Fertility Issues and Acupuncture
I had intend to write this blog over the winter, but for me at least, winter seemed to go by very fast! On reflection though, this moment, just on the cusp between winter and spring actually seems quite appropriate as the organs most associated with fertility are linked with these two season – The Kidneys, which are Water and therefore winter and the Liver which is associated with Wood and spring.
However, these organs do influence fertility in distinctly different ways:
The Kidneys are directly linked to conception, because they store Jing, which dominates birth, growth and reproduction. Therefore, Kidney energy, particularly Jing, is very important for all successful pregnancies. As Jing naturally declines with age, supporting the Kidneys can especially important for older women.
The Liver on the other hand, both stores menstrual blood and is in charge of the smooth flow of Qi in the body. In this way it has a particular effect on the hormonal rhythms that determine the state of the cycle. The Liver is also directly effected by stress, a symptom that often accompanies fertility problems and modern life.
As with all of these things, traditions differ and not all will give this exact list, but the major syndromes associated with fertility are:
1. Heart & Liver Qi Stagnation
2. Liver Blood Stagnation
3. Damp & Phlegm Accumulation
4. Kidney Yang Deficiency (Cold Uterus)
5. Kidney Yin Deficiency
6. Kidney Yin & Yang Deficiency
7. Kidney Jing Deficiency
1. Heart & Liver Qi Stagnation
Liver Qi Stagnation is characterized by moderately painful periods. There will also be a general feeling of bloating and distention at this time. Period pain is worse with pressure, and tends to comes in waves.
The cycle itself may be long or irregular or there may be a hesitant start to period, with spotting before the flow begins. Possible accompanying physical symptoms include tender breasts, discomfort and distention under the ribs or in the chest, clumsiness, headaches, tight muscles or feeling of a lump in the throat.
This syndrome is also often associated with emotional issues and is the one to consider if fertility problems seem to have had an emotional cause. Emotional variations that are common include: PMS, angry outburst or crying, sighing, depression, feeling wound up, nervous tummy and mood swings.
Symptoms usually begin before the period starts and improve with the onset of bleeding. Depending on the severity of the condition, they may start a week or even two before the period. There is also sometimes pain or discomfort at the time of ovulation.
Prolonged Liver Qi Stagnation can lead to Heart Qi Stagnation. In this case there will be additional symptoms of anxiety, insomnia and possibly palpitations. Blood tests may show that the pituitary gland is under or over producing FSH or LH and oestrogen levels may be low.
2. Blood Stagnation
Again the characteristic here is painful periods but in this case the pain is much worse. It tends to be continuous, fixed in one location (usually in the mid to lower abdomen) and stabbing. Pain may radiate down the thighs. Again it will be worse with pressure and unlike Liver Qi Stagnation there will be more pain than distention.
Pain tends to begin before the period but may continue for the first few days too. Menstrual blood will be, dark red, purple or black with large clots. The flow may be profuse or scanty, if stagnation is causing obstruction. Flow is often hesitant, with stopping and starting and is usually followed by spotting.
Stagnation may make the period late. This is usually a longstanding problem but may be due to trauma or surgery. Liver Blood Stagnation is often associated with endometriosis, uterine fibroids, polyps, fallopian tube blockages, ovarian cysts and in rare cases ovarian tumours.
3. Damp and Phlegm Accumulation
This syndrome is the third and final full condition associated with fertility. Therefore, we again see painful periods, with pain before or during period. In full conditions, such as this, pain is characteristically worse with pressure.
Damp and Phlegm Accumulation may also present with thick and sticky menstrual blood or mucus in blood. Flow is likely to be scanty and periods may irregular, or come in long cycles. There may also be vaginal discharge, ovarian cysts, blocked tubes, endometrial congestion, polycystic ovary syndrome or hydrosalpinx.
More generally there may be symptoms of stuffy chest, excessive sputum, feeling of heaviness and fuzzy head.
This syndrome usually develops as a secondary condition following on from Kidney Yang deficiency, Liver Qi or Blood stagnation so it is often complex. However, it can come on as a primary condition due to an excessively greasy and/or sweet diet. In this case it is often associated with obesity with difficulty loosing weight.
4. Kidney Yang Deficiency (Cold Uterus)
Once again here we see painful periods. Although this is a mixed condition, with underlying deficiency. Cold pain is classically, vice like, twisting, tight or contracting, and may refer to the lower back. There may be loose stools before the period but pain is more likely to start after the period and is better with heat, heating foods, pressure and massage.
The flow itself is likely to be watery, thin and dilute with a scanty flow of light red blood.
However, if Cold is pronounced, it may lead to dark purple/black blood, with clots, or profuse or lingering bleeding. Sometimes the clots also appear to be composed of tissue rather than blood. In this case, the period may also be late. All of these symptoms are due to the fact that Cold itself can be a cause of stagnation.
General symptoms of Kidney Yang deficiency include aversion to cold, feeling of cold in the back and generally feel worse in cold weather, bright white face, lassitude, lethargy of spirit, inappropriate fear, apathy, frequent or urgent urination and needing to urinate at night, weak legs, painful knees, low libido, delayed onset of periods, poor stamina and shadows under the eyes, poor appetite, slow metabolism, swelling and oedema.
In the context of fertility this syndrome is classically linked to exposure to cold in puberty. However, it can come from over strain of the body or from long-standing Qi stagnation.
5. Kidney Yin Deficiency
With this syndrome the period itself is fairly uneventful. The flow will usually be scanty due to Yin deficiency drying up the blood and making it deficient. However, if Yin deficiency has led to significant Empty Heat there may be bright red blood with a heavier flow.
