Fertility-Pregnancy Blog Series

This is the 2^nd blog in our fertility/pregnancy blog series. Continuing from the first one, which discussed menstruation, this one will be about infertility issues for women.  We will discuss the possible causes of infertility and how we use TCM to treat these issues. Our future blog will cover infertility involving male factor issues.

Infertility can arise from many different causes and disorders. Some women experience more than one cause at a time, as one symptom can cause another symptom, which ultimately may result in infertility. We will list disorders with descriptions of each except for PCOS (please see our blog from September 11, 2011 for details) and Endometriosis (please see our blog from March 22, 2011 for details). The following are possible causes:

Menstrual Disorders
 including:

• Irregular menses-
menses that is early, late, short, or long; it can also be bleeding in between regular cycles (“breakthrough bleeding”)
• Amenorrhea-the absence of menstruation; primary amenorrhea is the failure of menses to occur by age 16; secondary amenorrhea is the absence of menstruation for 6 or more months (for a woman after menarche)
• Oligomenorrhea-after a woman’s menstrual cycle has been established, oligomenorrhea is defined as
infrequent menstruation, occurring at intervals of more than every 35 days; usually a woman will have 4-9 menses/year
• Menorrahgia-abnormally heavy and/or prolonged menses; there may also be heavy pain associated with the excessive bleeding
• PCOS (Polycystic Ovarian Syndrome)-please see our former blog for these details
• Endometriosis- please see our former blog for these details
• Luteal Phase Defect-the failure of the endometrium (uterine lining) to develop properly during the luteal phase of the menstrual cycle; this may lead to difficulty with implantation
• Asherman's Syndrome-an acquired uterine condition where adhesions (scar tissue) form inside the uterus; this usually results from a D&C procedure
• Premature Ovarian Failure-when the ovaries stop working before age 40; there may be absence of menses and pre-menopause-like symptoms
• PID (Pelvic Inflammatory Disease)-an infection of the pelvic organs including the uterus, ovaries, fallopian tubes, and cervix; this is due to an STD
• Uterine Fibroids-noncancerous growths in the uterus, that usually occur in childbearing years; sometimes fibroids develop without any symptoms
• Tubal Disease-the fallopian tubes become blocked or damaged which may result from scar tissue, infections, and tubal ligation; this blockage/damage prevents the egg from descending correctly for conception and implantation
• Unexplained infertility-some cases are seen to be caused by autoimmune disorders

All of the above listed disorders have some disproportion of hormones-rather it be estrogen, FSH, or a combination of hormones.

In TCM, we are make our diagnosis of any infertility issue according to the meridian and it’s energy that is out of balance. We also look at specific fluids in the body that may be excessive or deficient, which can be related to infertility issues. When our qi (our energy) is not moving smoothly through our channels or if it is insufficient, then we may see symptoms arise in our body. All of the disorders listed above are due to either an imbalance of our qi and/or fluids in the body. The disorders can also be the result of a physiological abnormality, such as a blocked fallopian tube.

In our TCM treatments, we will diagnose which channel to be treated. We use acupuncture and herbs to do this, along with moxibustion and various modalities. With infertility, we tend to see imbalance often arising in our “kidney channel” energies. This is true for both women and men. An example is we see a deficiency of kidney energy when a woman is diagnosed with “premature ovarian failure”. The kidney energy plays a major role in regular menstrual cycles and reproduction. Without the normal amount of this kidney energy, the reproductive organs along with the hypothalamus and pituitary cannot function correctly each month to lead to a healthy conception. Another example is that with fibroids. From a TCM perspective, fibroids can be due to a stagnation of “phlegm”. Phlegm is a fluid in the body that causes slow movement and can form into nodules (fibroids). Phlegm can be caused by several factors including diet and lifestyle choices.

