National Fertility Awareness Week 27 October – 2 November 2014

National fertility week
National fertility awareness week

Today marks the start of National Fertility Awareness Week. 1 in 6 couples have difficulty conceiving. Sometimes some simple changes to diet and lifestyle or even a clearer understanding of our reproductive systems can help. However, for others, some form of assistance might be needed.

Acupuncture has grown a solid reputation for supporting fertility for both men and women. So much so that many mainstream fertility clinics recommend and offer acupuncture to support fertility. This article considers what optimal fertile health looks like through the Chinese medicine lens and how divergences from this can give helpful clues to an acupuncturist to help formulate a diagnosis and prepare a treatment plan and inform dietary tips or lifestyle modifications that can help to improve fertility.

Traditional Acupuncture is a branch of Chinese medicine, which is an excellent model to use to understand fertility. Chinese medicine is based on very simple principles that can be combined and interwoven to understand the very complex reality of an individual’s fertility and broader health.

The Yin and Yang of the Menstrual cycle

One of these sets of principles is the ebb and flow of Yin and Yang. This elegantly mirrors the different stages of the menstrual cycle. Yin is still and quiet, nurturing and moistening – it is the preparation phase. Yang is more dynamic and warming, it is the active growing phase.

Yin and Yang
Daoist Yin and Yang symbol

The Yin phase equates to the oestrogen dominated half of the cycle prior to ovulation. It is the first half of the cycle, and is preparing for ovulation by first shedding the endometrial layer from the previous cycle (the period), building the new layer for an embryo to implant into and ripening the follicles. It is responsible for governing the cervical secretions which need to be rich in potassium to fuel the sperm and loose and slippery for the sperm to swim through easily. The middle of the cycle is dedicated to ovulation when the follicle ruptures and the egg is released. The next phase is the Yang phase, the progesterone dominated half of the cycle. It dries up mucosal secretions to allow smooth passage the fertilized zygote and aid implantation. It facilitates the release of nutrients from the endometrial layer to nourish the embryo. If there is no conception and implantation, Yang is the motive force that builds to get the next period started to begin the new cycle.

Observing the Menstrual Cycle

A very useful fertility to tool to view the health of the menstrual cycle is charting. It can help a couple to know when the most fertile time is, and provide useful information for the acupuncture practitioner to track not only the length of the menstrual cycle, but also the length of the Yin/oestrogen phase and the Yang/progesterone phase. Charting is done based on your Basal Body Temperature (taking on waking at the same time each morning) and recorded on a chart. Below is a typical temperature chart.

Sample BBT chart

It shows that in the first half of a typical cycle the temperature is lower than the second half. It shows that there is a dip in body temperature, a result of an oestrogen surge just in advance of ovulation. Around this time you should also see an increase in cervical mucous. Shortly after ovulation at the start of the Yang phase, there should be a spike in temperature, which should stay relatively constant for the remaining half of the cycle.

Charting is not for everyone, it does take dedication to taking the temperature every morning and paying very close attention to the cycle. However, there are other signs and symptoms that can be very informative – details that may not be considered as particularly relevant by a Western medical doctor – but can provide insightful clues into why a couple may be having difficulty conceiving.

Examples of signs and symptoms of particular relevance are: when and how your period starts and finishes; colour of blood; pain at any time during your cycle; headaches; cervical secretions; sleeplessness; mood. These signs and symptoms and temperature fluctuations help to understand the how the balance of Yin and Yang is in the individual and therefore where the focus of treatment should be.

For example, the first half of the cycle is very susceptible to emotional strain and can cause early ovulation (i.e. before day 14). Emotional strain can cause imbalances resulting in a slightly raised temperature, irritability and a degree of insomnia. Early ovulation can mean that eggs are being released before they are fully ripe and therefore either might not be fertilized or may not implant well if they are fertilized. Acupuncture treatment in this instance would focus on regulating your temperature, calming the mind and reducing stress.

Another example can be where the temperature is too low in the second half of the cycle and this can cause poor implantation or early miscarriage. In this instance treatment would focus on raising temperatures and nourishing the endometrial layer.

Each individual woman’s cycle is different and as such each treatment is personalized for whatever your particular set of circumstances might be. Advice around observing the fluctuations in the menstrual will help to maximize chances of conception and can be provided around diet and lifestyle for each individual’s health.

Male Factor

Acupuncture is not just used to support female fertility but male as well. There are a variety of signs and symptoms that can help to identify areas of treatment to focus on for men too. For example, men who experience feelings of coldness, fatigue and reduced sexual desire may well have sperm with low motility. In this case, treatment would focus on supporting the Yang aspect of a man’s health and advice around eating habits may be appropriate.

Research

There has been research into how acupuncture can help support fertility naturally. Showing that it can:

  • be effective in regulating the hormones involved in fertility (Jin 2009, Huang 2009).
  • It can reduce the stress response, also known as “the fight or flight response” which can have a significant impact on the function of the reproductive organs and can inhibit ovulation (Magarelli 2008, Anderson 2007 ).
  • Increase blood flow to reproductive organs – improving the supplying of oxygen and nutrients to developing eggs in the ovaries and improve the blood supply to the uterus, thus making a healthier, thicker endometrial layer – which improves chances of successful implantation. (Stener-Victorin 2006, Lim 2010, Liu 2008)
  • It can work to counteract the effects of PCOS – balancing hormone levels, increasing ovulation and warming the uterus to improve blastocyst implantation (Stener-Victorin 2000, 2008, 2009, Zhang 2009.

