Questions about Me, my Acupuncturist and Herbs

by Tiffany

Hello Amelia,
I am seeking additional advice out of "desperation" from you as an acupuncturist/herbalist.

I am almost 30 years old and my husband and I have been trying to conceive for 2 1/2 years. To make a long story short, I have never had any known problems with my menstrual cycles in the past. They were most always around 29-32 days long and never had any spotting or cramping before the start of my bleed. However, about three years ago, a lot had happened that caused my husband and I a great deal of stress. We moved, I lost my job, we lost a family member, we had financial difficulties, etc. There was definitely some emotional stress that transpired as well. This is actually when my menstrual problems began. Basically, right around the time all this happened, I started to experience spotting and menstrual cramping 1 week prior to the start of my period and absolutely horrible breast tenderness. Unfortunately, this has continued for three years now.

My husband and I had decided to start a family about 5 or so months later after all that had transpired. (Job loss, move, etc.) Months and months went by and I wasn't getting pregnant. Finally, after about 7 or so months, I figured something was wrong. So, I went to a fertility specialist to see what was going on based on blood work/ultrasound, etc. He stated that everything looked pretty good other than some ovarian cysts (follicular cysts), but I had low progesterone, hence the spotting/cramping before my bleed. He said I had a luteal phase defect. He suggested progesterone supplements. I refused. I knew that I had to find out "why" I was having this problem and I didn't want a "quick fix" (even though I wanted a baby "quick")! I knew I was going to go about this in a natural, holistic way even though I knew it was going to take longer.

So, about 6 months later I tried acupuncture. I did about 7-8 sessions to help "regulate" my hormones and had no improvement at all. None! At this point, I didn't know what to do. I had found another job and the job was a very stressful one. I really couldn't handle the emotional aspect of not being able to conceive, not knowing where to turn to next, and having to work at this stressful job. So, my husband and I thought it would be best that I quit my job and see if that would help with the stress that could possibly be affecting my cycle. Unfortunately, three months rolled around and I was diagnosed with kidney stones in both kidneys. They ended up having to break these stones up using "Lithotripsy". I was so bruised and sore from this procedure in the kidney area. Unfortunately, I still feel the affects from it.

Also, about a week after the procedure, I experienced major vaginal dryness. I never, never had vaginal dryness prior to this procedure. Not even with all this spotting/cramping. I always had maybe two days of dryness after my period, then the start of the cervical mucus would appear and would experience more with ovulation approaching (like raw egg whites), then would turn back to white, sticky cervical mucus and so on. Again, after the surgery, I had no mucus all the way up to ovulation, then around ovulation, I would only experience a little mucus to where it was hard to tell if I was even getting "fertile fluid."

Another six months rolled around and I came across an herb company's website which sells TCM herbs. I thought I would try it, even though I was not familiar with herbs.I was assigned to a trained herbalist from the company and dealt with them for about 6 months. I knew that this wouldn't be a quick fix, but I figured by the 6th month, instead of cramping/spotting for 7 days before my period, I would only cramp/spot maybe 3 or so days. They not only worked on regulating my hormones, they worked on "warming" my body, nourishing my body, building blood, etc. I did notice some positive changes. They had me on so many different formulas that there are too many to list.

In the meantime, I thought that maybe I would try another round of acupuncture treatments since I've heard that you could have greater success using both herbs and acupuncture. So, I found a different person who is an oriental person from China that is certified in TCM acupuncture and is also a certified herbalist. I brought them the list of all the formulas I was taking. They had stated that I was taking way too many formulas and that some of them weren't the right ones. They stated that it could be condensed to where I would take only what I actually needed based on my symptoms. They changed most of everything that I was taking.

Most of the formulas from the herb company had Dong Quai in them. The new herbalist stated that I should definitely try to stay away from that one, at least for now. I was reluctant to change any of the formulas because I did see some positive change in my overall health, but again, no change with my menstrual cycle. So, about two weeks ago, they placed me on herbs they thought would be a better fit. I informed them when I first met with them, which was about 7 weeks ago, basically everything I stated above. They looked at my tongue and could tell I was a little anemic. They asked me several questions and I had informed them that my kidneys ached so bad still from my kidney stone procedure, had major vaginal dryness since the surgery, low blood pressure, feelings of "cold" most of the time, hands and feet cold of most time, chronic low back pain, ovarian cysts, hair loss, depression, stressed, acne around neck area and jaw line (close to ear lobes), and of course the spotting and cramping a week before my period.

