Acupuncture and Sub-Fertility
Acupuncture boosts the effectiveness of high-tech reproductive medicine procedures. Clinical studies have found that adding acupuncture to traditional in-vitro fertilization (IVF) treatments increased pregnancy success. There is also evidence that acupuncture stimulates blood flow and egg production in women who can't or decline to use fertility medications to help them get pregnant. Studies have shown a clear link between acupuncture and the body's natural "feel good" brain chemicals (endorphins).
Acupuncture also appears to affect two areas of the brain that control hormone production (the hypothalamus and pituitary glands) as well as the ovaries. Acupuncture may also "boost" the uterine lining when it is too weak to sustain a pregnancy, a problem known to increase the risk of miscarriage.
If you’re having difficulty becoming pregnant, why not try a natural, drug-free method to boost your fertility? Call or email my office today and enroll yourself in my fertility program.
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The 2009 US Preventive Services Task Force (USPSTF) guidelines on mammography and breast examination are controversial and the following facts should be seriously considered.
Breast cancer is the second most commonly diagnosed cancer in women. Breast cancer claims more than 40,000 lives each year. Only lung cancer reigns as the number one cancer killer. The mammography has been highly effective in the diagnosis and treatment of breast cancer. Historically, the USPSTF has recommended mammograms every 1-2 years for women who turn 40 years of age. Recently, the new guidelines recommend commencing mammography screening at age 50 until reaching the age of 74 and only one test every two years.
The USPSTF has determined that early screening adds only 2 lives saved per 1000 women screened. Screening women in their 50s averts "only" 1 death in every 1300 women screened, and screening women in their 40s prevents only 1 death in every 1900. Only one death might not seem so bad….unless that statistic is you, your mother, sister, wife, friend or significant other!
The American Cancer Society has stated that "The new guidelines are essentially telling women that mammography age 40 to 49 saves lives...just not enough of them”. 22% of breast cancer deaths occur in women in their 50s, 17% occur in women in their 40s.
The 2009 guidelines discourage teaching breast self-exam to patients, stating that this practice leads to more procedures, false alarms and unneeded biopsies, and doesn't reduce breast cancer mortality. They cite no conclusions on the value of clinical breast exam.
There is no recommendation for the preferable screening method (plain film, digital mammography, or MRI).
The USPSTF disclaimer reads: "This recommendation applies to women age 40 and older who are not at increased risk (of breast cancer) by virtue of a known genetic mutation or a history of chest radiation."
Healthcare reform is a priority of the national agenda presently, and these new guidelines could very well be used as fodder by insurance companies to use as a baseline to limit or restrict screening and testing that have been proven to be very effective tools in early detection and treatment of breast cancer.
Of course, mammography is not a perfect tool, but as a woman, I’d rather be safe now than sorry later on.
The American Cancer Society, the American College of Radiology, and the American College of Obstetrics and Gynecology say starting mammograms at age 40 is still the way to go. As a healthcare professional, I stand with this statement and I hope all who read this will agree. Go get the squeeze... please!
For more information on breast cancer, examinations and all other questions, please log onto the following NCI (National Cancer Institute) website:
http://www.cancer.gov/cancerinfo/screening/breast
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Painful Intercourse (Dyspareunia)
Pain during intercourse is a subject that can be uncomfortable for many women to discuss with their healthcare provider and closest friends for many different reasons.
The following is a list of a few of the many causes of dyspareunia:
Vulvodynia: perimenopausal women experience this most common type of dyspareunia. Women who suffer from vulvodeynia experience a burning sensation, pain, itch, stinging and rawness during sexual intercourse. This can be constant or sporadic, deep or superficial. There is really no known cause of vulvodynia. Acupuncture, Chinese herbal therapy, biofeedback, and behavioral therapy are all generally accepted modalities to treat vulvodynia. I have seen very good results in several patients who were experiencing vulvodynia while perimenopausal. The combination of Acupuncture and Chinese Herbal Formulas made a significant difference in the quality of these patients’ lives.
Vulvovaginitis: this is either inflamation or infection of the vagina. This results in very tender areas of the vulva and vagina. Wart-like lesions and irritation from spermicidal can be a root cause. Noncoital mutual sexual satisfaction should be a substitute for couples until the infection subsides.
Vaginismus: very often, psychological issues are involved with vaginismus. Negative attitudes about sexual contact during childhood, fear of intercourse, pain experienced during the first sexual encounter, sexual trauma - can all lead to the voluntary or involuntary contraction of muscles surrounding the introitus. Sexual counseling, anatomical education and instruction in self-dilation are common therapies. Coitus should never be forced or rushed until the female is comfortable physically and psychologically.
