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Women's health

The classic Chinese texts often state that ‘Women are more difficult to treat,’ probably referring to the complex interplay of hormones which constitute the Menstrual cycle. Womens health is my special area of interest and it is a particular bugbear of mine that symptoms such as pain and emotional disturbances are considered a ‘normal’ aspect of our cycle and can sometimes be disregarded as unimportant.

 

The Menstrual Cycle

The chart below shows an optimum cycle of 28 days. A cycle length of 26-32 days when regular is perfectly normal. It is also normal for the occasional disruption to the cycle due to illness or stress. (i.e. the cycle may lengthen or shorten by a few days). A cycle  that is always irregular suggests a problem as does pain, emotional disturbances, spotting and anything other than a smooth fresh bleed.

The acupuncturist will treat according to your TCM diagnosis but modifications are made depending on which part of the cycle you are in. The ‘nutritive’ Yin phase or follicular phase is all about egg development and preparation of the womb lining. The ‘active’ Yang or luteal phase is about the egg release and maintaining progesterone levels.

Sometimes treatment will be carefully timed to coincide with the part of the cycle that needs attention.

 

Menstruation (Days 1-7)

This is the time of the cycle when the body sheds the old endometrium in order for a new nutrient rich lining to form. The bleed should be fresh red in colour with a smooth flow which lasts ideally between 3-5 days.

Common problems during this phase include: pain (before, during or after), stop-start bleeding sometimes starting or finishing with brown discharge, small or large clots, a bleed which is watery or foul smelling, very heavy or scanty bleeding which may be prolonged, tiredness, low back ache, night sweating, sweaty palms and feet.

Acupuncture treatment during this phase includes encouraging the smooth flow of blood, improving egg quality and encouraging the development of the new endometrium.

Post menstruation (Days 7-14)

As well as the new endometrium forming, competing follicles are developing. Towards midcycle, there is a spike of LH (Lutenising hormone) which facilitates the release of an egg from the dominant follicle. As ovulation approaches, women will notice an increase of cervical mucus which thickens to an ‘egg white’ consistancy at ovulation.

Problems during this phase include: pain during ovulation, lack of cervical mucus, delayed/early ovulation, mid-cycle spotting. Acupuncture treatment during this phase includes: improving egg quality and encouraging ovulation.

Post Ovulation (Days 14 – 21)

Once the egg has been released it lives for around 1-2 days only unless fertilised in the fallopian tube. Levels of progesterone are high during this phase which prepares the endometrium for implantation.

Problems during this phase include: inability to maintain progesterone levels which can prevent implantation, low mood Acupuncture treatment during this phase is aimed at maintaing progesterone levels.

Pre-Menstrual (Days 21 – 28)

This is where progesterone levels are at their peak and should be a time of increased energy and creativity for a woman but as we all know, this isn’t always the case. I don’t know how to explain this in Western Medicine terms but the TCM understanding is that a ‘stagnation’ of Qi affects a womens mood. This is usually caused by stress which causes bursts of anger or tearfulness. I speak from past personal experience that this can cause great interference in a womens life. Some women will also start to experience pain a number of days before the period begins.

Acupuncture treatment focuses on promoting ‘a smooth flow’ of both emotions and the bleed (ie a pain free period).

 

Trying for a baby

Taking your Basal body temperature (BBT)

If the cycle is irregular or the woman isn’t sure of her time of ovulation then it may be worth doing the basal body temperature charting. The thermometers are cheap to buy, (it’s worth getting one that is sensitive to two decimal points) and it’s necessary to take the temperature immediately upon waking, preferrably at the same time every morning.

I’m particularly keen on the BBT charting as it gives us specific information on the cycle and also gives me direct feedback on my treatment!

Downloadable BBT chart

When is the best time to have sex?

The best time to have sex are days 9-16. How often is up to the couple. There are varying opinions as to whether, once a day, twice a day, every other day, morning or evening is best. My feeling is that whatever suits the couple although every other day is probably best as this maintains the quality of sperm. Young couples might not find once or twice a day too much of a challenge but forcing the issue could lead to exhaustion and resentment.

It’s important to maintain a healthy loving relationship and sex life. I’ve jokingly suggested to couples that the woman provides a signal such as hanging a pair of lacy knickers on the bedroom door to signal her fertile phase. As silly as it sounds, it could be a way of keeping things light and fun. Incompatible work schedules and stress puts pressure on couples trying to concieve.

The sperm survives for 4-5 days, so even if a couple only manage to have sex a couple of times during days 9-16, conception is still possible.

We have been trying to concieve for a year now and nothing has happened.

Don’t panic! It’s considered quite normal for conception to take as long as twelve months or more and it’s not neccessarily an indication that anything is wrong. However, a good starting point is ensuring that the male partner has a sperm test and the woman charts her BBT for 2-3 months (see above).

Don’t however let it take over your life. Getting stressed and obsessive about concieving is not going to be helpful. Taking a break from ‘trying’, having some fun, putting away the fertility monitors etc might be just what you need for a few months. There’s certainly plenty of anecdotal reports that couples get pregnant as soon as they stop trying.

IVF support

IVF is an emotionally taxing proceedure for a lot of women. I do my best to prepare women for the realities of the proceedure in respect to the fact that the success rate is fairly low (around 30%). However, this simply means that a number of attempts may be needed and it’s best to maintain a positive outlook. Most women will get there in the end.

There’s some good research on having acupuncture during IVF which suggest that the success rate is increased up to 50-60%. (see research article below). I prefer if possible, to see women for about 3-4 months prior to the proceedure (this is when the egg quality is being determined) which gives us time to work on whatever is appropriate. Where women have had previous failed attempts, perhaps due to poor egg quality or poor endometrium then we can utilise the information we have and target our treatment accordingly.

Research article: Acupuncture and IVF

Pregnancy

Acupuncture is perfectly safe during pregnancy. Traditional Acupuncturists will avoid certain points as they are regarded too stimulating according to classic Chinese medical texts. A lot of Women find treatment during the first trimester very supportive especially when they have miscarried in the past and naturally feel anxious.

There is however no reason why women can’t continue having treatment all the way through their pregnancy as it’s non drug treatment used for a wide range of conditions.

Acupuncture for delayed labour

I’m happy to provide treatment for women who have gone past their due date. This will most likely be some electro-acupuncture applied to points which are indicated to stimulate the uterus. I require however permission from your mid-wife and for you to bring someone with you.

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