Women's Health

General Gynecology

• Women's Health Overview
• Stress and the Female Reproductive System
• Treating Stress in Women's Health
• General Gynecology

Infertility

• Infertility Overview
• How Can Acupuncture Help with Infertility?
• What Infertility Symptoms Can Acupuncture Treat?
• When Should a Patient Start Acupuncture Treatments?
• How Long Will a Patient Need to Come for Acupuncture Treatments?
• Will it be Necessary to Take Chinese Herbs?
• How Can Acupuncture and Hypnotherapy Help with IUI and IVF Therapy?
• Can Acupuncture Help with Male Infertility?
• Are There Things a Patient Can Do to Improve Fertility?

Pregnancy

• Pregnancy Overview
• Conditions Treated with Acupuncture During Pregnancy
• A General Treatment Plan for Pregnancy
• Acupuncture for Labor Induction
• Pain Management with Acupuncture and / or Hypnotherapy During Labor
• Acupuncture for Post-Partum Symptoms
• Recommended Informational Internet Links

Women's Health Overview

A woman's body is superbly designed to perform the miracle of creating new life. From the onset of menstruation at puberty, through the decades of monthly cycles, during times of pregnancy and through the final stages of menopause, a woman's body must continually adapt to the perpetual state of change orchestrated by a dynamic interplay of hormones and biological processes.

A women's reproductive system is regulated by an almond-sized structure located in the central portion of the brain called the hypothalamus. This structure serves as the primary mind-body interface between the central nervous system and the endocrine (hormonal) system via the pituitary gland located just below it. Together, these structures form the hypothalamus-pituitary-ovarian axis which serves as the primary regulatory mechanism for the female reproductive system throughout life.

Many research studies have now confirmed that acupuncture has the ability to successfully manipulate this hypothalamus-pituitary-ovarian axis in ways that can restore hormonal balance during any stage of a woman's reproductive life. It can, therefore, be very effective in treating a wide variety of gynecological, infertility, pregnancy, post-partum and menopausal symptoms and conditions.

However, It is also extremely important to interject here before proceeding to more specific topics regarding women's health that a growing body of research has also confirmed that stress can often be the single most disruptive factor to the intricate balancing of hormones that are required in order for a woman's reproductive system to be able to function properly throughout each of the stages of her life. By stress, I am not just referring to the stressors a woman may be dealing with in her current life. I am also talking about a more insidious form that gradually accumulates within her nervous system over a lifetime as chronic stress.

A more detailed discussion of stress can be found under the topic of Stress and the Biology of "Dis-ease", however, because of the significant influence stress has on a woman's reproductive system and general health, a brief synopsis of that material will be presented here followed by descriptions of how it can be successfully treated with acupuncture, relaxation response training and/or hypnotherapy.

Stress and the Female Reproductive System

When the human mind perceives that it is undergoing a stressful event it sets off an alarm reaction initiated by the hypothalamus. The hypothalamus immediately recruits both the pituitary gland and the adrenal glands situated on top of the kidneys. These glands immediately begin to flood the bloodstream with a cascade of stress hormones including cortisol, adrenaline and nor-adrenaline to prepare the body for what is referred to as the fight-or-flight response. The primary goal of this adaptive response is to maximize the body's ability to survive the stressful event.

Unfortunately, this alarm reaction engages both the hypothalamus and the pituitary gland; both of which also function to regulate the proper hormonal balancing required for the female reproductive system. Consequently, during a stressful event, the human brain automatically chooses survival over reproduction. This, however, does not necessarily have to be a problem as long as the confrontation with the stressor is short-lived. Once the threat has been successfully dealt with, the alarm reaction shuts down and all bodily functions quickly return to normal.

The problem arises when stress becomes more chronic and the fight-or-flight response remains activated almost indefinitely. This causes the hypothalamic-pituitary-adrenal axis to remain engaged on the long term in an effort to continue to combat the unrelenting, chronic stress. The increased level of adrenaline in the bloodstream begins to disrupt the activity of progesterone; one of the key hormones in the reproductive cycle. The elevated level of cortisol has also been shown to inhibit implantation of a fertilized egg into the lining of the uterus. Prolactin levels also rise when the body is under stress which can prevent ovulation from even taking place.

