Fertility, Your Period, and TCM

According to the World Health Organization, infertility affects an estimated 1 in 6 adults (17.5%) globally, causing much strain on those affected. There is a great need for better access to compassionate fertility care that gives back some sense of control to those dealing with fertility issues by looking at the body as a whole integrated system instead of merely a bunch of individual lab numbers. Enter Traditional Chinese Medicine (TCM)!    

TCM has been used to boost fertility for centuries, and modern clinical trials confirm that implementing TCM (herbs, acupuncture, diet, and lifestyle) greatly impacts fertility and overall health outcomes. TCM herbal formulas, like Cycle Balance, boost fertility by supporting the underlying patterns of imbalance that may contribute to hormonal disruptions, thus encouraging the body to function better, leading to the production and release of the correct ratio of hormones at the right time of the menstrual cycle, setting a foundation for successful fertility. 

How TCM Views Our Period and Fertility 

TCM views the state of our menstrual health as a report card for not only our overall health, but our fertility health, too. The state of our menstrual and fertility health are largely dependent on the balance between our Yin and Yang energies and the interaction between two vital substances, Qi and Blood.

• Qi (Yang) is our vital energy, it sustains all life, and in relation to our menstrual and fertility health it provides the energy needed for all bodily functions. It is warming, protective, and active. 
• Blood (Yin) nourishes our reproductive organs and houses our Shen, the mental-emotional-spiritual aspect of our body. It is cooling and moistening. 

In order to have a healthy menstrual cycle and optimal fertility we need to ensure we have adequate Qi and Blood flowing smoothly and in the right direction. When our Qi isn’t flowing efficiently, neither will our Blood because Qi moves the Blood. TCM helps support fertility by improving the quality, quantity, and movement of Qi and Blood throughout our body. (This is exactly what Elix’s personalized Cycle Balance formulas are made to do!) There are a few TCM organ systems whose proper function is integral to a proper Qi and Blood dynamic due to their influence on reproduction, Qi, and Blood. 

Our Period and TCM Organ Systems 

TCM sees the body as a dynamic energy system, it is based on a theory that all of the body’s organ systems mutually support each other, so a dysfunction in one organ system has an impact on the functioning of other organ systems. Each organ system is more than its function, it has its own personality and emotional aspect. When it comes to our cycle and fertility the most influential organ systems include the Kidney, Heart, Spleen, and Liver organ systems. We need all of these organ systems functioning in top form in order to have the best chance of conceiving. 

These four organ systems are important for fertility and menstrual health because they play a large role in producing and circulating our Qi and Blood and reproduction in general. Below is a summary of how each of these TCM organ systems is related to Blood, Qi, and our menstrual and fertility health.  

• Kidneys: Our foundational organ system, in charge of reproduction and development, and stores our reproductive essence. Essence is known as Jing in TCM, the fundamental substance inherited from our parents that determines our constitution and overall vitality. It’s the foundation of growth, development, reproduction, and aging. The quality of our gametes and eggs (or sperm in males) is influenced by our Kidney Jing. The Kidneys play a large role with sexual function and our libido. They also influence the hormones that regulate the different phases of our cycle. 
• Heart: Governs the blood by controlling its circulation and manages the downward discharge of our menstrual blood. The Heart organ system is known as the master controller of other organs, it controls our hypothalamus and pituitary, known as the master glands of our body since they control other glands in our body and thus our menstrual cycle. It also influences our emotional well-being. 
• Spleen:  Supports the production of Qi and Blood. This organ system correlates to our digestive system. We need our Spleen functioning well in order to produce high quality Qi and Blood. 
• Liver: Stores and moves the Blood, and is the general in charge of the free flow of Qi. When the Liver Qi is not flowing freely, neither will our menses. The Liver is the organ system most impacted by stress, and since fertility issues can cause a lot of stress we focus a lot of attention on keeping the Liver organ system happy so it can do its important  job of regulating Qi and Blood flow. 

According to TCM, in order to have healthy menstruation and the ability to conceive we need plenty of blood sent from the Heart organ system to our Uterus, as well as enough Kidney Yin essence. The Heart Qi needs to send the Blood to the Uterus smoothly without obstruction. We need all these organ systems to play their part like each instrument in an orchestra needs to be in sync to create a harmonious melody, if one piece is off, the whole orchestra is off. When one or more of these organ systems is not functioning optimally symptoms occur as a way to signal us that there are imbalances in the body that need attention. Some of the most common patterns of imbalance seen with fertility troubles can be broken down into 2 main categories - deficiency or obstruction. It’s important to note that many of us will have a combination of these patterns, they are not mutually exclusive. This is why at Elix, we use a detailed health assessment to determine your unique root causes of imbalance to create a personalized Cycle Balance formula that supports your individual needs! 