I have so far received a total of seven acupuncture treatments, which have included around the pelvic area, and the kidneys, and a few in other areas (ankles, forehead, etc.). They also did "cupping" on my kidneys during one session. They could tell there was definitely still some stagnation from the surgery. All this bruising came to the surface of both kidneys. I started the new formulas a few weeks ago, and completely stopped with the herb company's I found online. So far, the cramping and spotting still continues. I started the cramping/spotting two days ago. I told my new herbalist/acupuncturist that I believe the second half of my cycle, "luteal phase", is shortened by about 7 or so days and asked if what I'm taking could increase the length. They stated the TCM doesn't really look at hormones, hence the luteal phase defect, or fluctuating body temperatures, etc.

At this point, I don't know what to do or what to believe! Like I said, I've had 7 treatments with this new acupuncturist (every week since mid October) and no luck at all with the cramping/spotting. I realize that TCM looks at kidney, spleen, stomach energies, etc. in general, but I would think that the new formulas would have something to do with increasing the length of the luteal phase. I also realize that if you don't have a good "follicular phase" and strong ovulation, you won't have a good luteal phase. I understand a little about the "Five Zang Organs", but can't understand why nothing has helped with my luteal phase!!! Could my emotional/mental stress from all of this be causing this problem not to "heal" sooner?

So below, I am going to give you a list of what they currently have me taking. Please note that this formula, along with the acupuncture, has seemed to help a little with the vaginal dryness, energy level, and has totally "cured" most of the kidney discomfort. Please also note that they have suggested that since I am spotting and cramping, that my period is ready to begin, so they also have me taking a formula to help "start" the period.(This is the first time I have taken this. I am starting the formula this evening.) They don't feel that the last half of my menstrual cycle is only a week or so long like I think. They think it's longer. For instance, I know I ovulated on the 18th or 19th day of my cycle. It it now day twenty eight. They think that the period should begin now since the cramping and spotting started. Technically, I should "start" on day 32 or 33, I thought?

Here is the formula they have me taking to "start" my period early...Dang Gui / Shu Di Huang / Bai Shao / Ehi Shao / Chuan Xiong (Take for three days until period starts. Then take nothing during the bleeding.)

Here is the formula they had me taking for the last two weeks...Shu Di Huang / Shan Yao / Fu Ling / Gou Qi Zi / Han Lian Cao / Mai Dong / Ze Xie / Mu Dan Pi / Fu Zi / Rou Gui.

Please note that they do plan on changing the formulas week by week based on where I'm at in my cycle. Unfortunately, I don't know what those are at this point.

I am so sorry for the long email. I would of loved to speak with you directly, but can't afford it at this time with the acupuncture and herbs that I am currently taking, and the herbs from the previous company that I invested well over $1,500 into. If you could just tell me whether you believe they have me on the right path based on everything I mentioned above, or suggestions I could make to the my current acupuncturist/herbalist.

Please also inform me of whether or not you feel that because I spot/cramp 1 week prior to my period, if that means I'm ready for my uterus to "shed". And, if you think this is an easy fix, but just need to find the right formulas. I am at a loss and totally devastated, including my husband. We just need some reassurance.

P.S. I also wanted to mention that my diet is pretty healthy and I take high quality vitamins, including a lot of "B" vitamins, fish oil, spirulina, drink at least 8 oz of water per day, etc. I also try to stay away from "cold" foods/drinks.

Thank you,


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Stress and Estrogen Dominance
by: Amelia Hirota

Hello Tiffany,
It definitely seems like the extreme stress that you had 3 years ago pushed your hormones out of balance. Your stress hormones and your reproductive hormones have the same base, so that if your body is making excess stress hormones, it's not able to made adequate amounts of the reproductive hormones. The spotting, cramping and breast tenderness before your period are symptoms of this hormonal imbalance. It appears that you may be estrogen dominant during your luteal phase. This is what causes the luteal phase defect that you mentioned.