While in this state of hyper-preparedness for survival, more blood is also being automatically diverted to the muscles at the expense of both the digestive and reproductive systems in an effort to maximize the body's ability to either fight off or flee from the stressor. Over time, this can actually lead to a thinning of the uterine wall lining. As if all the above were not enough, if the chronic stress prevails for too long, the adrenal glands become fatigued and eventually begin to lose their ability to secrete DHEA (dehydroepiandrosterone). This important hormone is a precursor molecule for the production of estrogen, progesterone and testosterone and is absolutely necessary for maintaining a balance of these sex hormones within the body. Consequently, a decrease in the level of DHEA not only contributes to a decrease in sex drive in both genders, it can also become a major causative factor in both menstrual problems and infertility in women.

If chronic stress ultimately causes disruption in a woman's menstrual cycle and/or ability to get pregnant it can only serve to exacerbate her overall level of stress even further; thereby creating a vicious cycle (no pun intended here) that can eventually effect both her mental and physical health as well.

Treating Stress in Women's Health

Obviously, in an ideal world without stress most women's reproductive systems would be able to function at an optimum level and there would probably be far less gynecological, fertility or pregnancy issues to treat. Unfortunately, in our fast-paced, hectic culture women have more than their fair share of stressors to deal with on a daily basis. Consequently, a major goal of any treatment for a woman's gynecological, fertility, pregnancy and menopausal issues should always include reduction of stress. This can be achieved in three ways as follows:

Acupuncture: Acupuncture can be an effective way to reduce stress because it has been shown to relax the nervous system over a course of treatments. Over time, this allows the mind to achieve a lower state of energetic balance that is referred to as its allostatic set-point. Acupuncture is able to accomplish this goal by causing both the brain and body to secrete enkephalins and endorphins, respectively. These are the body's own sedative, opiate-like compounds that are three times more potent than morphine. Consequently, they have a very calming effect on both the nervous system and body; causing a beneficial reduction in many physiological functions known as the "relaxation response." This leads to a lowering of heart rate and blood pressure, muscle relaxation and feelings of well-being. Acupuncture has also been shown to cause release of serotonin which is known to have a relaxing effect on both the mind and body; especially the digestive system.

Relaxation Response Training: Dr. Herbert Benson, M. D., discovered a method to relax the mind and body over time by utilizing classical hypnosis techniques such as progressive relaxation, guided imagery and verbal suggestion. With this method he was able to measure significant changes in key body parameters that were the exact opposite of what was generated by the fight-or-flight alarm response while a patient was under stress.

Knowing that his colleagues would have thrown him out of Harvard back in the 1970's if he called this method self-hypnosis, Dr. Benson wisely coined the phrase "relaxation response" training to denote his method. As with acupuncture, over time, this technique can also relax the nervous system to the point where the mind is able to establish a much lower allostatic set point from which it is able to maintain resiliency against subsequent stressful events. Relaxation response training has gained popularity at many fertility clinics as an adjunctive treatment for stress to support IVF and IUI treatments.

Please refer to the hyperlink of Stress and Symptom Reduction Program for the 10-week Mind Massage® program involving weekly hypnosis sessions to accelerate the relaxation response training process offered at Mind-Body Wellness.

Regression Hypnotherapy: It is important to emphasize the neither acupuncture nor relaxation response training actually treat the underlying causes of stress. Both methods are able to keep the symptoms of stress at bay by calming the nervous system down over time. Acupuncture does this by relying on secretion of the body's naturally occurring sedative substances - endorphins, enkephalins and serotonin whereas relaxation response training relies on the patient practicing the method many times per day over a period of weeks. Both methods must also assume that the patient will be doing everything they possibly can to reduce external sources of stress over the course of treatment.

Regression hypnotherapy, on the other hand, treats stress directly and can remove it from the nervous system altogether. For example, let us take the example of acute stress in a woman who has been struggling to get pregnant for the past 18 months without success. Besides feeling personally stressed and frustrated that she has failed to meet her own expectations, she might also now be feeling under the gun from her own parents, in-laws and even her partner. Although acupuncture may be able to relax this woman's nervous system over time in order to facilitate pregnancy, there would be serious doubt that she would have the patience to be able to practice relaxation response training several times per day over many weeks under her current circumstances.