Deficiency Patterns: 

• Kidney Deficiency: Since the Kidneys are in charge of reproduction when we have a deficient Kidney organ system we might not have enough energy to produce quality Qi and Blood, develop quality follicles (or sperm for males), or for the fertilization or implantation of an egg . Kidney deficiency can be broken down into two types:

1. Kidney Yin Deficiency: The Kidney Yin correlates to the factors and hormones that support follicle development, growth, and maturation. It relates to ovarian function and the quality of the uterine lining and secretions. You can tell the quality of the Kidney Yin through cervical mucus secretions. Kidney Yin relates to estrogen, which dominates the follicular phase from menses to ovulation.
2. Kidney Yang Deficiency: The Kidney Yang has a large influence starting at ovulation and through fertilization, implantation, and early development. It is the power behind all bodily transformations, which requires dynamic unobstructed movement. Kidney Yang relates to progesterone, which dominates the luteal phase from ovulation to the next menses.

• Blood Deficiency: When we don’t have enough Blood our reproductive organs aren’t getting the nourishment they need for successful conception.

Obstruction: 

• Heart and Liver Qi Stagnation: Our Heart and Liver organ systems are in charge of the circulation of our Blood and Qi, so a disruption in that function of these organ systems can cause a Qi and Blood to become stuck. WIthout the smooth flow of these substances we cannot have a smooth menstrual cycle, affecting our chances of conception. 
• Blood Stasis: When our blood is not flowing freely and is stagnated this can cause an obstruction that inhibits fertility. 
• Phlegm-Dampness accumulation: This can be likened to an internal buildup of “mucus” in our bodies (almost like a “cold” type of inflammation) that creates an obstruction that can hamper our ability to ovulate properly or have successful implantation of a fertilized egg.   

Basal Body Temperature

As our hormones cycle throughout the month, so does our basal body temperature (BBT), our baseline temperature. Tracking these changes can help us tune-in to our body, the state of our reproductive health, and where our underlying patterns of imbalance may lie. This is essential information if you are thinking about or actively trying to conceive as it can point to what organ system may need more support. If you feel BBT charting will cause too much stress or anxiety around conception then try to do only 3 cycles so any patterns of imbalance can be confirmed. 

The Basics of BBT Charting:

1. Take your temperature first thing in the morning before getting out of bed after 3-4 hours of uninterrupted sleep. If possible, try to take the readings at the same time everyday because the later we take a reading the higher the temperature will be. While you can buy a specific BBT thermometer, the most important thing is to be consistent in using the same thermometer throughout each individual cycle. The overall pattern of your temperature changes throughout the cycle is primarily what we are going to analyze.       
2. You can use an app to note your temperature and create a monthly chart. If you do not want to use an app just break out a piece of graph paper and chart each day's temperature on the paper. 
3. You will have one chart per cycle, so start a new chart on Day 1 of your cycle, the first day of your menstrual flow, not the first day of spotting.  

A healthy cycle will show up as follows in your chart:

• Follicular phase (menses to ovulation) -  the hypothermal phase, temperature stays relatively low during this phase, with a slight dip right before ovulation. This phase is ideally around 14 days.   
• Ovulation - temperature rise of 0.5-1.0 (F) right after ovulation, the day before the temperature starts rising usually indicates ovulation day   
• Luteal phase (ovulation to menses) - the hyperthermal phase, temperature stays relatively high, ideally for 12-14 days
• Temperature will usually start to decrease 12-24 hours before your next menses, if you are pregnant your temperature will stay higher  

The pattern of your temperature throughout each cycle can clue you in to possible patterns of imbalance that need attention, improving your chances of conception. Some common patterns that show up on a BBT chart include: 

• A longer follicular phase (longer than 14 days)  can indicate Kidney Yin or Blood Deficiency. Or if it's more of a one off rather than a consistent pattern it can indicate Heart or Liver Qi Stagnation. 
• A shorter follicular phase (consistently 9-10 days) means early ovulation and can indicate heat in the body manifesting from Kidney Yin Deficiency, there is not enough cooling Yin energy so the body heats up. 
• No ovulation (no rise in temperature) indicates a deficiency of Kidney Jing or Yin.  
• A short luteal phase (shorter than 11 days) can indicate a deficiency of Kidney Yang, as there is not enough warming energy.  
• Unstable temperature patterns (temperature shifts up and down dramatically) can indicate Heart and Liver Qi Stagnation, likely caused by our emotions.
• A long luteal phase can indicate pregnancy.  

