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Fertility in Chinese Medicine Pt 2 – Acupuncture for Infertility

In this series of articles I am focusing on Chinese medicine, and specifically on acupuncture, as a treatment option for a variety of medical conditions. In previous articles I have written about conditions that you may not automatically consider seeking acupuncture treatment for. To read more about these conditions and for more about acupuncture, you can read the following:

Acupuncture – What Is It and How Does It Work?
Shingles – What Is It and How Can Acupuncture Help?
Acupuncture, a Powerful Treatment for Stress and Insomnia
Acupuncture as a Treatment for Depression
Acupuncture to Prevent Chronic Infections
Fertility in Chinese Medicine Pt 1 – Supporting Kidney Essence

Last time, I started to write about one of the conditions most commonly associated with acupuncture, infertility. We discussed how kidney essence lies at the heart of female fertility and the importance of protecting it as young girls in order to prevent infertility later in life. In Chinese medicine, fertility is a reflection of our health from our own conception up until the time we try to conceive ourselves. In this second part, I will specifically outline the phases of the menstrual cycle as the Chinese view it and discuss the various patterns that lead to difficulties in getting pregnant.

The 4 Phases of the Menstrual Cycle in Chinese Medicine

Western medicine splits the menstrual cycle into two phases – the follicular phase (when the follicles in the ovaries mature in preparation for the release of an egg at ovulation) and the luteal phase (when, if the egg is fertilized, it is implanted in the uterus; if not, this phase ends with a period). In contrast to this, Chinese medicine recognizes four distinct phases. These phases are seen as a waxing and a waning of kidney yin and kidney yang as we discussed last time and are more fine-tuned than the Western ones. Each phase marks a specific and important moment in the fertility cycle and the acupuncture points and treatment principle will vary depending on which phase you are in at the time. I will outline each of these phases as they occur in a healthy menstrual cycle and the treatment goal for each of them before taking you through the Chinese medicine patterns of infertility, their treatment principles and associated acupuncture points.

A typical menstrual cycle is 28 days long; however some women’s cycles can be shorter or longer than this. The phases below are based on a 28 day cycle but the length of each stage may vary depending on your cycle length.

The Four Phases of the Menstrual Cycle

Phase 1: Follicular Development
This is when the follicle inside the ovary is ripening and lasts from the 4th or 5thday after the onset of the period until day 12.

The treatment goal during this phase is to tonify the kidneys and nourish the blood to help develop a healthy follicle and build up a thick, healthy uterine lining.

Phase 2: Follicular Maturity and Ovulation
This phase starts right before ovulation when the follicle is almost mature enough to be released from the egg (about day 12) and runs until it is released at ovulation (around day 16)

The main treatment goal at this stage is to trigger the release of the follicle. In addition to this you also want to nourish the blood to ensure a thick, healthy uterine lining for the fertilized egg to implant into. Good circulation in the pelvic area to optimize ovulation and implantation.

Phase 3: Luteal Phase
This phase lasts from about 3 days after ovulation until about 3 days before your period starts (day 25).

At this stage, the treatment goal is to tonify the kidneys and keep them strong for implantation. This is a key part of the cycle and is especially important for women who do in vitro fertilization. Strong kidney energy is needed for the success of the fertilized eggs to be strongly implanted into the uterus.

Phase 4: Atrophy of the Corpus Luteum
If the egg has not been fertilized and implanted into the uterus then the body will begin to shed the uterine lining and the period will start. This phase runs from the end of the luteal phase (day 25) until 3 days after the period starts (day 28).

It is important to clear the old lining so that a new healthy layer can begin to build up again so the aim of treatment is to invigorate the blood and shed the uterine lining.

Chinese Medicine Patterns of Infertility

When you are evaluated for fertility in Chinese medicine, the primary goal is to know if your diagnosis pattern is excess or deficient. Then, within each of these, there are more specific diagnoses.  In addition to where you are in your cycle at the time of your assessment,  your constitutional diagnosis will also be assessed based on your menstrual history, the type of blood flow you have during your period, and any more general symptoms you may be experiencing. The following are descriptions of the possible diagnoses, the treatment principle for each and the key acupuncture points that will be needled (instead of needling, you may also burn moxa – dried mugwort plant – over many of these points):

Deficient Conditions
Deficient conditions lead to infertility because the uterus and ovaries do not get sufficient nourishment from the blood, kidney yin or kidney yang.

Blood Deficiency
Symptoms: Irregular cycles, pale blood, light blood flow, depression, pale complexion, lethargy, dizziness, blurry vision
Treatment Principle: To nourish the blood and the kidney essence, strengthen the liver and the kidneys.
Acupuncture Points:
Ren 4 – Tonifies the kidney and nourishes yin, strengthens the uterus
Location – 3 inches below the belly button
Stomach 36 –This is the most powerful point for building qi and nourishing the blood
Location – About 4 finger widths below the knee on the outside of the shin bone. If you feel around there is usually a place your finger easily lands on, this is stomach 36.