If, on the other hand, she was willing to try regression hypnotherapy, she would have an excellent chance of accessing all the emotional energy she has been accumulating over the past 18 months as stress and discharging it from her nervous system in just a few sessions via emotional releases while under hypnosis.

Furthermore, by learning how to enter the hypnotic trance state, she can be taught how to achieve the relaxation response with self-hypnosis much more rapidly than if she were to just practice it herself on a daily basis. This woman's nervous system would then be able to achieve a state of complete relaxation much more rapidly and the benefits of acupuncture for fertility could then be achieved with potentially fewer treatments.

With women who have either an intuitive sense or conscious awareness that they may possess a past history of either emotional or physical/sexual abuse or believe they suffer from chronic stress and have a desire to become pregnant, it would be advisable for them to seriously consider undergoing regression hypnotherapy either before or concurrent to their acupuncture treatments in order to be able to achieve optimum results over the shortest period of time with the least total number of acupuncture treatments.

In her best-selling book, Women's Bodies, Women's Wisdom, which has become almost a bible for women's health issues, Dr. Christiane Northrup, M.D., emphasizes the negative role stress plays on almost every aspect of a women's reproductive life. She also strongly advocates the use of both acupuncture and hypnotherapy to treat a wide variety of women's gynecological and reproductive health issues.

General Gynocology

Most gynecological conditions respond exceptionally well to Chinese medicine and can usually be brought back into balance within three to six menstrual cycles. Some of the many conditions that can be successfully treated are as follows:

Infertility

Infertility Overview

In the United States today, more than 15% of couples have difficulty conceiving a child. Furthermore, with the relatively recent shifts in cultural norms, more women in their late 30's and early 40's are attempting to conceive with 20 % having their first child after the age of 35 years.

Traditionally, infertility was always considered a women's problem, however, recent research has shown that only 35 - 45% of all infertility problems are due to the female gender with from 15 - 35 % now being caused by male factors; the remaining 15 - 20% being attributed to unknown causes (think stress here).

Infertility is defined as the inability to conceive after one year of actively trying for women less than 35 years of age whereas for those over 35, it is defined as such after only six months of actively trying. An inability to carry a pregnancy to term is also considered a form of infertility with its frequency increasing dramatically to about 50% after the age of 40 (usually due to abnormal genetic material in the egg).

Even when no diagnostic issues can be found, one should not assume that it is going to be an easy task to become pregnant. On average, women under the age of 30 have a chance of becoming pregnant every 3-4 cycles whereas over the age of 30 it may take 5-6 cycles. Women over the age of 40, on the other hand, have a 1 in 20 chance of becoming pregnant during any one full cycle. Obviously, when fertility problems are also added into the equation, months of trying to conceive can often lead to years of frustration and even more stress.

How Can Acupuncture Help with Infertility?

Acupuncture has been successfully used to treat fertility problems for over 2,000 years. Some of its action works to reduce stress which facilitates fertility by normalizing the hypothalamus-pituitary-ovarian axis that is so critical to regulating the reproductive system. Researchers from the Weill Cornell Medical Center in New York recently published a lead review article listing the following fertility-boosting benefits of acupuncture:

• Reduces stress and the hormones associated with the fight-or-flight response that have been shown to be detrimental to promoting fertility.
• Improves uterine wall thickness by improving blood supply to the area which can then significantly improve the possibility for egg implantation.
• Increases the release of endorphins which are known to have a direct influence on the release of gonadotropin-releasing hormone (GnRH), a decapeptide that is necessary for regulating the reproductive process.
• Regulates the menstrual cycle by directly influencing the plasma levels of the fertility hormones: follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and Progesterone (P).

What Infertility Symptoms Can Acupuncture Treat?

