The diagnosis of infertility or being infertile is very damning for people. It’s scary. It’s like the doctor says, you’re infertile so well, what do I, what am I even trying for?
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Hi, this is Dr. Martha Lucas here with you today. I am a research psychologist and practitioner of Chinese medicine in Denver and Littleton Colorado. In Littleton, I work in a western medicine clinic so that’s a cool way for Chinese medicine to be integrated with Western medicine. Also, in my private practice, I treat mainly internal medicine. My specialty is the diagnosis but I also teach Chinese medicine topics including Mei Zen cosmetic acupuncture, pulse diagnosis and balancing, and a number of other practice building topics.
Let’s go to the slides. You may notice that I say fertility, I don’t say infertility. I call it a fertility challenge. It means that you as the patient have some issues with fertility, with conceiving. The diagnosis of infertility or being infertile is very damning for people. It’s scary; when a doctor says you’re infertile, you’re never going to have a baby, why would you even keep trying. When we call it a fertility challenge, we know that we are working on a goal that may actually happen, rather than just saying you are infertile.
Parenthood is one of the most desired and valued goals of adulthood. Issues with fertility is a very common diagnosis. That’s why we have so many fertility clinics or I guess some call them infertility clinics. Parenthood is a very much desired goal for women and men.
Fear, is an expectation of negative outcomes right? And fear can be constructed from a very complex interplay of different factors – cultural, psychological, social, physical – and this fear actually has a name. It is called Fear of Infertility. It impacts us globally, it is not something that is just in the United States. Basically, it is the fear of inability to achieve pregnancy or father a child.
Some Fear of Infertility is born out of misinformation. And as you can guess, there is a lot of misinformation out there. Years ago, a book called Everything you need to know when you are pregnant came out and I told my patients not to read it. I told them that it’s a natural process to be pregnant, just go with it. For one thing, you are coming for treatment. We will keep good track of it. I actually had a pregnant young lady come in once, who told me that she was a nervous wreck all night because she had slept on her left side for a while and she had read in some book that if you sleep on your left side when you’re pregnant, the fetus is not going to get any blood flow. Naturally, I told her to stop reading that book. Pregnancy is a natural process. You are coming to see me, you are getting medical care, everything is fine.
Some of this misinformation includes things like that though. Some say that the oral contraceptive pills stay in the womb and accumulate. Some of the information is very crazy sounding but it is something that women hear and sometimes believe. Some people believe that birth control blocked their ability to get pregnant and makes them infertile. There is the idea that the HPV vaccine is something that will make you infertile. Or just the idea that if you use any kind of contraception, your womb is going to get weak.
So all of these fears and misinformation can impact behavior. For example, people may not do family planning anymore. They might just try going for getting pregnant without any help or advice. One of my patients was having intercourse every day and not getting pregnant. I told her to stop that, you don’t need to have intercourse that frequently because the sperm needs to regenerate and all the energies need to rebuild in between intercourse. Studies show that if you have intercourse once every three days, eventually you are going to hit ovulation. Within a three month period, you are likely going to hit the best time to conceive. And sure enough, after they stopped having intercourse every day, she was pregnant the next month. So again, misinformation keeps women from going to the doctor and trying some other crazy stuff rather than getting information that is bona fide and true. The idea that the male is harmed if you have an IUD is another piece of misinformation.
What all of that does is construct fear. It constructs expectations of negative outcomes. And there is the famous misinformation that you cannot get pregnant after you are 35 years old. That is one of my favorites, and believe me, I have had plenty of women and probably so have you, say I’m over 35 and I can’t get pregnant now. That is a distortion of the truth. So is if you try for a year and don’t get pregnant you will never get pregnant – another one. Some women tell me their periods have been so irregular that they must be infertile. All that is misinformation and they also get interesting advice like you just have to try harder. It really does not work that way.
And there is the big issue that fertility is a female problem. That is absolutely not true. 40% of the time it’s the male’s issue. So this is why in my practice, I see both the man and the woman. I am happy to see the woman and get her periods in order before we move to my fertility protocol, but I insist on seeing the male part of the conception team because if his Dai Mai is blocked, his reproduction is not getting appropriate energy – the kind of energy it should be getting. So I really do work hard on making sure that the male comes in for treatment because for another thing, he is suffering from fear of infertility and dealing with the female’s emotions; they’re both lumped into this big worry thing, in a fear experience. Therefore I strongly recommend that you also treat the male, that you treat couples with fertility challenges, not just the woman. The male has an impact on conception.
