls.
The Pulling Down the Moon yoga program consists of six consecutive sessions, each of which is comprised of a yoga posture practice coupled with a group discussion focused on how to apply different yoga techniques (breathing, meditation, working with negative thoughts, etc.) to the fertility journey.
“One of the most interesting things about the recent research findings is how quickly our program was able to create a large reduction in anxiety,” states Pulling Down the Moon Co-Founder and Study Co-Investigator Beth Heller. “We knew from 12 years of teaching that the class was beneficial but seeing it in numbers is great!”
While we do not know the exact mechanism, here are some of our hypotheses:
1. Yoga is a low-intensity form of exercise that works on the physical body, stretching and bending the spine and limbs and emphasizing deep diaphragmatic breathing in a way that is believed to mechanically stimulate the body’s relaxation response. It is hypothesized that yoga poses and breathing exercises mechanically stimulate the vagus nerve, a large nerve running the length of the spine that is a key regulator of our body’s parasympathetic nervous system (PNS). The PNS in turn stimulates the relaxation response.
2. The six-week yoga program in this study included breathing and meditation practices, which have been shown to decrease anxiety and alleviate depression in many different conditions.
3. The yoga program in this study also included group discussion focused on the most stressful elements of the infertility process – medical aspects, feeling of lack of control, separation from one’s usual peer group and feelings of guilt/self-blame. The group dynamic immediately provides a support network and reduces sense of isolation.
What the study did not look at was yoga’s impact on pregnancy outcomes so we cannot yet say whether yoga for fertility will help you get pregnant faster.
Why look at yoga for fertility?
“As a casual yogi,” says Study Investigator and Reproductive Endocrinologist Dr. Jennifer Hirshfeld-Cytron of Fertility Centers of Illinois, “ I have personally appreciated the calmness and peacefulness that yoga provides. I was interested in learning how this simple intervention could benefit our infertility patients; given the stress and anxiety that goes along with the treatment process.”
When asked what they would like to examine next, these researchers hope to conduct a larger study where patients are randomized to receive either yoga posture practice plus the discussion session or yoga posture practice alone to learn which component of the fertility yoga class is most beneficial. They would also follow women longer to learn if the impacts extend to pregnancy success and likelihood of staying in treatment long enough to allow for lifetime success given that often patients require greater than one cycle of therapy.
For more information about this study and the Pulling Down the Moon Yoga for Fertility program visit www.pullingdownthemoon.com or call 312-321-0004 in Chicago or 301-610-7755 in DC Metro.
by Lisa Meyerson LAc
Recently, NPR presented a show on the Japanese buddhist ritual for women who have had miscarriages and pregnancy losses. Around that time, I saw a patient who was on her way to Japan to participate in the ceremony. She had a late term miscarriage and was devastated to return to work and share the news with her coworkers. Because of the late stage of pregnancy, She was not able to grieve privately. The ceremony in Japan provided her with this opportunity.
For anyone who has experienced a miscarriage, the pain is difficult to articulate and hard to explain to one who hasn’t gone through it. Although it my be described in words, no one can really understand it unless they’ve experienced this kind of loss themselves. It’s similar to Persephone, possibly, after she was dragged into the Underworld. I imagine that, upon her return, no one could really understand where she had been unless they’d gone to that place, too. And it is likely the pain of a miscarriage or pregnancy termination is even too painful even for mythological comparison.
In Japan, the ritual called Mizuko kuyo was created during the Edo periiod (between 1603 and 1868). Mizuko translates as ‘water fetus’ or child who died. In the ritual, an offering is made to Jizo, a bodhisattva believed to protect children.
You can listen to the NPR story here:
Or read more about loss ceremonies here:
by Nicole Holovach, MS, RD, LDN
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. Typical symptoms include hirsutism, menstrual irregularity, and infertility. Furthermore, PCOS predisposes women to metabolic dysfunction, overweight and obesity, and an increased risk of type 2 diabetes. Obesity exacerbates the insulin resistance that is a feature of PCOS in many women. Reducing insulin levels and improving insulin sensitivity are an essential part of treatment and management.