The following is a list of fertility problems that can be helped with acupuncture:

• Stress
• Amenorrhea (no periods)
• Irregular menstruation
• Ovulation factors (including no ovulation)
• Hormonal imbalances
• Premature ovarian failure & poor ovarian reserve
• Endometriosis
• Elevated FSH
• Luteal phase irregularities
• Thin uterine wall lining
• Cervical mucus issues
• Conception at an advanced age
• Thyroid problems
• Autoimmune conditions
• Immunity factors
• Fallopian tube blockage (incomplete forms)
• PCOS (polycystic ovarian syndrome)
• Male sperm count and motility factors
• Pelvic Inflammatory Disease (PID)
• Recurrent miscarriages
• Unexplained Infertility

When Should a Patient Start Acupuncture Treatments?

Studies have shown that it usually takes a minimum of 3 to 6 cycles before the benefits of acupuncture are able to positively improve various reproductive system abnormalities such as menstrual cycle irregularities, thin uterine wall lining, hormonal imbalances, etc. Consequently, if a woman were to consider using acupuncture alone to help her to become pregnant, she should begin her treatments at least 6 - 9 months prior to considering IVF or IUI therapy as an alternative.

Related to this is the fact that most women do not realize that ovarian follicles are selected from a pool of resting follicles almost an entire year before they begin to advance to the ovulation stage and that it takes approximately 5 months for an ovum to grow from a follicle in its resting state to a mature egg ready to be released for possible fertilization.

Unfortunately, at this time, most women are not aware of how beneficial acupuncture can be for assisting them toward becoming pregnant until they have given up trying on their own and have committed to Western ART (assisted reproductive technology). Under these circumstances, it would still be beneficial for them to start acupuncture treatments as soon as possible to help to improve the chance of conception with ART.

How Long Will a Patient Need to Come for Acupuncture Treatments?

Because it usually takes a minimum of 3 cycles to begin to affect positive change in a woman's reproductive system combined with the fact that it typically takes more than one cycle of trying even when there are no reproductive issues, the recommended course of treatment to achieve conception with acupuncture is 3 - 6 months. It is important to emphasize that a woman's chances for success may be greatly improved if she is also willing to take an active role in reducing stress, coming for her treatments on a regular basis, taking herbs if prescribed, and implementing dietary changes if they are recommended. Hypnotherapy can also help to reduce stress and motivate a woman to make these changes.

Although 3-6 months may seem like a very long time to be trying to get pregnant, it is important to develop the proper attitude over this period of time and not to turn the process into stressful work. Each treatment strengthens the body and works toward restoring a healthy reproductive system. If a woman only focuses on watching the clock until she becomes pregnant, she may be significantly increasing her chances of becoming impatient and frustrated which can only end up being counter-productive to her goal.

If, on the other hand, she focuses on all the personal benefits she will be experiencing from her treatments as well as looking forward to the intimate times she will be sharing with her partner, she will optimize her chances toward becoming pregnant. It is also important for a woman to realize that, by strengthening both her body and her reproductive system, she will be maximizing her chances of maintaining a healthy pregnancy and delivering a health baby.

Will it be Necessary to Take Chinese Herbs?

Although herbs are an important part of Chinese medicine, many Western fertility specialists do not want their patients taking herbs along with the medications that are prescribed with ART. If a woman is fortunate enough to discover the benefits of Chinese medicine while she is trying to get pregnant on her own, herbs may be recommended to support her acupuncture treatments if needed.

How Can Acupuncture and Hypnotherapy Help with IUI and IVF therapy?

Acupuncture can be very effective toward supporting a woman's body and improving the success rate of Western fertility treatments. For example, recent studies in both Germany and Denmark have demonstrated that when acupuncture treatments are administered on the same day, both before and after IVF embryo transfer, the pregnancy rate almost doubled that achieved by patients who did not receive acupuncture treatments.

The number of drugs and procedures a woman is required to undergo during ART in order to manipulate her menstrual cycle to produce multiple eggs can put a lot of stress on both her body and emotional state of mind. For example, women are warned by their fertility specialists that they may experience side effects such as emotional volatility, fatigue, abdominal bloating and headaches when they are given FSH preparations. Acupuncture can support the body during ART and hypnotherapy can significantly reduce the stress, emotional volatility and associated, physical side effects.

On average, women typically go through between 3 and 7 cycles of Art before they either conceive or stop trying. Consequently, it is important to provide the body with as much support as possible so that, if a woman does conceive, her body will have maintained the strength it will need to support a healthy pregnancy and deliver a healthy baby. Again, this is another good reason why it can be very beneficial to start acupuncture treatments many months before undergoing ART.