Remnants of the Hyman: some women have a thin, thick or even partial rim of the hymen that remains after several sexual encounters. This can cause painful intercourse. Treatment is highly individualized and consultation with one’s gynecologist is strongly urged for appropriate treatment.
Insufficient Lubrication of the Vagina: insufficient lubrication of the vagina leads to friction, irritation and pain. Sexual counseling is in order if arousal is the root cause. Lubricants can be highly effective. Speak with your ob/gyn about insufficient lubrication and have your hormonal levels tested. Low plasma estrogen levels can be the cause of insufficient lubrication.
Endometriosis, Tumors, and Infection: acute or chronic infection of the cervix, uterus or adnexa all lead to painful intercourse. Endometriosis, adnexal tumors or adhesions from prior surgeries or infections can cause dyspareunia. Women should consult with their ob/gyn about appropriate treatment of the above. Sexual positions that limit deep thrusting and non-coital mutual sexual satisfaction can be practiced to prevent pain to the female.
The ‘take home’ message here is this: dyspareunia is more common than you think and not to discuss this with your healthcare practitioner is doing yoursef an injustice. There is help for all types of dyspareunia. If you are suffering from dyspareunia, make an appointment with your ob/gyn and take positives steps in improving the quality of your life!
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| Endometriosis Defined and Your Treatment Options |
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Endometriosis is a chronic condition of ectopic endometrial tissue. What does this mean? Simply put, the soft tissue that normally grows inside the uterus begins to grow OUTSIDE the uterus. The tissue usually will attach itself to pelvic organs, but it can show up in other regions as well.
The signs and symptoms of endometriosis can include the following:
Fatigue
Painful intercourse
Painful periods
Pelvic pain between periods
Painful bowel movements
Infertility
Constipation
Low back pain
Nausea
Heavy bleeding
Headaches
Dizziness
Ectopic (outside the uterus) tissue acts the same as endometrial tissue and reacts to hormonal changes. As the endometrial tissue goes though its monthly cycle of growth, maturation, sloughing and bleeding; the ectopic tissue acts the same, but the actions take place OUTSIDE the uterus, in the pelvic cavity. This can wreak havoc in the system. Dead tissue and bleeding in the pelvic cavity equals PAIN, PAIN, PAIN!
So, how does this tissue travel and grow outside the uterus? Well, there is no clear answer. Possible causes can be: congenital, or tissue that is mixed with menstrual flow that has coursed UP the fallopian tubes and traveled into the pelvic cavity. Wherever the tissue lodges is usually the location where the cells will replicate and grow.
How does the tissue get into the fallopian tubes? Several causes include: sexual intercourse during menstruation, tampon use, accidental transfer of endometrial tissue during surgery (caesarean section, amniocentesis, episiotomy).
How is Endometriosis Diagnosed? LAPARSCOPY. Laparoscopy enables the endometriosis to be clearly seen but involves anesthesia and general abdominal surgery.
What Are a Woman’s Choices of Treatment?
There are several western medical approaches to the treatment of endometriosis:
1. Synthetic Testosterone is prescribed. This suppresses the levels of estrogen and progesterone in the body. This creates a ‘false menopause’. The idea is to stop the growth and shrink the ectopic tissue by staving it of the hormones it requires for growth. The side effects of this is such: the endometrial tissue shrinks and starves (causing pseudo menopause) so there can occur weight gain, night sweats, acne, hair growth, voice changes and vaginitis….how nice!
2. Birth Control Pills can be prescribed. Pregnancy (or false pregnancy) can limit the tissue growth for a time but this method is not a cure. Side effects include: nausea, reduced sex drive, cramps and spotting, vaginitis, acne, headaches, nervousness, insomnia, weight gain, tender breasts and hair loss.
3. Surgery to remove the tissue can be performed, but there is no guarantee that all the tissue will be removed. In certain cases, the ovaries are removed. The upside of surgery is that many women who undergo surgery to remove tissue (and NOT the ovaries) can become pregnant afterward.
The Good News! Traditional Chinese Medicine (acupuncture treatments and Chinese herbal prescriptions) treatment on a regular basis over a six (6) month to one (1) year period of time can make a significant difference for women suffering from endometriosis.