Unexplained infertility is one that is frustrating and difficult for patients and practitioners as not to be able to give a clear reason for an infertility case. TCM does a wonderful job at treating these types of cases because we look at the energy imbalance of the body and treat the root and branch of a disorder. TCM treatments are ALWAYS treating the entire mind, body, and spirit-because all our connected. An emotion we have in our minds can easily have an effect on our physical body-and vice versa. Infertility usually takes an emotional toll on us for many reasons. The amount of time we go through to even reach a diagnosis of infertility is quite a bit, depending on a woman’s age and medical history. The constant stress and worry over becoming pregnant can begin to have an effect on how our bodies physically function. By holding onto stressful and anxious emotions, this can create barriers in our physical systems. For example, the anxious feelings may lead to insomnia, which can have an adverse effect on conception. If our bodies are not having adequate and quality rest each night, it cannot function at it’s optimal level-which is vital in all aspects for a healthy conception.

As TCM practitioners, we choose the acupuncture points that are best to treat each channel that is out of balance. Specific points in the body have a direct effect on our hormones, therefore, resulting in a decrease in symptoms and a return to overall health. Along with acupuncture treatments, we recommend a wide variety of herbal formulas to treat specific illnesses. For a woman with amenorrhea, we may recommend the classic Chinese herbal formula “Si Wu Tang” which supplements and nourishes the blood. Another formula that is commonly used for infertility is “Xiao Yao Wan” which is used to course the qi through the body efficiently. Many times these classic Chinese herbal formulas are modified to distinctly treat a woman’s various symptoms.

Infertility involves so many factors that must be determined and identified in order to make the correct diagnosis. With a diagnosis and thorough treatment plan, infertility issues can safely and effectively be treated with TCM.

Caroline Jung, L.Ac, MSOM

Managing and preventing diabetes with acupuncture and herbs

Today, diabetes is a growing epidemic among children, young adults, and adults. This is a disease that we all need to be informed about and November is American Diabetes Awareness Month. Diabetes can be prevented and treated with various medications, food plans, lifestyle adjustments, and exercise. There is no known cure for this disease. Along with traditional treatment, we use acupuncture and Chinese herbs to effectively treat and prevent diabetes.

Diabetes, also referred to as diabetes mellitus, is a disease in which the body has a shortage of insulin, a decreased ability to use insulin, or both. Insulin is a hormone that allows glucose (blood sugar) to enter the cells and to be converted to energy. Glucose is essential for the cells that make up our tissues and organs. Glucose is the brain’s main source of fuel-so it is essential for every living being to function and thrive. When diabetes is not treated and managed, the glucose and fats can remain in the blood and, over time, may damage vital organs (such as the kidneys).

There are three main types of diabetes:

Type 1 Diabetes is usually diagnosed in children and young adults (it was previously known as juvenile diabetes). In type 1 diabetes, the body does not produce insulin. Commonly seen symptoms of type 1 include:

>Unusual thirst
>Extreme hunger
>Unusual weight loss
>Extreme fatigue and Irritability

>Frequent urination

Type 2 Diabetes is when either the body does not produce enough insulin or the cells ignore the insulin.

Commonly seen symptoms of type 2 include:

>Any of the type 1 symptoms

>Frequent infections

>Blurred vision

>Cuts/bruises that are slow to heal

>Tingling/numbness in the hands/feet

>Recurring skin, gum, or bladder infections

 *Often people with type 2 diabetes have no symptoms

Gestational Diabetes develops during pregnancy, it is usually around the 24th week that many women are diagnosed with it. A diagnosis of gestational diabetes does not imply that a woman had diabetes before the pregnancy, or that she will have diabetes after giving birth. For most women, gestational diabetes subsides after giving birth. Although, it does put a new mommy at risk for future type 2 diabetes. It is important for one with gestational diabetes to manage it properly during the pregnancy as to prevent from having a c-section delivery. For most pregnant women, gestational diabetes does not cause the normal diabetes symptoms, therefore, it is necessary to be tested for it at week 24.