Can Acupuncture Help with Male Infertility?

By comparing data generated as far back as 1940, recent studies have shown that the average male sperm count as well as semen volume has dropped so significantly over the past 65 years that it has now been reduced to 50%! Consequently, male factors now account for as much as 40% of fertility problems. Researchers are still uncertain as to what has caused this dramatic drop in male potency, however, they are very suspicious that it is due to factors such as a significant increase in exposure to environmental pollutants, prescription medications and antibiotics, alcohol consumption and recreational drug use.

Studies have also shown that although men who smoke generally have lower sperm counts as well as more abnormal sperm, once they stop smoking, the number and quality of sperm can significantly improve within 6-12 months. Hypnotherapy has been shown to have the highest success rate of any modality for helping individuals stop smoking.

A 2005 study showed that 12 sessions of acupuncture can not only quadruple the number of sperm, but also significantly improve the structure, quality and motility by as much as 50%. Since it takes approximately 70 days for new sperm to develop, a course of acupuncture treatments should be for at least three months.

Are There Things a Patient Can Do to Improve Fertility?

There are many things a patient can do to improve reproductive health and increase the chances of becoming pregnant. The Confidential Patient Information Form each patient is required to fill out at the beginning of the first appointment includes a number of questions pertaining to current diet and lifestyle choices. As part of the customized treatment plan that will be developed, your practitioner may make recommendations as to what you can do on your own to improve your chances for success. Since reducing stress is so vital to improving a woman's reproductive health, this topic will be discussed with you in detail to determine if acupuncture alone may be all that is needed to keep stress at bay or whether hypnotherapy sessions or enrollment in a 10-week Mind Massage® course should also be included to support the overall treatment protocol.

Pregnancy

Pregnancy Overview

Although pregnancy should be one of the most wonderful and fulfilling times in a woman's life, the number of physical and hormonal changes that must occur over the 9 months required in order to nurture the developing fetus to full term can burden a woman's body with many uncomfortable symptoms that are considered normal under the circumstances. These may include morning sickness, nausea, fatigue, carpal tunnel syndrome, backaches, sciatica, headaches and many others. Obviously, these symptoms can also add a great deal of stress to what might already be a very demanding lifestyle for a woman.

Since many Western medications may present a risk to the developing fetus, most Western doctors do not recommend them to their patients over the course of a pregnancy. Acupuncture, on the other hand, has proven itself to be a very safe, gentle and effective method of managing the added stress pregnancy can impose, successfully treating many of the symptoms that commonly occur and supporting the woman's body throughout this time period in preparation for delivery. For example, studies have shown women who receive acupuncture treatments on a regular basis over the course of their pregnancy frequently experience shorter and more comfortable deliveries than women who don't.

Conditions Treated with Acupuncture During Pregnancy

Some of the conditions that acupuncture can treat during pregnancy are as follows:

• Stress
• Emotional volatility (anxiety, depression, agitation)
• Morning sickness and nausea
• Hyperemesis gravidarum (hypnosis is excellent for excess vomiting)
• Heartburn
• High blood pressure (due to pre-eclampsia)
• Fatigue
• Insomnia
• Constipation
• Back pain and sciatica
• Carpal tunnel syndrome
• Gestational diabetes
• Miscarriage risks (some forms)
• Symphysis pubis pain
• Breech presentation
• Pre-term labor
• Delayed labor

A General Treatment Plan for Pregnancy:

First Trimester: The focus of weekly acupuncture treatments during the first trimester is to strengthen the body as much as possible to support a full term pregnancy, reduce the risk of miscarriage, and treat the common side effects that occur during this first stage such as nausea, fatigue and sleep disturbance.

Second Trimester: The frequency of acupuncture treatments may vary during this mid-stage of pregnancy depending upon the number and intensity of symptoms experienced. Patients with little or no complaints may only need one treatment per week to help to control stress and support the body, whereas others experiencing significant symptoms or complications may have to come more frequently.