In traditional Chinese medicine, the kidney system is a powerhouse right? The fire in the belly is one of our most important energetics systems. It is the root of pre-heaven and post heaven qi and kidney essence is a combination of those. It is very important for growth and development and sexual maturation after puberty. It more focuses on reproductive function and fertility in adulthood. And, as it declines with age, we get things like loss of teeth, hair loss, the symptoms of menopause. We do eventually become unable to conceive and then of course we have impairment of cognitive functions. So maintaining good quality kidney qi is important for us and as practitioners, understanding the relationship of fear, kidneys, and fertility is important.
It is the kidneys that fund all of the pulse positions. So if kidney qi is scattered, if it is not well formed and weak and scattered, then how is it going to support all of the other systems? So if it looks like this, all those little scattered points, then it is going to be hard to fund all the rest of the organ systems. In addition to regulating the body fluids and growth, the kidneys also keep yin and yang in balance. That is partly why it is so important to balance, to make sure that the kidney pulses are balanced and strong, because as I just said, they fund all of the other organ systems and keep yin and yang balanced. They also govern body fluids so tears, saliva, perspiration, and fluids that lubricate all of our joints are regulated by the kidneys. They store the life force and are associated with the healthy transitions through life stages.
So from childhood, early adulthood, all the way through the aging process and then separating as we get closer to death is how they work. It makes sense that we need kidney energy to live so it also makes sense that we need it to procreate. But that energy, kidney energy can become lost and scattered as a result of fear that men and women have about the possibility that they cannot conceive. I know you see more women and they are the ones who almost always make the phone call/appointment about being infertile or having fertility challenges. But I can tell you from experience that when the male of the partnership is involved and treated, everyone is a little more calm. They understand the situation a little better instead of it all being a woman’s problem, just a woman’s problem.
We know that stress can negatively affect the ability to conceive as well. So does fear. The fear that people have that they are not going to be able to get pregnant and carry a healthy pregnancy through a healthy birth, can and does negatively affect fertility. Just like we know that stress can make irregular periods it can also cause lack of ovulation. Fear also can negatively affect sperm quality and motility. So there again, we have information about fear and stress. We also need to treat the male partner to manage hormonal imbalances. Stress can wreck the hormones which can also have a negative effect on someone’s ability to conceive.
Besides the usual and customary pulse positions, we all know what they are, my system also includes on the left kidney side the uterus and the prostate. So the left kidney side is where you are looking for uterus and prostate. And it is on the left side where you are going to follow the pregnancy. In the beginning it feels like a little blip, a little knot upward hitting your finger. But as the pregnancy goes on, that knottiness gets bigger and feels stronger in the pulse.
So let’s go on to what does a scattered kidney pulse feel like. First of all, you feel the kidneys with deep pressure. So there’s a lot of pressure with your fingers down on the pulses, and you should be able to find the kidneys there. But when there is fear in the system, the kidney pulse feels what I called diffused or scattered. That means that it is scattering under your fingers instead of feeling like a flow. A flow between the organ systems is what we want to feel. We want to feel a flow like a river. But fear makes it feel more scattered. I describe it as – you know how fireworks start out strong right? There’s a boom, they go up in the air, and then they fall down in the air like this – like little points of light. I like to say that’s how the kidney pulse feels when fear is involved. It feels like little points of information on your finger, like little fragments of the pulse. If it’s that scattered, there is no ability for it to move forward and fund the rest of the pulse positions. That is the main problem with fear.
We need to get the kidneys open and flowing in order to make the rest of the positions work correctly. One of the things we need to remember is that fear is going on and that it is damaging the source qi. It does not allow the kidneys to have regular pulse form. In other words, the sine wave, yang and yin, yang and yin – it doesn’t allow the flow to the rest of the meridians systems.