Estrogen dominance (ED) is a common factor in unexplained infertility. You can have regular cycles and appear to ovulate, but with ED a woman doesn't make a strong dominant follicle. The key to conception is making a strong dominant follicle that has 2 attributes; the ability to cause the other developing follicles to go through atresia at ovulation and the the ability to make a corpus luteum that secretes adequate amounts of progesterone to sustain a pregnancy. Your ovarian cysts are the follicles that are continuing to develop post ovulation.

When your body doesn't make a strong dominant follicle with these 2 key attributes, pregnancy doesn't occur. Instead, you will see ED symptoms like spotting, cramping, mood changes, cravings, breast tenderness, back pain, acne, headaches, etc. These occur because the remaining follicles continue secreting estrogen post ovulation. In a healthy cycle, these remaining follicles would have broken down and stopped secreting estrogen and instead progesterone from the corpus luteum would be dominant during the luteal phase. Hormonal balance exists when estrogen is dominant in the follicular phase and progesterone is dominant in the luteal phase.

I believe in your case, the extreme stress of 3 years ago depleted your reproductive hormone precursors. Unfortunately, this is common in women who undergo extreme stress. I admire your instinct in refusing the progesterone supplementation. The key is nourishing your body and supporting your reproductive process, so that you make a strong dominant follicle that is able to cause the other follicles to breakdown at ovulation (hence estrogen is not being excessively secreted) and your corpus luteum makes adequate amounts of progesterone.

I'll continue my answer in Part 2.

I hope that you find this information helpful. I wish you the very best in your quest for optimal health and a baby.

Sending Baby Dust Your Way,
Amelia Hirota

Diet, Lifestyle and Estrogen Dominance
by: Amelia Hirota

Dear Tiffany,
Let's talk about what you can do to get out of ED. I think that the formulas that your acupuncturist is currently giving you are fine. I like the fact that they are changing the formulas with your cycle. If we talked about ED in TCM terms, we would say that you are Yin Deficient. Yin rules the follicular phase and Yang rules the luteal phase. You need adequate amounts of Yin to make good quality cervical mucus and a dominant follicle. Because the follicular phase is the foundation (as you noted), if Yin is deficient, the Yang will be weak. This is why the luteal phase defect if part of the ED scenario. I hope this makes sense. I'm trying to give you both the hormonal explanation and the TCM terminology.

In the clinic, I run saliva hormone tests and hair analysis that gives us a clear idea of a woman's ability to conceive. From these tests, I've learned that extreme stress and poor diets deeply harm the body and are the back drop to the fertility issues.

When I see patients with similar presentations to you, I find that we need 6 months to a year to nourish and strengthen the body. None of my patients like to hear a long time frame, but when the body has bottomed out, it takes a lot of attention and work to bring it back to a flourishing level. As far as the body is concerned, reproduction is optional. First and foremost, your body will devote it's nutrients to rebuilding your tissue, organs and glands. What you have leftover is then targeted for reproduction. Therefore, the agenda is to nourish your body thoroughly, so that there is plenty leftover for reproduction.

I would recommend continuing with the herbs. It sounds like you have some budget constraints, so maybe reduce the frequency of the acupuncture. Sleep is very important when working to heal and restore the body. I would recommend 10-12 hours of sleep a night, preferably with a bedtime before 10:00 PM. Because stress is zapping your hormones, managing stress with daily meditation would be helpful. Also, if you meditate daily, you can get by with less acupuncture.

You mentioned that you have a healthy diet. My fertility diet entails eating organic real foods from the earth; no packaged or processed foods. Ideally, you would consume two half plates full of nourishing cooked veggies daily. Don't eat raw veggies, as they are hard on digestion. Also, keep the simple carbs like pasta, bread, potatoes, crackers, chips and sweets to a minimum. A diet like this keeps blood sugar stable and this is important when clearing ED. The ovaries have insulin receptors and too many sugars and carbs contribute to ongoing ovarian cysts. Lastly, you need to be sipping at least 96 oz of water throughout the day.

I hope that you find this information helpful. I wish you the very best in your quest for optimal health and a baby.

Sending Baby Dust Your Way,
Amelia Hirota

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