Third Trimester: While still managing symptoms, the focus of acupuncture treatments begins to shift more toward preparing the body for labor and delivery. If the baby is still situated in the breech position by the 32-36 week, efforts should be made to assist the rotation of the fetus into the proper head down position at this time.

Breech Presentation: Breech presentation occurs approximately once out of every 25 full term pregnancies. Western medicine relies on a manual method called ECV (External Cephalic Version) which is essentially the external application of force to the abdomen to rotate the fetus into the more correct, head down position. Obviously, this can be quite uncomfortable for both the expectant mother and fetus and carries the risk of placental separation, rupturing of membranes and fetal distress which can sometimes lead to emergency Caesarean section. This method is successful about 50% of the time.

Chinese medicine, on the other hand, offers a very gentle and safe alternative method for turning a breech presentation that has been used for thousands of years, creates no risk to the mother or baby, and, based upon recent studies, is successful 75 - 90% of the time. It involves a technique referred to as moxabustion where the smoldering embers of the mugwort herb are used to warm an acupuncture point located on one of the toes of the foot. Researchers are still not sure how this works, but it apparently encourages the fetus to turn on its own!

Acupuncture for Labor Induction

As long as there have not been any serious complications during the course of the pregnancy, inducing labor with acupuncture during the week of the baby's due date has been shown to be a very safe and gentle method for both the mother and baby with studies demonstrating a success rate of over 70%. Acupuncture points are selected which are known to stimulate the release of prostaglandins and oxytocin; hormones which soften the cervix for dilation and initiate the uterine contractions that bring on labor. Just how far the mother's body has advanced toward the pre-labor condition determines how many acupuncture treatments will be needed. Typically, one to four treatments are sufficient.

Western medicine, on the other hand, commonly induces labor with synthetic drugs such as Pitocin that are designed to mimic the action of nature's own prostaglandin and oxytocin hormones. Where acupuncture treatments will only initiate uterine contractions if the mother's body is ready to start labor, drugs like Pitocin start contractions indiscriminately. Unfortunately, 40 to 50% of the time the mother's body is not ready to progress to labor at the time of Pitocin injection.

This can potentially cause the resulting uterine contractions to start a cascade of events that can ultimately require Caesarean section as an emergency procedure. Synthetic drugs like Pitocin have also been associated with an increase in risk factors such as uterine rupture, cardiac arrhythmias, fetal distress and even death to the mother or infant. Furthermore, a significant number of women complain that these drugs appear to cause their uterine contractions to be so intense that labor can become quite painful.

Pain Management During Labor

The November 2004 issue of the American Journal for Obstetrics and Gynecology reported on several clinical trials demonstrating that acupuncture treatments can significantly reduce pain associated with childbirth. In one study involving 496 expectant mothers who received acupuncture treatments with the onset of labor, there was a 30% reduction in the need for epidurals and other pain-relieving interventions when compared to a group of women who did not choose to use acupuncture. Furthermore, 86% of these women reported that they would use acupuncture again to manage pain during labor.

Hypno-birthing is also becoming progressively more popular among expectant mothers. Women who learn how to self-induce the hypnotic state through a series of classes are often able to watch their baby being born with little to no discomfort whatsoever.

Acupuncture for Postpartum Symptoms

Birthing can obviously be a very draining experience on both a woman's body as well as her energy reserves. In an ideal world with a good family support system, a woman would be permitted to get plenty of bed rest for the first month after delivery in order to restore her strength and vitality. Unfortunately, with today's fast-paced, hectic lifestyles a month of rest has become more of a luxury than a mandatory health requirement. Consequently, many women are forced to get back to taking care of the daily demands of life along with a newborn infant before their bodies have had an adequate chance to fully recover. This sad fact can potentially lead to a significant number of other health issues down the road. Acupuncture treatments throughout the post-partum period can be very beneficial toward rejuvenating a woman's mind and body as she prepares to move forward as a new mother.

Some of the postpartum conditions that acupuncture can treat are as follows:

• Stress
• "Baby blues" (postpartum depression)
• Energy depletion and fatigue
• Persistent bleeding
• Lactation problems
• Mastitis
• Hormonal imbalances
• Abdominal pain
• Night sweats

For further information on treating women's health visit or read the following:

General Women's Health Issues

General Fertility Information

General Pregnancy Information