The use of Chinese medicine for women's health issues can be traced back to the Shang Dynasty of 1500-1000 BC. Chinese medicine excels in treating women's health complaints because it understands the importance of treating the whole person including body, mind and spirit to achieve and maintain health. The goal of treatment is to restore harmony, which is attained by identifying and treating the root cause of the illness to help recover one's own healing capacity. Disorders treated include irregular, heavy, or painful menstruation, premenstrual syndrome (PMS), menopausal problems, infertility, fibroids, endometriosis, and pregnancy related complaints.

Menstruation & Reproductive Health
Traditional Chinese medicine explains that the female reproductive system is a network of energy pathways that have corresponding organs and hormones. The body's network can easily become off balance due to stress, poor diet, emotions, lack of exercise, and chemicals. Based on symptoms and observations, a practitioner of Chinese medicine identifies the underlying pattern of imbalance that is causing a woman to manifest disease. Restoring the body back to balance is the goal of treatment through the use of acupuncture, herbs, and dietary and lifestyle changes.

In Chinese medicine, menstruation relies mainly on the balanced functioning of the Liver, Spleen and Kidney energetic systems as they relate to the uterus and hormones. The Kidneys store the essence that provides the basic material for the formation of menstrual blood. Essence has a great influence on the menstrual cycle, fertility, conception, pregnancy and menopause. The Liver has a direct relationship with the uterus which stores blood that is received from the Liver. If Liver blood is deficient, a woman may have scanty or late periods. If the Liver energy is not moving properly, she may experience irregular periods, cramps, and PMS. In Chinese medicine, the Spleen is said to produce blood which is stored in the Liver. An imbalance in the Spleen system can cause symptoms such as a prolapsed uterus or bladder and excessive menstrual bleeding.

Normal menstruation has a regular cycle (26-32 days) with bleeding that lasts 4-6 days and a consistent flow pattern without clots. Cramps that are increasing or require pain relievers are not normal. Chinese medical theory views pain as an indication of a blockage of energy and blood flow. Because acupuncture releases areas of "stuck"energy in the body, menstrual cramps can be treated effectively with Chinese medicine. In addition to addressing the symptoms of menstrual disorders, Chinese medicine seeks to find and correct the underlying cause of the imbalance. By identifying a woman's pattern of disharmony, appropriate acupuncture treatment and/or herbal medicine is given.

Menopause
In Chinese medicine, menopause is seen as the "Springtime"of the second half of a woman's life or as a "gateway" that leads to opportunity. In most cases, a woman's body is out of balance which causes her to present with symptoms like hot flashes, night sweats, irritability, trouble sleeping, vaginal dryness, fatigue, and poor memory.

Chinese medicine views the cause of menopause as being a normal decline in Kidney energy with many variations of this pattern depending on each individual woman. The most important organ and energetic system involved in menopause is the Kidney because it stores essence, our basic life energy that maintains health and provides the energy for the production of follicles or eggs in the ovaries. Because the Kidney energy is declining, the main meridian associated with fertility becomes deficient in energy and blood. At this time, a woman's cycle changes where she begins to have irregular menstrual periods until they stop completely. This process can also affect other organs and their energetic systems in the body. For example, the Heart is usually involved in insomnia and anxiety, whereas the Spleen is involved in digestion problems and weight gain. The Liver is said to be the cause of depression and mood swings. The goal of Chinese medicine is not to prevent this decline of Kidney essence from occurring naturally, but it can help control the symptoms by allowing the body to function in a more balanced way.

Western and Chinese medicine explain the symptoms associated with menopause in very different ways. In Western medicine, hot flashes are due to unpredictable fluctuations and imbalances of hormones, especially estrogen. In Chinese medicine, they are due to imbalances of yin and yang energy. A normal decrease in yin or cool energy can no longer hold down yang or heat energy, leading to a flare up of heat in the body. This increase of heat can lead to sweating especially at night, a time in which yin should predominate. Psychological and emotional symptoms are due to estrogen deficiency in Western medicine. In Chinese medicine, the Liver system has a strong connection to the uterus and menstrual cycle where it regulates the smooth flow of Qi and blood. If the Liver's energy is unbalanced, the energy can stagnate and lead to anger, frustration and depression. This blocked energy can heat up which contributes to additional heat in the body again leading to hot flashes. Osteoporosis, a decrease in bone density leading to skeletal weakness, is a major health concern in menopausal women due to estrogen deficiency. The Kidneys in Chinese medicine rule the bones, teeth, marrow and brain. If the Kidney energy or essence is nourished, the bones strengthen.

Hormone Replacement Therapy (HRT) is Western medicine's solution to relieving hot flashes and other symptoms of menopause. Because the cause of menopause is seen as a hormone/estrogen deficiency, HRT is used to artificially replace this hormone in a woman's body. HRT gained widespread popularity in the US in the 1960s and 1970s. However, in 2002, a research study showed that HRT actually increases a woman's risk of breast cancer, heart disease and strokes. Fortunately, the Chinese medical treatment of women with menopause is natural, effective and has no side-effects!