Research into acupuncture for male fertility has shown that acupuncture can help to improve sperm maturation (Crimmel 2001), lower scrotal temperature (Siterman 2009), improving blood supply to the reproductive organs (Komori 2009).

More details on this research and full references can be found on the British Acupuncture Council website at the following links:

Female Fertility: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html

Male infertility: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/male-infertility.html

Understanding Yin and Yang Theory – Part 2: Yin and Yang Theory in Health and Chinese Medicine

The importance of Balanceskye

The theory of Yin and Yang outlined in Part 1 can be applied to health and is fundamental to the philosophy of Chinese Medicine. Throughout its development and evolution, Chinese Medicine has drawn parallels between patterns observed in nature and people. Lets take the example described in part 1 of the blog which demonstrated the importance of getting the balance between yin and yang right… Plants need the sun to grow – which is Yang – it is light, dry and provides warmth. However the plant also needs water, which is Yin, it is cooling and moistening. If the balance of sun and water is wrong the plant can either shrivel and die or become saturated and rot.

The same can be said for people, we need to live a balanced life. We can use the theory of Yin and Yang to understand what balance means. A good illustration is Hot (Yang) and Cold (Yin) in people. If it is too hot, people become red, to cool themselves down, they need more water due to increased sweating. If the heat continues people can become irritable, get headachy, agitated and so on. If people overheat, it can lead to serious illness such as dehydration and heat stroke. There are similar impacts on the other end of the scale if it is too cold. When someone gets cold, they shiver and lips can go blue as blood is stored in the trunk to conserve heat, eventually they can become sleepy and even hypothermic. However, we as humans have ways to keep warm in the cold and cool in the heat – we naturally try to keep ourselves at the right temperature. We put on jumpers and coats when it is cold or sit in the shade and drink ice drinks when it is too hot.

There is another dimension to this – not everyone will feel the heat and the cold to the same extent – some will be able to tolerate the heat much more than others and similarly, others can tolerate the cold much better than others. From a Chinese medicine perspective, this is due to the balance of Yin and Yang in the individual. Yang is warming, so someone who is lacking in Yang will feel the cold much more than someone who is lacking in Yin. Yin provides basis for the cooling and moistening function in people so if this is lacking, the person may experience symptoms of heat and dryness. This might manifest in agitation, anxiety and restlessness. The Yang deficient person on the other hand, in addition to feeling the cold may also feel sluggish and tired.

The theory of Yin and Yang in health does not just apply to Hot and Cold, but can be applied widely to every part of our lives. If we think about activity and rest – activity is Yang and rest is Yin. If we do not have enough activity in our lives and oversleep and lack exercise our Yang energy can’t move causing us to become more lethargic. The stuck Yang energy can create stagnation and doesn’t flow to the organs and muscles as it should resulting in reduced functionality. On the other hand, if we are overactive and work too much we don’t have enough restful, Yin time. We may also feel tired but struggle to sleep and switch off. Overtime, the over use of our Yang side – this heating, active function, can deplete the Yin as it overworks trying to keep the Yang in balance. This can result in sleeplessness and feelings of anxiousness or an overly active mind.

This is why living in balance is so important for our health. However, lives tend to be complicated and living a life in balance is not always possible. We can try to mitigate it by making adjustments where we can, but where we can’t and imbalance arises, illness or lack of wellbeing can occur. Traditional acupuncture addresses these imbalances in the body and mind’s function. By stimulating carefully selected points, the acupuncturist can move stuck energy, sedate overactivity or restore good function as needed for the individual. This can make significant improvements to our sense of wellbeing.

Understanding Yin and Yang Theory – Part 1: The Basics

Yin and Yang
Daoist Yin and Yang symbol

The theory of Yin and Yang is one of the most important paradigms underpinning Traditional Chinese Medicine. Yin and Yang are complementary opposites which define each other. They exist only in relation to each other and each contains an aspect of the other. The famous Daoist symbol depicting Yin and Yang accompanies this article and elegantly describes the theory. The symbol shows Yin and Yang intertwined with each other in a continuous circle. Each has a dot of the other demonstrating that each contains an aspect of the other and has the potential to transform into the other.

Everything in the Universe can be categorised as being either Yin or Yang. Perhaps the simplest example of this is night and day. Night is Yin and day is Yang. To understand what day means – when the sun is up and there is light, we need to have night – the time when the sun is down and the sky is dark. The contrast between the two enables us to understand the significance of each. Moreover, Day will transform into night and night back into day. Another good example of this are the seasons. We have just passed the Summer Solstice – that wonderful time of year that makes living in Northern Europe worth while with the long days. The summer solstice is the time of maximum Yang – the time when the days are as long as they can be – but yet, within this Yang time, there is Yin because we still have night.

Some more examples of Yin and Yang are below:

Yin                      Yang

Dark                     Light
Water                   Fire
Cold                     Hot
Slow                     Fast
Activity                Rest
Female                 Male
Death                   Life
Chronic                Acute
Stillness               Movement

 
A further factor of the theory is that Yin and Yang are relative. For example, dawn is Yang in relation to night, but Yin when in relation to day. Water is Yang in relation to ice, but Yin in relation to steam.

The balancing of Yin and Yang can be seen throughout nature and in Daoist philosophy is necessary for a healthy environment, life and universe. Take the weather and growing vegetables for example, if you have too much sunshine and not enough rain, vegetable plants will wither and die. Similarly if you have too much rain and not enough sun, vegetables can rot or will be feeble and bitter. A balance of sun and rain is essential for healthy plant growth.

To be continued in my next Blog: Yin and Yang Theory – Part 2: Yin and Yang Theory in Health and Chinese Medicine