The other obvious disruption to the cycle is significantly reduced or absent cervical mucus at ovulation.
General Kidney Yin Deficiency symptoms include insomnia, particularly waking in the night, dry mouth at night, hot hands, feet and face, with frequent flushing, feeling restless, anxious or ‘wired’, dizziness, tinnitus, vertigo, poor memory, thirst, backache, constipation, dark scanty urine and inappropriate fear.
This like all Yin deficiency tends to occur due to the frantic pace of modern life. The Kidneys need rest and take the toll when we do not get enough.
6. Kidney Yin and Yang Deficiency
Yin and Yang are inextricably linked, especially in the Kidneys where they both originate. This means that prolonged deficiency of one tends to lead to deficiency of the other. This can either result in the symptoms of each condition canceling one another other so that very little other than the fertility problem is evident, or it can mean a mix of both Yin and Yang deficiency symptoms – such as wired anxiety and having to get up in the night to urinate, or lethargy and constant thirst. This is often a good place to start treatment if there are no known physical reasons for not falling pregnant, particularly for those over 30.
7. Kidney Jing Deficiency
Kidney Jing deficiency is a more extreme form of Kidney Yang deficiency so it includes the symptoms of this, such as low energy and poor stamina, shadows under the eyes, frequent or urgent urination and needing to urinate at night.
However, Kidney Jing Deficiency tends to be a congenital problem. There may have been late closure of the fontanel or poor bone development in childhood; little or late onset of secondary sexual characteristics, such as breast development; obvious developmental issues of the sexual organs or under functioning of the ovaries with irregular ovulation As adults there may be bone disorders, falling teeth and hair, sore back and knees, poor memory, premature graying or hair loss and low libido. It may also be indicated if the ovaries do not respond to fertility drugs.
So what can you do to help yourself?
Obviously, acupuncture can be useful but there are other things you can do too.
The very best thing for stagnation is movement – shake all that stuck energy up. Do what ever moves you (literally). Stagnation is also linked to low mood so if you can do some form of exercise that you love it will be especially beneficial.
As I said earlier, stagnation is also compounded by stress so anything you can do to reduce this will help. Begin by trying to identify what your stress triggers are – is it the drive to work or one particular task you have to do there, or is it whenever you think about a certain event or person? I know that wanting a baby itself can cause loads of triggers, so look out for them too. Once you have identified your triggers try and pay attention to where you feel the stress in your body – does your stomach, back or shoulders tense, or are you clenching your teeth?
Becoming aware of these cues will help you to think about changes you can make to avoid them and also to recognize when you have been triggered by the things you can’t change.
For the unavoidable stressors, the key is to try and notice that you have been triggered as soon as possible – you know that this has happened because you fall into familiar negative thought loops and your body tenses up. As soon as you become aware of this – go into the sensation of stress in your body, breath into it and try to relax it. You will also need to ‘unhook’ the thought from your mind as these trigger actually become addictive. It is not easy and it takes time but it can be done!
In the case of Phlegm and Damp the best course of action is to look at diet. Phlegm and Damp are exacerbated by heavy, greasy foods and excessive dairy, sugar or wheat. Unfortunately, these are all the types of food that are not only readily available but also delicious…. If you tend to be a comfort eater try working through the advise above for stress but instead think about what trigger your eating. Often we are unconsciously programmed to grab a biscuit as a response to something. It took my husband about three months to notice that I started grazing as soon as I got on the phone to my Mum (she’s a feeder!) – I had been unaware of that for over 30 years!
Another think to avoid, that is less obvious is cold foods. This does mean physically cold things like ice cream or anything straight out of the fridge but in Chinese medicine it also refers to excessive raw fruit and veg. Yes I’m afraid that does mean smoothies too! I know they contain masses of antioxidants and good stuff but if this is your condition you would be much better of with a soup maker than a nutribullet…
Kidney Yin Deficiency
For Kidney Yin deficiency the best thing you can do, is sleep. The Kidneys particularly love rest so get a few early nights if you can.
Acupuncture has taught me the danger of never switching off, because the consequence is we get more and more deficient. Have you ever noticed that when you race around too much, there comes a point when it’s actually quite difficult to stop? You try to sit down but the list in your head just wont let you. You’re just too wired to relax. I do understand that, it’s Yin deficiency… I also know that insomnia is often a problem for people with this condition so just do your best and make an effort to give yourself the time to at least rest in the day.
It takes effort, but again, you can begin to slow yourself down gradually, and eventually you will get to a healthy pace that is just as effective but not nearly so draining. Mediation, mindfulness, qi gong, and yoga (especially Yin yoga) are really good tools to help here and are excellent investments for your health…
Kidney Yang and Jing Deficiency
If you have identified with this condition first of all be honest with yourself and check that it is not a consequence of prolonged Yin deficiency. I say this because Yin deficiency is much more common in our current culture, particularly in females. Yin is feminine energy and therefore, by nature women tend to rely on it more.
If you are sure that you are more Yang deficient then the most important thing is to keep warm. Make sure you are dress appropriately in cold environments and eat more warming herbs and spices such as ginger, cinnamon, chill and garlic – don’t go over board – we are aiming at balance here so think of a see-saw – you don’t just want to bang down onto the other side… Gentle exercise is also helpful. As you are likely to feel pretty tired already, high impact sports will wipe you out but walking, Qi Gong or Yoga should be very restorative.
So good luck all : ) I hope this has been helpful.