Written by Dr. Amy Nykoluk, DTCM
Traditional Chinese Medicine, or TCM, is being sought out more and more as a natural alternative or addition to our more common western medicine health regime. People are looking for ways to prevent future illness and keep their bodies in a healthy balanced state, rather than just look for a quick fix once an illness, imbalance, or state of disease is reached. It is much cheaper and easier to maintain good health than to seek out treatment once we become sick.
Our reproductive health is often one of these issues that we don't consider until we realize we have a problem, which about 10-15% of couples trying to conceive will eventually find out they do! Of this group of people, 35% are issues relating only to the man, 35% are issues relating only to the women, 20% are issues including both the man and woman, and the last 10% arises from an unknown problem in either partner. Of course it can be a very scary and sad thought to some couples that having a child isn't happening as quickly as we would like, so many people are turning to very invasive, complicated and expensive procedures to help conceive. Just like any other health issue, TCM is an excellent option to consider before spending large amounts of money on other available treatments.
Fertility issues, along with any issue treated with TCM, can arise from multiple organ or substance imbalances in the body, and the correct diagnosis is critical when creating an effective treatment plan. In order to ensure proper diagnosis and treatment, we must first take a complete patient history, including sleep patterns, diet choices, menstrual cycle, bowel movements, mood patterns, family history, etc., so we can see the workings of the body as a whole. In addition to these topics, a thorough examination of a person's pulse and tongue are done, as these are two very important diagnostic tools used in TCM.
Once the correct diagnosis is determined, we treat by stimulating points along meridians with needling, burning moxibustion, cupping, applying ear seeds, or Tui Na, an acupressure or massage technique. Meridians are like rivers of energy running through our body from top to bottom and in and out. There is a meridian connected to every organ, as well as 8 extra meridians, including the conception and governing vessels. In addition to acupoint stimulation, herbal medicine is often used and lifestyle changes are almost always necessary in cases of infertility. It is estimated that 50-90% of infertility cases are successfully treated with Traditional Chinese Medicine.
There are four main syndromes or differentiations to consider when treating fertility cases. It is possible to fall under one category completely, but most often, patients will have a unique combination of two or more of the following imbalances.
Kidney Deficiency - The kidneys are responsible for our growth and development, as well as the health and proper function of our reproductive organs and cycle. The kidneys contain essence, or vital qi, which is essential to life. This essence is passed down to us from our parents, comparable to our genetics. Kidney essence can be depleted through an over active sex life, healing from a serious illness, multiple miscarriages, and aging. The health of our essence is also largely dependent on the health of the essence passed on to us from our parents. All three types of kidney deficiencies, qi, yang, or yin, can similarly present with tinnitus, dizziness, and lower back pain that can travel down the legs. Because yang is a warming, active energy, when the kidney yang is depleted, patients will present with a cold sensation on the lower back, and a general lack of warmth in the body. If kidney yin is the issue, a person will feel warm, with a possible dryness or lack of fluids.
Liver Stagnation - The liver holds the blood and is a very important organ to consider when dealing with reproductive health. Stress, whether it be mental, physical or emotional causes the energy flowing through the liver to become stuck, or stagnate in and around the organ. When the liver isn't happily free and flowing we experience irritability, bad temper, frequent sighing, painful menstruation and/or breast distention. Kidney essence and liver blood work closely together and can be interchangeable, so it is common to see a patient present with both a kidney and liver disharmony.
Dampness Retention - Dampness accumulates in the body when the spleen becomes deficient or slow. In TCM, the spleen is the foundation of the digestive system and plays the very important role of holding organs in place and substances in the body. If the spleen isn't functioning optimally, a person can experience frequent urination, diarrhea, excessive vaginal discharge, gas, and bloating. The energy of the spleen rises upward, and if there isn't enough of it, the spleen cannot do its job of transforming the food we eat into qi and blood and transporting it to all parts of the body. When this happens, we end up with a sticky and damp condition, which hinders the body's ability to conceive. Most people with spleen issues will present with digestive problems ranging from being overweight, to nausea, tight chest, loose stool, low appetite, or slight dizziness.