Infertility
Chinese medicine can effectively treat women diagnosed with infertility and is beneficial as an adjunctive therapy for women choosing Western medical procedures. The modalities used in the treatment of infertility include acupuncture, herbs, abdominal massage, and dietary therapy. The advantage of Chinese medicine in the treatment of infertility is its holistic perspective that determines imbalances in the body rather than just focusing on disease or lab results. When these imbalances are addressed, the body's normal function returns and conception takes place. Acupuncture is a safe, natural treatment whose goal is to enhance the quality of eggs, sperm, uterine lining and cervical fluid.

Chinese medicine can also help prepare the woman's body for interventions such as Clomid, Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF). Because Chinese medicine focuses on restoring balance and health in the body, it will help Western medical treatments work better. Research studies show that acupuncture increases the success rate of these medical procedures and helps to alleviate their side effects including mood swings, abdominal pain, headaches, and hot flashes. Acupuncture is an effective treatment for infertility alone or as a compliment to Western procedures.

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In The News: Nicole Jurkovic Peterson Treating Infertility With Acupuncture

Success Story: High Stress and Anxiety
A 30 year old woman had been trying to conceive for three years before trying Chinese medicine. She was diagnosed with low progesterone and had tried two rounds of Clomid without success. She reported having a very stressful job, and she suffered from high anxiety and irritable bowel syndrome. Her menstrual cycles were regular, but she had PMS and very little cervical fluid at ovulation. Her Chinese medical diagnosis revealed an imbalance in her Spleen, Heart, Liver and Kidney organ and meridian systems. After three months of acupuncture, herbs, and dietary and lifestyle changes, she had much less anxiety, no PMS, increased cervical fluid, and normal digestive functioning. After seven months, she sent an Email saying: "I just wanted to let you know that I am pregnant. Can you believe it?!?!?! I didn't even have to do the crazy fertility treatments. Yeah!! I had a feeling when I saw you last, and the feeling was right. I just wanted to let you know before my appointment." She now has a healthy baby!

Success Story: Low Progesterone
A 28 year old woman came to me in tears who had been trying to conceive for 4 years. Her tests showed that she was low in progesterone. She tried three unsuccessful attempts at Clomid after which she started using progesterone cream. As a result, she did become pregnant but miscarried at five weeks. The interview revealed that her menstrual cycles and bleeding were normal, but she did complain of PMS before her period and some cramping on day 1. She felt cold in general with especially cold hands and feet and was under a fair amount of stress. Using the theory of Chinese medicine, I determined that her pattern of imbalance was affecting her hormones. I gave her acupuncture treatments once a week and put her on two herbal formulas. I also suggested dietary and lifestyle changes. After a month of treatment, she reported that her body was feeling warmer and she no longer had premenstrual acne. She no longer complained of menstrual cramps after two months of treatment. The next month, she became pregnant and carried the baby to full term!

Success Story: Irregular cycles
A 24 year old woman came to me who had been trying to conceive for over a year. She had been on the birth control pill for three years, and after stopping, she could not get pregnant. Her menstrual cycles were irregular often lasting 44 days, and her basal body temperatures were very erratic. She complained of very sore breasts before her period, headaches, a lack of cervical mucus during ovulation, and a tendency toward hypoglycemia. After her first month of treatment using acupuncture, herbs and dietary changes, her cycle shortened, she no longer had breast tenderness and her blood sugar became balanced. On the second month, she noticed an increase in cervical mucus at ovulation and to her surprise became pregnant!

Success Story: Advanced Maternal Age
A 39 year old woman came to me because she was having trouble conceiving. She had no Western medical explanation her diagnosis of infertility. She had regular menstrual cycles, menstrual cramps, PMS, no cervical fluid, poor sleep, and low energy. She was given weekly acupuncture sessions and herbal medicine for 4 months before she became pregnant. During those 4 months, her cervical fluid increased significantly, her sleep improved, her energy increased, and her PMS stopped. Unfortunately at 8 weeks into her pregnancy, she discovered that she had a blighted ovum and had to have a D&C. She then continued acupuncture and herbal medicine treatment for 2 more months and became pregnant again. She is now 16 weeks pregnant with a healthy baby.

Success Story: Recurrent Miscarriage
A 32 year old woman came to me to receive treatment for recurrent miscarriages. She had no problem conceiving but she had 3 miscarriages in the past year and a half. Her blood tests and lab work were all normal. Her periods were regular, but she did complain of PMS and menstrual cramps. She had digestive issues that included diarrhea, bloating, and gas. Shortly after beginning acupuncture and herbal treatment, she became pregnant. She continued treatment weekly through the first trimester and then once a month for the rest of her pregnancy. She had no complications and carried her baby to full term!