Diet plays a significant role in the regulation of blood sugar and insulin levels. Low-glycemic index diets are currently popular with both registered dietitians and patients in the management of PCOS.
The glycemic index is a rating of how much a food is going to potentially raise your blood sugar levels. Glycemic load in another rating that was basically created to address one of the shortcomings of glycemic index, which is it doesn’t take serving size into account. So watermelon is high on the glycemic index, but the amount of carbohydrates in a general serving size of watermelon is pretty low.
I have a confession to make: I’ve never loved the glycemic index. Even in my initial days of nutrition counseling years ago when it was first getting popular, it seemed rather arbitrary. Of course whole foods like vegetables, fruits, and legumes would be better for a person’s blood sugar control than refined and processed foods like bagels, crackers, cookies, cakes, doughnuts, croissants, waffles, and most packaged breakfast cereals! And I still resent the fact that the glycemic index has just about destroyed the reputation of healthy, nutrient-dense foods like carrots, watermelon, bananas, and white potatoes.
But, my biggest *issue* with the glycemic index is that the glycemic index of a particular food can be influenced by what it is eaten with. Food is rarely eaten in isolation, rather as part of a meal. A white potato, combined with protein and fat, has a much lower effect on your blood sugar than a potato alone. Who eats a potato by itself? Foods like bananas that you might grab and go, can be made even healthier by combining with fat or protein, like almond butter or yogurt. Also, the way a food is cooked affects its rating on the glycemic index. Al dente pasta has a lower rating on the glycemic index than pasta that is cooked longer.
Although the research is generally not supportive of either glycemic index or glycemic load for weight loss, insulin, or blood sugar control, it continues to be popular in forums and among health professionals in the management of PCOS. Instead of having patients memorize a list of random foods, I’d much rather focus on having them plan regular meals and snacks with a healthy balance of carbohydrates, protein, and fat for blood sugar control. And also focus on the myriad of other things that can improve insulin sensitivity like sleep, stress, and physical activity.
by Meghan McMillin MS, RD
Did you know that vitamin D is not really a vitamin at all, but rather a hormone? And as a hormone, it plays an important role in fertility and reproduction. Vitamin D is necessary for the synthesis and metabolism of the reproductive hormones estrogen and testosterone. Additionally, multiple studies have shown that higher blood levels of vitamin D can improve glycemic control and insulin resistance in women with PCOS, decrease inflammation in women with endometriosis and is associated with better IVF outcomes.
Now, a new study published in July in the American Journal of Clinical Nutrition has revealed a connection between vitamin D deficiency and risk of miscarriage in the first trimester. The study tested the blood levels of vitamin D of 1,683 pregnant women prior to week 22 of gestation. Of the 1,683 participants, 58 had a miscarriage (3.5%), 25 in the first trimester and 33 in the second trimester. Those who had a miscarriage had lower blood concentrations of vitamin D at the time of sampling compared to those who did not. These findings suggest the protective role vitamin D may play against miscarriage and the importance of adequate intake.
So are you getting enough vitamin D? Knowing approximately 80-90% derives from sunlight-induced production in the skin, it’s safe to say most of us living in the northern hemisphere are likely deficient. Only a small amount of the body’s total vitamin D is derived from diet, so supplementation is often necessary to achieve adequate blood levels. At Pulling Down the Moon we recommend supplementing with 1000 IU of vitamin D daily. Depending on your levels you may need to supplement with more, so we always recommend having your doctor do a blood test first.
by Anna Pyne, LAc, MSOM, FABORM
Acupuncture and herbs are the main treatment modalities in traditional Chinese medicine (TCM). I have helped treat a myriad of postpartum women struggling with insufficient breast milk using both therapies. It is important to establish a good supply at the very beginning so that it is easier to maintain it. That is not to say however that TCM is not an effective treatment at a later date.