Spleen qi deficiency often can be caused by Kidney yang deficiency, as the kidney yang is needed to warm the spleen, and give it the energy to carry out its job of transforming and transporting. Lifestyle choices play a large role in the health of our spleen and how it functions. Exercise is important to keep the qi and blood flowing smoothly, and food choices are imperative to keeping a healthy digestive balance. Dairy, heavy food, greasy or fried food, and over eating of any food puts a large amount of strain on the digestive system, often leading to an accumulation of dampness. Women with PCOS often present with many spleen qi signs and dampness retention.
Blood Stagnation - There are three main reasons why the blood can stop moving and begin to get stuck or stagnated. The first being a low amount of qi or energy to keep the blood moving. If the blood slows down, it is much easier for it to become stuck and accumulate as more blood pools in the area. The heart needs a good supply of qi to ensure the blood is pumped steady and stagnation doesn't occur. The blood also needs to be warmed by yang energy, to keep moving. If the blood cools down too much, its movement slows, and as in qi deficiency, when it slows it stagnates. The third way the blood can accumulate is a deficiency of yin energy. Because yin is fluid, if it becomes deficient, the blood becomes thick, and the thicker the blood, the slower it moves. Some symptoms that arise from blood stagnation are sharp, fixed pains, painful menstruation, large dark blood clots and poor circulation.
Once we are able to correctly diagnose the single or multiple differentiations that a patient has, we determine a treatment course, often consisting of acupuncture, herbal medicine and some modifications to lifestyle. Herbal medicine is frequently used and there are many herbs that work very quickly and effectively to restore balance to any combination of organ patterns. Some commonly used herbs to boost the kidney are fresh water turtle shell (Gui Ban), to tonify or strengthen the Kidney yin, and deer antler glue (Lu Jiao Jiao) to tonify kidney yang, which is an important herb to use when dealing with a low sperm count. Thorowas root (Chai Hu) and nut grass (Xiang Fu) are both important herbs that quickly promote free flow of the liver qi, reducing PMS symptoms, and stabilizing the mood. To activate the blood, and break up stagnation, we could use Angelica Sinensis (Dang Gui), often referred to as female ginseng, and safflower flowers (Hong Hua), regulating menstruation and nourishing the blood. Lastly, if we are dealing with a dampness accumulation caused by a spleen qi deficiency, we may choose white Atractylodes (Bai Zhu), or Wolfiporia fungus, or Poria (Fu Ling), which is a herb used for over 2000 years to treat dampness disorders, by draining excess fluid and kick starting the spleen to prevent further accumulation.
Although acupuncture is a very effective way to re balance the body quickly, it is not the only way to stimulate acupoints, Acupressure is an easy addition to a daily health care routine that can be learned and practiced by anyone. The inside of both legs, between the knee and the medial malleolus, or ankle bone, is a very important spot that can be massaged daily because the spleen, kidney and liver meridians all run through the area. You can begin down by the ankle; squeeze the calf muscle, concentrating on the inner leg, moving up towards the knee, ending at the belly, or highest point of the calf muscle. Doing this regularly will promote good digestion, can balance hormones, and boost qi in the body. Caution should be taken during menstruation and should be avoided during pregnancy, as stimulating this area can cause uterine contractions. Another spot to massage is on the chest, over the sternum, directly between the nipples. This is a very important point to activate and move the blood and qi. It is very calming and can help ease anxiety. Lastly, a great acupoint to massage to improve digestion, drain dampness, and move the qi is found on the forearm. To locate the point, cross your arm in front of your body, palm facing your belly button, thumb pointing up. The area to massage is the highest point on the forearm muscle, this area is often tender to the touch, so begin gently.
The last area to concentrate on would be the lifestyle of the patient. The amount and quality of sleep the patient is getting should absolutely be considered. Our bodies need to regenerate during night, or yin time, so it is incredibly important to try to sleep by 11:00 pm and sleep soundly for 7-9 hours, every night. When we don't get enough sleep, our qi gets depleted and our yin can begin to weaken. Along with proper sleep, 20-30 minutes of brisk walking is a great way to help keep the qi and blood flowing smoothly, help drain dampness, and to keep weight in check.
Fertility issues are very common among men and women, and although it can be a very tough subject, seeking out treatment options as soon as you can, is always the best option. Along with the changes that can be easily adopted into a person's daily routine, a proper diagnosis by a TCM practitioner is very important in effective prevention and treatment of infertility, or any other disease or disharmony. Through the use of acupressure, acupuncture, cupping, herbal medicine and other TCM tools, it is very possible to return the body to balance and allow for a healthy pregnancy to flourish.