Traditional Chinese Medicine looks at the endometriosis as the pooling of blood (or stagnation of blood) in the pelvis - the “shi”. By examining the patient and utilizing the principles of eastern medicine, a root cause of the radical tissue growth (the branch) is determined and treated. Thus, treat the root and you treat the branch.
Case One: a 30 year old female presents with a chief complaint of painful periods, chronic pain in the pelvic region and painful intercourse. Her ob/gyn diagnosed her with endometriosis. Two years prior, one of the patient’s ovaries had been surgically removed. Upon examination, the pelvic region is tender and painful upon light palpation, especially where the remaining ovary resides. Pain subsides after treatment session and a treatment strategy includes acupuncture once per week in addition to a combination of herbal formulaes and dietary changes. After one menstrual cycle, the patient reports that pain has subsided on a scale of 10 from 8 to 6. Herbal formulaes are altered slightly and treatment continues for another 6 months. At the termination of the 7th month, the patient reports no pain in the pelvic area, smooth flow of menstrual blood without pain and her intimate relationship with her significant other has resumed in a normal fashion.
Case Two: a 22 year old female presents with a chief complaint of severe pelvic pain in the lower left region. Tenderness upon palpation and a full examination leads me to believe this patient is suffering from endometriosis. This patient has a family history on the maternal side of ovarian cysts, ovarian cancer and endometriosis. The patient is advised to seek further examination and testing by an ob/gyn to confirm suspected diagnosis. Patient is soon diagnosed with endometriosis and because of familial history, a partnership between ob/gyn, the patient and acupuncturist is formed for a complete treatment plan. The combination of both western and eastern medicine and treatment, along with the full cooperation and participation of the patient leads to a significant reduction of ectopic tissue and relief of pain within the course of several months.
If you or someone you know have been diagnosed with endometriosis, consider Traditional Chinese Medicine as a choice of treatment. Together, we can create a treatment plan to reduce and eliminate the pain and other nasty side effects of endometriosis, while slowly shrinking the ectopic tissue growth.
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How Do You Know If You Are Pregnant?
Most women are not so tuned into their bodies to know if they are pregnant until they either miss a few periods or begin to develop signs of pregnancy. Below, I’ve listed a few early possible signs of pregnancy for your reading. If you are pregnant, you might experience one or more of the following:
A Missed Period. If you are like clockwork with your menstrual cycle, this can be a green light for pregnancy, but if you have a history of infrequent periods, this can be a false positive.
Frequent Urination. HCG (human chorionic gonadotropin) is the hormone produced once the embryo attaches itself to the uterine wall. Frequent urination is a byproduct of this hormonal change.
Exhaustion. Your body’s level of progesterone increases during pregnancy. Fatigue results.
Morning Sickness - it’s not just in the morning. Nausea, dizziness and vomit can occur at any hour of the circadian clock and can be triggered by a near empty stomach.
Hypersensitive and Enlarged breasts. Changes to the mammary ducts and increase in fat tissue surrounding the breasts (to prepare for the post partum stage) make for swollen and tender breasts. Some women experience this sensitivity just before their period begins - for others, this could be a first tell tale-sign of pregnancy.
If you are experiencing any of these aforementioned symptoms, you might consider taking a pregnancy test. It is always highly recommended to take a pregnancy test twice to make certain of the result. If you smoke or ingest alcohol - STOP! If your test results are positive, you will want to cease smoking and alcohol consumption. Remember, everything that goes into your body, goes straight to your baby. Give the kids a clean ticket on their way out into the world…do everything you can to make them healthy from the onset of pregnancy!
Schedule weekly visits to your acupuncturist during your pregnancy. We can help with all the side effects of pregnancy and help maintain your optimal health during this wonderful time of your life!
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| Exercise During Pregnancy |
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Regular exercise during your pregnancy will contribute to better well-being, an easier delivery and faster recovery from childbirth. Exercising during pregnancy can help to minimize common discomforts such as backaches and fatigue and help with certain postural issues. Of course, even if you are not pregnant, exercise is well known to relieve stress and increase endurance (needed for labor).
So How Much Is Enough?
For those ladies who were physically active before becoming pregnant, common sense and moderation prevail, but there should be no problems continuing with any given exercise program. Consider this: it is not advisable to exercise at your pre-pregnancy level; comfort is key. Lower your level of cardiovascular activities and certainly, if you are engaged in a contact sport - back off to non-impact! It is commonly advised that your heart rate should not exceed 140 beats per minute.
If you are a competitive athlete and are now pregnant, it is necessary for you to be under the constant supervision of your obstetrician. For those women who have not been exercising regularly, discuss a safe exercise program with your obstetrician.