How TCM Supports Our Fertility and Our Menstrual Cycle 

TCM works to support our underlying patterns of imbalance that are affecting the function of our organ systems, and in effect how our Qi and Blood are flowing. By supporting our dominant underlying patterns of imbalance we help our body function better, keeping our Qi and Blood flowing freely and in the right direction. When everything is working together in concert we have a smooth flow of Qi and Blood, smooth periods, and the best chance at conception. Supporting our body at the root cause level can take time, so ideally we would use TCM for at least 6 months before actively trying to conceive. This would get our bodies into the optimal balanced state, creating an environment most hospitable for successful conception, implantation, and fetal development.  

Cycle Syncing and Fertility 

Syncing certain activities to the natural rhythm of your cycle according to TCM is another way to support fertility. TCM breaks our cycle into 4 phases: menses, Yin, ovulation, and Yang. Below we’ll break down what each phase represents and how we can adjust our lifestyle to live in harmony with each phase of the cycle. 

Phase 1 Menses: This is a time our Qi is working hard to discharge our old blood and oftentimes we feel extra fatigued. It corresponds to winter time in TCM, a time of dormancy to give nature the time it needs to recover and recharge before the spring growth. This is the phase of our cycle where we should prioritize rest by lowering the intensity level of our activity. Activities like yin yoga, stretching, walks in nature, meditation, or naps will assist in recovery. Another TCM tip for this phase is to stay warm, reducing your exposure to cold as much as possible. Cold creates more stagnation in the body and we are more susceptible to cold during our menses.  

Phase 2 Yin: The Yin part of our cycle includes the remaining days of our follicular phase. Our bodies need a lot of nourishment during this phase because we are building up the Blood we lost during our menses, our endometrium lining is thickening, and our follicles are developing. It is associated with springtime, the season of growth. To best support this phase of our cycle we should focus on foods that nourish us and help us build a quality blood supply like bone broths (or seaweed or mushroom broth if you are vegetarian), root vegetables, legumes, and high quality meats and fish. Many may start to feel more energy during this phase so it’s a great time to increase the intensity of our movement, cardio is a great thing to increase during this time. 

Phase 3 Ovulation: This is a transition time from the cooling and nourishing Yin to the active and warming Yang time of our cycle. As with any transition time we need strong Liver Qi, focusing our diet on lighter easier to digest foods will support this, making sure to include plenty of dark leafy greens. This is also a time many of us will experience peak energy, like its associated season summer. We can increase the intensity of exercise even more with HIIT training or more intense cardio. This movement also helps keep our Liver Qi flowing. This peak energy phase also means we often feel more social and have an increased urge for intimacy. It corresponds to the summer season.  

Phase 4 Yang: The last phase of our cycle is the Yang luteal phase. We might start to feel our energy wane the closer we get to our next menses, just like we see in nature during the fall season. It's a great time to tune-in to your body and adjust your activity level accordingly, decreasing the intensity of exercise as energy dwindles. This is also a time to support our Liver Qi since we need the smooth flow of Qi and Blood to have an easy, symptom free menses. It’s an important time to express our emotions, when we bottle up our emotions our Qi stagnates leading to more menstrual symptoms. We can support ourselves during this phase by increasing fiber intake (especially dark leafy greens) and fluid intake, while decreasing the amount of caffeine, alcohol, and added sugars. This is also the time (a week before your scheduled menses) we recommend taking Cycle Balance since its job is to support the underlying imbalances inhibiting the free flow of Qi and Blood. 

Stress and Fertility 

A large component of fertility is dependent upon our stress response and overall emotional well-being due the effect on the flow of Qi and Blood. A poor stress response and emotional instability will largely affect the functioning of the Liver organ system because of the role in regulating the movement of Qi and Blood. A poor functioning Liver organ system can have negative effects on other organ systems since all organ systems work together to create balance. When we are stressed out or hold in our emotions our Liver Qi stagnates (the Liver’s function of moving Qi and Blood is impaired), and we need our Qi and Blood flowing freely to have the best chance at conception. While our emotions also affect our Heart organ system we are going to focus on the Liver organ system due to its role as the general in charge of the free flow of movement.  