There is one particular acupuncture point that has the single function of enhancing breast milk. This is quite unusual as typically each point is useful for treating a multitude of different issues. Needling this point is the most potent way of stimulating it. The location is on the outer corner of the nailbed on the pinky finger. It is typically tolerated by most patients quite easily, however for those few that are a bit needle sensitive I have placed a small gold pellet that sticks to the point which does not penetrate the skin. Doing this makes it portable as well, meaning the patient can walk out of the office and continue the treatment outside of the acupuncture session every time the patient presses the gold pellet. Of course there are many other points that help enhance breast milk supply and when a number of these appropriate points are used together with this especially specific one, it greatly impacts breast milk supplementation. Patients have reported starting to feel engorged while lying on the table with the needles placed during treatment. I have also heard feedback (and personally experienced) that more milk is produced at the next pumping session.
There are a number of wonderful single herbs as well as formulas that benefit the breast and support breast milk supply. I typically use herbs with acupuncture when treating this problem for optimal treatment results, but have seen great benefits with using herbs alone without acupuncture, and vice versa. I also teach a class at Pacific College of Oriental Medicine (PCOM) on traditional Chinese herbs for postpartum care, which includes the topic of breast milk insufficiency.
If you have any questions or to learn more please email me at firstname.lastname@example.org or any of our other acupuncturists.
Call our office to schedule an appointment (312)321-0004.
Anna Pyne LAc MSOM FABORM
by Beth Heller
Ghee is a form of clarified butter used in Indian cooking. Butter is slow cooked until all of the water has evaporated and then the milk solids are skimmed off, leaving rich oil (ghee) that is solid at room temperature. Ghee does not require refrigeration and adds a deep, nutty flavor to foods. It has also been used as the base for traditional medicines for thousands of years. In the Ayurvedic system of medicine ghee is classified as a “sattvic” foods – a food that is fresh, light and provides the body necessary energy as well as promotes the expansion of consciousness.
Since a fertility-friendly diet contains ample calories from healthy fat we are always looking for new and delicious sources of this beneficial macronutrient. Now science is getting on board with ghee and new evidence suggests additional benefits unique to this delicious fat:
- Ghee is rich in medium chain triglycerides (MCTs), fats that go directly to the liver and can be used for energy. MCTs can provide immediate fuel in the without raising blood sugar levels the way that simple carbs do.
- Unlike many other oils ghee contains butyric acid, a fatty acid that the healthy bacteria in our gut can easily turn in to energy. By keeping our gut healthy we improve our body’s ability to digest and assimilate nutrients from food as well as efficiently eliminate waste.
- Ghee is thought to stimulate the production of gastric acid, which promotes digestion. In Ayurvedic medicine it is said that ghee feeds agni, the digestive fire. The stress, anxiety and uncertainty of infertility can dampen agni.
- Ghee made from the milk of grass fed cows is a good source of Conjugated Linoleic Acid (CLA), a form of fatty acid which may have antioxidant and cancer-preventive benefits.
- Most individuals with dairy sensitivity or milk allergies can use ghee because the allergens in ghee have been removed with the milk solids.
- Sauteeing herbs and spices in ghee helps release the therapeutic substances found in those foods. The ghee becomes infused with them and speeds the digestion and absorption of these substances into the body.
Ghee can be purchased or you can ensure purity by making your own. We hope you will give it a try!
If you are trying to conceive here’s one more reason to take off your shoes, put on some comfy pants and hop on your yoga mat! A recent study conducted in India found a 50% increase in the DHEAS levels in women who participated in a 12-week yoga program that included breathing, yoga postures and meditation practices. (1)
DHEAS (dihydroepiandosterone sulfate) is the precursor of the active form of the steroid hormone DHEA and is produced by our body’s adrenal glands. DHEAS levels peak around the age of 25 and then decrease naturally with age. Because DHEAS plays an important role in the formation of reproductive hormones, declining levels of this hormone are believed to play a role in the age-related decline in fertility.
In fact, many fertility specialists currently recommend that patients who are presenting with ovarian failure or who are not responding to fertility medications consider taking a nutritional supplement containing DHEA. While supplementation is a useful approach, many women report side effects from DHEA supplementation including mood swings and acne.
How is yoga impacting DHEAS levels? Researchers are not yet sure. Yoga, through breathing and the use of physical postures, stimulates the autonomic nervous system (ANS). The ANS is the “rest, nest and digest” hormonal response that serves to balance the often over-active flight or flight stress response. Yogic exercise has also been shown to increase blood flow to internal organs and tissues. Better blood flow could result in healthier endocrine tissue and function.
