Postpartum Hormonal Imbalances

by Kristen

Hi Amelia,
Great website! I was hoping to get your opinion on TCM for my current situation - postpartum hormonal imbalances (anovulatory).

Just a little background - I went through infertility treatments last year (male and female issues)and conceived with my first IVF, even though I responded poorly to the drugs (GonalF.) Only three eggs were retrieved. We lost our baby 5 months into the pregnancy (Jan '08).

I am 5 months postpartum and had what I thought was my first period six weeks after delivery, but then 30 days later started bleeding again continuously. I used Chinese herbs in April to stop the bleeding, but it started again 9 days later and is continuing.

The doctor's test last week showed low progesterone, and he has prescribed Provera to induce a period so that he can do a saline ultrasound and rule out placental tissue remains. If this is ruled out and the bleeding is being caused by lack of ovulation (as we suspect), what can I do from a TCM perspective before resorting to birth control pills (which is what the doctors have suggested)?

I have been getting acupuncture since the end of January, but not sure about whether herbs can help? I was taking some herbs prior to all this bleeding in Mid-March(for Kidney yin deficiency I believe), but stopped with all of the bleeding.

I was hoping to get your thoughts on treatment. Also, how do I evaluate the quality of my acupuncturist?

Thank you!

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Uterine Bleeding and Herbs
by: Amelia Hirota

Hello Kristen,
I'm so sorry for your loss. Please take some time to nourish your body, emotions and spirit after this challenging event. Ideally, a year or two would be taken to shore up your qi before trying to conceive again, especially with IVF.

If the bleeding is due to hormonal imbalances (not placental remains) I strongly recommend working on balancing the hormones naturally. Low progesterone or unopposed estrogen is often the backdrop for DUB or dysfunctional uterine bleeding.

One of my first gynecological cases was a young woman with nonstop uterine bleeding. Her doctor wanted to do a hysterectomy, but since she was young and hoped to have more children, she really wanted to keep her uterus.

I determined that her DUB was due to extreme stress and repression of anger and frustration. I gave her an acupuncture treatment and sent her home with raw Chinese herbs (the traditional way) for her to boil up and drink for the next 10 days. Her bleeding stopped the next day and never returned again.

I strongly recommend taking properly prescribed Chinese herbs for DUB. There are about 5 different diagnosis in TCM for uterine bleeding, so it's important to do a thorough evaluation. Herbs are an acupuncturist's form of internal medicine. They are extremely powerful and effective when prescribed correctly.

In treating this extended bleeding issue and helping your body recover from the pregnancy, I believe that personally formulated herbal prescriptions are a must. Stopping the bleeding and taking the time to nourish your body to a balanced state of health is paramount.

You mentioned that you did IVF because of both male and female fertility issues. I strongly recommend that you have your partner's sperm thoroughly checked out with a Strict Kurger semen analysis.

In terms of evaluating your acupuncturist. First, he or she should be board certified in both acupuncture and Chinese herbs by NCCAOM. Secondly, it helps to see an acupuncturist that is specializing in gynecology or women's health. Practice does make one better. Lastly, you should be seeing improvements in your menstrual cycle, PMS, BBT chart, moods, hormone levels and sperm quality after about 2 months of weekly treatments.

I have all of my fertility patients charting, having the requisite fertility workup, and getting sperm tests, so that we can see what's working and what's not. After 2 cycles of treatment, female patients have better BBT charts and menstrual cycles with less PMS. Male patients generally see a jump in sperm count and motility. I hope that this is helpful to you.

Warm regards,

Amelia Hirota
Licensed Board Certified Acupuncturist and Herbalist

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