So here’s a picture of it. As you can see, this is the left side, kidneys, gallbladder, liver, small intestine, heart, and then those little dots in the kidney position. That is how the kidney pulse feels under your fingertips when it is scattered. When you are feeling the pulse and the person has fear, it is scattered. You might not say the words to them, do you have any fear in your life? Sometimes you need to just ask about stress or ask about the period, ask about their digestion, the things that are funded by the kidneys and you can then move onto a more specific question about fear.
I have a case study of a woman who I felt fear in her pulses. She was only 34 years old, no reason for her to be infertile, but of course the fertility clinic told her when do you want your IVF? She said she knew an acupuncturist who helped her daughter, who happens to have lupus, get pregnant and have a successful pregnancy so she was going to do that first. Of course, they told her we will see you in three months, we’ll go over your blood work and your hormones again, and then we will schedule your IVF. But she was determined that she was going to get pregnant naturally. So I was feeling her pulses, and could feel some fear but from the outside her life looked wonderful. She did not have any health problems, both of the couple had good jobs, they were happy for all intents and purposes. So I asked her about her childhood. She said it was perfect but then as we talked about it more and I told her about the fear I felt, she remembered that she grew up in a small European country during war time. I asked her if any of her brothers or her father were involved in the war. Did they get hurt? She said no, it was just normal life but there was a war going on and when that sort of history is with the patient, we need to study the pulse is the kidney pulse is a little bit more.
As I said earlier there are a number of big issues when the kidney qi is scattered because all of the organ systems are funded by that. When I show my patients their pulse picture, I always show them that, that these kidneys, the section right here in the middle, is what’s funding everything else. It is funding all of the other organ systems. So it’s really important that the kidney qi be secure and have a flow, have a movement instead of there just being little pieces of it.
As you can see, because the person probably has some anxiety along with their fear, the liver energy is using up the little bit of the scattered kidney qi and attacking the heart small intestine position, and making the person even more anxious and more fearful. So this is the importance of knowing how to feel the scattered kidney pulse so that you can consolidate it and it can work with the other systems.
That is a perverse movement in the liver right? We want all of the organ systems to be nice, smooth, sine waves. So that is for me probably the biggest issue of the kidney qi being scattered, it cannot fund the rest of the positions for good health. So all of the positions are going to suffer. And when you get a perverse movement like that here in the middle jiao, the problem with that is that it’s using whatever kidney energy is in there to fund that perverse movement rather than fund healthy movements.
As I said, the arrow at the top is where the liver is attacking the heart and small intestine. Now you will notice it goes into kind of a block. Because our systems are all made to protect the spirit. We are not going to let any perverse energy into the spirit. That’s what our body is always trying to do. So this is why we need to resolve issues like that, in the liver, that frustration, because when the heart is blocked, when the spirit part is blocked, not only does the person not feel any sadness but they don’t feel any joy either.
And as you can see, the scattered kidney pulse can lead to the other organ systems getting out of balance. Also remember, heart blood goes to the uterus. That means the heart manages blood. So if it’s blocked like in this picture, then it’s not helping the uterus at all. So again, putting together all of the functions of all of the organs, letting the kidneys fund everything is the key. They need to be in order, if they are not, then they are going to let the other organ systems get out of balance.
If the liver is attacking the heart and small intestine position, it is unable to do the blood flow to the uterus. The patient is even more anxious and sad. And it is partly because the fear is in the scattered kidney qi.
If you look at the right side where it is kidneys, stomach, spleen, lung, large intestine, you would see perhaps a dip in the digestion, a dip in the Earth spleen stomach sector, because again, the kidney qi on that side is scattered and cannot fund digestion. And we know that digestion is involved in blood flow also. So if the person’s digestion is not working well, then they are not making good quality qi or good quality blood either. And that’s what we need for the uterus. We need a nice, warm, blood-filled organ in order to be able to conceive and carry through a pregnancy, a good strong pregnancy. Because remember, the completely healthy childbirth – everybody is healthy – is still a small percentage of what happens. Many times there is some sort of complication like preeclampsia, high blood pressure, something going on so the healthy live birth and healthy pregnancy is still not 100% of the time. So this is why it is important to see your patients during their pregnancy, not only to help them get pregnant. They come to see us, they get pregnant and they think, OK, I’m good. My treatment is over. No, not really. For one thing the Dai Mai is probably blocked during the whole pregnancy. This means come for treatment, let me open the Dai Mai, let me get all the blood and oxygen flowing again instead of being stuck.