Want to learn more about Yoga for Fertility? Join us for our Fertility Yoga 101-Mini Retreats!
(1) Chatterjee S et al. Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 240581, 15 pages
by Tracy Lingwai
I was put on birth control when I was 17 years old, though not for the implied purpose- because years after all my friends had started their period, I still had not. My doctor said late menstruation is common in girls with my thin body type and that the pill would start my period.Eleven years later I was addressing a different concern with my gynecologist- motherhood. I told my doctor I was concerned that being on the pill for so many years and never having a natural period would affect my chances of getting pregnant.
She asked, ” Do you want to start trying now?” , I was one month into marriage, my answer was no. She told me there was no need to stop taking the pill until about a month before we wanted to start trying.
“How do we know my body will do what it’s supposed to after all this time?” I questioned,
“We have no reason to believe it won’t” she replied.
This did not sit well with me. I did not understand how a medical doctor thought it was ok that a healthy 28-year-old woman had never menstruated without the help of a magic pill. How did she know how my cycle would be after I stopped birth control? I quietly said “ok”, not wanting to question this professional any further. We were obviously not on the same page.
Needless to say, I went straight home and told my husband that I was going to stop taking the pill. I felt very strongly about experiencing my cycle without the help of synthetic hormones. There was something also quite strange about being a grown woman and not knowing what my natural cycle was. Through talking with others and many Google searches, I knew it might take a while for my period to come after stopping the pill; I had no idea just how long that would be. After six long months of waiting, my period finally came. During this waiting game my husband and I were discovering a different form of natural birth control, charting your basil body temperature (BBT). After my post-pill period came I immediately started tracking my BBT. After several months I noticed that my temperatures were not following a consistent pattern and my cycles were abnormally long, averaging 55-60 days.
Around this same time I decided to leave my corporate job after 7 years and quickly found myself accepting a job at Pulling Down the Moon. Shortly after I started I began acupuncture to address my irregular cycle. After a few months of regular treatments, my cycle lengths became shorter and while I was not following the normal 28-days cycles, I was consistent. I continued to chart my BBT, making note of changes in cervical fluid, and other associated symptoms, and a new discovery came to light. Although I was having regular periods, my charting was congruent with an anovulatory cycle. In short, I was not ovulating. This was a bit shocking. Like most women, I assumed that having a period meant I was ovulating. After this new discovery we made some slight changes to my acupuncture treatments and a few months later I began to ovulate on my own. On my second cycle of ovulating on my own I noticed a new change in my BBT chart, consistently high temperatures post-ovulation. Every morning my temperature was still high I got a little more anxious. Finally, after about 18 days of high temperatures, I took a pregnancy test and it was positive. I couldn’t believe it. Even though deep down I knew the test was going to be positive (based on my temperatures and symptoms), I was still shocked, but so incredibly happy.
My joy and happiness, however, was short-lived. At almost 6 weeks pregnant I went to the ER with sharp abdominal pain and bleeding and discovered I had suffered a ruptured ectopic pregnancy. A few hours after that I was being prepped for surgery to remove the pregnancy and damaged fallopian tube. It was very surreal; I couldn’t believe how much had changed in such a short period of time. Even though my pregnancy was very new, I had formed a connection to my future child and the pain of that loss was very real. With everything in life, you must learn the power of positivity or else moving forward becomes very difficult. I have seen many strong women walk through our doors at Pulling Down the Moon and I have seen how they have overcome loss and uncertainty and I knew I would too. My silver lining through this whole experience was knowing that conception is possible. With the help of acupuncture, massage, and a healthy diet, my body finally learned how to ovulate.
If there is one thing I have learned from this whole experience it is to be your own advocate. If something seems off, ask questions. If you do not feel right about the answers you are getting, seek guidance elsewhere. Had I not decided to follow my gut about stopping the pill, my journey would have been much more difficult. I may not have had the time to work through my cycle irregularities before deciding to start a family or could have been misdiagnosed as infertile. It is never too early to start thinking about your future, whatever that may look like.
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