Kidney Yin Deficiency
Symptoms: Short periods, light blood flow, light colored blood, infertility for many years, night sweats, dizziness
Treatment Principle: To nourish kidney yin and kidney essence.
Acupuncture Points:
Ren 4 –Tonifies the kidney and nourishes yin, strengthens the uterus
Location – see blood deficiency above
Spleen 6 – Builds yin
Location – 3 finger widths above the ankle on the inside of the leg.

Kidney Yang Deficiency
Symptoms: Long menstrual cycle, blood flow could be heavy or light, low back pain, fatigue, cold, depression, frequent urination
Treatment Principle: To build up and nourish kidney yang.
Acupuncture Points:
Kidney 13 – Tonifies the kidneys and strengthens the uterus
Location – Find Ren 4 (3 inches below the belly button) then move ½ an inch to either side.
Kidney 3 – Tonifies the kidneys, nourishes the essence
Location – on the inside of the ankle in the depression between the ankle bone and Achilles tendon.

Excess Conditions
Excess conditions lead to infertility by contributing to obstructions that affect the uterus and ovaries.

Cold in the Uterus
This is commonly caused by a kidney yang deficiency (see above) and is most common in young women.
Symptoms: Delayed cycles, small clots, painful periods that feel better with heat (such as a hot water bottle), feeling cold, a pale complexion
Treatment Principle: To warm and tonify kidney yang, warm the uterus and scatter the cold.
Acupuncture Points:
Ren 2 – Scatters cold in the uterus
Location – 2 fingers above the center of the pubic bone.
Kidney 7 – Tonifies kidney yang
Location – 2 inches above Kidney 3 on the inside of the leg above the ankle in front of the Achilles tendon.

Dampness in the Lower Burner
Symptoms: Irregular periods, mid-cycle pain, increased vaginal discharge, adhesions, polycystic ovaries, obesity, heaviness
Treatment Principle: To resolve dampness and unblock any obstruction the dampness may be causing.
Acupuncture Points:
Ren 3 – Drains dampness in the uterus.
Location – about 1 inch above the center of the pubic bone and 4 inches below the belly button.
Spleen 9 – Drains dampness
Location – on the inside of the lower leg, below the knee in the indentation of the tibia bone.

Blood Heat
Symptoms: Frequent periods (more than one a month), heavy flow, feeling hot during your period, thirst, anxiety
Treatment Principle: To cool the blood and regulate the periods.
Acupuncture Points:
Liver 3 – Clears heat and moves qi
Location – On the top of the foot in the web between the 1st and 2nd toe.
Large Intestine 11 – Clears heat
Location – When the elbow is bent the point is at the outside of the crease in the elbow in front of the bone.

Qi Stagnation
Symptoms: Irregular, painful periods, lots of PMS, breast tenderness, irritability, angry, short-temper.
Treatment Principle: To move the qi, eliminating stagnation, calming the liver and regulating the periods.
Acupuncture Points:
Liver 3 – Moves the qi and clears heat
Location – See blood heat above
Gallbladder 34 – Eliminates stagnation
Location – On the outer part of the lower leg in front of and below the head of the fibula.

Blood Stasis
Symptoms: Irregular, painful periods, dark clotty blood, angry, irritability, mood swings, mental restlessness, abdominal pain
Treatment Principle: To move the blood and the stagnation, soothe liver qi and regulate periods.
Acupuncture Points:
Liver 3 – Moves liver qi and blood, eliminating the stagnation
Location – See blood heat above
Spleen 10 – Moves the blood stagnation
Location – Above the knee on the inside of the leg at the place your thumb lands when you put your hand on someone’s knee.

Closing Thoughts

Chinese medicine and acupuncture play an important role in keeping the body healthy and restoring any deficiencies or clearing any excesses that may be a cause of a woman’s infertility. Because it looks at the subtleties in a woman’s body, it can recognize a delicate imbalance that may not be obvious in a traditional medical model. For example, because in Chinese medicine there are several different patterns that can affect a women’s fertility, it can sometimes identify a pattern that is not recognized in the Western medical model.

Acupuncture helps to strengthen the body and bring it into balance and this it is why it is so good for improving fertility outcomes. For many women, acupuncture alone can help with their fertility while others may need to draw on Chinese herbal formulas, naturopathic medicine and assisted reproductive technologies to help successfully conceive a healthy baby. In fact, receiving acupuncture for a few months prior to beginning any assisted reproductive technologies like intrauterine insemination or in vitro can improve the chances of success.

If you are in the Seattle area and would like to schedule an acupuncture treatment with me, my clinic is in Issaquah. I also offer naturopathic appointments in person or on the phone and you can book any of these by using the book online tool above.

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Dr. Maura Scanlan

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