Safe Exercises During Pregnancy
Swimming, brisk walking, and indoor stationary cycling are considered safe. If you have been playing tennis and racquetball prior to your pregnancy, they remain fairly safe to play, but be careful - rapid movements can affect your already changing sense of balance. Other activities such as jogging can be done in moderation. Tai Chi and Qi Gong, both Chinese forms of exercise, are my own recommendations. No equipment is necessary, loose clothing encouraged, and the best place to practice both types of exercise is outdoors while observing nature. If you are interested in either Tai Chi or Qi Gong, contact me via email and I connect you with a master of these two arts. Prenatal yoga is a safe and wonderful activity; you will lengthen and strengthen your muscles, practice relaxation and breathing and feel much better overall. Find a qualified prenatal yoga instructor in your area. The added bonus: you will meet other women who are at various stages of pregnancy who can give you added support and encouragement during this wonderful time of your life. Lastly, walking is an inexpensive and safe mode of exercise.
The American College of Obstetrics and Gynecology (ACOG) has recommended a daily dose of moderate exercise for 30 minutes (every day unless there are complications with the pregnancy).
Exercise Is Not Advised If:
Exercise is not recommended for those with asthma, heart disease, diabetes, bleeding or spotting, low placenta, threatened or recurrent miscarriage, previous premature births or history of early labor, or a weak cervix.
Consult with your health care provider and partner with him or her to establish an exercise program that will serve you well during your pregnancy.
Exercises And Activities To Be Avoided During Pregnancy:
Holding your breath.
Skiing
Horseback riding
Contact sports (softball, football, basketball, volleyball, kickboxing) and activities that include jarring motions or rapid changes in direction (soccer).
Jumping, hopping, skipping, bouncing or running. If you are already a runner or endurance athlete, consult with your obstetrician and trainer regarding modifications to your normal routine. Unless you are already doing about 200 of the following every day, try to avoid deep knee bends, full sit-ups, double leg raises and straight-leg toe touches.
Twisting of the waist or exercises that require lying on the back and/or right side for more than three minutes. Strenuous output of exercise proceeded by no activity - vice versa - is really a ‘no-no’. Unless you are a native of a hot and humid climate, avoid exercise on the ‘dog days’ of summer.
Things to Remember While Exercising During Pregnancy
Don’t forget to warm up and stretch for five minutes or so. Fifteen minutes of cardiovascular activity should be your minimum target (this includes walking if it is your main source of raising your heart rate). And speaking of your heart rate: measure your heart rate at times of peak activity. After your aerobic portion of your program, continue with five to ten minutes of gradually slower exercise that will eventually wind down with gentle stretching.
Helpful Tips
A good support bra is necessary! Don’t skimp on this one. For the remainder - loose fitting, comfortable clothes are the plan. Your shoes should be activity-appropriate. Don’t wear running shoes to play tennis, don’t wear tennis shoes to run…pretty standard fare here. Make sure you are getting enough calories if you are pursuing a regular exercise program. Consult with your nutritionist or healthcare practitioner to ensure you and your baby are getting everything you both need for optimum health. Whether you are pregnant or not, do not eat for at least an hour before exercising. Be conscious of the water you drink before, during, and after your workout. If you are practicing floor exercises, don’t get up quickly…take your time so you do not become dizzy
The basic rule of thumb: if you can talk normally while exercising, you are at a comfortable level. If you have difficulty carrying a conversation while performing any activity, then SLOW DOWN!!!!
BE SMART!
Stop exercising and contact your health care provider if you feel chest pain, abdominal pain, pelvic pain or contractions. If you have a headache or notice cessation or decrease in fetal movement, you might consider going to the hospital. If you are feeling faint, dizzy, nauseous or light-headed, cold or clammy - contact your healthcare provider. If you experience vaginal bleeding, or there is a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily - contact your healthcare provider immediately.
If you are experiencing an irregular or rapid heartbeat, shortness of breath, or have sudden swelling in your ankles, hands or face or calf pain with difficulty walking - call for help.
How Soon Can I Exercise After Delivery?
Good question! It is best to ask your health care provider how soon you can begin your exercise routine after delivering your baby. Although you may be eager to get back into fighting form quickly, return to your pre-pregnancy fitness routines gradually. Follow your health care provider's exercise recommendations. Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Practice about half of your normal floor exercises and don't try to overdo it. Wait until about six weeks after birth before running or participating in other high impact activities.
SOURCE: The March of Dimes.
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