Our emotions and physical health are intricately related, each influencing the other. So when we hold onto our stress or our emotions we create more stagnation in the body, setting up a less than optimal environment  for conception. That is why treating fertility issues in TCM places a lot of emphasis on increasing the body’s ability to metabolize and respond to the stressors of life. We cannot always control what life throws at us, but we can adjust how we choose to respond to those stressors. Keeping our Liver Organ System healthy is one big piece of the stress response puzzle. The following tips can help keep of TCM Liver happy:

1. Start your day with a room temperature or warmer glass of lemon water, as a moderate amount of the sour flavor nourishes the Liver Organ System.
2. Express your emotions, whatever that looks like for you, as holding onto emotions stagnates our Liver Qi. 
3. Increase your intake of dark leafy greens, the color green is associated with the Liver, so any green foods will nourish it.
4. Take a moment to really breathe deeply - inhale through the nose into your belly, and exhale longer than your inhale. 
5. Consider adding in Elix’s Daily Harmony to your daily routine, this herbal formula contains adaptogens that help your body respond to stress more efficiently and keeps the Liver Qi flowing. 

Cycle Balance and Fertility 

Cycle Balance is another great way to support fertility. Our Cycle Balance formulas combine hormone balancing herbs tailored to your unique patterns of imbalance and also include herbs that promote circulation, optimal organ and tissue function, and stress management, making them an ideal choice for fertility support. Cycle Balance works to help the underlying root causes of imbalance that are contributing to hormonal issues, making it tougher to get and stay pregnant. While planning ahead and getting your body in its most optimal state before trying to conceive is optimal, Cycle Balance can help you reach your ideal fertility state at any point in your fertility journey.

General Fertility Tips 

Lifestyle is an important piece of the fertility puzzle. Below are tips based on Elix’s SIx Foundational Holistic Wellness Pillars that will help you along your fertility journey. 

1. Connection: Tune-in to your cycle by tracking your basal body temperature daily before getting out of bed, you gain a lot of useful information about where in your cycle imbalances might be. 
2. Recovery: Try to aim for 7-8 hours of sleep each night. If this is not an option, try to have consistent sleep and wake times, even on the weekends. 
3. Stress Response: Take 1 minute to take deep belly breaths - inhale through the nose, and exhale longer than inhale.  
4. Movement: Aim for 30 minutes of movement a day, breaking it up into smaller chunks if you don’t have time for a longer 30 minute session, concentrating on activities that bring you joy, listening to your body’s cues and adjusting intensity accordingly. 
5. Nourishment: Try to transition to a mostly whole foods diet, increasing the amounts of fresh produce, especially dark leafy greens; and reducing the amount of processed foods (i.e. decreasing industrial seed oil and added sugar), alcohol, and caffeine intake. Focus on healthy fats like - fish, avocado, nuts and seeds, butter and ghee from pasture raised animals.  
1. Quick tip - If possible, switch to pasture raised or wild animal products and organic hormone free dairy products.  
2. Quick tip - Eat one more serving of vegetables a day.
3. Quick tip - Switch out one processed snack for fresh produce or nuts and seeds. 
6. Environment: Try to avoid products with chemically derived scents (often noted as fragrance on the ingredient list) as these can disrupt our endocrine system (our reproductive hormones). Essential oils are ok to use as scents.

While lifestyle plays an important role in our fertility health, it's important to not get too caught up in perfection. If the above tips seem unattainable, break them down into smaller more attainable steps. Small daily actions will result in large sustainable changes that will improve your fertility. 

We know navigating the fertility journey can be daunting, but Eilx is here for you on every step of that journey. Get started with Elix today by filling-out the health assessment to receive your own personalized hormone supporting herbal formula!

 References

https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597078/

 https://clinicaltrials.gov/ct2/show/NCT04842825

 https://www.sciencedirect.com/science/article/abs/pii/S0965229914001915

  https://clinicaltrials.gov/ct2/show/NCT04935073

 https://www.safecosmetics.org/chemicals/phthalates/

Lyttleton, Jane. Treatment of Infertility with Chinese Medicine, 2nd Ed. 2013. Churchhill Livingstone Elsevier  

This article was reviewed by Dr. Elizabeth Fine.
Dr. Elizabeth Fine, DAOM, LAcDr. Fine is currently the Dean of Clinical Education at Emperor’s College and has been practicing Acupuncture and Herbal Medicine for over 25 years, with a specialization in Women’s Reproductive Health.