In the beginning when we help them get pregnant, they always want to say hey Dr. Martha I’m pregnant. But your treatment isn’t over. Don’t let things get to having headaches every day, or back pain every day, or morning sickness every day. Don’t let it go there before the person comes in and gets treated during their pregnancy. Keeping everything open and flowing is important. We will keep their digestion moving. If they wake up tired in the morning, it’s not because they’re pregnant, it’s because the digestion isn’t working well.
So realizing and remembering how important it is for all of the organ systems to work well, even during pregnancy or especially during pregnancy, is an important thing.
Now what treatment can you do for somebody who has fertility challenges that are related to fear? As I said, you need to get healthy kidney qi going. You need to get it bound together with the other organ systems. I say here, remember, a blocked Dai Mai is going to prevent that. So even if you don’t know how to feel a blocked Dai Mai in the pulses, open it anyway. There’s nothing wrong with using that extraordinary channel. You see a pregnant woman, you open it, then you know that it’s going to keep flowing through that area. In fact, a blocked Dai Mai may be part of the problem because it is affecting ovulation, menstruation, and in men affecting men’s ability to be a conception partner. So it is always important to remember about the Dai Mai.
And the Ren and the Chong, they help reinvigorate kidney qi and also the Chong helps with emotions and digestion. The Ren Mai of course, helps with any kind of fertility or menstruation issue even libido. For example, some women get dryer. They get symptoms of dry vagina and they say that they lose their libido and really do not want to have intercourse. They want to because they want to get pregnant, but it doesn’t feel very good. So knowing all of that and the ways that we can help that with acupuncture and herbs, will help the person.
I sometimes just do channel work also, I don’t do particular points. I just want to make sure that the meridians are all flowing. So needling the channels like kidney, bladder which is water, so moisture, get the kidney qi flowing, get it built up through the bladder channel. So it doesn’t necessarily mean certain acupuncture points or that I have a specific protocol or scattered kidney qi point formula because everyone’s pulse is different every time you see them and so it’s important to deal with what is in front of you at that moment.
And then there is lifestyle advice for people. We know that the kidneys are traditionally sensitive to cold, so we would like the person maybe to put a hot water pack on their back just to help warm up the kidneys. Eat warm foods, your water – drink it at room temperature instead of from the refrigerator. Some people say keep alcohol and things like coffee to a minimum. It depends on what their lifestyle is. If you are yin deficient, obviously you don’t want to be drinking three pots of coffee a day. So it is all about being aware of the patient’s lifestyle. We know that a little salt is beneficial to the kidneys. It is why when you crave salt, you know that our kidneys are a little out of balance. The color is traditionally black or blue so black or blue foods to strengthen and nourish the kidneys. Things like eggplant, black sesame seeds, and other foods that can nourish the kidneys including walnuts, figs, brown rice and other grains. Asking your patients to change their lifestyle is completely acceptable. One of the ways you can help them is by giving them food ideas that are going to help the kidneys.
And then there are other ways – meditation or at home Qigong. Try to control their emotions that are leading to the fear response in the kidneys. You can show them Qigong circles on their belly to help their digestion, do them clockwise. It’s a little Qigong massage; it doesn’t have to be a hard massage. It can be barely touching the belly. Meditation is just focus. Studies on meditation don’t even like to call it meditation, they call it focus. So find five minutes a day to focus. Focus on a bird singing, focus on a candle, focus on a chant. Five minutes of that a day will change your brain to be more calm. It literally changes your brain to reduce fear and anxiety. Have them do some sort of at homework to work along with your treatments to help them boost up their fertility chances.
With all that, I want to thank you very much for attending and I want to again thank the American Acupuncture Council for sponsoring this webinar.
Next time we are going to talk about worry and fertility, so I hope you’ll be able to tune in for that. This is Dr. Martha Lucas, my website for teaching is lucasteachings.com and my private practice one is acupuncturewoman.com; feel free to contact me.