A condition known as “prediabetes” is when the blood sugar level is higher than normal but not high enough to be considered type 2 diabetes. Although, if not treated, it can easily become type 2. Often, prediabetes does not present with symptoms. Although a possible and common one may be darkened areas of the skin, such as the neck, elbows, and knees.

Traditional Chinese Medicine (TCM) plays an important role in treating and preventing diabetes. In TCM, we use acupuncture and Chinese herbs to effectively manage the symptoms and to help prevent diabetes from furthering into an advanced stage of the disease. TCM recognizes specific patterns of the diabetes disease. One of the main patterns, which is also a distinctive pattern, is termed as “wasting-thirsting” disease.  This presents with a deficiency of the yin the body. “Yin” is an energy that runs throughout the body and is essential for overall health and balance. The yin helps to keep the “yang” of the body in check. Yin and yang both have to be in balance for optimal well-being. Yin is cold in nature and so when we have a deficiency of it, we tend to have more hot symptoms-such as thirst, dry mouth and lips, and increased urination. These are classic symptoms of diabetes and the wasting-thirsting pattern of TCM. Acupuncture and herbs are used to treat these presenting symptoms. Acupuncture helps to tonify the yin and help to ease the “hot” symptoms. Specific herbs that may be chosen to treat the yin deficiency would be herbs with  a cooling property.

By using acupuncture, we choose specific acupuncture point prescriptions to treat the presenting symptoms. We also use herbs to treat these symptoms. For example, acupuncture and herbs have a direct effect on our digestive system and our metabolism. Both of these are affected by diabetes and we see symptoms, such excessive thirst, excessive weight loss, and hunger. Acupuncture and herbs can help to regulate our hunger and help to manage the weight loss that may result from diabetes. Another common symptom of diabetes is neuropathy, which is a nerve disorder caused by the diabetes.  These symptoms may include tingling, numbness, and pain of the arms, legs, hands, and feet. Acupuncture is wonderful in helping to relieve these symptoms, which usually develop for diabetes patients after 25 years or so.  

From a study published in February 2011, the use of electro-acupuncture on a specific acupuncture point has shown to reduce  blood glucose levels. The acupuncture point tested in this study is “Stomach-36”. This is a classic acupuncture point that is used for many indications, many of those including metabolism and digestion. The findings of the study indicate that electro-acupuncture on Stomach-36 decreases the blood sugar level by stimulating the cholinergic nerves and involving the adrenal glands, which signal insulin proteins. To read the full article, please go to this link:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136799/?tool=pubmed

TCM can be used to prevent diabetes. If there is a family/medical history of diabetes, regular acupuncture can help to maintain the yin and yang of the body as to not allow imbalance to bring about diabetic symptoms. It is also beneficial with gestational diabetes in preventing it from worsening throughout the pregnancy and causing complications for mother and baby. Acupuncture plays a role in helping a woman carry her baby to full term with a healthy delivery.

It is ideal to begin prevention with children and young adults.

Along with a healthy diet, adequate exercise, TCM can help to manage and heal diabetes. By educating one another with the facts of this disease and the easy steps we can take to prevent it, the diabetes disease can be managed to further the health of our future.

Caroline Jung, L.Ac, MSOM

Chinese Herbology Explained

As an herbalist, I am often asked questions like, "what are some good herbs for allergies?"  Or for migraines, of fertility, or energy, or whatever.  There is never one particular herb (or herbal formula) for a single symptom.  That is not how Chinese medicine works and it has never been practiced that way.  The health magazines always have stories promoted on their covers promoting this fallacy- "The top 5 headache herbs" or similar.  It is important that you understand how Chinese medicinals are prescribed and why.

But first, if herbs have not been practiced that way, why do we have this notion?  It is only to sell us products.  It is much better for me as a manufacturer to sell one formula to everyone, rather than having to customize a formula to each specific patient.  Supplement makers are guilty of this as well- "This pill is specifically beneficial and necessary for everyone in the world!"  There is no magic bullet and no one-size-fits-all.