Success Story: Intrauterine Insemination (IUI)
A 35 year old woman came to me after having tried to conceive for 3 years. She had tried Clomid five times and an IUI one time with uncomfortable side effects. Her doctor diagnosed her with poor egg quality and high FSH. She had regular cycles, light menstrual flow, menstrual cramps, back pain and headaches. Her Chinese medicine diagnosis was an imbalance in her Kidney and Liver energy systems which was affecting her ability to conceive. After four months of acupuncture and herbs, she decided to do an IUI with injections. She continued to receive acupuncture during the hormonal injection and insemination procedures. Chinese medicine helped to balance her body and improve her egg quality so that when she combined it with an IUI, she became pregnant. She writes: "I AM PREGNANT!!!!!! Yippee, horrayyyy!! I just wanted to say Thank You so much for helping to get my body in line and ready for this wonderful experience. Before when I took the fertility meds it made me so crazy with hot flashes, mood swings,etc. This time around it was much more powerful meds, and I had almost no side effects. I know I owe that to you and your accupuncture expertise."

Research Studies
Studies have shown that acupuncture affects the menstrual cycle by stimulating the endocrine system to release hormones that create change in a woman's body. It also increases blood flow to the uterus and ovaries which is necessary for the health of the uterine lining as well as the follicle. In addition, it increases endorphin levels in the body which induces relaxation and decreases stress and affects the production of Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH) while influencing the hypothalamus-pituitary-ovarian axis. Because there is a direct connection between the hormones released when under stress and the hormones necessary for fertility, stress can be a significant cause of infertility. Chinese medicine can effectively build the immune system and decrease inflammation, both of which are important for fertility. In men, studies show that acupuncture significantly improves sperm quality, viability and mobility.

Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection. Fertility Sterility. 85(5):1347-51, May 2006.
This randomized, controlled study was done to determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection. Two hundred twenty-five infertile patients who were undergoing IVF/ICSI were used. In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. Results showed that in group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%).

Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women. Fertility Sterility.85(5):1341-6, May 2006.
In this study, one group of patients received acupuncture on the day of embryo transfer (ET), another group on ET day and again 2 days later. Both groups were compared with a control group that did not receive acupuncture. The conclusion was that acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, compared with no acupuncture. Repeating acupuncture on ET day +2 provided no additional beneficial effect.

Reduction of blood flow impedance in the uterine arteries of infertility women with electro-acupuncture. Human Reproduction, 11(6), 1996.
In this study, women who had been diagnosed with a thin endometrial lining as a possible cause of fertility were divided into two groups. The women in the group that was given acupuncture for 4 weeks leading up to their IVF cycle had a dramatic increase in blood flow through the uterine artery which led to a thicker endometrial lining.

Acupuncture may improve sperm quality. Fertility Sterility. Vol 84:141-147, July 2005.
This is a prospective study of uncontrolled trials using acupuncture in infertile men. 28 men received acupuncture twice weekly for five weeks. After acupuncture, there was a statistically significant increase in the percentage, number, and quality of sperm.

Recommended Reading
Lewis, Randine. The Infertility Cure. New York, NY: Little, Brown and Co., 2004.
Weschler, Toni. Taking Charge of Your Fertility. New York, NY: HarperCollins, 2002.

Pregnancy
Chinese medicine is rapidly becoming more popular for pregnant women to ease complications associated with pregnancy and labor. Acupuncture is all natural and has no harmful side-effects for mother or baby! Several conditions related to pregnancy can be treated successfully with Chinese medicine:

Prenatal complaints: morning sickness, edema, fatigue, breech presentation, threatened miscarriage, anxiety, constipation.

During labor: pain relief, difficult or delayed labor.

Postnatal complaints: depression, abdominal pain, retention of lochia, urinary difficulty, constipation, hemorrhoids, fever, joint pain, acute mastitis, breast milk problems.

Research Studies:
Acupuncture to Treat Nausea and Vomiting in Early Pregnancy:
A Randomized Controlled Trial Birth, 29:1, March 2002.
This study grouped 593 women less than 14 weeks pregnant with symptoms of nausea or vomiting. The four groups of women received different treatments: traditional acupuncture, pericardium-6 acupuncture, sham acupuncture and no acupuncture. Treatment was given weekly for 4 weeks. The conclusion was that acupuncture is an effective treatment for with nausea and vomiting in early pregnancy.

Moxibustion for Correction of Breech Presentation.
JAMA, 280 (18), November 11, 1998.
Moxibustion was applied at the acupuncture point Bl-67 (outer corner of fifth toenail) for at least 7 days to women in their 33rd week of gestation with an ultrasound diagnosis of breech presentation. The conclusion was that using moxibustion for 1-2 weeks increased fetal activity during treatment and cephalic presentation after the treatment period.