Every symptom can come from at least two different imbalances.  We do not prescribe based on the presenting symptom but rather on the underlying imbalance that is causing the symptom.  The same imbalance can cause different symptoms in different people and require the same treatment.  The same symptom can be caused by different imbalance and require different treatments.  There is a saying in Chinese Medicine:  Same disease, different treatment.  Different disease, same treatment.  This is not just Confucious-style obscure communication.  It makes sense and is how Chinese medicine is practiced.

One important difference in the way that the Chinese view the body compared to the way we in the West tend to see it is:  The Chinese see us as being part of our environment (and nature) whereas in the West we view ourselves as distinct and separate from nature.  Because of the Chinese view, they tend to understand the way things work inside the body in terms of how they work outside the body.  In nature, things can be too hot, too cold, too damp, too dry, too still, too active, too windy, too replete, too deficient, etc.

Too much heat in the body can manifest as myriad symptoms.  What does heat do in nature?  It makes things red, it makes things move (like a still pot of water coming to a boil), it can dry things out, etc.  In the body, heat can give you fever, a red face, agitation, hypertension, constipation, scanty menses, insomnia, red rashes, and more.

What does cold do in nature?  It makes things pale.  It makes things contract and slow down.  Heat is necessary for transforming water, so too much cold can impair water metabolism.  Too much cold in the body can manifest as stiff joints or arthritis, feeling cold, constipation, excessive urination, and much more.

You may have noticed that Constipation is on both lists.  Heat can dry out the stool and make it difficult to pass.  Cold can make things contract and stop moving.  So it is not enough for me to know that you have constipation.  I need to evaluate you to determine why you have that constipation and that will help me decide what formula to give you.  If you have cold constipation and I give you a cooling formula, it can make you worse.  This is why you should never take herbs based on an article or the advice of a friend or store clerk.  As much as herbs can help in the right circumstance, they can harm when not used properly.  When you hear about adverse reactions to herbal formulas it is usually when the patient self-prescribed and did not seek the guidance of a trained herbalist. 

So I can see two patients with constipation and give them completely different formulas. I could see patients with constipation, arthritis, wheezing, and excessive urination and treat them all with the same formula.  Same disease, different treatment.  Different disease, same treatment.

Herbs have been studied continuously for the past 4,000 years.  The Chinese invented the printing press and the first thing they started printing with it were medical texts.  The field of Chinese medical herbs is the result of thousands of years of experimentation, observation, and documentation.  Because of the written language, a new physician can start his or her research at the end of the previous generation's research.  The knowlege base has been expanding for millenia.  In the West, we lost all of our classically-gained knowledge with the fall of the Roman empire.  It was not until the Renaissance that we started rebuilding, so our medicine is at best some 500 years old. Chinese medicinal herbs are safe only when properly prescribed. 


In Chinese medicine, there is a saying:  If an herbal formula causes unwanted side-effects, then it is clearly not the right formula.  Can you imagine if we had such expectations from Western medications?  We accept side-effects as just part and parcel of treatment.  We don't have to.  I am not anti-drug.  Medications have helped billions of people too.  For every medication, it will be a great fit for 10-30% of people, a fair fit for about 50% of people, and it will be a lousy fit for another 10-30%  The problem with medications is that they are not easily modified for those patients in whom they are not a great fit.   And there are so many instances where the latest miracle drug has to be pulled off the market because it is killing people.  I worry about every new drug just because they have not been studied long enough.  This is one of the things that I love about Chinese medicine- it's longitudinal research.  I don't prescribe anything for a patient that has been studied for less than 1000 years. 


When you have an ailment, I suggest you start your treatment with the safest, longest-studied, and most natural remedies.  If they fail, then you can progress to the more risky and powerful drugs.  But why take risks if you don't have to? 

- Jason Bussell MSOM, L.Ac